The Assisted Dying Bill offers an opportunity to re-shape the law governing terminally ill people who want to voluntarily end their own life. It gives Parliament the chance to offer choice and dignity to a small group of people at a time in their lives they most need it.
The scope of the Bill is quite narrow, and numerous safeguards are built in which I believe address the fears of most who oppose it. But first we should consider the law as it stands.
It is a mess. A Director of Public Prosecutions ruling in 2010 accepts the principle of compassionate assistance to die, but fails address the reality. A terminally ill person who wants to deal with their situation by choosing to die can, but must travel to Switzerland and rely on that country to manage the consequences. Those who can afford to travel abroad have the choice; others do not.
At the very least the law needs to be clarified, either prosecuting those who go abroad with the intention of taking their own lives, or else ensuring they can do so in this country.
As legislators, MPs cannot continue to turn a blind eye to the situation where those who can afford to exercise a choice to end their life can do so, whilst those without resources cannot.
Some concerns have emerged in recent weeks about the Bill, so we should properly consider what it does and does not do.
It is a compassionate and modest Bill, tightly focused to only allow adults of sound mind who have a terminal illness, with a life expectancy of six months or less, to voluntarily end their life.
Its scope does not extend to people dying of many conditions. People with disabilities, however serious, are not covered unless they also have a terminal illness.
And for those who meet these strict criteria there are a number of procedural safeguards. For example:
- The person voluntarily signs a declaration that they wish to end their own life
- His or her own doctor countersigns the declaration that the person is terminally ill, of sound mind, and acting voluntarily
- This declaration is countersigned by an additional, independent specialist doctor
- If a doctor has a conscientious objection to any of this, they do not have to participate in any way
- A High Court judge must also agree the person is terminally ill, of sound mind, and acting voluntarily
- There is then a 14 day cooling-off period
- After the 14 day period, the doctor takes the medicine to the patient, and waits there
- The patient must choose: to take the medicine themselves (it cannot be administered by any third party), or to change their mind and not take it. If the latter, the doctor leaves, taking the medicine away.
Like many people my own opinions on the issue have been partly shaped by experiences of friends and family. But having worked in the NHS until May 2015, my views have also been profoundly influenced by professional experience. A few years ago, working with some specialists I learnt a huge amount about developing communications skills for doctors and nurses to help patients live and die with long term conditions. My eyes were really opened to how poorly equipped patients and clinicians were to talk about dying with dignity. It also became evident how lonely it becomes for a patient when nobody has responsibility to talk with them about dying.
I respect and understand objections to the Bill by people of faith, but I do not believe that this can override the choice of those whose faith allows this, or the choice of those without faith.
I respect the fears of those who are worried about vulnerable people of old age or who have a disability. And of course, as with much legislation, I understand there are those who fear a leap into new legislative territory: crossing the rubicon. But the current law is not fit for purpose and the train has already left the station. Parliament must act. MPs cannot simply hope someone else will sort this out or that it will go away.
The Assisted Dying Bill seeks to establish the principle that terminally ill people can be afforded choice and dignity whilst reducing suffering for dying people who want to control how and when they die. It merits support from all sides.
Karin Smyth is the Labour MP for Bristol South