The opinion piece by Dave Sowry, a board member of My Death, My Decision, highlights the risks of treating autonomy as an ethical principle in isolation (I accompanied my wife to Dignitas. The Lords’ filibustering is an insult to all like her who have suffered, 3 December). While it is sad that he was widowed early, he and his wife were able to travel and make choices – choices shaped principally by fear. That does not mean the law should be altered.
What his account overlooks are the thousands of patients in the UK denied genuine choice because they lack access to palliative care. The House of Lords is rightly undertaking line‑by‑line scrutiny of the proposals, and expert testimony has raised serious concerns and widespread opposition. The current law already affords dignity and protection to vulnerable, elderly and disabled people. What we lack is sufficient palliative care and hospice provision, as repeatedly shown by Hospice UK and National Audit Office reports.
Mr Sowry refers to differing moral frameworks, yet does not grasp the consequences of elevating autonomy above all other ethical principles. Healthcare staff cannot be detached from patients or the process; nor can families remain unaffected by a loved one’s decision to seek assisted suicide. To leave poor and vulnerable people unsupported, and potentially pressured into an assisted death, would be a grave injustice.
If the bill is to proceed, it should be removed from the health service – assisted suicide is not a medical treatment. Only by recognising the social context in which decisions are made can we understand why this legislation is so deeply flawed.
Dr Sarah Davies
Consultant physician, Old Colwyn, Conwy
Dave Sowry writes: “Watching the House of Lords debate, it would be easy to forget who the bill is about. Terminally ill people should be the focus of all the deliberations.” Mr Sowry is entitled to represent his own situation, but legislators have an obligation to consider the second-order effects of laws that are going to affect everyone. This is a classic individual v collective dilemma. Individuals with terminal illnesses who are very clear in their own mind that they want to die are disadvantaged by our current laws – but in a compassionate society oriented around trying to prevent suicide, legalising assisted suicide for terminally ill people undermines all suicide-prevention efforts.
Five per cent of all deaths in Canada are now attributable to assisted suicide. Countries with state-assisted suicide programmes have seen their overall suicide rate increase. It would become a nonsense to have suicide-prevention programmes if this bill were passed into law. Assisted suicide is not legislation that can be passed in principle and the details worked out later, when every tweak means unnecessary deaths. If supporters of the assisted dying bill are frustrated by its progress, they should have crafted a better bill.
Sarah McCulloch
Borehamwood, Hertfordshire
Like Dave Sowry’s wife, my sister-in-law also died with the help of Dignitas. She was in the final stages of untreatable mesothelioma, and had access to the best possible palliative care, but knew that even with that, the process of dying would be frightening as she gasped for breath. Gordon Brown (It is not too late to put the brakes on assisted dying, and focus on what is really needed, 2 December) is right to argue for more funding for hospices to make them more accessible, but that still doesn’t address the issue that people want a change in the law to allow people to make a choice about the manner and timing of their death.
I am sure I am not alone in opposing the lords’ use of their unelected privilege to subvert the expressed will of those who wish to see this bill passed. We are capable of managing the risks. I have tried to convey my concerns about the lords’ obfuscation through their 1,000-plus amendments to the Speaker of the House of Lords without success.
Jean Farrer
Berkhamsted, Hertfordshire
The data cited by Gordon Brown in his argument against assisted dying make for grim reading. But it’s the people behind the data that matter most. A gentleman we recently spoke to said he’d have gladly accepted an assisted death while in his local hospital. For all the efforts of the staff, his pain was unmanaged. He wanted to die.
Once in the care of his local hospice, though, he changed his view. He enjoyed several more weeks with family and friends close by. That same hospice, like most, regularly turns patients away. It can’t afford to run services in line with demand. This same heartbreaking decision is happening thousands of times each year.
And so while there is a legitimate discussion about the clinical limitations of palliation, we should be clear that the limiting factor on palliative care in this country is not medical science, but how the service is planned, delivered and paid for.
Hospices are collectively neutral on whether assisted dying should be an available choice. But the question which parliamentarians must reckon with, is how to guarantee, as close to practically possible, that no one makes that choice because of a fear of not getting the care they need.
Charlie King
Director of External Affairs, Hospice UK
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