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Douglas Noble on the Falconer report

5 Jan, 12 | by BMJ Group

Last year I blogged about the commission set up by Lord Falconer on assisted suicide.  It was clear from the outset that this commission was fatally flawed, not least because of the pro-assisted suicide stance of almost every member of the committee. 

Unsurprisingly the collection of evidence and hearings was unlikely to have a major impact given its biased beginnings. Most notably the British Medical Association refused to give evidence, and at the annual representative meeting in Cardiff in 2011, the association spoke clearly against the commission.

The report adds no value to previous parliamentary inquiries and the guidance of the director of public prosecutions. Assisted suicide, according to the report, is only to be permitted if a patient has less than 12 months to live. On the face of it this may appear workable, until the practicalities of establishing such a prognosis are explored. For example, consider the predicted outcome of Al Megrahi. 

Yet, one thing is certain, this debate is not going away despite parliament having ruled against legalising assisted suicide in 2006 and 2009. In political terms this issue is a dead duck – so why the continual fascination by a minority of vocal campaigners?  The answers are complex. 

Perhaps, though, it is ultimately because of an inability to accept that suffering is an integral part of our world, common to all who share the human condition. Dealing a fatal injection and dressing it up as dignity is not a solution to suffering and pain. High quality palliative care is part of the answer, but so too is the effect of the affection, love, and commitment (sometimes over long periods of time) that we can show to one another when the worst hand is dealt. 

The United Nations through article 25 of the Universal Declaration of Human Rights seeks to ensure security in the event of sickness and disability. This is at the root of the argument that has convinced our leaders to desist from legalising assisted suicide: protection of ill, vulnerable, and disabled individuals from being put under pressure to die because they are made to feel they are a burden to society.

Douglas Noble has worked in surgery, emergency medicine, public health and for WHO. From 2006 to 2008 he was clinical adviser to the chief medical officer for England. You can follow him on twitter @douglasnobleMD

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  • Egyptsteve

    Death is also part of the human condition, and forcing people to accept medical treatment they don't want, or else to live out their final moments in agony because of your own moral qualms, is no solution to the “problem” of human mortality.

  • TStacy

    “Dealing a fatal injection and dressing it up as dignity is not a solution to suffering and pain.”

    Because you say so? What's the argument here? It doesn't work because we've decided it's cheating a life out of the full experience of the 'human condition?' What nonsense.

  • Mark Rosenthal

    I'm sorry but I don't find that at all persuasive. I can accept that suffering is part of the human condition but that doesn't mean I'm not going to try and minimise it. While i know nothing about your relgious beliefs, it has a distinct air of christianism. That's fine, but don;t expect to persuade anyone who isn't a christian

  • Matt Ceanfaglione

    who owns their body & life? them? or the state? and in that i think you will find the answer to this assisted suicide debate…

  • Stevarious

    My vet said something to me a couple of years ago, when I brought my beloved German Shepherd there to die. 
    “Isn't it tragic that we can provide this kindness to our pets, but not for the people we love?” The statement brought tears to my eyes.  It was a mercy to give him that shot – he was dying already of a tumor in his chest that was both extremely painful and made it incredibly difficult to breath.  The very real fact that it is a mercy and a kindness that I can offer to a dog but not to my own mother is twisted and cruel.

    Why is it mercy to end the suffering of an animal, but somehow 'wrong' to end the suffering of a human?  We can only guess at the animals desire for an end – the human can tell us plainly and clearly when they wish to die.  Why, exactly, do you desire to extract as much suffering as possible from each human life?

    Your statement: “Dealing a fatal injection and dressing it up as dignity is not a solution to suffering and pain” is not just wrong in sentiment, it is wrong in fact.  You may disagree as to the quality of the solution, but that it IS a solution is undeniable.  Death is an end to suffering and pain, and the only one we are (so far) guaranteed in this life.  Until there is a cure for death (itself a tragedy and a cruelty), no one has any business telling another thinking, feeling human being that they can't die yet – they have three more months of pain and suffering and medical bills to go through first.

  • Wolf Baginski

    I am at a loss to see why the BMA should be so keen to declare bias when they couldn't make the effort to present evidence. Yes, some of the practical flaws are clear, and there is the whole question of the capacity to choose. But instead of trying to to win the argument, even to show that the Commission was biased, you stand on the sidelines until it is all over, and then cry “foul!”

    I don't have an answer. After seeing my mother's prolonged decline to death, I am, I admit it, scared at the possibility of the same happening to me.

    And then you bring up the idea that “suffering is an integral part of our world”. That's a dangerous argument for a medical professional to express.

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