We Need Properly Funded Palliative Care, Not Suicide on the State

I’ve written a piece for the Telegraph about why I’m opposed to the assisted dying bill. No doubt it will divide opinion on the Daily Sceptic, as it has divided opinion among the Telegraph commentators. I think it’s a complicated issue, but I’m wary of granting the state the power to kill patients and this bill isn’t fit for purpose.

Here’s how it begins:

When the Terminally Ill Adults (End of Life) Bill was debated in the House of Lords last month, the Bill’s sponsor, Lord Falconer, argued that it would improve palliative care.

That view isn’t shared by Toby Porter, the CEO of Hospice Care UK. He testified before the Terminally Ill Adults Bill select committee in the House of Lords last week and warned that hospices are facing “significant cuts”. The last thing they need is for NHS funds to be diverted to an assisted dying service.

The NHS already struggles to provide enough GPs, consultants, nurses and psychiatrists to meet demand. Yet the Bill assumes there will always be qualified professionals on hand to assess patients, confirm mental capacity, and prescribe life-ending medication. In reality, those resources are already stretched to breaking point.

The Royal College of Psychiatrists has stated repeatedly, including last week in the special committee set up in the Lords, that it also doesn’t support the Bill. It doesn’t feel psychiatrists will be able to properly assess mental capacity and consent in their proposed roles on the panels.

Wes Streeting has repeatedly emphasised that the budget for the assisted dying service – the Bill’s name for the proposed suicide unit – would come out of the NHS budget, meaning other services would have to be cut to fund it, at least in the short term.

There are also practical questions that no one seems to have answers to. The Bill insists patients must self-administer the life-ending drugs – one of the so-called “safeguards”. But many patients in palliative care – those with Motor Neurone Disease, Parkinson’s, or simply very advanced illnesses – can’t even self-administer their regular painkillers. Nor can they walk to a pharmacy to pick up a prescription. Would the life-ending drugs be delivered by post? If relatives collect them and hand them to their loved ones, would they risk prosecution? Or would they need to be handed to patients by doctors who would then be required to stand over them while they swallow the lethal pills?

That last method is the one suggested by the Bill, with doctors being allowed to “assist [the patient] to ingest or otherwise self-administer the substance”, i.e., they could spoon the poison into their mouth. They will also be permitted to prepare “a device which will enable [the patient] to self-administer the substance“ i.e., set up an intravenous line with an infusion which the patient would then have to activate.

In practice, this would create a system very similar to how euthanasia works in Canada where the majority of deaths are by IV infusion, with the only difference being that in the UK the patient presses the button. Doctors who administer or help administer the lethal drugs in this way are also required by the Bill to stay with the patient until they die and it’s worth bearing in mind that in Oregon deaths have taken up to 137 hours to occur after the suicide pills have been taken. Needless to say, this would eat into other clinical commitments.

Worth reading in full.