Leading article: An issue of dignity that can no longer be avoided

Even with all the benefits of medicine, the terminally ill may face extreme pain and indignity
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The Independent Online

Assisted suicide is a peculiarly divisive issue, one that raises profound and difficult questions about everything from medical ethics, to family dynamics, to the ultimate expression of individual choice. But the complexity of the subject must not be used as an excuse to avoid addressing the concerns of those who are ill.

According to the Commission on Assisted Dying, a terminally ill person with less than a year to live should be able to go to their GP for help in taking their own life – providing that they are aged over 18, of sound mind and have reached their decision voluntarily. Unsurprisingly, given the sensitivity of the issue, the recommendations have provoked a storm of protest. But they are still the right ones.

Critics start with allegations of bias in the commission itself. It was set up by Dignity in Dying, a lobby group, and paid for by the author Sir Terry Pratchett, who has Alzheimer's disease and has long campaigned for changes in the law to allow assisted suicide. Both the commission's chairman – Lord Falconer, the former Lord Chancellor – and a significant proportion its members are also well-known advocates of reform. With such membership, critics ask, is the conclusion that there is a "strong case" for changing the law any surprise?

It is a point worth making. But only to put the findings into context. To suggest that it undermines the whole exercise is a step too far and a distraction. Of much greater substance are the concerns that any legal changes which admit suicide as an option would be open to abuse.

The risk that a dying person might be pressured into taking their lives is, of course, one which cannot be glibly dismissed. It is also difficult to control: there are many forms of pressure, and fears of "being a burden" can be easily, and covertly, kindled, particularly in the older generation. These are complex issues indeed. But to claim, as some people are this week, that even to discuss the question is a moral corruption that opens the door to abuse is to be guilty of moral cowardice.

More useful are the commission's suggestions about what a well-framed law might look like. The suggested model includes a GP assessment to ensure that the patient is of sound mind, and that their decision was voluntary, to be verified by another doctor. There should also be a two-week "cooling off" period, to give the person an opportunity to change their mind. And although the doctor would be present, the patient must be required to administer the lethal drugs themselves. All are sensible recommendations.

The strongest argument for change, however, is the reality of the current state of affairs. As the commission rightly notes, the law as it stands is "incoherent". Under the 1961 Suicide Act, it is illegal to help someone to take their own life, with a possible jail term of up to 14 years. But the Director of Public Prosecutions issued guidelines in 2010 setting out factors to be taken into consideration when making a judgement, and since then there have been no prosecutions. It is hard to see how such an ad hoc situation constitutes a better protection of the vulnerable than a system that admits to allowing assisted suicide and carefully polices it through the involvement of doctors.

Ultimately, of course, the question is one of dignity and free will. Even with all the benefits of modern medicine, people with terminal illnesses may face extreme pain and loss of independence in their final weeks and months. It is only fair that they have a choice.

As the number of people travelling to "suicide clinics" in Europe continues to rise, it is no longer defensible to claim that the ethical issues involved are too complex for public policy to take on. The Commission on Assisted Dying has made a brave start. Now the debate must move to Parliament.