Joel Joffe
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There can be no better evidence of the urgent need to change the law on assisted dying than the ruling made yesterday by the High Court on the case of Debbie Purdy.
Ms Purdy, a woman suffering from multiple sclerosis, brought a case to clarify the law on assisted suicide. She wanted to ensure that if she travelled with her husband to a Swiss clinic to end her life, he would not be prosecuted on his return to Britain.
The law as it stands means that if her husband does accompany her he may be prosecuted if the Director of Public Prosecutions decides that there is sufficient evidence and it is in the public's interest to do so. But so far there have been no prosecutions of the relatives of the 101 British citizens who have gone to the Dignitas clinic.
The judges said that although they have every sympathy with Ms Purdy they cannot help her to clarify the law. The courts can give her no guidance even if it means that she will have to take her life earlier than she would wish, while she is still healthy enough to travel alone to Switzerland. What a terrible dilemma for Ms Purdy and her husband that this should be the law.
It is not only Ms Purdy who faces this dilemma. There are many others who feel that travelling abroad to die is a gentler way of death than the choices that are available in Britain, but who cannot do so for financial reasons or the sheer physical impossibility of their making an arduous journey.
The only other legal option is to commit suicide. But a botched suicide attempt increases the suffering of already sick people. There are also mercy killings and some doctors do illegally assist their patients to die out of compassion, but they do so at great risk to their careers and, in some cases, their freedom.
The solution is clearly a change in the law to allow mentally competent, terminally ill adults the option to end their life in their own home with the assistance of their caring doctors. This is what the Assisted Dying for the Terminally Ill Bill that we introduced in the House of Lords in 2005 would have achieved. In drafting the Bill we recognised that we had a duty not only to allow terminally ill people to make their own decisions about their own lives, but we also had a duty to protect vulnerable people.
This required that we included an array of safeguards before the patient made a final decision. The process, as the Bill envisaged it, would begin with a written request to his or her doctor for assistance to die. Thereafter the patient would have to undergo a consultation with two doctors, one of whom must be an independent consultant.
If either of the doctors had concerns about the patient's mental competence he or she would be referred to a psychiatrist. There would also be a minimum period of 14 days for reflection. And recognising the importance of palliative care, the patient would also have to consult a palliative care specialist.
It was only after all these and other safeguards were met that patients could make a final written request to a doctor willing to prescribe medication to end their life. The patient - not the doctor - would administer the drugs.
The Bill was based on the law in Oregon in the United States, where assisted dying has been lawful for ten years and where there has been no credible evidence of abuse. The Bill included more safeguards than the Oregon legislation.
Why then was there such opposition to assisted dying? The answer is that a small minority of the population - probably under 20 per cent - largely under the influence of their religious leaders, sought to impose their beliefs on the 80 per cent of the population who supported assisted dying and who did not share their beliefs.
The Bill did not in any way seek to interfere with the rights of any of this small minority to die in any way they choose, nor did it seek to encourage any of the majority to ask for assistance to die. It simply aimed to provide an additional end-of-life option to the existing choices - chiefly of palliative care, but also of refusing medical treatment or of patients starving themselves to death.
The leading article in The Times last Saturday was in tune with public opinion when it called for the Bill to have another reading. When a new Bill is introduced I hope the debate will not abound with misleading and emotive buzz phrases such as “care not killing”, or references to the Holocaust or the religious objections of the minority. Rather, I hope that it will be a calm, rational debate that focuses on the safeguards necessary to protect the vulnerable, and the need to ensure that every mentally competent terminally ill person has a right to die at a time and in a way he or she chooses.
Sadly, however, the last thing the opponents of assisted dying seem to want is a debate. This was shown by their conduct at the last hearing of my Bill when they broke a longstanding tradition in the Lords of never opposing a Private Member's Bill at second reading. They succeeding in summarily bringing the debate to an end before a detailed examination of its provisions could even take place.
This week Sir Ken Macdonald, the Director of Public Prosecutions, stated that if this issue is to be resolved it should be done so by Parliament. This was echoed in yesterday's judgment. In the words of Lord Justice Scott Baker and Mr Justice Aikens: “The offence of assisted suicide is very widely drawn to cover all manner of different circumstance; only Parliament can change it.”
I respectfully agree. Opinion polls consistently show that the overwhelming majority of the public support change. For the law to change the voices of the silent majority must be heard. We should all draw courage from Debbie Purdy.
Lord Joffe is a human rights lawyer
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December 10, 2008
I just learned of Debbie Purdy's fight. For God' sake have compassion. Change the law and let them be. She is a well balanced, intelligent woman. Give her peace.
JoAnne Parks, Merrill, Oregon
I too am a nurse and do not believe in assisted suicide, this view has only come to light because society's ideas of 'ideal type' and body image impactsstrongly upon young people - note the increase in eating disorders and young people accessing plastic surgery.
Materialism and hedonism prevail
justina Barber, Barnsley, South Yorkshire
And when someone in Authority decides that you are too expensive to keep and signs your ' Elimination ' papers, what will be your last thoughts ?
Desmond Taylor, Houston, USA Tx
Lord Joffe must now revive his bill whilst the subject is fresh in peoples minds. The hypocrisy of religiuos people beggers belief; they preach love, but always act in a way that shows love has little to do with their beliefs. I urge Lord Joffe to revive his bill without delay.
Barry Winchurch, Derby, Derbyshire
I am an trained nurse, and an atheist. I oppose assisted suicide because I believe that good nursing and medical care of the terminally ill can provide a pain-free and peaceful death. People can already refuse medical intervention if they wish.
I would be surprised if mine is a minority view.
P, dorset,
I'm sorry but ultimately - who has the say on whether I live or die on this Earth? Who gets to choose my fate? The fact that any third party has any say in my life in adversity is abhorrent. If I choose it, who are you to say "No - I choose that you should suffer more"? Live your life - leave me be!
Richard, Newbury, UK
Why should a dogmatic inhuman individuals deny the rest of us the choice of not suffering an unbearable pain for nothing and ending it with dignity. Anybody who is afraid of their family pushing them to die then they must sort out with the family instead of ruining our quality of life and death.
S Yogarajah, Harrow, UK
Absolutely correct. Enough of religious fanatics imposing their views on non-believers. The same argument supports a woman's right to an abortion with appropriate safeguards. We're adults! We can take rational decisions! Keep your beliefs to yourselves; let us decide for ourselves how & when we die!
JF, Canterbury, UK
Lord Joffe, be careful what you wish for. With the population increasingly skewed towards the elderly, I see a future where the old and the sick will be considered a burden on the young and forced to volunteer to die when they can no longer contribute. Does that scenario sound attractive to you?
john, london, UK
When those against the right to die, see their loved ones suffer, let's ask them again, shall we?
Francine Morris, Manchester, united Kingdom
I am fed up with the misconception that it is just a religious minority who is opposing the debate on assisted suicide. It is repulsive for many of us who are not religious, because it can lead to abuses and put the lives of the most vulnerable people in our society at risk.
Mary, London,
The assumption that Doctors will willingly or happily help with assisted suicide is rubbish. Quite the opposite. And neither should they be obliged to but you can bet that is where it will end-up. They will be expected to relinquish any objections as part of their 'duty of care' and that is not on.
Rob, London,
It is time to change the law so that those who are terminally ill have the right to a pain-free death at a time of their choice.
Modern medicine has enabled many of us to survive diseases which killed previous generations in a matter of months. The key issus is not life, but quality of life.
Malcolm Grills (Rev), Minchinhampton,
Joffe tainted his argument by belittling religious people's concerns and claiming to care about the poor. Until he can guarantee any dying patient's wish to have good basic nursing care is carried out, euthanasia will be abused despite the safeguards.
Carolyn, Surbiton,
I've always felt the best way to settle this is by a multiple-question referendum polling the different aspects of euthanasia by asking a wide variety of relevant questions. Then parliament will have some solid research to work with.
Living in the Netherlands; I'm now passionately pro-euthanasia.
Daquan Quartermaine, Middelburg, Netherlands
To the few opponents of this wise and considered perspective - Lord Joffe has listed the safeguards against abuse which seem to be adequate to prevent either misuse on an individual basis or a wholesale slide into mass suicide. The church has enough errors to answer for, let it not add to them.
tom, London,
Wonderfully argued Lord Joffe. It continues to astound me that this country continues to pander to the opinions of a vociferous religious minority, allowing them to interfere with decisions that have nothing to do with them, and will not (should they so wish) have any effect on their lives.
John Dale, Sunderland,
I am wholeheartedly in favour of assisted dying and hope that, should it be necessary, my family and Doctor could assist me without fear of prosecution.
With respect to those whose religion proscribes such I would not allow my pets to go through what some people endure.
Phoebe, Manchester, England
Attempted suicide used to be illegal. Then it became legal, but illegal for a second person to assist.
"Slippery slope" is no fallacy. Pretty soon we will have a pro-suicide culture, in which it becomes normal to end one's life deliberately.
Malcolm McLean, Bradford, UK
For in that sleep of death what dreams may come
When we have shuffled off this mortal coil,
Must give us pause: there's the respect
That makes calamity of so long life;
Keith, bishkek, kyrgyzstan
Good article, and good argument. I hope and pray that something like what you're proposing will be in place before I get to the stage of working out how I die.
Anything would be better than the way I watched my father go, in helpless pain and fear, without the mercy we extend to pet animals.
T Austin, London, UK
Suicide is legal! I have asked on several occasions why a person helping another to pursue a legal act is considered to have committed a crime - it is illogical. The ramifications of this bad logic are horrendous - I legally by a car but my advisor could be held guilty; that is how stupid it is.
M. Cawdery, Portadown, Co. UK, EU courtesy Brown
the law ,
if it is changed, it should allow relatives only to complete the mission. Of course they will want to absolve all responsibility and lay the burden of guilt on doctors and nurses whose duty of care is being stretched ever more, but hey they dont realy care, do they?
Lizzy, Lincoln, uk
Senior members of the various religions in the UK make up more than half of the group upon whose beliefs and decisions
our Right to Die is decided.
What %of the UK is a member of a church?
By what right does any religious person have in my say in MY RIGHT TO DIE?
It is outragious.
Trish Niblock, Edinburgh, Midlothian
I have MS. The then husband decided he would rather be with someone who does not have MS and said he would kill me to achieve that, having apparently already taken over all my finances against my will.
Society must not recognise this or any other reason for murder as permissable. Murder is murder
Sue Doughty, Twyford, UK
Give us the right to end our own lives in peace, no one is telling you what to do so don't tell us that want to die that we must keep suffering. My Aunt took her own life last year by refusing food & drinks, it was her wish so although we miss her why should we force her to live, now she is at rest.
Contax, Brigg, UK