Assisted Dying - time to change the law

“I don’t want to go to prison, I’ve never committed a crime, I feel so helpless!”

These were Maria’s words as her husband Antonio was brought in to see us yet again after his fifth attempt to take his own life*. The fiercely independent man that Maria had married 45 years ago changed completely after his stroke in 2017. Unable to care for himself, depression had set in and despite good treatment he still cried every day, begging Maria to allow him to die. He was slowly deteriorating every day but had managed to squirrel away some of his medication, taking a massive overdose that day.

This week MPs are debating the assisted dying bill in parliament, designed to allow terminally ill people to choose to end their life. There has been fierce opposition from some campaigners, yet a new poll shows that a great majority of the UK population supports it.

As an anaesthetist/anaesthesiologist I and all of my colleagues have looked after patients in a similar situation as Tony above, many with progressive muscular dystrophies with a steady deterioration, others with cancer, heart failure and a myriad of other disease processes. Many of the patients we looked after would definitely not have chosen the treatment we gave them, protracting their lives and denying them the dignified death they would have chosen.

This week the Royal College of Anaesthetists released the results of their Assisted Dying survey and changed its stance from “no stance” to neutral. In the survey almost half of the anaesthetists who took part wanted the college actively to campaign for a change in the law, such was the strength of support, and only a relatively small minority wanted it to campaign against.

I have long been a supporter of changing the law to allow our patients the right to choose how their life ends. I think the safeguards in the bill are good, I do not think society will collapse because of a change in the law. If we change our law we won’t be the first to do so, and other countries such as Switzerland, Holland, Spain, Canada and some states in the US have already done so and the service is generally working well.

I have heard many arguments against: now is not the time, we need to have good palliative care services first, what about patients being coerced into it?

My response to that is if not now, when? Yes, our NHS is in a state, and palliative care services are not what they should be (see my previous blog about our friend Keith, who incidentally would never have chosen an assisted death), but it’s going to take a very long time to improve them. Even with excellent palliative care I have seen many truly awful deaths that the patient would never have chosen. Our terminally ill patients today do not have the option of waiting for our palliative care services to improve. We do them a disservice by using this as an argument for denying them the choice. Many would also end their lives earlier, sacrificing months of good quality life to ensure they’re still fit enough to travel to Switzerland.

I really do hope this bill becomes law. It would improve our ability to care for our patients, and give us as autonomous people some degree of choice over what is an inevitability to us all – our death.

*All identifying details changed, but the situation is real and I’ve experienced it many times.