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Assisted dying assisted suicide Disability Meacher Bil Mental Capacity Mental Health

The complexity of addressing mental capacity and mental ill-health

The Meacher Bill and its safeguards

The Bill states clearly that before assistance to die could occur the High Court (Family Division) would need to be satisfied that a person seeking assistance to die has the mental capacity to make that decision.

The attending doctor and independent doctor involved would need to be similarly satisfied of the person’s mental capacity. If they have doubt, they must refer the person for assessment to a specialist (any registered psychiatrist[1]) and take account of any opinion given.

The Bill also states that the Secretary of State may issue Codes of Practice on issues including assessment of mental capacity; and taking account of depression and other psychological disorders that may impair a person’s decision-making (2 distinct topics, in one or more Codes).

On the face of it these sound like sensible safeguards; but they raise significant questions, some practical, some much more fundamental.

The fundamental challenge of providing safeguards linked to depression and other mental health challenges in the context of assessing capacity

The interaction between mental health challenges (‘psychological disorders’) and mental capacity is complex. Wesseley’s recent review of the Mental Health Act[2] attempted to address its complex relationship with the Mental Capacity Act but there remain unresolved issues.   

Assessing capacity in someone with both terminal illness and depression is not straightforward.  Depression is common amongst people who are terminally ill: indeed a diagnosis of terminal illness is the kind of major loss that can trigger depression. A desire for suicide is a major symptom of depression, but it may also be a well-thought-through response to impending death. Weir argues that it is very hard to distinguish between the two[3]. The person may be motivated by a combination of the two, in which case, how does the assessor decide whether the person’s desire to die is coloured more by depression or more by their rational response to terminal illness? And how do assessors across the country do so consistently?

In addition, depression tends to fluctuate, which presents both challenges in assessing what is truly the person’s ‘settled will’  – and opportunities to support people through their times of despair: with treatment and support, the wish to die can be ameliorated even if prognosis is short[4]. Price et al (2014)[5] summarise the research evidence as follows:

Depression is common in palliative care[6] and desire for hastened death is strongly associated with depression in palliative populations[7]. In Oregon it has been shown that depression is not always appropriately identified in patients requesting assisted suicide[8]. There is evidence to suggest that treatment of depression can reduce the wish for hastened death[9]  

Even if the wish to die is coloured by depression, it is perfectly possible that she or he would still be assessed as having capacity (depending on the definition used – see discussion below). Many people experiencing depression or other mental health challenges meet the ‘capacity’ criteria of the Mental Capacity Act: they are quite able to understand information, weigh up options and communicate a decision on life issues large and small.

It is not straightforward to remove autonomy just because someone has depression; indeed it could be a case of disability discrimination if someone with depression, with capacity, were denied a ‘treatment’ option just because of their impairment (depression). If, as seems likely, large numbers of people with mental health challenges would be considered to have capacity, then the apparent safeguard for people with depression rather melts away.

It is also not clear that the attending independent doctors would always refer effectively for a capacity assessment. The Royal College of Psychiatrists pointed out that many doctors do not know how to assess for the presence of depression in people who are terminally ill[10].

The (potential) Code topic of ‘taking account of depression and other psychological disorders that may impair a person’s decision-making’ may sound like a safeguard that is additional to the (separately listed) safeguard of assuring that the person has mental capacity. However, the legal question (as laid out in this Bill) is simply whether the person has capacity to make this major decision. Therefore the ‘depression’ safeguard appears to be a subset of the ‘capacity’ safeguard – in effect a reminder to think about the impact of psychological disorders (alongside learning disability, dementia or other potential sources of incapacity) when assessing mental capacity to decide.

This would face mental health services and voluntary sector partners with a challenge. Should they sustain their long-standing commitment to prevent suicide amongst people experiencing mental health problems wherever possible, driven by a national policy agenda that has set targets for suicide reduction and ensured that every local area has an all-age multi-agency suicide prevention plan in place? [11] Should multiple agencies always start by reaching out to people who are seeking to die, listening, valuing them, supporting them to want to live? Or should they accept that for the sub-set of people with mental health problems who also have a terminal illness, the one question is whether they have the capacity to decide and have made a decision – in which case, would they ditch the whole approach to suicide prevention in favour of autonomy?

This dilemma brings into sharp focus some of the well-known contradictions between Mental Health and Mental Capacity law. Under Mental Health law, someone who DOES have capacity to make decisions can nonetheless be detained and treated against their will if they have a mental disorder and certain risk criteria are met. It seems possible that under this Bill someone could be given psychiatric treatment against their will – ie denied autonomy – but nonetheless have the right to assistance to die as long as they met the definition of mental capacity.

Much depends on how mental capacity is defined and assessed. Price et al[12] note that where the ‘bar’ is set – on a continuum from a basic cognitive capability through to a full understanding of context and implications – has not been settled in jurisdictions with assisted dying legislation. Different clinicians set the bar at different points, influenced by factors including their own values. In a survey of US forensic psychiatrists, those with ethical objections to assisted suicide recommended higher thresholds for competence and a more extensive review of the decision [13].  The Mental Capacity Act requires that clinicians first assume capacity and have to demonstrate a LACK of capacity to act in someone’s best interests. The Mental Capacity Act does not provide a clear framework for deciding whether someone DOES have capacity to make the major life and death decision of assisted suicide.  

The Bill does not begin to address these dilemmas. It may gently imply that taking account of depression will offer safeguards; but these would risk being paternalistic if they applied to people with capacity (however defined). As drafted they may turn out to be a chimera.

In addition, there may be a question about whether some mental health problems ARE terminal illnesses. Someone with advanced anorexia, for instance, may be very reasonably expected to die within 6 months. Treatment options may have been exhausted. She or he might or might not have mental capacity to decide – but if they did, is there any reason they should not be assisted to die? The same could potentially apply to someone with severe depression who has not responded to treatment and makes repeated suicide attempts. In a climate of commitment to ‘parity of esteem’ between mental and physical ill-health, a non-discriminatory case could be made for accepting some people with mental health problems (and no other terminal illness) for assisted dying.  

Finally, the Bill suggests another potential Code topic, on the information on treatment, support and end of life care that would be made available to the person. There is no requirement for actual availability of mental health support or end of life care – just a potential requirement to inform people of what does exist. This is a weak safeguard for people with mental health challenges in a context in which there are huge gaps and delays in getting mental health support: the Mental Health Foundation, for instance, estimates that 85% of over-50s with depression receive no help at all from the NHS[14]. There are also of course no guarantees in the Bill of support with social isolation, financial challenges or inappropriate housing. These social determinants make mental health challenges (including suicidal depression) more likely in the first place; and once people have mental health problems, such social problems tend to intensify, in a vicious cycle[15]. Surveys by the CQC of the experience of people receiving community mental health support consistently find that over 40% report that they would have liked support with finance, benefits and employment but did not get them[16]. It would be quite possible for people to develop depression in the context of major social problems, subsequently become terminally ill, get no support with their isolation and poverty and opt to die while the opportunity to intervene with multi-faceted support went unaddressed.     

Specific points

On mental capacity assessments, the attendant and independent doctors must seek an opinion from a registered psychiatrist if there is any doubt about the person’s capacity. It is not clear, though, that every registered psychiatrist has the necessary assessment skills: many psychiatrists are much more familiar with assessing criteria for detention or treatment under the Mental Health Act (which do not include the mental capacity to make decisions) than criteria under the Mental Capacity Act. This increases the risk of inconsistent assessments of capacity. Assessing capacity amongst people with learning disabilities and autistic people has been found, in the Netherlands, to be inconsistent between clinicians and to be influenced by views of disabled people’s lives[17].

Secondly, we know that existing Codes of Practice are not implemented with sufficient effectiveness in relation to people with mental health challenges: the CQC’s 2019 evaluation of compliance with the Code under the Mental Health Act 1983 notes ‘particular areas of concern where we found that the guiding principles were not being routinely implemented to inform practice in the way they should’. This was true in fundamental areas such as using the least restrictive approach, and involving patients in their own care[18]. ‘Through our review, we have not found evidence that the Code has prompted a substantial change in the way services are empowering and involving people in their care’. These are deep-rooted problems of culture and practice and we cannot assume that provision of one or more Codes on assisted dying would be sufficient to ensure that real engagement would take place with people with mental health challenges at a time when they were facing major decisions about their life and death.   Similarly, the post legislative review of the Mental Capacity Act found that the Act was not being implemented in the way intended and that the duties imposed by the Act were not widely followed.[19]

Conclusion

Parliament should think very carefully about these complexities rather than being reassured by potential Codes and safeguards that seem to melt away as they are examined. Ambiguities and complexities leave doors open to subsequent legal interpretation, challenge and legislative amendment that could expand the remit of this Bill and erode the apparent (but often flimsy) safeguards. There is a tension between the equality of disabled people and safeguards that have not been grappled with in this Bill. If there is an assumption that the presence of depression or other mental health challenges means someone should be denied autonomy, that flies in the face of the Mental Capacity Act and the equality of disabled people. If that is not the assumption, then the safeguards are very narrowly delimited, the Bill seems to drive a coach and horses through the mental health policy objective of suicide prevention and there may be risks of following countries like Belgium in making assisted dying increasingly available to people with mental health problems, and the Netherlands, where people with a learning disability and autistic people are being offered euthanasia by doctors who are unable to make consistent, competent capacity assessments[20].

People living with mental health challenges, learning disabilities, dementia and other cognitive impairments should be at the heart of a deeper discussion about assisted dying than has informed this Bill to date.  

Liz Sayce. October 2021

This article is written in a personal capacity and does not reflect the views of any organization.  

Liz Sayce

Liz Sayce chaired the Commission for Equality in Mental Health, hosted by the Centre for Mental Health, 2019-21. She is a Visiting Senior Fellow at the London School of Economics and was Chief Executive of Disability Rights UK (and its legacy charity Radar) from 2007-2017, where she led work for equal participation for all, through programmes on independent living, career opportunities and shifts in cultural attitudes and behaviour. Liz is a Trustee of ADD (Action on Disability and Development), Vice-Chair of the Social Security Advisory Committee and a member of the Disability Advisory Committee of the Equality and Human Rights Commission. She has been a Non-Executive Director of the Care Quality Commission and a member of the Healthwatch England Committee. With a background in mental health and disability policy, previous roles include Director of Policy and Communications at the Disability Rights Commission and Policy Director of Mind. She led an Independent Review into disability employment programmes for Government in 2011 and has published widely on mental health, disability and social participation. She undertook a Harkness Fellowship in the USA resulting in a book (From Psychiatric Patient to Citizen, 2000 – updated in 2016).

      


[1] A doctor ‘registered in the specialty of psychiatry in the Special Register kept by the General Medical Council’ according to the Bill

[2] https://www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-review

[3] https://www.apa.org/monitor/2017/12/ce-corner

[4] Royal College of Psychiatrists Presidents’ Blog: Assisted suicide for the terminally ill 26/7/2014

[5] Price et al.: Concepts of mental capacity for patients requesting assisted suicide: a qualitative analysis of expert evidence presented to the Commission on Assisted Dying. BMC Medical Ethics 2014 15:32. doi:10.1186/1472-6939-15-32

[6] Rayner L, Lee W, Price A, Monroe B, Sykes N, Hansford P, Higginson IJ, Hotopf M: The clinical epidemiology of depression in palliative care and the predictive value of somatic symptoms: cross-sectional survey with four-week follow-up. Palliat Med 2011, 25(3):229–241

[7] Price A, Lee W, Goodwin L, Rayner L, Humphreys R, Hansford P, Sykes N, Monroe B, Higginson IJ, Hotopf M: Prevalence, course and associations of desire for hastened death in a UK palliative population: a cross-sectional study. BMJ Support Palliat Care 2011, 1:140–148

[8] Ganzini L, Goy ER, Dobscha SK: Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey. BMJ 2008, 337:a1682

[9] Breitbart W, Rosenfeld B, Pessin H, Kaim M, Funesti-Esch J, Galietta M, Nelson CJ, Brescia R: Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA 2000, 284(22):2907–2911

[10] ODOC BMA Briefing.pdf

[11] https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973935/fifth-suicide-prevention-strategy-progress-report.pdf

[12] Op cit

[13] Ganzini L, Leong GB, Fenn DS, Silva JA, Weinstock R: Evaluation of competence to consent to assisted suicide: views of forensic psychiatrists. Am J Psychiatry 2000, 157(4):595–600

[14] https://www.mentalhealth.org.uk/statistics/mental-health-statistics-older-people

[15] Sayce L (2016) From Psychiatric Patient to Citizen Revisited. Palgrave

[16] https://www.cqc.org.uk/publications/surveys/community-mental-health-survey-2020

[17] Tuffrey-Wijne I, Curfs L, Finlay I, Hollins S (2018) Euthanasia and assisted suicide for people with an intellectual disability and/or autism spectrum disorder: an examination of nine relevant euthanasia cases in the Netherlands (2012-2016). BMC Medical Ethics 19:17; and Tuffrey-Wijne I, Curfs L, Finlay I, Hollins S. (2019) “Because of his intellectual disability, he couldn’t cope.” Is euthanasia the answer? Journal of Policy and Practice in Intellectual Disabilities 16 (2), 113-116

[18] https://www.cqc.org.uk/sites/default/files/20190625_mhacop-report.pdf

[19] House of Lords – Mental Capacity Act 2005: post-legislative scrutiny – Select Committee on the Mental Capacity Act 2005 (parliament.uk)

[20] Tuffrey-Wijne e al op cit

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Assisted dying assisted suicide Care Not Killing Disability Do Not Resuscitate Meacher Bil

Campaign Gathers Pace

First, a big “thank you” to all of you who managed to find a time to either send us messages of support or who put together one or two-minute videos explaining why you are so opposed to a change in the law on assisted suicide. These video messages are now being distributed to the House of Lords where we hope they will help persuade Peers not to progress the bill.

You can see all of the videos by clicking on https://www.youtube.com/channel/UCsHhEX9nXB1x3m840GiFFyg/videos

We have compiled a short film showing the written messages sent in by supporters please keep them coming. Write to us at info@notdeadyetuk.org

Here’s a link to the messages video. https://youtu.be/moLwo6FskLI

Our founder Baroness Campbell is preparing her speech for the debate to be held on the 22nd of October. As a precursor, she has written an article for the Parliament’s internal “newsletter” The House. You can read her article by clicking here.

https://www.politicshome.com/thehouse/article/assist-disabled-people-to-choose-life-not-death

Finally, one of our supporters John Smith has put together a Mind Map that he used to collect his thoughts before he wrote his letter to the Peers. You might find it helpful

Categories
Assisted dying assisted suicide Disability Meacher Bil

Let’s Get Writing!

Hello once again.

Thank you for your response to our call for action. Tremendous!

Now we need more from you. Can you write to a member of the House of Lords?

As you know the debate on the Assisted Dying Bill takes place in the House of Lords on the 22nd of October so it is vital that as many disabled people as possible write to say why they are worried about a change in the law as proposed in the Meacher Bill.

Your email or letter doesn’t need to be more than one page or a couple of paragraphs.

We are urging you all to speak up because our voice needs to be heard in this vitally important debate. Remember Nothing About Us Without Us!

We have suggested some ideas to use. If you have any difficulties contact us at info@notdeadyetuk.org

Thank you


Dear (Name),

I’m/We are writing to you about the Assisted Dying Bill which has its second reading in the House of Lords on 22nd October 2021. 

I/We really need your help in influencing other members of the House of Lords to reflect carefully on this Bill which will affect the lives of thousands of disabled and terminally ill people. As a disabled person, I am deeply concerned about the impact of the changes being proposed in the Meacher Bill. I/We am/are asking you to oppose the Bill.  

(You could choose any one of these issues to include in your note)

– Non-existent and badly drafted safeguards to the Bill

– The inevitable change in the relationship between Doctor and Patient (Do no harm.)

– Potential abuse by Doctors of believing their patient will be better off dead (because they are subject to the same discriminatory attitudes as the rest of society)

– Possible coercion from family members

– Discrimination, for example between those with physical and/or learning disabilities.

– Slippery slope (for example other countries expanding the law to include non-terminal conditions and disabled people)

You only need to choose one or two of the above which directly affects your situation and/or that of someone who you advocate for.

If it helps, you can send your letters to us and we will address and send them on your behalf to info@notdeadyetuk.org

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Assisted dying assisted suicide Disability Meacher Bil

We Need Help to Live Not To Die.

The briefing below lays out NDYUK’s concerns about the Meacher Bill and was used at the APPG for Dying Well webinar in July 2021


Assisted suicide bills introduced at Westminster and Holyrood

Baroness Meacher speaking in the Lords

Baroness Molly Meacher, the chair of Dignity in Dying, has introduced a bill in the House of Lords to make assisted suicide legal. The second reading is expected in the autumn.

MSP Liam McArthur has laid a similar bill before the Scottish Parliament.

Not Dead Yet UK’s view

Those who support the Meacher bill and campaigners outside Parliament use the term assisted dying. That is a euphemism. This legislation would give doctors legal powers to help patients kill themselves, to commit suicide.

We don’t claim to speak for all disabled people. Some of our members used to be in favour of changing the law.

Hands cupping and surrounding wooden figures of people

But we cannot see how safeguards will work well enough for us to feel confident that a change to the law will ensure disabled people are protected. This includes protection from coercion, from feeling a burden, from limited resources or from professionals subjectively deciding our lives are not worth living.

A review of how assisted suicide legislation is operating – in Oregon, Canada, Holland and Belgium – shows our fears are well-founded.

There are no organisations run by disabled people calling for the law to change.

Disabled people are living in difficult times. Cuts to social care and health services mean we don’t get the support that we need, and the pandemic has hit us harder than any other group. We can see the argument for a change in the law; but the current backdrop means now is not the time to support the Meacher bill.

We need help to live, not help to die. The law should remain as it is and protect the majority, rather than the few who might benefit from this bill.

The issue of ‘choice’

Freedom of choice has limits; such as where choice threatens the life or wellbeing of others. Legalising assisted suicide would pressure some of the most vulnerable people to end their lives. It would set a precedent for extending assisted suicide to other groups.

Signposts pointing in opposite directions one labelled individual the other Society

Society does all it can to prevent suicidal thoughts being enacted amongst the mentally ill and those who (temporarily) feel they cannot face the future.

Those seeking a change to the law say such ideals have no place when considering severely disabled and terminally ill people. If you can take your own life without assistance, society generally strives to protect you; but, if assistance to die is needed, they argue, it should be provided.

A fundamental shift in the relationship between doctors and patients.

Doctor holding a patient's hand.

The current blanket ban on assisted suicide provides absolute protection for disabled people. Medical staff cannot suggest an assisted suicide because it’s against the law. It makes the bond of trust between patients and doctors strong.

Legalising assisted suicide will irrevocably damage that relationship.

This debate is reinforcing negative perceptions of disability. It feeds into desires for a body beautiful and a perfect life untroubled by illness.

Guilt around being a burden on the family or society

Ill and disabled people may feel that they have a duty to die. Evidence from palliative care specialists shows most people who seek assisted suicide give ‘not wanting to be a burden’ as the main reason for seeking death.[1]

Wheelchair user at the foot of stairs while people go up leaving them behind.

Some 59% of those assisted in their suicides in Oregon in 2019 stated that being a ‘burden on family, friends or caregivers’ was one of their main reasons for requesting it.[2] Some 34% of those who were euthanised in Canada in 2019 cited ‘perceived burden on family, friends or caregivers’ as one of their main reasons.[3]

Other people will face pressure from relatives to seek help to end their lives. Such pressure might be subtle, but it will be there.

This bill raises deep concerns about how disabled people are viewed by society. Many people believe people they do not know would be better off dead because of their perceptions of illness and disability.

The role of good quality palliative and social care

Those who support this bill ignore the evidence from professional medical organisations that the prognosis of date of death is extremely difficult.[4]

There are no concrete rules to determine whether a person is terminally ill and in the last months of life, or whether they are ‘suffering unbearably’.

The choice of people nearing the end of life or who are suffering might be very different if they received the palliative and social care they should get. There is no right in Britain to palliative care.

Lots of words all jumbled up with Palliative Care standing out.

With modern medicine, the cause of much of the suffering is often not the illness itself – but unmet physical, mental or social care needs.

Nearly 14% of Canadians who requested legal medically assisted suicide in 2019 cited isolation and loneliness as a factor in their ‘choice’.[5]

The vast majority of doctors specialising in palliative and end of life care do not support a change in the current law[6]. We should listen to them.

The experience abroad: Evidence of the slippery slope

The idea that we would be embarking on a slippery slope is borne out by data and experiences from countries that have introduced so-called right-to-die legislation. Most laws abroad have been expanded and restrictions loosened.

The 2002 law in the Netherlands refers to ending ‘unbearable suffering’. However, the legalisation of euthanasia in the Netherlands “has contributed to a normalization of physician-assisted dying and… an expansion of its practice”.[7]

This expansion has involved acts of euthanasia that many would regard as abuses: the expansion of euthanasia from 12-year-old children to severely disabled new-born children[8];  and an expansion from voluntary euthanasia to non-voluntary euthanasia, particularly in cases of dementia where patients are incapable of giving consent[9] and chronic psychiatric patients, from 0 cases in 2009 to 60 cases in 2016[10].

Sign saying Danger Slippery slopes keep away.

Canada introduced assisted suicide legislation in December 2015. The Canadian Government now proposes that from March 2023 patients with mental illness alone and no other underlying issues can be given medical assistance to die.

Within six years the scope of the assisted suicide legislation in Canada has been amended twice. More people are now eligible and protections weakened.

A study in Belgium found that in only half the cases in Flanders were doctors assisting suicide reporting the death to a review committee as required by the law.[11] Around14% said they didn’t report a case either because they suspected the legal requirements had not been met, or they feared possible legal consequences.

Conclusion

Baroness Meacher’s bill addresses the needs of a small proportion of the population. And the cost is too high. The provisions of the bill, with their inadequate safeguards, open the door to dangers for disabled people which may literally prove fatal.

We don’t believe any parliamentarian will be able to put their hand on their heart and say ‘no disabled people will die because this bill is robust and fully protects everyone from any type of pressure or mistake’.

References

1 Hoffenberg R. Assisted dying. Clin Med 2006672–74. [PMC free article] [PubMed] [Google Scholar]

2 Oregon Health Authority Public Health Division, Center for Health Statistics Date written February 25, 2020

3 First Annual Report on MEDICAL ASSISTANCE IN DYING IN CANADA 2019

4 PMC Journal- A Systematic Review of Predictions of Survival in Palliative Care https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999179/

[5] First Annual Report on Medical Assistance in Dying in Canada 2019

[6] BMA Survey on Physician-Assisted Dying 2020

[7] Koopman J and Boer, T, “Turning Points in the Conception and Regulation of Physician-Assisted Dying in the Netherlands”, American Journal of Medicine Vol 129, No 8, August 2016[7]

[8] https://www.proquest.com/openview/2f5f978f061e5f38e3bf34c2b4e06d50/1?pq-origsite=gscholar&cbl=47659

[9] BMC Medical Ethics https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0401-y

[10] BMC Psychiatry https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-017-1369-0

[11] Reporting of euthanasia in medical practice in Flanders, Belgium: a cross-sectional analysis of reported and unreported casesBMJ 2010; 341 doihttps://doi.org/10.1136/bmj.c5174 (Published 05 October 2010)

Categories
Assisted dying assisted suicide Disability Do Not Resuscitate Meacher Bil

A Message for DPOs

We are writing to seek your support in opposing the legalising of Assisted Suicide, which will soon be debated in both the UK and Scottish Parliaments. Although, over recent years, there have been several attempts to pass legislation to make Assisted Suicide legal in the UK, these have been overwhelmingly defeated. The UK Supreme Court also ruled against legalising assisted suicide.

The Covid-19 pandemic has been a stark reminder of how disabled people are already denied life-saving support based on their impairments. How, then, can we even contemplate legalising Assisted Suicide at this point, when we are routinely denied the resources and support to assist us in living with dignity and respect?

How can you help? At the moment, we are simply asking that your organisation signs up to the statement below. Then please email us back confirming that your organisation is supportive of this. (info@notdeadyetuk.org)

“We add our support to the growing number of disabled people’s organisations, both nationally and internationally, who oppose Assisted Suicide.  At a time in the UK when disabled people are recovering from the effects of the pandemic and facing massive cuts to social care support services and benefits, we need support to live, not assistance to die.”

Finally, below are links to some articles about why many disabled people object to legalising Assisted Suicide and how Covid 19 has highlighted the fact that the lives of disabled people are increasingly deemed to be of less value within our society.

We’re told we are a burden. No wonder disabled people fear assisted suicide; https://www.theguardian.com/commentisfree/2018/jun/01/disabled-people-assisted-dying-safeguards-pressure

6 out of 10 people who have died from COVID-19 are disabled; https://www.health.org.uk/news-and-comment/news/6-out-of-10-people-who-have-died-from-covid-19-are-disabled

Disabled people like me fear legal assisted suicide: it suggests that some lives are less worth living; https://blogs.bmj.com/bmj/2019/02/06/disabled-people-like-me-fear-legal-assisted-suicide-it-suggests-that-some-lives-are-less-worth-living/

Doctors Issuing Unlawful ‘Do Not Resuscitate’ Orders For Disabled Covid Patients ‘Outrageous’; https://www.forbes.com/sites/gusalexiou/2020/06/23/unlawful-do-not-resuscitate-orders-for-disabled-covid-patients-outrageous/?sh=66aea2f26cf1