If Lord Falconer’s aim (Letters, 4 October) is to develop a safe and compassionate assisted dying law he should want to understand and address, rather than dismiss, the serious concerns raised by people like me who work with terminally ill patients on a daily basis and who he expects to enact his legislation (I see the worrying consequences of assisted dying in other countries. Britain’s bill needs a radical rethink, 2 October). He should also be actively seeking to learn from, rather than ignore, what is not working well in other countries.
Lord Falconer believes there is a fundamental difference between feeling suicidal and wanting a medically assisted death. However, it is absurd to claim that just because someone has a terminal illness they cannot, apparently by definition, be suicidal. On the basis of this claim, he would require doctors to treat a patient saying they want to end their life in a radically different way just because they have a terminal illness. This is not “person-centred” and does not represent “choice” – and has prevented serious deliberation about what would warrant assisting someone to end their life rather than trying to prevent suicide.
Lord Falconer’s repeated assertion that his proposed legislation is “tried and tested” and “safe” is belied by evidence from other countries. We should be exploring alternative approaches to avoid repeating their mistakes.
Dr Lucy Thomas
Palliative care and public health doctor, Hitchin, Hertfordshire
Charles Falconer’s flattery of doctors is hypocritical. He claims they have an important voice in assisted dying but ignores inconvenient facts. Only 2% of doctors in Canada and Oregon prescribe lethal drugs – even fewer in Australia. More than 98% of doctors in those jurisdictions do not want direct involvement with assisted deaths. They recognise the dangers to patients, healthcare and to themselves (ongoing adverse personal impact has been reported in between 15%-20% of physicians taking part in an assisted death). Falconer would have you believe that it is safe to hand the decision to two isolated doctors who decide in secret without any monitoring or review. This is contrary to all good practice and seems designed to hide errors, bias and discrimination.
If a person in a wheelchair complained that a barrier was preventing their ability to see the view beyond, the caring solution would be to install a transparent barrier. Falconer’s solution is to remove the barrier altogether, regardless of the impact on vulnerable individuals.
More than 100,000 people each year in the UK cannot access the specialist palliative care they desperately need. That is the priority, but if MPs decide assisted dying is the solution, then having a multi-professional socio-legal model outside healthcare is safer for patients and health services by providing greater transparency and legitimacy. Such a model exists, and it is time Falconer and fellow politicians listened to the voices calling for such a model.
Claud Regnard
Retired palliative medicine consultant, Merseyside
Assisted dying is a hugely emotive topic, and many personal experiences trigger understandable demands that the law should be changed (Two deaths shaped my belief in the right to die. This bill could change everything, 9 October). But what might appear to be best for individuals might not be what is best for society. As a former chair of the National Institute for Health and Care Excellence, I was often asked how I coped with being responsible for an organisation that sometimes denied treatment for NHS patients, often with the question: “But what if it was one of your family?”
My answer was simple – if one of my family were seriously ill, of course I would want no limit on what was paid to keep them alive. But I also understood that what might seem best for an individual might not be best for society as a whole. Every pound can only be spent once, and aspiring to help individuals may well harm the care offered to others.
The same societal caveat applies to assisted dying. From individual perspectives, assisted dying might appear a logical development. But from the perspective of society, it is likely to have a profoundly different impact – with a legion of unintended consequences.
It is vital that lawmakers focus on the whole of society and the risks implicit in redrawing the boundaries of the law. Once we blur that boundary, there is no going back, and the elasticity with which assisted dying laws have been applied in other countries should serve as a warning that such legislation is inherently unstable.
David Haslam
Dorchester, Dorset
I write this letter as carer for my late wife. She died, aged 42, in 2006. She and members of her family had Von Hippel-Lindau disease – a genetic condition that, in her case, caused brain and spinal tumours and kidney cancer (which led to several years on kidney dialysis).
Life was extraordinarily hard for my wife in the seven years leading up to her death. She suffered chronic pain and increasingly severe disabilities and many months in hospital as her condition worsened. She felt the weight and responsibility for the care I and others gave her very heavily. I know that if the assisted dying bill had existed, she, out of her deep love for the people around her and a sense of guilt about what the burden of care entailed, would have chosen to end her life. This would have been deeply wrong. I have grave concerns for people who feel the impact their illness and disability has on others and that it will lead to premature deaths, motivated, not out of pain and disability, but due to a lack of care and support.
The first priority for our society must be to provide proper care and appropriate pain management. Any legislation and associated guidelines linked to assisted dying must include provision for an assessment of the care and support available to terminally ill people and their carers. My wife and I fortunately never had the option to choose a premature death. I could not have faced that burden. With deepest respect for those with a terminal condition and whose views differ from mine.
Andrew Beeforth
Plumbland, Cumbria
I accompanied my wife to Dignitas in Switzerland exactly two years ago and I welcome the announcement of Kim Leadbeater’s private member’s bill on assisted dying (MPs to get historic vote on England and Wales assisted dying bill, 3 October). However, she appears to be proposing a very restricted set of eligibility criteria and my wife, who had MS, would not have been covered as her situation came under the category of intolerable suffering from an incurable condition, and MS isn’t generally considered to be a terminal illness.
Research by the campaign group My Death, My Decision shows that half of all UK residents who travelled to Switzerland for an assisted death had neurological conditions that probably wouldn’t be covered by Kim Leadbeater’s bill.
If her bill passes unamended then people like my wife will still be faced with travelling to Switzerland. I sincerely hope that the proposed bill allows time for a full discussion of the eligibility criteria for an assisted death as well as learning best practice from other countries’ experiences.
Dave Sowry
London
As a 74-year-old diagnosed with Alzheimer’s disease, I share the experiences and sentiments expressed by Colin White and Marika Sherwood in their letters (4 October). The paradox, however, is that the safeguards envisaged in current proposals would require that those seeking assistance must demonstrate unimpaired mental capacity and would so preclude dementia sufferers, regardless of previously expressed wishes or the current severity of their mental distress.
Name and address supplied
