Movers and Shakers: Assisted Dying
You might not think a discussion about changing the law to make it easier to end your life is exactly your cup of tea, but rest assured this week’s episode of Movers and Shakers is both lively and illuminating. You’re going to hear strong views expressed about the divisive issue of whether the state should step aside when terminally ill people want to end their lives with the support of their families and friends. You will also hear top notch legal analysis from two of the country’s most distinguished lawyers, former Lord Chancellor Charlie Falconer and former High Court judge Sir Nicholas ‘the judge” Mostyn.
And why is this relevant to the Parkinson’s community, I hear you ask. Well, according to Nick Mostyn, the bill put forward by Lord Falconer would exclude “Parkies” because they would not meet the definition of people with a short time to live. (One thing to note - we recorded this episode before the Labour MP Kim Leadbeater introduced her assisted dying bill and Lord Falconer withdrew his on the grounds that an MP would have a better chance of seeing a law enacted. )
We start with the Movers and Shakers giving a quick summary of where they stand. The judge, Gillian Lacey-Solymar and Mark Mardell are all enthusiasts for a change in the law. Mark says “I think on the whole that we shouldn't listen to Western Christian heritage and be more like the Romans and Japanese perhaps, and respect those who want to kill themselves.”
But Paul Mayhew-Archer is not keen on the law intervening in a process he believes is just happening anyway: “The more we insist that the law gets involved, the more difficult it becomes.”
But he is reminded that the law is already involved. Since 1961 committing suicide has not been a crime but assisting suicide has been an offence, and that has put the families, friends and doctors of people who decide to end their life at risk of prosecution and a prison sentence of up to 14 years.
Lord Falconer explains that new guidelines introduced when Keir Starmer was Director of Public Prosecutions stipulated that if people were motivated by compassion - and were not healthcare professionals - they would not face prosecution. But if someone returns from Switzerland having accompanied a friend or relative to Dignitas, they may still face an investigation: “Everybody who has gone through the process of being investigated says it is absolute hell, because they've just lost their loved one, and now they're being investigated.”
His bill - and it is expected Kim Leadbeater’s will follow a similar path - would remove that threat of prosecution under certain conditions: “It's for terminally ill people with six months or less to live, certified by two doctors, and it also needs the approval of a judge.”
But our judge is not happy with this: “Would you accept,” he asks Lord Falconer, “that people with Parkinson's who are facing a nasty end will very rarely be able to get a terminal diagnosis and thereby take advantage of your bill?” He agrees that this is indeed the case and explains why: “I am strongly of the view that the state should not be providing assistance to people to take their own life unless they are dying imminently anyway.” He gives as an example the case of someone in their thirties with a mental illness so severe that their life had become intolerable - should the state be involved in assisting their suicide?
Judge Mostyn points out that Spain recently introduced a law allowing assisted dying with one category being people with a serious, chronic and disabling condition facing intolerable suffering. “There are about 300 cases in a year - we're not talking about a lot - in Spain. And the most commonly cited condition for people seeking an assisted death is Parkinson's.”
The discussion then centres on the question of how you define intolerable suffering and who would decide whether that applied in any particular case. Switzerland appears to have the most permissive assisted dying regime, with Dignitas only wanting to know if its customers are of sound mind. Mark thinks that it would be precisely when he had lost any capacity to think or act that he would want his life ended but that, says Lord Falconer, would amount to euthanasia and would almost certainly be rejected by Parliament.
The debate rages back and forth, without reaching any firm conclusion. At one point, Paul is challenged by Gillian and Nick about the consistency of his position from an intellectual point of view. “It’s difficult to pin me down,” says Paul, “because actually, it isn't down to intellectual things, it's down to emotional things, isn't it?”
And then, being Paul, he ends the episode with a joke.
Assisted dying laws are spreading across the USA. Like most other things in life, why not follow the gold standard, rather than trying to reinvent the wheel. As a healthcare professional, I have witnessed the deaths of many. Perhaps more judges and politicians should spend a few years caring for the dying. Perhaps then they will have a full understanding of the need for assisted dying/euthanasia.
The podcast left me disappointed with the proposed Bill. It is either a cynical attempt to appear to give campaigners and the majority of the public what they are seeking but apply obstructive limitations or a cunning attempt to get assisted dying on the Statute Book with a view to making less limiting amendments in the future.