A matter of life or death

Deborah Annetts asks the government to support the Patient (Assisted Dying) Bill in the name of human rights and the protection of the vulnerable

On 6 June, the House of Lords will debate the Patient (Assisted Dying) Bill.

The purpose of the Bill is to give a competent adult who has a terminal illness the right to request medical help to die within tight safeguards.

A recent NOP poll reported that 81% of people support a change in the law to this effect.

But MPs, concerned about endangering vulnerable people, have been more cautious.

In 1993, the House of Lords select committee recommended there be no change in the law.

Ten years on, Lord Joffe is finding that many colleagues support his Bill.

The increasing importance of human rights is a factor here.

There is also new supportive evidence from countries which have regulated assisted dying, and a growing awareness of the problems our own law creates, or fails to address.

Parliament's joint committee on human rights has examined the Bill and found it compatible with the European Convention of Human Rights.

Its report concludes: 'In our view, the safeguards set out in the Patient (Assisted Dying) Bill would be adequate to protect the interests and rights of vulnerable patients.

They would ensure that nobody could lawfully be subjected to assisted dying without his or her fully informed consent.'

Under the Bill patients must be competent adults and must either be terminally ill or have a serious incurable and progressive physical illness.

They must satisfy the attending physician that their suffering is unbearable.

Only the patient can make the request for help to die.

Once the attending physician has carried out a thorough examination, and discussed with the patient all other options, including palliative care, he must refer the patient to a consultant physician.

The consultant physician must also examine the patient, confirm the diagnosis and prognosis, satisfy himself that the patient is suffering unbearably, investigate all other options and satisfy himself that the patient is making the request voluntarily.

Only then can the patient make a request for medical help to die in the form of a declaration.

This declaration must be witnessed by a solicitor and another independent person.

The solicitor must ensure the patient understands the full force and effect of his request.

The Bill includes a fixed waiting period so that patients can be certain of their decisions.

The patient must be informed by the doctor of his right to revoke the declaration at any time.

Lastly, there is a strict reporting mechanism.

The Bill would give vulnerable people more protection than they have at present.

Doctors and relatives help patients to die for compassionate reasons, even though this is against the law.

Our legal penalties for assisting suicide are the harshest in Europe, but prosecutions are rare and 'mercy killers' invariably escape custodial sentences.

Dr Michael Wilks, chairman of the British Medical Association's ethics committee, says there is an 'unhelpful gap between what the law says and what the law does'.

A 1998 Sunday Times survey found one in seven UK GP's admit to helping patients to die at their request.

Without government-backed research guaranteeing doctors immunity from prosecution, this probably understates the situation.

Whatever the actual figures, people are being helped to die without legal safeguards, in unregulated situations.

Research from abroad suggests the level of non-voluntary euthanasia (when doctors make decisions to end patients' lives rather than patients asking for assistance to die) is nearly five times higher in countries which fail to regulate assisted dying.

Two UK Parliaments, Guernsey and the Isle of Man, have already voted to take steps towards legalising assisted dying.

Now there is well-drafted legislation before Parliament, the government should support the Bill in the interests of human rights and protecting the vulnerable.

Deborah Annetts is the solicitor chief executive of the Voluntary Euthanasia Society