Assisted dying should be legalised for terminally ill people so long as they are not put under pressure to end their lives and palliative care is much improved, a major inquiry has concluded.
Even with high-quality care some people experience suffering towards the end of life they consider can only be relieved by ending their life or by knowing that they can end it when they choose, found the Commission on Assisted Dying.
This meant there was a “strong case” on ending the current prohibition on assisting another’s suicide, concluded the commission, which was set up and supported by think-tank Demos, chaired by former Labour Lord Chancellor Lord Falconer, and included experts from across health, social care and policing.
It found that the current legal framework around assisted suicide was “inadequate, incoherent and should not continue”. Its criminal status did not allow for open discussion with professionals and support for people contemplating assisted suicide, while there was “significant concern” that assisted suicide remained an “amateur activity” with no safeguards for people seeking help with dying.
At the same time, there had been no prosecutions for assisted dying since a policy was issued by the Director of Public Prosecutions in February 2010 stipulating when prosecutions should take place.
Under the commission’s proposals, an assisted death by lethal medication should be available to adults with a terminal condition likely to result in death within 12 months, who have a settled desire to die, have the mental capacity to make the decision, are not being coerced by family members or professionals and have been fully informed of all treatment and care options. It said safeguards were needed because of the risk of people being pressured into ending their lives.
Two doctors, who were independent of each other, would need to assess the individual and decide whether the patient met the eligibility criteria, with one doctor made responsible for prescribing the medication and certifying the death. Further safeguards would include that the person take the medication themselves, with appropriate practical support, and the existence of a national monitoring commission to review every case to ensure compliance with the law and investigate problematic cases.
However, it said that any new legal framework had to be underpinned by a much improved end-of-life care system.
The commission found that there needed to be better and more uniform access to end-of-life care across the country and client groups, warning that people with life-limiting conditions other than cancer and those with mental health problems or learning disabilities were at particular risk of poor care.
Help the Hospice chief executive David Praill welcomed the emphasis on improving palliative care, adding: “It is vital that people facing terminal and life-limiting illnesses are aware of and able to access the tailored care and support that hospices provide to people with a wide range of needs, conditions and ages. However, there are still too many people who could benefit from such care but are not receiving it. It is estimated that there are 92,000 people with unmet palliative care needs each year – some of which could be met by hospices.”
The commission, which was set up in September 2010, has faced questions over its impartiality on the basis that it was funded by advocates of a liberalisation of the law – author Terry Pratchett and businessman Bernard Lewis and its establishment by Demos was brokered by pro-reform campaign group Dignity in Dying.
Demos said that Lewis, Pratchett and Dignity in Dying had no further involvement in the running of the commission. However, a number of groups opposed to reform, such as the British Medical Association, declined to participate in the inquiry.
It received 1,200 pieces of evidence and heard public evidence from 46 experts and individuals with relevant experience of the issue. Its recommendations were signed up to by 10 of the commission’s 11 members, the exception being Reverend Canon Dr James Woodward, a former hospital chaplain, who concluded that a change in the law was not appropriate.
What do you think? Have your say on CareSpace.
Keep up to date with the latest developments in social care and sign up to our daily and weekly emails.