Assisted dying 'does not worsen end-of-life care'

4 months ago 21

A patient with a care workerImage source, Getty Images

By Nick Triggle

Health correspondent

End-of-life care has not become worse in countries which have allowed assisted dying, MPs say.

The House of Commons' Health and Social Care Select Committee said there is even evidence it has led to better support with more money being invested.

But the cross-party group of MPs did not rule in favour or against a change in the law in England, saying it only wanted to inform debate.

It said hospices here needed extra money as access to care was patchy.

Currently hospices only receive a third of their funding from the NHS, despite providing the majority of the palliative care.

The committee's review looked at places where assisted dying for the terminally ill is allowed, including parts of the US, as well as Australia, Switzerland and New Zealand.

In England and Wales, the 1961 Suicide Act makes it an offence to encourage or assist someone to take their own life.

Separate laws in Scotland and Northern Ireland prevent dying people asking for medical help to die.

Despite some expressing concern that a change in the law would lead to poorer support at the end of life, the committee's report said, if anything, it was linked to improvement in the countries which have taken the step, with evidence showing the alterations resulted in extra investment in palliative care.

The 83-year-old Childline founder and broadcaster, who has stage four cancer, has called for a free vote for MPs in Parliament.

She told BBC Breakfast people should have a choice about "the way we want to end our lives".

"We don't want our families memories to be overwhelmed by the memory of us in pain, suffering."

She added she had a "very narrow choice" as if she wanted to end her life and go to Dignitas she would have to do it without her family there as they could be accused of conspiring to bring about her death.

Over the last eight years, more than 250 people have travelled to Dignitas to end their lives, according to the clinic.

'Law change would give dying control'

Image caption,

Sophie Blake is living with cancer

Sophie Blake was diagnosed with stage four breast cancer in 2020 when she was 49. The cancer has spread to her lungs, liver, abdominal lymph nodes and pelvis and is incurable.

She has always supported people's choice to end their lives after seeing friends and family die in pain.

"I always thought that's so cruel, why would we subject people to end up in so much untreatable pain when the meds can't even touch the sides because we're not allowed to help them [end their lives]?"

Since her diagnosis, Sophie says she is hoping for the best, while preparing for the worst. A priority for her is that her 16-year-old daughter Maya does not see her suffer.

"I don't want that to be her lasting memories, seeing her mum in horrendous pain," she says.

Sophie says knowing there was a choice to end life would help many terminal patients.

"So many people would benefit psychologically knowing that there would be a form of help when the time comes if needed," she said.

"It would give you that final control at the very end, to have a good death rather than a death of suffering."

The committee also highlighted problems and confusion with the way the current system works for doctors, saying it was not clear whether they could provide medical evidence for people who wanted to go abroad to die.

Guidance from the General Medical Council says providing access to patient records is allowable under the Data Protection Act.

But the British Medical Association (BMA) advises doctors against producing medical reports to facilitate assisted suicide.

It also said the government needed to consider how it would handle changes in the law in places such as the Isle of Man and Jersey, which are currently considering the issue.

Select Committee chairman Steve Brine said he wanted the report to have a "lasting legacy" by providing evidence for future debates on the law.

But he said assisted dying was the "most complex" issue at which the committee had looked.

The report pointed out that even what term to use is contested, with the committee referring to it as assisted dying/assisted suicide. It defined this as doctor-assisted deaths, including self-administration of a lethal drug as well as where the doctor gives it, which is often referred to as euthanasia.

Both the BMA and Royal College of Nursing have neutral positions on assisted dying.

The government says any change is a matter for Parliament - and has indicated it would allow a free vote on it.

Numerous attempts have been made to alter the law over the years - the most recent in 2021.

The law has also been challenged in the courts, with a number of people with terminal and life-limiting illnesses putting their case for a right to die.

Dr Gordon Macdonald, of anti-assisted dying campaign group Care Not Killing, said he was disappointed the committee did not come out against assisted dying.

He said he believed there were "many problems" with changing the law, including that limits on who qualifies could in time be lifted to include people with disabilities, those with non-terminal health conditions and problems such as dementia and depression.

The MPs should have "firmly shut the door" on "state-sanctioned killing", he added.

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