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Assisted Dying Bill: can you really tell if someone's of sound and settled mind for suicide?

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'Assessing mental capacity isn't like checking the oil level in a car: it's a complex business' - an article by Sheila Hollins

In an article for The Telegraph, former president of the Royal College of Psychiatrists Baroness Sheila Hollins has voiced concern that proposals to license doctors to supply lethal drugs to mentally competent, terminally ill patients fail to take account of the complex process involved in assessing a patient's mental capacity. According to Baroness Hollins, assessing mental capacity "isn't like checking the oil or water level in a car" or "the sort of thing that can be done in a single consultation, especially if the decision in question - as it is in this case - is one with life-or-death consequences."

Commenting on the US State of Oregon, where assisted suicide is legal and which is the model for current proposals before Parliament, Baroness Hollins writes:

"Researchers have found that some patients who have ended their lives under the terms of Oregon's assisted suicide law had been suffering from clinical depression. Depression impairs decision-making capacity, it is common in elderly people and it is treatable. But in some cases in Oregon it has not been diagnosed by the doctor who assessed the patient's capacity and prescribed lethal drugs. Oregon's law requires referral for psychiatric examination in cases of doubt but in some cases that has not happened."

Baroness Hollins also speaks from personal experience: 

"People do change their mind. This happened to a friend dying of motor neurone disease who told me 6 months before his death, that he would gladly take a lethal prescribed drug if it was available. Much closer to his death, when he was very frail and incapacitated, he confided that it had been a precious journey and he had so valued the closeness and closure that this time had brought him. He died gently and peacefully having learnt to let go.

We would do well to remind ourselves what the law is there for. It's there to protect us, all of us and especially the most vulnerable amongst us, not to satisfy the determined choices of a vocal minority."

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