I absolutely support the principle of ‘my body, my life’ whether it is for abortion or for when and how I die. I think the argument that people would be coerced into taking their own lives has been grossly exaggerated by very powerful but deluded lobbies on behalf of disabled people and the religious right.
The legislation currently before the UK parliament, for introduction in England and Wales, is very wrong headed. Let me take you through the process.
Assisted dying legislation: the criteria
First you have to be told that you have only six months to live. Few medical experts can predict that exactly and you could have three weeks or three years, most of the time no one really knows. But, let’s assume that six months is the likely and accurate prediction.
Then you have to do every part of the complex process involved in the process alone, because if someone helps you, they may be at risk of facing 14 years in prison if anyone accuses them of coercion. You don’t want to put your daughter or partner at risk of prosecution and imprisonment after your death for helping you, perhaps at the instigation of a malign police investigation or angry relative. You have to go it all alone. The media obsession and hysteria around coercion has had an evil impact.
You also have to make appointments and have conversations with two different doctors who have to agree that your diagnosis of six months is accurate. The two doctors both have to agree with your decision. You will have to find two doctors who don’t have fundamentalist religious or other views opposed to the principle.
Lawyers and legality with proposed assisted dying legislation
Doctors will not be permitted to help to administer your medication which would mean that a family member may have to or want to help, but that would put them in serious danger of being accused of coercion and spending years in prison after your death.
Then you will have to hire a lawyer as you have to present your case to a high court judge. The legislation has more than 40 clauses and is 38 pages long. You need help in understanding it so that your case can be presented to the judge. It is not clear whether the hearing will be in public, will you be able to attend, will your lawyer be able to present your case? If the judge decides against you, will you be able to appeal? Will there be legal aid as hiring your lawyer will be expensive, particularly if the hearing is in public. If it is in secret, how will you know whether you were properly represented?
The judge who until recently was in charge of the family courts has said the system is unworkable. Mr Justice Munby, well known for his humane judgments, pointed out that the hearings should be held in public which would mean rigorous procedures, including challenges to the evidence. Your case and your personal details could be published and available to all and sundry.
The killing quandary
Sir Nicholas Mostyn KC, another family court judge, said that we would be asking judges to order treatment designed to kill, something that has not been the case since we had capital punishment. Currently, judges may decide that treatment is withdrawn in individual cases when it is contrary to the patient’s interests, but to decide on treatment to kill is quite a different thing.
All this will take time, so you will probably be dead by then anyway and you will have undergone extreme stress. And much of your precious estate will have been spent on lawyers.
The bill excludes all sorts of people who may not be facing imminent death but are suffering appallingly and wish to make a considered decision at some point to put an end to it.
Speaking personally, I don’t really care about the state of palliative care as I don’t want to go into a hospice to have end of life care. I want to go peacefully and serenely before I need palliative care. I have led a robustly healthy and energetic life and I want to be remembered like that. I don’t want my grandchildren to remember me lying in bed tied up to pain killing drugs, incontinent and incoherent, however flowery a garden the hospice may have. This is my decision and I want to make it.
A dignified death?
If I get dementia, I want to go before I go gaga. This is my decision and I want to make it.
This bill may have the unintended consequence of making everything so unworkable, protracted and painful that legislation that would be sane and compassionate will be put off for the foreseeable future.
What the NHS needs is a death service. We all die. Would it not be better to have a state run medical and psychological service, perhaps as an offshoot of GPs where I could go and discuss my decisions calmly well in advance? It should be normal to have such a service.
People may think that this bill is better than nothing. I’m not so sure. There is public support for a much broader and sensible process. Maybe we should get it right rather than getting it wrong.
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