Legalising ‘assisted dying’ would have been putting the cart before the horse.

Guernsey has focused on care of the dying rather than on giving them help with suicide

The States of Guernsey, the Bailiwick’s Legislature, has rejected a Requete – a formal proposal – to commission a working party to develop a legal framework to enable doctors to supply or administer lethal drugs to seriously-ill people.  Instead, it has instructed its Committee for Health and Social Care to consider how quality of life and health outcomes might be improved for all islanders as they near the end of their lives.  The decision was taken at the end of three days of debate in which there were eloquent interventions by Deputies holding views on both sides of this complex and often-emotive issue.

One of the problems with the Requete was that it failed to recognise that there are not one but two questions in the ‘assisted dying’ debate – whether the existing law is in need of change; and, if so, how it should be changed.  The Requete wanted to commission a study of the second of these two questions but neglected the first – whether the law should be changed.  Its signatories took that for granted.  But it is a vitally important question.  To ignore it was, in the words of Living and Dying Well’s co-Chair Lord Carlile QC, to put the cart before the horse.

The Requete also seems to have been prepared without a great deal of thought.  Its original version left the door open to both physician-assisted suicide (on the Oregon model) and physician-administered euthanasia (as in The Netherlands), and it was unsure whether ‘assisted dying’ should be offered only to people who had received a terminal diagnosis and prognosis or whether others with longer-term conditions who were not dying should also be included.  It even envisaged the possibility that doctors might not be allowed to refuse on grounds of conscience to involve themselves in ending or helping to end the lives of patients. 

Predictably, the Requete’s opponents were not slow in exposing these serious defects, and the days immediately before the debate saw a number of hasty amendments tabled to try and limit its scope.  While these amendments may have gone some way to improving the Requete, they did nothing to remove the impression that its signatories had no clear view of what they wanted, let along of what might be right for Guernsey.

A number of Deputies on both sides observed in the three-day debate that this was unlikely to be a subject that will go away.  They have a point.  Thanks to advances in medical science, we are living longer, though not always healthier, lives.  Dying can sometimes now be a longer process than was once the case.  At the same time death has become more medicalised, with crises in the trajectory of dying increasingly met with a rush to A&E and with people dying in hospital and away from their families, who are denied familiarity with the natural phases and processes of dying.  Unfamiliarity breeds fear and what we fear we seek to control.  That word ‘control’ appears over and again in the lexicon of the ‘assisted dying’ lobby.

No, the issue won’t go away and those who govern us are going to have to find answers to the problems that a changing society is bringing.  But they need to be well-considered answers based on careful study of serious evidence and they need to be answers for all, not just for some.  Slogans about personal autonomy or about Britain being ‘left behind’ by jurisdictions who have legalised ‘assisted dying’ are just not enough. 

Guernsey has wisely judged that the priority lies with ensuring that people nearing the end of their lives get good-quality and accessible end-of-life care rather than help to take their own lives.  That judgement reflects credit on the Bailiwick’s legislators which others would do well to note.