I'd like to die with dignity. And I don't want the medieval brigade interfering.

By Camilla Cavendish, The London Times, May 11, 2006

Editorial

Camilla Cavenish

FOUR YEARS AGO today, Diane Pretty died. Remember her? Or have you blotted out her fight to avoid the medieval death the law prescribed: to be slowly asphyxiated by the motor neuron disease paralysing her body until she was reduced to a shred, a shard of pain, an intelligent mind attached to a feeding tube? "Diane had to go through the one thing she had foreseen and was most afraid of," her husband has said. "And there was nothing I could do to help."

Our civilised society regularly puts dogs and cats out of their misery on compassionate grounds. Yet it views with distaste those who beg to be spared the final stages of a terminal illness, and criminalises anyone who dares to help them. Some doctors, thank heavens, still drive through the countryside with heads down and morphine hidden. One, Dr Michael Irwin, was struck off by the General Medical Council last year for taking tablets to a terminally ill friend. Most now desert their patients in their hour of need. For in the 21st century the law insists that God shall dictate our time of passing. Our churchmen preen and preach and rage about the immorality of assisted suicide. But it is their position that is immoral.

They are amassing again tomorrow, the holies and the holier-than-thous, the bishops, the Evangelical Alliance and Care Not Killing, to vote down the Assisted Dying for the Terminally Ill Bill. The House of Lords will be overrun with self-righteousness, in a false cause. For this legislation is sane and merciful. It is clear and limited. It would make it lawful for a physician to give lethal drugs to a terminally ill patient if that patient was judged mentally competent, had signed a written request, was deemed by two doctors to be suffering unbearably and was due to die within six months. No doctor, hospital or clinic, could be forced to assist. But Good Samaritans would no longer be punished.

The ferocity of the opposition contrasts with the modesty of the proposals. In March The Catholic Herald described the opposition to assisted suicide as "the biggest political campaign [by the Church] in its modern history". Religious people have every right to reject suicide for themselves. It's fine for them to extol the wonders of palliative care, ignoring the doctors who acknowledge that even the best clinics in the world cannot relieve all pain.

But it is not for them to impose pain on others. "Suffering can be good for us," was the astounding comment from the Rev George Curry, chairman of the Church Society, criticising Anne Turner's decision to die in Switzerland in January. Turner was a 67-year-old doctor who knew precisely how horrible her death from progressive supranuclear palsy would be. The only charitable view of Mr Curry is that perhaps he didn't.

Turner tried first to take her own life: suicide has been legal here since 1961. When that failed, she wanted help to achieve death with dignity. Yet even that option is now in peril. Stefan Sliwinski, whose mother died last week at a Swiss centre run by the group Dignitas, is being questioned by Essex Police. Mr Sliwinski said that his mother had cancer and multiple sclerosis, was in constant pain and wanted to die. But her sister has made "a complaint". So he could be charged with assisting a suicide, for having accompanied his mother.

The most powerful argument against euthanasia is the fear that a right to die could become a duty to die. It would clearly be abhorrent if elderly people were to feel pressurised to go early to preserve the kids' inheritance. Lord Joffe's Bill is drawn explicitly to avoid any such slippery slope. In Oregon, which has had similar legislation for eight years, there has been no suggestion of elderly people feeling under pressure. In eight years there have been 265 prescriptions of lethal drugs, of which only 117 were taken, with the elderly using assisted dying less than other age groups.

Meanwhile, palliative care has improved in Oregon, according to Professor Raymond Tallis, former chair of the Royal College of Physicians ethics and medicine committee, because the law takes end-of-life decisions seriously. Plus, there is now open discussion. There are genuine concerns about the Netherlands, where the law is not limited to adults or to the terminally ill. About 9,700 requests for euthanasia are made annually, of which 3,800 are met. The Dutch do seem to interpret their guidelines in ever broadening terms: in one case a court ruled that "psychic suffering" could qualify, as well as physical pain. This is a direct consequence of the loose wording of the law, which bears no comparison with the safeguards in the assisted dying Bill. But do not expect to hear that from the scaremongers.

We hate to dwell on death, but we know we may not be lucky enough to go quietly. A 2004 poll found that 51 per cent of respondents would want a doctor, relative or friend to break the law if they were terminally ill and suffering, and 55 per cent would break the law to help a loved one. That is a courageous stance. Abandoned by the law, many people have sacrificed themselves to help relatives desperate to die. They have ended up addicted to drink or drugs, or killed themselves.

Many doctors are reluctant to take on that burden. Yet yesterday's headlines, that doctors have come out against changing the law, were misleading. First, the survey quoted covered only a quarter of doctors. Secondly, 30 per cent of them were in favour of assisted suicide. That is more than enough physicians to deliver help to the tiny number of terminally ill patients who might request it. Since there has never been any question of forcing doctors to act against their consciences, it is meaningless to treat this survey as a poll.

Tomorrow's battle pitches the medieval forces of religion against the modern forces of freedom. If the Bill succeeds, it could end a shameful legal, ethical and medical fudge. If it fails, it turns us all into potential Diane Prettys. Let that be on the conscience of all those who so loudly claim that their opposition is based on conscience.

LINKS

Read the Assisted Dying Bill

Click here to read written statements from Dr Anne Turner and others

Times coverage of the Royal College of Physicians poll: Doctors in revolt over legalising euthanasia

Information from the British Humanist Association about how religious groups are campaigning

The opposing view (pdf file): House of Lords briefing paper from Care Not Killing

Click here to make a living will

camilla.cavendish [AT] thetimes.co.uk