Despite the backdrop of COVID-19 and the emphasis on caring for the most vulnerable in society, an old issue is firmly back on the political agenda. Assisted dying (assisted suicide and euthanasia) is being debated in different jurisdictions of the British Isles, with some MSPs and MPs planning to bring Private Members’ Bills to Holyrood and Westminster in the near future. Assisted suicide is the prescription of lethal medication to a patient at their request to allow them to end their life at a time of their choosing. Euthanasia is the prescription and administration of lethal medication to a patient to end their life. The introduction of assisted suicide and euthanasia would not simply affect a small number of patients and doctors but all patients and all doctors.
Jersey is currently holding a Citizens’ Jury on the issue of assisted dying. This is a method of considering a complex topic by a small, representative group of people. It was established by the Minister of Health for Jersey after public support for assisted dying was indicated by an e-petition and surveys of public and doctors’ opinions. The question for the jury is ‘Should assisted dying be permitted in Jersey and, if so, under what circumstances?’ and is being considered by 23 Jersey citizens who have been chosen at random but have been stratified to be representative of the population. Over the course of ten sessions, the jury members hear evidence from expert witnesses and have time to ask them questions. After the evidence has been heard, there is time for deliberation on the issue and then the jury will reach a final decision. They will also make final recommendations which will form a report to the States Assembly. The Assembly is the decision-making body that can change legislation and is expected to consider this in late 2021. In 2018, a proposal to develop recommendations for assisted dying legislation in neighbouring Guernsey was defeated by 24 votes to 14.
In Ireland, a Bill to legalise assisted suicide and euthanasia has been proposed by Gino Kenny TD. Currently, both assisted suicide and euthanasia are illegal in Ireland, but the Dying with Dignity Bill 2020, which would legalise assisted dying, passed its second stage in the Dáil by 81 votes to 71 in October 2020. However, it still must pass its final stages to become law. In response, there has been huge opposition from Irish palliative care consultants and other health care professionals. In a letter to the Irish Times, they argued that those marginalised in our society – the elderly, the disabled and those with mental illnesses – may be harmed by the legislation. They feared that some may feel under pressure to have euthanasia to stop being a burden on their family. They said that many people do not know how excellent palliative care can ease distress and address fears and sadness. They concluded, ‘We are convinced that as dying with dignity is already present within healthcare in Ireland, no change to our current laws is required.’
We need a similar response by doctors and nurses who are opposed to assisted suicide or euthanasia in the UK to make clear their opposition. A campaign called Our Duty of Care has been launched by Care Not Killing to bring together healthcare professionals to:
- state the value and worth of the lives of disabled and dying people;
- preserve the trust in the doctor- and nurse-patient relationship;
- protect the vulnerable from being pressurised to take their own life; and
- prevent future extension to children, psychiatric illness and dementia.
The campaign is administered by David Randall, a specialty registrar in renal medicine working in London, and myself, a former palliative medicine registrar based in Scotland. We would be delighted to talk with you about our ideas and listen to yours. Our team can help you raise the issue in your place of work. We need a grassroots campaign where this dilemma is discussed in GP practices, hospital wards and medical schools. We want doctors and nurses to have their say and be heard. It will be ordinary doctors and nurses who will end up delivering this. Many want no part in it. This issue can be won, but we need a groundswell of grassroots support.
Please sign up at Our Duty of Care.
Dr Gillian Wright is a former palliative medicine registrar now working in medical ethics. She lives in Glasgow and works for Care not Killing as a researcher.