Euthanasia- Passing the new bill

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Doctors oppose right-to-die law -May 10th

Leading doctors have declared their opposition to proposed legislation which would allow patients to choose when to die.

A Royal College of Physicians poll found 73% were against a law change.

The Royal College of GPs has also altered its previously neutral stance after members spoke out against new legislation.

The House of Lords will debate Lord Joffe's controversial assisted dying Private Member's Bill on Friday.

Both royal colleges said better palliative care, not a law change, would help the terminally ill most.

Medically assisted dying is a bad solution to a difficult problem

Palliative care experts

Lord Joffe's Bill seeks to make it legal for doctors to prescribe drugs that a terminally-ill person could take to end his or her own life.

Five thousand doctors responded to the Royal College of Physicians poll.

Call for better care

A spokeswoman said: "Irrespective of whether the present Bill is enacted or not, it should be seen as a further signal to campaign for better dying for patients.

it is very unlikely that this is representative of doctors' views

name here

"This should include an extension of palliative care services and more discussion of end of life issues in the face of changing values, ethnic diversity and technological advance."

The Royal College of GPs' council also concluded that improvements to palliative care were all that was needed.

On Tuesday, 24 palliative care experts signed a letter to the Daily Telegraph said: "We believe medically assisted dying is a bad solution to a difficult problem."

They raised a series of difficulties in allowing people to ask for help in dying, saying prognoses of how long someone was set to live were "notoriously inaccurate", and that a patient should not "offload" responsibility for their death onto another person.

The doctors, headed by Sam Ahmedza, professor of palliative care at University of Sheffield Royal Hallamshire Hospital, added: "We believe the law should protect the vulnerable from the subtle pressure of society, the pressure of feeling a drain on resources and the pressure of feeling a burden on the family."

'Narrow' consultation

Supporters of the Bill say doctors should be able to prescribe drugs that a terminally ill person suffering terrible pain could take to end his or her own life.

Deborah Annetts, chief executive of Dignity in Dying (formerly the Voluntary Euthanasia Society), said: "This was a narrow and rapid 'consultation' on assisted dying."

But the RCP said members had four weeks to respond.

All the political parties are allowing a free vote on this issue and if passed the amendment will delay the measure by six months.

A poll published in the Sunday Telegraph earlier this week showed 65% of people agreed that if the proposed law change went ahead, "vulnerable people could feel under pressure to opt for suicide".

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Peers are deeply divided over a controversial bill which would allow terminally ill people to be helped to die by physicians.
Lord Joffe's bill would apply to those in England and Wales set to die within six months and suffering unbearably, but still able to make decisions.

He told the Lords patients should not have to endure unbearable pain "for the good of society as a whole".

But Lord Carlile said the bill would end with doctors giving lethal drugs.
We believe this is a very bad bill and one that would create serious problems

'I've still got so much to do'
'We were there with mum'

The Lib Dem peer said: "Everybody in your Lordships' house knows that those who are moving this bill have the clear intention of it leading to voluntary euthanasia.

"That has always been the aim and it remains the aim now."

The bill proposes that after signing a legal declaration that they wanted to die, patients could be prescribed a lethal dose of medication to take.

The bill is not likely to become law, but 90 peers are due to speak on it.

The debate highlights divisions between supporters of the right to die and those who want better palliative care.


Campaigners gathered at Westminster to protest against Lord Joffe's bill

Lady Finlay, a professor in palliative care told the house: "In letting this bill proceed, we give a message to the world that we will abandon the vulnerable and treat suffering by ending the sufferer's life.

"Let us get on with working for patients to live as well as possible until a naturally dignified death, not taken up with becoming complicit with suicide."

Lord Joffe's bill, which is having its second reading in the Lords, proposes that doctors would be able to opt out if a request was made to them.

WHAT THE TERMS MEAN
Assisted dying - a physician prescribes medication which a patient can take to end their own life
Voluntary euthanasia - the physician would actually help the patient die

The crossbench peer said: "We must find a solution to the unbearable suffering of patients whose needs cannot be met by palliative care.

"This bill provides that solution in the absence of any other."

But even if it survives an amendment tabled by Lord Carlile to halt its progress, the government would have to allow the bill debating time in the Commons in order for it to become law.

'Vulnerable at risk'

Archbishop of Canterbury Dr Rowan Williams is among those against the bill.

He has written a joint letter to Friday's Times newspaper with Archbishop of Westminster Cardinal Cormac Murphy-O'Connor and Chief Rabbi Sir Jonathan Sacks.

Speaking on the BBC Radio 4's Today programme, he said there was now a broad consensus against the measure which extended beyond the Church and religion.

Even with the high quality of our palliative care, some people will still want this option

Deborah Annetts
Dignity in Dying


The ethics of assisted suicide

"This comes not simply from people who are, so to speak, enslaved by clerical superstition.

"It comes from a number of people who are very close to the very hardest practical decisions on this and who still say that the cost of voting this through is disproportionately high to the benefit to certain individuals."

Cardinal Murphy O'Connor warned the Bill could lead to pressure on vulnerable people to take their own lives.

"There will come a situation where people will feel that not only I have a right to die, there will be other people who feel I have a duty to die. This is the danger when you start on this."

Disability campaigners echo these concerns, and say the real need is ensure palliative care can help people have a dignified death.

The group Care Not Killing delivered a petition signed by 100,000 people to Downing Street demanding an end to attempts to change the law.

And the Not Dead Yet campaign, bringing together disabled people opposed to the bill, was launched in a House of Lords committee room as the lords debated.

Opponents are also holding a demonstration outside Parliament.

'Clear support'

But supporters of the bill say doctors should be able to prescribe drugs so a terminally ill person suffering terrible pain could choose to end their own life.

HAVE YOUR SAY
It is unbelievably cruel to force someone to continue in terrible suffering if their life could be ended peacefully

Gareth Morgan, York, UK


Send us your comments

A YouGov survey of 1,770 people for Dignity in Dying (formerly the Voluntary Euthanasia Society) found 76% were in favour of assisted dying as long as there were safeguards in place.

Deborah Annetts, Chief Executive of Dignity in Dying, said: "The public is being massively turned off by this week's well-funded demonstration of religious opposition against a bill they clearly support.

"Even with the high quality of our palliative care, some people will still want this option."

Robert Kenneth, from the Death with Dignity National Centre in Portland, Oregon, said similar laws in his state benefited the terminally ill.

He said patients in Oregon used the rules to "maintain control over the final days of their lives, to maintain dignity, and simply to control their end-of-life care".

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By Daniel Sokol
Medical ethicist, Imperial College London
On Friday the House of Lords will debate Lord Joffe's private member's bill, Assisted Dying for the Terminally Ill.
If passed, the bill will allow terminally ill adults in unbearable pain to receive medical help in dying.

Many objections to physician-assisted suicide are based on religious prohibitions.

These can only be countered by refuting the religion itself - a notoriously hard thing to do - or by arguing that religious teaching actually permits the act.

I shall not employ either of these arguments.

Harm is, at least in part, a subjective notion


Religion-based reasons will not persuade the secular folk, and hence many objectors usually replace or supplement their arguments with non-religious reasons.

Some of the secular reasons against physician-assisted suicide (PAS) appear speculative or ill-informed.

Initial doubts

They remind the historically aware of the initial reactions surrounding practices which are now widely accepted (for example, human dissection, considered an affront to human dignity in Hippocratic times, and vaccination, considered unnatural and a thwarting of God's will in the 19th and 20th centuries).

Some reasons, however, are more convincing.

HAVE YOUR SAY
If we allow assisted suicide of any sort, we undermine the value of life itself

AM Costley, Carmarthen, Wales


Send us your comments

One such reason is that PAS will change the way members of the public view doctors.

In the public's mind, doctors will become part-time executioners.

We cannot predict if this will occur, but even if it did at first adversely affect the public's perspective, it is not a sufficient reason to reject the bill.

People's views can, and do, change.

If physician-assisted suicide is morally acceptable, then the fact that people might frown upon it does not alter the morality of the act.

Hippocratic Oath

Another common argument about PAS, especially amongst doctors, is that it violates the Hippocratic dictum: 'first, do no harm'.

If we strictly adhered to Hippocratic teachings, abortion should also be abolished


This principle was insightful in Hippocratic times when doctors mostly did more harm than good - magic and superstition were rife, and efficacious treatments few - but not in this scientific age.

The oath is now out of date. If we strictly adhered to Hippocratic teachings, abortion should also be abolished, for the Oath says "Neither will I give a woman means to procure an abortion".

It is therefore wrong slavishly to revere - as some still do - the Hippocratic Oath.

If taken literally, the only way doctors could 'do no harm' would be by declining to treat all patients.

Even simple medical procedures, such as taking a blood sample or injecting a local anaesthetic, entail some risks to the patient.

Many procedures and treatments require doctors to inflict harm in order to bring about some good.

In an appendectomy, the surgeon cuts open the patient's abdomen (a harm) to remove the troublesome appendix (a benefit).

Balance of good

As the ethicist Professor Raanan Gillon points out, doctors have a duty not to cause net harm.

In my view, physician-assisted suicide can be compatible with love, kindness and compassion


Is PAS a net harm to the patient who wants it?

Those in favour of the act will argue that helping a terminally ill patient to die is a benefit, not a harm.

Harm is, at least in part, a subjective notion.

What is beneficial or harmful to a particular patient is determined to some extent by the patient's perception.

If I choose to donate a kidney to my sick brother, no one would rightfully accuse the surgeon of having harmed me by removing the organ.

Overall, the operation would benefit me in spite of the physical harm.

Respecting a patient's autonomous wishes can itself constitute a benefit.

Thus it is far from clear that allowing doctors to help patients end their lives infringes the dictum 'first, do no (net) harm'.

An answer to the morality of PAS can be found by reflecting on the essence of medicine. This is no easy task.

Paracelsus, in the 16th century, wrote that medicine was grounded in love. More recently, Sir William Osler stressed the importance of humanity, which consists in showing 'tenderness and consideration to the weak, infinite pity to the suffering, and broad charity to all'.

He reminded doctors to keep a 'clear head and a kind heart'.

When the late Jean Bernard, the distinguished French haematologist, was asked by a journalist a few years ago: "technology aside, on what is medicine based?", he replied "on love, on compassion, since medicine will always be about man".

In my view, physician-assisted suicide can be compatible with love, kindness and compassion.

The real difficulties lie in regulating the practice to limit the possibility of abuse and, once that is overcome, in summing up the courage to do what is morally right in the face of anticipated abuse and opposition.


Daniel Sokol is the co-author if Medical Ethics and Law: Surviving on the Wards and Passing Exams.

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Dr Nigel Sykes
Consultant in palliative medicine

Lord Joffe's bill to legalise assisted suicide is being debated by the House of Lords again.
As the debate continues, some people with progressive illness have spoken of their support of a change in the law, fearing that age, illness or medical interference will involve a loss of dignity at the end of their lives.

As a palliative care physician, I provide pain relief and care for hundreds of people who do not speak out, but whose deaths have been achieved with peace and dignity, through care and not killing.

We owe the many the right to high quality end-of-life care and I do not believe that a change in law best serves their interests.

Doctors know that their future practice stands to be severely compromised should this Bill succeed


The Royal College of Physicians has responded to their members and renounced their neutral stance in favour of giving patients the support and advocacy they need.

Doctors know that their future practice stands to be severely compromised should this Bill succeed.

Social, professional and personal de-sensitising to taking human life will be just one unwanted effect.

There is a real danger that in a health care environment subject to economic pressure, possibilities to provide comfort for patients would not be pursued fully if the law were to be changed.

Cautionary tales

Provisions in Holland and Belgium, Switzerland and the US state of Oregon, allow assisted suicide or lethal injections.

The risk is of a gradual change in how we look after those who are elderly, chronically ill or disabled


These are mostly aimed at people who are very close to the end of their life anyway but, in fact, studies show that fewer than one in 20 of this group wish to discuss euthanasia with their physician.

Even among those who do, few persist with the idea once they discover what hospices and palliative care can offer, and once other symptoms, such as depression, are addressed.

The purpose of euthanasia is usually framed legally as the relief of "unbearable suffering," but if this is so there is no obvious reason why it should be restricted to the terminally ill.

Indeed Lord Joffe is open that he would like assisted suicide to be of "much wider application."

In an ageing society beset by increasing health and social care costs, the legal and social acceptance of any form of euthanasia may well affect attitudes and decisions in care delivery.

The risk is of a gradual change in how we look after those who are elderly, chronically ill or disabled.

Paradoxically, legislation driven by people's fear of loss (of capacity, dignity and control) may end up sacrificing the very care, hope and personal choice that they would want at the end of their lives.


Dr Nigel Sykes is a consultant in palliative medicine at St Christopher's Hospice, London.

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Diane Pretty fought for assisted suicide but failed
You can watch this Panorama film live and then whenever you want on demand by clicking on the button on the top right of your screen.
Panorama asked should society allow people to receive medical assistance to die if they are suffering unbearably with terminal illnesses?

Or is physician-assisted suicide a step on a road to euthanasia?

Four years ago, Diane Pretty fought for the right to die on her terms. Suffering from motor neurone disease, she felt that she was effectively dead.

The programme would allow pupils to see the reality of living with terminal illnesses.

Andrew Lloyd
Teacher
Your responses to the programme
Follow the BBC debate here


Your questions answered

Diane Pretty wanted to change the law on assisted suicide for terminally ill people so that her husband Brian could help her to die.

But the British courts ruled that she did not have the right to determine when and how she died.

When she took her case to the European Court of Human Rights in Strasbourg it upheld the British law claiming it protected the weak and the vulnerable.

Since the Diane Pretty case, 43 Britons have travelled to Switzerland to commit suicide with the aid of a Swiss charity called Dignitas.

The House of Lords is due to debate a bill on Friday 12 May which will attempt to change the law on assisted suicide.

Ahead of the bill, some of Britain's foremost lawyers in medical ethics debated the issue on Panorama on Wednesday 10 May. The programme also contained interviews with people for whom this is a very personal issue.

Gill Gerhardi has cerebral palsy and multiple sclerosis but is a firm opponent of assisted suicide and told Panorama she believes "it encourages people to give up".


Dr Anne Turner chose assisted suicide outside the UK

Panorama also interviewed Sophie Pandit, the daughter of Dr Anne Turner who was one of the 43 Britons who travelled to Switzerland to commit suicide.

Sophie believes that the current law meant her mother had to choose to die before she was ready and denied her time at the end of her life.

The programme featured Baroness Ilora Finlay who is a pioneer of palliative care and opponent of the change in the law.

In the film, Diane's husband Brian is equally forceful in his belief that assisted suicide for the terminally ill who are suffering unbearably should be legalised.

Production team:
Reporter: Steve Bradshaw
Producer: John Thynne
Researcher: Millicent Bamford
Picture editor: Mark Senior
Deputy editors: Andy Bell, Frank Simmonds

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As the Lords debate a bill which supports physician-assisted suicide for the terminally ill, Edward Turner - whose mother went to Dignitas in Switzerland to end her life - explains why he backs the proposal.
In November 2004, our mother Anne announced that she had been diagnosed with Progressive Supranuclear Palsy, an incurable degenerative neurological illness.



Anne Turner invited the BBC to travel with her to Switzerland

As if this weren't enough to take on board at the time, she also announced in the same breath that she planned to end her life, rather than allow her illness to run its natural course.

This was a logical decision for her, as she was a long-standing member of Dignity in Dying, and had always believed strongly in the right of the individual to opt for an assisted death in these very circumstances.

She had also nursed our father through another degenerative neurological illness and had seen his quality of life erode over a period of years to the extent that, when he died, he was virtually a breathing corpse.

She did not want the same outcome for herself.

Suicide attempt

Our immediate reaction was a combination of enormous grief at the prospect of losing our mother, as we are a very close family, but also of logical acceptance of her course of action.

If our mother hadn't gone to Zurich to die, she would have had a miserable existence, waiting for her illness to kill her over a period of months and years.

Edward Turner

However, in the coming months we tried every possible course of action to distract or dissuade her from carrying out her threat.

We knew we were being selfish, but losing our mother was the worst thing we could imagine.

It was only in October 2005, after a failed DIY suicide attempt at home, that we realised that nothing we could do would stop her from ending her life.

We could either support her in her hour of need, or we could turn our backs on our own mother and let her die a painful death alone.

The latter option was unthinkable to us.

We therefore decided to contact the Dignitas clinic in Zurich to arrange for an assisted suicide.

Once our mother had received the "green light" from Dignitas, her whole attitude to life changed.

It was as if a huge weight had been lifted from her shoulders, allowing her to enjoy life, without fear as to what the future would bring.

Messages of support

There were many occasions in the run-up to our trip to Switzerland where we shed tears together as a family and where we really questioned our mother's motivation.

But the final couple of days which we spent together in Zurich were surprisingly calm.

We had all said our goodbyes long before, and we felt that there was nothing left unsaid between us, so that we could just focus on the task in hand - supporting our mother and being with her as she died.

If our mother hadn't gone to Zurich to die, she would have had a miserable existence, waiting for her illness to kill her over a period of months and years.

I am so thankful that she enjoyed her last weeks with us, safe in the knowledge that she would be spared what for her would have been an undignified end.

On our return from Switzerland we were swamped with messages of support from everyone: friends and strangers alike.

We realised that we weren't alone and that our mother's case had struck a chord with the vast majority of the country. We received not one offensive or unsupportive message.

Lord Joffe's bill is very welcome and would give the UK the most advanced assisted dying legislation anywhere in the world - and with the largest number of safeguards.

I agree with the faith groups' belief that life is to be treasured and celebrated.

But there comes a point in every life-cycle when we must accept that death is logical, timely and kind.

Our mother was a very determined and, at times, combative woman.

She felt acutely the injustice of being unable to die in her own country at a time which was right for her, as much as she felt the injustice that she, as a wealthy woman supported by her family, could afford to go to Dignitas.

She wanted assisted dying to be available to everyone, not just the well-off. We can now see clearly that what she did was right for her.

We are so enormously proud of her.

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By Mandy Paine


As the Lords debate a Bill which supports physician-assisted suicide for the terminally ill, 44-year-old Mandy Paine, who is seriously ill, explains why she opposes the proposal.

It's 18 years since I was diagnosed with the lung condition chronic Obstructive pulmonary disease (COPD).


'You have to stay positive'

I have been told I have end stage disease - which means I'm terminally ill, although I prefer to call it a life-limiting disease.



After all we all start dying from the moment we are born - we just go a different speeds.

I am on oxygen 24 hours a day which is fed through a nasal tube.

At the last count, there are 32 different drugs which keep me alive - it seems that for every drug you take you need two others to control the side-effects.

I am on two types of morphine to control the pain in my lungs when I breathe. The pain is a bit like having a rat gnawing on my lungs.


The pain is a bit like having a rat gnawing on my lungs.


I also have angina, gout, osteoarthritis, and many allergies. Nonetheless, I feel that life is worth living.


At the end of the day life is what you make it. It's not easy, but you have to stay positive.

And if you stay positive then your life extends. I was told I wouldn't live till I was 30 but I have.

'I must carry on'

I've lost count of the number of times I've been taken into intensive care.

I know that I must carry on, especially for the sake of my two wonderful sons Craig and Daniel.

Friendship is also very important. I met a wonderful friend called David who has terminal liver cancer through the Help the Hospices movement.

He's my soul mate, a buddy, and we help keep each other positive.

'No right to take a life'

I am opposed to the bill on Assisted Dying for many reasons.

First there is the risk of it being abused.

Then there's the pressure it would put on other people to help kill you.

It's written in the Ten Commandments, "thou shalt not kill" and you've no right to take another person's life.

Then there's always new medical research. Look at stem cells. Someone you love might kill themselves and then the next day you read there's a cure and how would you feel then?

I do get depressed. I call them my black dog days and I'm at the bottom.

Then I think I have a mum and dad and children and I know I must carry on. There's so many things I still want to do. I have a wish list.

My son Daniel composes and plays the piano and we both enjoy musicals.

I've been to see Chitty Chitty Bang Bang but I'd love to see Mary Poppins.

There's still so much to do.

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Several hundred people have gathered outside the House of Commons to protest against Lord Joffe's bill, which would allow terminally ill people to be helped to die by doctors.

The demonstration came after Campaign group Care Not Killing handed in a petition of more than 100,000 signatures at the prime minister's residence in Downing Street.


ALISON DAVIS, 51, FROM DORSET


I'm here because 20 years ago I wanted to die. I am suffering from severe spinal pain, and I tried to kill myself several times. Doctors thought I was terminally ill.

If Lord Joffe's bill was passed I wouldn't be here today, and I would have lost some of the best years of my life.

I have spina bifida, hydrocephalus, emphysema and osteoporosis. My spine is collapsing and trapping the nerves, so my life is limited. But the doctors are reluctant to say how long I have got because they got it so wrong 20 years ago.

Two things changed my life. One was my carer, Colin, who has been with me for 17 years.

The second was when I started supporting two disabled boys for a small project in India. Colin and I decided to visit them. I just fell in love with them. They hugged me, they called me "mummy" and I wanted to do something to help them. When I came back I said: "Now I want to live." It was the first time I had said that in 10 years. Now I am the "mother" of 550 children there.

It's a cliched thing to say but it's true, they do more for me then I do for them. They saved my life.


MARIA RYAN, 56, SHANE FREEMAN, 19, FROM LONDON

Shane: My grandfather Tom was diagnosed with cancer that spread to his bones. He was originally given six months to live, but because of the care he received, he lived another 13 years.

If this bill went through, it might put pressure on these people by implying that assisted dying is a natural route to take.

If people don't have proper care, then they will say: "Please kill me."

Maria: What worries me terribly is that if this bill is passed, it could affect premature babies and disabled people. There's not enough publicity about the implications of it.


REV IAN DENSHAM, 58, SUSAN MARSHALL, 71, ANDREW CHARLES, FROM HERTFORDSHIRE

Andrew: We feel this bill is the thin edge of the wedge. We feel the sanctity of life is more important than anything.

Susan: We think more resources should be out into palliative care. If they pass this then what is next? If it comes in i believe it would be a slippery slope.

Ian: A great friend of mine died of motor neurone disease. He was a living testament to why this bill should not be in place he was sound of mind right up until the end. If it had been in place then it would have placed incredible pressure on his family.


RACHEL HURST, 67, FROM WILTSHIRE


I understand people's fear of dying in hospital, but the solution is not killing - it's palliative care.

People have such fear of what it must be like to not be able to live normally. But life has much more to it than that. There is family, there is spring, and autumn, there's music, there's art, there's reading a good book, there's the air we breathe.

Lord Joffe needs to think about what he is setting in motion.


ANTHONY, 33, FROM KENT

I'm here to support life and to protest against this bill.

A friend of mine is paralysed, but he's OK and everyone still loves him. I fear that the bill would mean that if he was feeling low one day, he might just do it. I wouldn't want that to happen to him.


RODERICK AND JANE MACAULAY, FROM KENT, RICHARD MURRAY, FROM WEST SUSSEX

Roderick: I'm a retired GP and as far as I'm concerned this bill is an antithesis of everything I have lived and worked for.

There is nothing that can't be dealt with in palliative care. But maybe it is much more convenient not to.

Jane: There is just this feeling that market forces are at work, that this is a more cost-effective measure.


PAMELA AND MARTIN HALL, 82 AND 76, FROM LONDON

Martin: The reason I am here is because of the experience I had with my mother in 1989. She was in her 80s and had broken her leg. She wasn't demented but at the time she gave that impression.

I noticed when she was in hospital that she wasn't given anything, she didn't even have a drip. I was told she would die within six months anyway and there was no point in trying to keep her alive. I believe that everyone has the right to proper care.

I was completely confused and as my mother was raving at the time, I believed the doctor. She died a day or two later. It was only until a few days after that I realised I should have questioned them.

They allowed her to die. I relive those moments every day.

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Euthanasia is extremely rare in the UK and few doctors want to see it legalised, a study says.
Pro-euthanasia campaigners have long argued terminally-ill patients are helped to die in secret.

But fewer than 1% of deaths were by euthanasia in 2004 and few doctors want to see the law change, the Brunel University survey of 857 doctors found.

Euthanasia and doctor-assisted suicide, whereby the patient is given the means to kill themselves, are both illegal.

Of the 584,791 deaths in the UK in 2004, 0.16% (936) were by voluntary euthanasia, the survey revealed.

Some 0.33% (1,930) involved the doctor ending a patient's life without consent from the patients, for instance if they are in a coma. This is sometimes known as involuntary euthanasia.

This work shows that UK doctors are less willing to take such actions than in several other countries

Professor Clive Seale, report author

But not one GP or hospital doctor said they had taken part in physician-assisted suicide in the poll which asked them to report on the last death they had attended.

A third of deaths were put down to alleviating symptoms which may have the effect of shortening life, while just under a third were from withholding treatment because it is deemed in the best interests of the patients. Both practices are legal in the UK.

Just 2.6% of doctors said changing the law would benefit patients.

It is the first time such a comprehensive study into medical practice has been undertaken in the UK and shows euthanasia rates are lower than in many other countries.

Report author Professor Clive Seale said: "Euthanasia and physician-assisted suicide are understandably very emotive subjects, but this work shows that UK doctors are less willing to take such actions than in several other countries.

"We have a very strong ethos of providing excellent palliative care in the UK, reflected in the finding that doctors in the UK are willing to make other kinds of decisions that prioritise the comfort of patients, without striving to preserve life at the cost of suffering.

Bill

"The results suggest that providing the best kind of patient care is a major driver behind medical decision making."

The findings come after a private members bill was introduced into the House of Lords in November proposing a relaxation of laws governing doctor-assisted dying.

Lord Joffe's bill advocates assisted dying, whereby doctors can prescribe a lethal dose of medication for a patient to take themselves.

But proposals to legalise voluntary euthanasia, where the doctor actually helps a patient die, which were in his original draft, were dropped.

Deborah Annetts, chief executive of the Voluntary Euthanasia Society, said the report supported the calls for a change in the law.

"This research proves some doctors break the law and deliberately help patients die.

"This is all done in secret and denied in public. This cannot be safe."

But Julia Millington, political director of the ProLife Alliance, said: "Surely the response of a civilised society is to stop this unlawful killing altogether rather than use such research to support demands for doctors to be permitted to do it legally."

And Dr Vivienne Nathanson, head of science and ethics at the British Medical Association, said she was "concerned a tiny minority of doctors have apparently admitted they have acted illegally in deliberately ending a patient's life".

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The progress of a controversial bill which would allow terminally ill people to be helped to die has been blocked by the House of Lords.
Lord Joffe's bill would give doctors the right to prescribe drugs that a terminally ill patient in severe pain could use to end their own life.

But peers backed an amendment to delay the bill by six months by 48 votes.

Lord Joffe said the move was intended to end the debate, but pledged to reintroduce his bill at a later date.

The bill will be back and the campaign has not stopped

Mark Slattery
Dignity in Dying


'I've still got so much to do'
'We were there with mum'

The government has said it will not block a further hearing of the bill.

Peers had spent the day in a passionate debate on whether or not it was right to allow people who were terminally ill to be given drugs they could then use to end their life.

'Message to the world'

Lord Joffe had told the house that patients should not have to endure unbearable pain "for the good of society as a whole".

The crossbench peer said: "We must find a solution to the unbearable suffering of patients whose needs cannot be met by palliative care."


Campaigners gathered to protest against Lord Joffe's bill

But Lord Carlile said the bill would end with doctors giving lethal drugs.

The Lib Dem peer said: "Everybody in your Lordships' house knows that those who are moving this bill have the clear intention of it leading to voluntary euthanasia.

"That has always been the aim and it remains the aim now."

The bill, which had its second reading on Friday, proposed that after signing a legal declaration that they wanted to die, patients could be prescribed a lethal dose of medication to take.

WHAT THE TERMS MEAN
Assisted dying - a physician prescribes medication which a patient can take to end their own life
Voluntary euthanasia - the physician would actually help the patient die

Only people with less than six months to live, who were suffering unbearably and were deemed to be of sound mind and not depressed would be able to end their life under Lord Joffe's proposal.

The debate highlighted divisions between supporters of the right to die and those who want better palliative care.

Lady Finlay, a professor in palliative care said: "Let us get on with working for patients to live as well as possible until a naturally dignified death, not taken up with becoming complicit with suicide."

'Vulnerable at risk'

Archbishop of Canterbury Dr Rowan Williams was among those against the bill, saying the cost of voting the bill through would be "disproportionately high to the benefit to certain individuals".

Speaking on the BBC Radio 4's Today programme, he said there was now a broad consensus against the measure which extended beyond the Church and religion.

We will continue to resist any change in the law

Julia Millington
ProLife Alliance


The ethics of assisted suicide

Cardinal Murphy O'Connor, Archbishop of Westminster, warned it could lead to pressure on vulnerable people to take their own lives.

Disability campaigners echoed those concerns, and said the real need was to ensure palliative care could help people have a dignified death.

Opponents to the bill submitted a petition signed by 100,000 people to Downing Street, and demonstrated outside Parliament.

'Clear support'

But the bill's supporters said doctors should be able to prescribe drugs so a terminally ill person suffering terrible pain could choose to end their own life.

Labour's Baroness David, 92, supported the bill, saying: "If I were terminally ill, I believe I would be the only person with the right to decide how I died, and whether I preferred palliative care to assisted dying.

"It would provide me with an additional option on how to end my life, which I would find tremendously reassuring."

HAVE YOUR SAY
It is unbelievably cruel to force someone to continue in terrible suffering if their life could be ended peacefully

Gareth Morgan, York, UK


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Mark Slattery, of the charity Dignity in Dying, formerly the Voluntary Euthanasia, said the campaign to introduce an assisted dying bill would continue.

"The bill has faced the an onslaught from the biggest political campaign in church history, but public support for it has held firm.

"The bill will be back and the campaign has not stopped."

Julia Millington of the ProLife Alliance welcomed the Lords' decision.

"Legislation that permits doctors to assist in suicide, fundamentally changes the role of doctor from someone who cures or cares to a killer. We will continue to resist any change in the law."