In the UK surveys show that the public at large believe that, within carefully delineated safeguards, doctors should be allowed to assist intellectually competent adults with terminal illness to die when and where they wish. At present such action would be illegal. With this in mind, on Wednesday 13th October, a healthcare group was established to lobby for change. At the launch, the three objectives of the group, which is called “Healthcare Professionals for Change” and is chaired by Dr Ann McPherson who herself has a terminal illness, were set out.
First, to change medical culture. Society should recognise that dying is inevitable and is part of life. For those with terminal conditions, the dying process is not a failure of the healthcare team or the patient – but it does become a failure if the patient suffers an undignified death. Moreover since dying in these circumstances is not a failure, help in dying should be thought of as assisting dying and not assisting suicide.
Second, to change the law. Healthcare professionals can indirectly hasten death through the withdrawal or withholding of treatment or via the principle of “double effect,” but direct and deliberate assistance to die, at the patient’s request, is illegal. The law must change to provide safeguarded greater choice at the end of life, ensuring that within reason the wishes of terminally ill, mentally competent adults are respected.
Third, to change medical practice. Assisted dying should be just one of many options at the end of life. It should complement end-of-life care, as it does in other countries that have legalised and regulated assisted dying. Those wanting an assisted death should be supported by their healthcare professionals to die when and where they choose, within safeguards.
There will be a lot of opposition to change and I expect the campaign will take many years. In my view change will ultimately come, and I would prefer this to be sooner rather than later. Anyone interested in knowing more about the group, and possibly even joining it, can contact it through http://www.healthcareprofessionalsforchange.org.uk/.
Conflict of interest: I am the Healthcare Professionals for Change group’s deputy chair.
Joe Collier is emeritus professor of medicines policy at St George’s, University of London