Peter Lapsley on the assisted dying debate

Peter Lapsley What interests the public and what is in the public interest can be two rather different things but can come together to argue strongly for change. Such is the case with British law in respect of assisted dying. It is wrong to say, as some do, that the law is adequate as it stands. It is not. The uncertainty that surrounds it is causing great distress to significant numbers of people and may be shortening the lives of some.

The recent increase in media coverage of the subject suggests widespread concern about the legal ‘fudge’ that exists at present. (It is illegal to aid or abet a suicide and anyone convicted of doing so faces up to 14 years imprisonment. As yet, nobody who has travelled abroad with someone intent on suicide has been prosecuted. But the courts will give no assurance that others will not be prosecuted – and perhaps sent to prison – in similar circumstances.) 

Clearly, there is a public appetite for a debate on this subject, but the government seems reluctant to allow one – perhaps because they foresee the questions that would inevitably follow any change in the law. If people are to be allowed to ‘aid and abet’ suicide abroad, why should they not be allowed to do so in the UK? And, if suicide may be assisted by clinicians abroad, why should clinician-assisted suicide not be allowed in the UK? And, if clinician-assisted suicide were to be allowed in the UK, why not euthanasia? That may seem a slippery slope, but it may equally be that those are the sorts of questions the public would wish to have answered.

Such a debate should be conducted in Parliament, which has the capacity to change the law if necessary. It seems improper that people in authority should seek to pre-empt or stifle it by stating their personal positions publicly or setting their faces against change.

The debate should be objective and properly informed, and it should examine the principles surrounding the issue and the safeguards that would be needed were the law to change, rather than focus on particular disease areas.

Clinicians (especially palliative care clinicians) who become involved in public discussion of this subject or in the debate itself should be circumspect in their contributions. They have a professional predisposition to saving and extending life, and there is a risk that their views may carry undue weight in a matter that is, in truth, more social than medical.

Peter Lapsley is Patient Editor, BMJ