Monday, 30 January 2012

Event report: Philip Satherley - 'The Case for Assisted Dying'

Time: 19 January 2012, 19:00-21:00
Place: Ramsay LT, Christopher Ingold Building, University College London

We invited Philip Satherley, the Research and Policy Officer of Dignity in Dying (DiD), to give a talk on assisted dying.

DiD is a UK organisation campaigning for the legislation of assisted dying for terminally ill, mentally competent adults. They work alongside Compassion in Dying, a partner organisation focused on informing and supporting terminally ill individuals concerning their current choices and rights at the end of life.

To introduce the topic, Satherley sought to clarify what is meant by assisted dying, and its definition relative to similar concepts:
  • Assisted dying applies to terminally ill, mentally competent adults who are medically deemed to have less than 6 months to live; and who have met strict criteria and safeguards, including psychological tests. This involves the patient receiving life-ending medication, which they will self-administer at their own will - quite often this is done at a very advanced stage in their terminal illness. Assisted dying is practiced legally in Oregon and Washington. 
  • Assisted suicide applies to not only terminally ill individuals, but also chronically ill and disabled individuals who wish to receive assistance to terminate their life. This is legalised in Switzerland. 
  • Voluntary euthanasia allows a medical doctor to administer life-terminating medication - usually injection - directly to the patient. Strict safeguards and tests are still undergone. Voluntary euthanasia is practiced in the Netherlands and Belgium. 
  • Non-voluntary euthanasia applies to cases where the patient has lost all mental capacity, yet a third-party administers life-ending medication without the explicit consent of the patient. This is not to be confused with involuntary euthanasia, which is when euthanasia is performed against the will of the patient. While illegal all across the world, non-voluntary euthanasia is practiced in the Netherlands under the Groningen Protocol.
Satherley stressed that DiD campaigns for assisted dying only, specifically addressing critical safeguards such as appropriate mental capacity, 18 years of age, the patient having a terminal illness and voluntarily and repeatedly having requested assisted dying.

Two examples of personal stories illustrate the types of cases DiD works with:
  • Waltraud Coles: Waltraud's husband wrote to DiD telling them about his wife's struggle with advanced secondary progressive multiple sclerosis. Due to excessive fatigue and severely limited mobility, severe side effects from partially effective pain relief, and an onset of pneumonia, she self-terminated her life by refusing all foods and water for 19 days. Her last words were: "Society is making me die in this abysmally cruel way. Society is anybody who cannot be bothered to lift one single finger to change this (current) inhumane law, and thus give completely helpless people like myself, in the very advanced phase of a degenerative illness, no other legal option (than starvation) when we want to end the unbearable daily ordeal which is all that is left of our 'life'."
  • Geraldine McClelland: A member of DiD, Geraldine contacted the organisation when she was informed of her terminal illness - lung and liver cancer metastasised from breast cancer. On the day of her death, she wrote a letter to DiD, detailing her actions and what she believed needed to be changed in UK legislation regarding assisted dying. Her condition, which involved serious breathing problems, had confined her to her home. She wanted the option to take life-ending medication to terminate her life surrounded by friends and family. However, as UK laws prevent this, she travelled to Dignitas, an assisted dying organisation in Switzerland. As she could not die in her own country, she pleaded for the UK laws to be changed such that other people would not need to travel abroad in order to die. 
Importantly, and also expressed by Waltraud Coles, Geraldine believed loved ones should not be in a position of breaking the law in such situations. Debbie Purdy, suffering from multiple sclerosis, won a significant case through the House of Lords where she succeeded in arguing that the partner of a terminally ill patient should not be prosecuted when accompanying them abroad for assisted dying.

Satherley proceeded to summarise why DiD strongly believes laws should be changed to allow assisted dying in the UK:
  • Personal autonomy: as Sir Patrick Stewart, one of the patrons of DiD, put it - "We have no control over how we arrive in the world, but at the end of a life we should have legal control over how we leave it."
  • Research from Oregon: approximately 40% of patients receiving life-terminating medication choose not to use it, but consider the option a great comfort or an 'insurance policy'; most patients are well-educated, medically insured (i.e. no financial difficulty), had no prior disabilities or mental illness, and had cancer as the underlying cause of illness; and while some had symptoms of depression, all patients receiving assisted death had full mental capacity and were able to make rational decisions. 
  • Opinions of the general public: the 2010 British Attitude Survey (BAS) found that 82% of the general public supported assisted suicide, and the 2008 BAS found that 80% supported assisted dying. 
  • Opinions of religious people: breaking down the survey between religious and non-religious people, the 2010 BAS found that 92% of non-religious people supported assisted dying and assisted suicide, while 72% of religious people did the same.

One important question that was raised during the following Q&A session was why DiD campaigns for assisted dying, specifically, and not the other forms of euthanasia. Satherley stressed the importance of having safeguards in place, e.g. ensuring that the patient has a terminal illness, and not a chronic illness or disability which may be open for improvement of life quality. Moreover, DiD believes it is essential that physicians are involved as there are problems with taking the procedures out of the medical system; and that voluntary euthanasia ultimately takes the final decision out of the hands of the patient by - to an extent - forcing the practitioner to end an individual's life. 

DiD campagins for what the UCLU ASHS believes is a very important cause, and they are always looking for people to get involved. If you want to join the campaign, they can be found on Facebook and Twitter.

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