A Question of Public Safety.

A fundamental reappraisal is needed of the concept of safeguards for ‘assisted dying’.

In this paper published today, co-Chairs of Living and Dying Well Baroness Finlay and Lord Carlile have called for the issue of safeguards to be placed firmly in the centre of the ‘assisted dying’ debate.

They have highlighted the need for “a fundamental reappraisal of the assumptions underlying the campaigners’ proposals for ‘assisted dying’”.

What is needed, they argue, is “to move away from the presumption underlying much of the campaigning that an ‘assisted dying’ law is inherently desirable and that, while safeguards to protect the majority are obviously needed, they are of secondary importance to giving choice to a minority”.

They continue:

“If Parliament is to be asked to consider legislating to allow the deliberate bringing about of the death of seriously ill people, public safety rather than personal choice must be the paramount consideration”.
The authors highlight serious weaknesses in the ‘safeguards’ that have been proposed to date and indicate what needs to be done to remedy these.

In addition to addressing specific areas of concern – areas which were highlighted six years ago by a parliamentary select committee but have been ignored by the campaigners – they argue that any new proposals to legislate for ‘assisted dying’ should not involve health care professionals either in the assessment of applicants or the prescribing of lethal drugs. They write that “the only connection between ‘assisted dying’ and a profession dedicated to supporting rather than ending life is that doctors treat seriously ill people and they have access to lethal drugs” .

Most doctors, however, would be unwilling to participate in ‘assisted dying’, leading to ‘doctor shopping’ and postcode lotteries. More important still, given the trust that exists – and must exist – between patients and their doctors, “embedding ‘assisted dying’ in health care could easily encourage patients who are less than wholehearted about the project to suppose that it is like any other medical treatment, that it is being offered for their good and that, notwithstanding any reservations they may feel about it, it is probably for the best – otherwise why would any doctor agree to proceed with it?”
The authors conclude that, “if ‘assisted dying’ were ever to be legalised, it should be as a highly exceptional event resorted to only by persons whose circumstances are themselves highly exceptional”. Whether any law could succeed in achieving this state of affairs is debatable, but “where what is at stake is the deliberate and premature ending of human life there is a need for a very high level of safety assurance – much higher than would be derived from the safeguards so far proposed”.


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