Assisted Dying, should it be legalised? Jo Cartwright Dignity in Dying September 2010

Assisted dying v. assisted suicide and euthanasia Assisted dying - terminally ill, mentally competent adult choosing to shorten the dying process Assisted suicide – chronically ill, mentally competent adult choosing to shorten their life Euthanasia – direct action to end a person’s life

Public opinion 82% of the general public believe that a doctor should probably or definitely be allowed to end the life of a patient with a painful incurable disease at the patient’s request BSA survey 2010 3

Public understanding Times (Populus) 2009 74% support AD for terminally ill adults 85% believe legislation should have strict safeguards 13% want legalisation without restriction Introduction People sometimes raise concerns that the widespread public support for assisted dying lacks sophistication and is based in kneejerk reactions to illness, suffering and disability. This is not borne out by the evidence. BSA 2007 The BSAS 2007 found that 80% support assisted dying for terminally ill adults. But in the same survey only 43% agreed that a person who is not in much danger of death, but becomes dependant on relatives for all their needs should be allowed assistance to die. Times 2009 In a Times (Populus) survey, conducted July 2009, 74% supported a change in the law for terminally ill adults to allow for doctor assisted dying[1]. The poll also found that 85% thought that if assisted dying were to be legalised, it should have strict safeguards and only happen in certain circumstances. Just 13% thought it should be legalised without restriction. Summary The BSAS and Times surveys demonstrate a sophisticated understanding of the issues at hand. They show that there is a clear difference between the public perception of assisted dying for terminally ill people, and assisted suicide/unfettered right to die. 4

Disabled people’s opinions 75% of people with a disability and 81% without support AD for terminally ill people BSA survey 2007 Introduction Anecdotally we are told that many disabled people oppose assisted dying, but what does the evidence say? Well overall, disabled people support safeguarded assisted dying for people with terminal illness. 2007 BSA The 2007 BSA survey showed that people with a disability were only slightly less likely to support assisted dying in comparison to the non-disabled general public. Analysis of the 2007 BSA survey found that 75% of people with a disability and 81% without were supportive of assisted dying for terminally ill people* (with 80% overall).[1]. DRC survey The Disability Rights Commission commissioned a poll in 2003 which found that 60% of disabled respondents supported assisted dying legislation[4]. You Gov 2004 A YouGov survey in 2004 found that disabled people were equally likely to support physician assisted dying as non-disabled people[6]. 5

Opinions from religious/faith communities 71% of religious people and 92% of non-religious people agree with assisted dying , BSA survey 2010 “Would the Assisted Dying Bill lead to a duty to die?” 76% responded ‘no’, Church Times survey 2004 6

Terminally ill people’s opinions Overall support was in favour of a change in law with any concerns on grounds of religion or possible abuse - Chapple et al 2006 7

Where it is lawful, is assisted dying in the public interest? Oregon law passed Nov 1994 51% : 49% Repeal defeated Oct 1997 60% : 40% Washington law passed Nov 2008 60% : 40%

In Oregon in 2007: 30,000 people died in Oregon 15,000 were in a hospice 9,800 considered a prescription 1,050 talked to a doctor about it Of these 85 received the prescription 49 then used the prescription

Where it is lawful, is assisted dying in the public interest? Hundreds more people take comfort from the law than actually use it. Just knowing they have the option if their suffering becomes too much provides them with great comfort. Terry Pratchett expressed this desire for emotional insurance well: “If I could die I would live!”

Upholding the law Lord Brown Purdy v DPP Judgment, 30 July 2009 “..he or she may fairly hope to be, if not commended, at the very least forgiven, rather than condemned, for giving assistance.”

Debbie Purdy

The DPP’s policy DPP’s policy = effective decriminalisation for amateur compassionate assistance to die No one wants to see the prosecution of compassionate assisters To give dying adults true choice, and to protect potentially vulnerable people, we need safeguards

Duty to die? In countries where assisted dying is legal, people in vulnerable groups were less likely to have an assisted death. We can protect people from a duty to die, whilst also protecting people from a duty to suffer.

Advance Decisions Legally binding document to refuse life-sustaining treatment in advance of a loss of capacity.

John’s story