The Simon Heng column

    Sometimes, when people meet me for the first time, I get the
    response “I don’t know how you manage to keep going. If I couldn’t
    take care of myself, I’d kill myself”. This is a visceral response:
    when they see how disabled people actually live, people usually
    change their minds. When faced with the reality of their own
    disability, people do find some way of constructing a new life for
    themselves, eventually. But I think that most people suffer
    post-traumatic stress when they become disabled.

    With the passing of the Mental Incapacity Bill last month and
    the High Court judgment on a local authority (through its
    vulnerable adults protection procedure) applying to prevent a
    terminally ill woman from getting an assisted suicide, the legal
    capacity to quicken the end of one’s life because of illness or
    disability has come closer to being a reality.

    The new legislation merely recognises that people are often de
    facto assisted to die, because they would have an unacceptably poor
    quality of life through pain, distress or incapacity: doctors and
    carers are constantly making life and death decisions about
    treatment and care, for people who can’t communicate their wishes
    at the time. The Mental Incapacity Act puts the decision-making
    firmly where that decision should belong – with the individual.

    I know that there is a strong possibility that my health will
    deteriorate earlier than most people’s, and that I’ll have a real
    choice whether I want to live with increasing pain and distress. At
    the moment, I have no thoughts about ending it all; I have worked
    too hard to survive and to have a reasonable quality of life. But I
    don’t pretend to speak for everyone in my situation.

    But where does this leave local authorities, with a duty of care
    for vulnerable individuals? We need to ensure that an individual
    isn’t being pressurised into a decision because they are a “burden”
    on their family. On the other hand, how do you decide whether
    someone’s decision to hasten the end is a reasonable one, or
    an emotional reaction which might change?


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