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Safeguarding choice.

Whatever we may want for ourselves, the overwhelming majority of people, regardless of their beliefs, respect a dying person’s wish to end their suffering. Improvements in palliative care mean that it is possible in most cases to minimise suffering, and access to good quality end-of-life care must be continually improved. However, we must also be realistic and acknowledge that such care, however good, is not always the answer – tragically, there are some cases where individuals will still suffer terribly no matter how hard we try to alleviate it.


As the law stands today, if a dying person wants to end their life because their suffering has reached an unbearable level, they face a very difficult dilemma. They can ask someone to help them, but they know that if that person agrees they may well be risking prosecution. If they are able to and can afford to, they might travel to Switzerland. Or they can seek to take their own life, most likely alone in order to protect their loved ones. I don’t think that that is a dilemma that our society should force a dying person to endure; I think everyone should have a dignified choice.


As a society we generally believe that wherever possible suffering should be minimised, and that the wishes of the patient should be put first. Opinion polls consistently show that a large majority consider that for some, death is sadly, but understandably, preferable to a few extra days, weeks or months of continued suffering. But that is not the settled position under the law: rather, we currently rely on the goodwill and good sense of the prosecution service to follow the Director of Public Prosecution’s guidelines on whether to prosecute someone who assists a dying friend or relative to make that choice. In that sense, the majority of public opinion is way ahead of the decision makers, both in Westminster and the medical professions.


The fact that public opinion is in favour of a change in the law on assisted dying is of course not necessarily of itself sufficient reason to effect such a change. But that does not mean public opinion is irrelevant.


As parliamentarians we have a duty to look at the bigger picture, to look beyond the individual cases however difficult they are, in order to consider how a change in the law might impact on society as whole. Some say that focussing on hard cases can make bad law. But I would ask this: how many hard cases does it take to indicate that the current law is not in the right place?


I recognise the concerns amongst some who oppose a change to the law that it will be abused, and result in vulnerable people being put at risk. Those are important concerns, and we must ensure that any legislative changes include appropriate safeguards. But I do believe that it is possible both to enable choice at the end of life and continue to protect vulnerable people.


For me the argument boils down this: I support change because I believe that a dying person should have the right to control his or her own destiny and dignity towards the end of their life. I believe that everyone should have a choice. I recognise that there will be plenty of people who for a variety of reasons will choose to exercise that choice by making no attempt, either by themselves or through assistance, to end their life. They will be entirely right to do so, and I would oppose wholeheartedly any suggestion that they should not have that option. But I am sure that there are others who would choose to take a different path, a path that is not currently open to them without potentially significant risk.


The Commission on Assisted Dying, chaired by Lord Falconer, concluded that “the current legal status on assisted dying is inadequate and incoherent”. It recommended that alongside continued improvements in end-of-life care, the law could be safely changed to legalise and regulate assisted dying for terminally ill, mentally competent adults.


The All Party Parliamentary Group on Choice at the End of Life, in conjunction with Dignity in Dying, has built on the Commission’s recommendations and drafted an Assisted Dying Bill for consultation. The consultation, which closes on 20 November 2012, seeks the views of politicians, stakeholders and the public on the criteria and safeguards of an assisted dying law. My hope is that this will allow us to produce a thorough and robust Bill both to enable choice and to better protect people at the end of life.


I hope that everyone who is concerned about this issue, whether in favour of change or not, will engage constructively with our process and make their view heard. This is too important an issue to put on the “too difficult” pile: the status quo is far from ideal, and I believe we must explore carefully whether there is a better alternative.