I AM in the strange position of being a doctor who has known what it’s like to be made miserable – suicidal even – by chronic pain. Let’s suppose that Lord Joffe’s Bill to allow people to be given help to end their lives had not been blocked by the House of Lords in 2006. Not long after that, if I’d had a terminal illness and a GP who had left me some medical poison, then I would not be here to write this now. I would never have known that I was going to quickly move from severe pain to moderate pain and hope. My three teenage children would have lost their dad. My beloved wife would have lost years of life with me.
Well, it seems to work fine in Switzerland, you might say. Don’t they have a clean, safe law to assist the suicidal? My wife is a Swiss GP. Last year she was working in the region of the Dignitas clinic. On a home visit she found an old man cowering in the corner. He quivered as he asked her: “Doctor, have you come to kill me?”
For years I have been asking senior Swiss doctors what they think of their assisted suicide law. All of them are embarrassed. A Zurich doctor said it greatly confuses and weakens good care of the dying. British doctors on the other hand are world leaders in giving hope for a good death. Time and again studies have shown euthanasia is not practised here, though it would be easy to do so in secret.
I was once visiting a patient who knew she would soon join the near 500,000 Britons who die naturally each year. On her TV, the House of Lords were debating assisted dying. As I concentrated on writing up my notes by her chair, I felt a skinny hand laid on mine. “Doctor,” she wheezed. “You haven’t come to do that to me have you?”
What kept me from “helping” her to die? Was it her wish to live? No, I could have injected her and no one would ever have known. That’s what official Dutch government reports demonstrate happens in Holland – over a 1,000 a year. What? You mean they kill patients without knowledge or consent? Yes. And 14 per cent of these were fully competent to decide.
Lord Falconer’s Bill on assisted dying, which receives its second reading in the House of Lords on Friday, would be like forcing a wedge into the join of a closed door. It would open a crack in the law against murder. The forbidden work of medical killing could then begin. Lord Joffe plainly said in 2006 that a limited law was just the first step towards full euthanasia.
The euthanasia lobby seek to reassure us that it will not be full euthanasia like Holland has. It would be nearer the law of Oregon in the United States, one of a tiny number of jurisdictions on earth that have legalised medical killing. But the figures from Oregon teach us that leaving people poison often fails to kill them. In about one in five instances they vomit the drug or just go to sleep. It leaves the doctor to complete the deed, which promptly becomes full euthanasia. Oregon also teaches us that Lord Falconer’s idea to kill only those of sound mind will be actively extended beyond the limits of the law, such as to killing the depressed.
Falconer’s emollient words sound safe enough. There will be two doctors who each have to independently confirm that the patient is terminally ill and had reached their own, informed decision to die. But recent widespread flouting of the Abortion Act’s similar requirement shows us how easily over-ridden this assessment process is. We are told the right to die will only be offered to patients of sound mind – yet there will be no psychiatrist to make that difficult assessment. It’s only for those with less than six months to live – but that discriminates against those who live longer, like Leeds man Paul Lamb who was recently, and wisely, refused the right to be killed.
The Falconer Bill will not help him, but once it is passed in Parliament, how long will it be before there are calls to extend it to cases such as his? The present laws are a closed door against abuses of medical power. Our world-leading care of the chronic sick and terminally ill dignifies the sober realities of disease and dying. I want these safe laws to go on covering me and my family for the rest of our lives. It’s not the natural deaths that trouble me, but the unnatural.
Dr Mark Houghton is a GP in Sheffield.