Dying with dignity through ‘assisted suicide’

Published in The Hindu on March 10, 2011

“I think suffering is much more than a medical situation. There’s this notion that suffering can be controlled by medicine and healthcare practice. I think that’s a very spurious notion,” the British Medical Journal (BMJ) quoted Pauline Smith, West Midlands NHS Strategic Health Authority as telling the unofficial commission, hosted by the independent think tank Demos. Mrs Smith is an end of life care lead for West Midlands region.

“Our view is that the current law doesn’t match the requirements of the 21st Century,” BMJ quoted her as telling the commission chaired by former Lord Chancellor and Labour peer Charles Falconer.

The commission has been set up as England and Wales are taking the first steps to facilitate assisted dying – providing assistance to someone to die. The commission “plans to produce proposals on whether the current law should be changed and, if so, in what way,” notes BMJ.

There are many who share Mrs. Smith’s views. Many doctors in U.K. are for assisted dying. A new group for health professionals called the “Dignity in Dying: Healthcare Professionals for Change” has taken on itself the task of challenging the British Medical Association and a number of royal colleges in their stance against assisted dying of terminally ill people.

“Dignity in Dying: Healthcare Professionals for Change” was set up by Ann McPherson, a fellow of the Royal College of General Practitioners.

Public support

Even the public supports the idea of assisted dying. British social attitudes survey undertaken last year found that 82 per cent people support assisted dying, according to a BMJ News item published on October 5, 2010.

Assisted dying is different from euthanasia; it is not a doctor but the patient himself who administers the lethal dose to kill himself in the case of assisted dying. The doctor’s role is limited to prescribing a life-ending dose of medication to a mentally competent, terminally ill adult at his request.

Assisted dying is currently illegal in England, and doctors who help patients to die are committing an offence. The 12-member commission will be submitting its report by the end of the year.

Even as it is illegal in England, many patients travel from U.K to Switzerland for assisted dying. While assisted dying or assisted suicide is not illegal in Switzerland, people in U.K who have helped the patient to travel to Switerland can be punished.

According to the New York Times, as on September 23, 2009, more than 100 terminally ill or severely disabled Britons have travelled to Switzerland in recent years for assisted dying.

But it is not Switzerland alone that has legalised assisted dying. Even in the U.S. where destroying embryos for harvesting embryonic stem cells is not permitted using Federal money, the State of Oregon legalised it in 1997. Washington State followed Oregon’s footsteps and legalised assisted dying in November 2008.

Number of deaths

About 460 patients have taken advantage of the “Oregon’s Death with Dignity Act” and ended their lives between 1998 and 2009. In the case of Washington State, 11 people have ended their lives within six months of the law coming into force.

According to a paper published in the New England Journal of Medicine (NEJM), there were 23 who got legal prescriptions for lethal medications in Oregon in 1998, the first year when doctors could legally assist people to die; 15 of the 23 actually used the lethal medications and ended their lives.

A News item in BMJ states that in 2009, 55 physicians wrote 95 lethal prescriptions. Only 59 people actually took the lethal prescription to its logical end by ending their lives.

Three other countries excluding Switzerland have legalised assisted dying — Belgium, Luxembourg and the Netherlands.