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Assisted dying assisted suicide Disability Meacher Bill

We would not take patients’ lives’

Medics write a letter to Health Secretary against Assisted Suicide Bill which would let clinicians provide legal drugs for terminally ill people

By Christopher Hope,  CHIEF POLITICAL CORRESPONDENT and Maighna Nanu Daily Telegraph

Nearly 1,700 doctors have written to Sajid Javid to oppose weakening assisted suicide laws, saying they will refuse to help patients take their own lives.

The intervention comes ahead of Friday when peers are expected to pass a Private Members’ Bill through the Lords which would allow doctors to provide lethal drugs to terminally ill people who want to end their lives.

Boris Johnson, the Prime Minister, and Mr Javid are understood to be against weakening the law – but the peers’ Bill is expected to go to the House of Commons within months when it will probably be put to a free vote of all MPs.

‘Enormous’ shift ‘should not be minimised’

The letter – signed by 1,689 doctors and sent to the Health Secretary on Tuesday – said: “The shift from preserving life to taking life is enormous and should not be minimised.

“It is impossible for any government to draft assisted suicide laws which include legal protection from future extension and expansion of those laws.”

They added: “Any change would threaten society’s ability to safeguard vulnerable patients from abuse, it would undermine the trust the public places in physicians, and it would send a clear message to our frail, elderly and disabled patients about the value that society places on them as people.

“Far from one person’s decision affecting no one else, it affects us all. Some patients may never consider assisted suicide unless it is suggested to them.

“The cruel irony of this path is that legislation introduced with the good intention of enhancing patient choice will diminish the choices of the most vulnerable.”

Signatories include Professor Johann de Bono, a professor in experimental cancer medicine at the Institute of Cancer Research; Prof David Galloway, the former president of the Royal College of Physicians and Surgeons of Glasgow; and Rob George, professor of palliative medicine at King’s College London.

They conclude: “We would not take patients’ lives – even if they asked us to – but for the sake of us all, and for future generations, we ask that the law remains unchanged.”

Concerns dismissed by Baroness behind the bill

It comes after the British Medical Association, the biggest union of doctors, dropped its opposition to assisted dying last month and adopted a neutral stance.

Baroness Meacher, pictured here speaking in the House of Lords, is the peer behind the Bill

The doctors’ concerns were brushed aside by Baroness Meacher, the peer behind the Assisted Dying Bill, who said: “It is always easy to find a list of people to support any position.

“More significant is that the BMA last month ended its opposition to assisted dying following their survey of their members showing a majority of doctors in favour of assisted dying.”

The Royal College of Physicians said it was neutral on the issue in 2019.

Recent research from the pro-assisted suicide campaign Dignity in Dying found that up to 6,500 terminally ill people try to take their own lives every year because of a ban on assisting their death.

Mr Javid declined to comment.

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Assisted dying assisted suicide Disability

BMA Goes Neutral

Doctors and medical students at the BMA annual representative meeting on the 14th of September passed, by a narrow majority, a motion which said: ‘In order to represent the diversity of opinion demonstrated in the survey of its membership, the BMA should move to a position of neutrality on assisted dying including physician-assisted dying.’

The motion was carried by 49 per cent of representatives, with 48 per cent against and 3 per cent abstaining.

This supersedes the association’s previous policy of opposing assisted dying, which had been in place since 2006. Being neutral means the BMA will not support or oppose a change in the law.

Separately, the BMA representative body passed another motion calling for ‘robust conscience rights’ to be included in any future legislation on assisted dying in the UK, meaning healthcare workers should be able to object conscientiously to participating in assisted dying.

The move to a position of neutrality comes after the association polled its membership on the issue last year. When asked about a change in the law to permit doctors to prescribe life-ending drugs to eligible patients, the survey found:

  • 40% of surveyed members said the BMA should actively support attempts to change the law, one in three (33%) favoured opposition and one in five (21%) felt the BMA should adopt a neutral position
  • Half (50%) of surveyed members personally believed that there should be a change in the law to permit doctors to prescribe life-ending drugs. 39% were opposed, with a further 11% undecided.
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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 Meacher Bill

We need your help.

The Meacher Bill

We need to ensure that the Meacher Bill fails to attract the necessary support in Parliament. We need your help to contact and persuade Peers and MPs of the dangers this Bill poses to many disabled people.

Letter writing, social and broadcast media work and direct contact with MP’s and Peers are critical.

We have drafted a letter you could use as a template to contact your MP.  Please feel free to edit to suit your purposes.

MP Letter Template

BMA

The BMA is due to debate assisted suicide later this year. It is crucial that they stay neutral or, if possible, are persuaded to oppose a change in the law. We need you to engage with your GP’s and other medical practitioners to express your concerns.

This is why we need a strong campaign to defeat this latest attempt to legalise Assisted Suicide.

Peter Thomas, 47 from Birmingham says, “I’m fearful of others, including some medics, questioning why I haven’t opted for assisted suicide”.

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Assisted dying assisted suicide

Great News for Not Dead Yet UK

Not Dead Yet UK has always been a small “but beautifully formed’ group dedicated to fighting for the rights of disabled people, specifically to prevent a change in the legislation around assisted suicide.

We are pleased to announce that Zeynab Al-Khero has joined our growing group of supporters as a freelance consultant. Her passion is human rights and humanitarianism after getting to know and working alongside our founder Baroness Jane Campbell she has decided to commit her considerable talents to support the work of Not Dead Yet UK.

Zeynab will concentrate on research and provide us with important data and insights that we can then deploy to support our work and our campaign.

Zeynab has a Post Graduate Diploma in Legal Practice and has previously volunteered for the United Nations Conference for Trade and Development.

We are pleased and delighted to welcome Zeynab to the group.

Categories
Assisted dying assisted suicide

BMA to Discuss Assisted Dying

As a result of the pandemic, the BMA postponed discussing the survey results on assisted dying in 2020.

The BMA stated, “The intention has always been to allow time for thorough, in-depth debate on this issue, and therefore, after careful consideration and consultation with members, it was decided that assisted dying should not be debated or voted on during this year’s (2020) one-day meeting. Instead, it will be debated at the next full ARM in June 2021”.

Not Dead Yet UK is totally opposed to a change in the law on assisted dying. We are formulating plans to contact GP’s to persuade them to remain opposed to assisted dying in order to protect their vulnerable patients.

We will contact all Not Dead Yet UK supporters over the coming days to share our plans and to seek support.

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Assisted dying assisted suicide

BMA survey published in June 2020

Several of our supporters have mentioned their concerns about the recent RCGP poll which although it maintained its opposition to a change in the law on assisted dying the overall support was reduced.

A majority of GP’s voted to oppose any change in the law as against those supporting a change (47% to 41%) but the 47% had apparently dropped from 77% in 2013. Campaigners for assisted dying are capitalising on the fact that if you take account of the votes for a position of neutrality (11%), the proportion supporting the status quo is actually in the minority.

The RCGP has stated they will not have another poll for five years unless there are ‘significant developments’ on the issue.

The British Medical Association (BMA) are planning their own poll which they will report on at their conference in June later this year.

It is clear that we must take every opportunity to ensure that doctors understand our vigorous opposition to a change in the law on assisted dying.

  • Is your GP aware that you have serious concerns about a change in the law on assisted dying?
  • Have you discussed how vulnerable you feel?
  • Have you discussed the damage that could be caused to the patient/doctor relationship if assisted dying was legalised?

For more information about the recent RCGP poll follow these links: –

https://www.rcgp.org.uk/about-us/news/2020/february/royal-college-of-gps-remains-opposed-to-change-in-the-law-on-assisted-dying.aspx

https://www.bmj.com/content/368/bmj.m708.