We are repeatedly told by those who want to see assisted suicide legalised for terminally ill people that there will be "upfront" and "stringent" safeguards. Lord Falconer's recent Private Member's bill therefore provides an opportunity to see just how upfront and stringent are these safeguards are.
A report by eleven Peers, published today by Living and Dying Well, is quite clear in the matter. "The bill", it says, "contains no safeguards, beyond stating eligibility criteria, to govern the assessment of requests for assisted suicide". This, it says, is "wholly inadequate for a bill, such as this, with life-or-death consequences". Questions such as how mental capacity, clear and settled intent and freedom from coercion are to be established are "critical and integral" aspects of any decision by Parliament to license doctors to hasten the deaths of some of their patients. "They cannot be pushed aside for consideration later as administrative matters". "While detailed codes of practice may well be necessary in the event that the bill were to become law", says the report, "a decision to enact such a law cannot responsibly be taken without at least the nature of the assessment process being disclosed". "This lack of transparency regarding crucial issues of safety", the authors conclude, "raises serious doubts as to the bill's fitness for purpose".
In their analysis the Peers note that Lord Joffe's 'assisted dying' bill, rejected by Parliament in 2006, had specified some minimum requirements for assessing requests for assisted suicide; and they observe that it might reasonably have been expected that Lord Falconer's bill would try to improve on the safeguards in Lord Joffe's bill. But, say the Peers, it has done nothing of the sort. Lord Falconer's bill contains some second-level safeguards - for example, the procedures for carrying lethal drugs to a patient where a request for assisted suicide has been approved. But it is completely silent on the primary question of what procedures should be taken in order to assess whether a request for assisted suicide meets the criteria that are laid down.
There is therefore nothing "upfront" or "stringent" about the safeguards in the bill. In effect, Parliament is being asked to approve the principle of physician-assisted suicide and to leave the safeguards to others to deal with later. But, if patient protection is, as the campaigners for legalisation claim, at the heart of their proposals, the two cannot be separated. A decision cannot be taken to license assisted suicide until at least the nature of the safeguards has been disclosed. Openness and transparency are needed.