1. Why we need an assisted dying law in the UK1

2. Dignity in Dying
The campaign to change the UK law to allow the choice of an assisted death for terminally ill, mentally competent adults who are suffering intolerably.
My name is [NAME] and I’m a local volunteer from the Dignity in Dying [NAME OF GROUP]. I’m here to talk to you today about why we need an assisted dying law and to ask you to support the campaign.
DiD is a national campaign and membership organisation. We demand greater choice and control to alleviate suffering at the end of life – in particular we campaign for the choice of assisted dying for terminally ill, mentally competent adults who believe that they are suffering unbearably. Our vision is for everyone to have choice at the end of life and the kind of death that they consider to be dignified.
Dignity in Dying was set up in 1935 as the Voluntary Euthanasia Society. In 2006, we changed our name to Dignity in Dying. As a membership organisation, we only exist because of the invaluable support we receive from our thousands of members and supporters. We have a small office based in London with 15 employees, and we have lots of local Dignity in Dying groups made up of volunteers spread across the country.
Lesley Close, Dignity in Dying patron 2

3. Why do I campaign for assisted dying?
My brother’s life
Why do we campaign for Assisted dying? People are suffering in pain and agony. People should have control and choice over their death. The current law doesn’t protect people. Everyone deserves to have a good death.

4. Why do I campaign for assisted dying?
My brother’s death
Why do we campaign for Assisted dying? People are suffering in pain and agony. People should have control and choice over their death. The current law doesn’t protect people. Everyone deserves to have a good death.

5. What is assisted dying?
A terminally ill, mentally competent adult, takes prescribed medication which will end their life.
Two doctors are required to assess the patient to confirm that the patient is mentally competent, is making their own choice, that their condition is terminal and that they have are likely to die of their condition in six months or less.
If assessment leads to approval, there is a two-week period of reflection during which the case would be checked by a High Court Judge before the patient could receive the life- ending medication.
[NOTES FOR TWO SLIDES]
Assisted dying is when a terminally ill, mentally competent adult, takes prescribed medication which will end their life.
Under an assisted dying law, two doctors are required to assess the patient to confirm that the patient is mentally competent, is making their own choice and that their condition is terminal (6 months or less to live).
 The laws that have been proposed in this country have also included the requirement that a High Court Judge oversees the request for assistance. 5

6. Assisted dying is different to assisted suicide and euthanasia
Assisted dying – terminally ill, mentally competent adults are in control of the manner and timing of their death.
Six states in the USA including California and Oregon
Assisted suicide – chronically ill and/or disabled adults are given help to end their lives.
Luxembourg, Netherlands, Switzerland, Canada
Voluntary euthanasia – terminally ill adults, sometimes chronically ill or disabled, are helped by doctors to end their lives.
Belgium, Luxembourg and Netherlands
[NOTES FOR TWO SLIDES] Language is extremely relevant to our campaign and it is important to acknowledge the distinctions between these terms in order to debate the issue accurately and fairly.
Assisted dying (permitted in the US States of Oregon, California, Washington, Vermont, Montana and Colorado) sometimes referred to as physician-assisted dying, applies only to terminally ill, mentally competent adults and allows the dying patient, after meeting strict legal safeguards, to self-administer life-ending medication.
Assisted suicide (permitted in Switzerland and Canada) allows assistance to die to chronically ill people with incurable suffering, who are not terminally ill.
Euthanasia is a term often used to refer to the administration of life-ending medication by a third party. Voluntary euthanasia (permitted in the Netherlands and Belgium) allows a doctor to administer the medication directly to a requesting patient. Non-voluntary euthanasia describes a situation where a third-party (usually a doctor) administers life-ending medication without the consent of the patient. Both voluntary and non-voluntary euthanasia are illegal in the UK, although evidence shows that both do occur.  
The assisted dying legislation we propose is similar to that in place in 6 states of the USA and would give terminally ill adults choice and control over the timing and manner of their death. Dignity in Dying does not campaign for a change in the law to allow people who are not terminally ill assistance to die. 6

7. What is the current law in the UK?
The 1961 Suicide Act bans someone assisting another person to die.
Nonetheless, the Director of Public Prosecutions issued guidelines which show that the law turns a blind eye to compassionate amateur assistance to die.
The current law does not protect vulnerable people. There are no safeguards as cases are only investigated after someone dies.
The current law does not allow dying patients to seek advice from their healthcare professionals about assisted dying.
- It is currently illegal to assist someone to die in the UK under the 1961 Suicide Act and carries a sentence of up to 14 years in prison
- Although assisting another person to die is illegal, in February 2010, following the Debbie Purdy case, the Director of Public Prosecutions set out those circumstances under which someone would face prosecution for this act in England and Wales. Debbie Purdy won her case to clarify the law around assistance to die two years later. This did not bring a change in the law on assisted dying but recognised in certain circumstances, someone who compassionately assists someone to die will not be prosecuted.
- This does not safeguard either those who are assisted to die or those assisting them because the investigation occurs only after the person has died.
- However, without a REAL change in the law there still remains no safe means of assisted dying for dying people. Without which these people rely only on the amateur assistance of friends or relatives, or doctors willing to act outside of the law – at the very least risking a criminal investigation but also possible prosecution. 7

8. The current law is broken
It’s inhumane
People suffer horrific deaths
Even the best palliative care cannot relief all suffering
Some people take matters in to their own hands and attempt to commit suicide, often violent and botched
Some people decide to exercise control over the time and manner of their death by refusing food and water
We claim to be a humane and compassionate society and yet we allow people to suffer in ways that is illegal for our pets
Many people have shared with Dignity in Dying stories of the horrific deaths their loved ones have experienced. Suffering from pain, discomfort, poor quality of life, distress and lack of dignity. This can be even with all the pain relief and quality palliative care possible.
Suicide attempts are often carried out alone and can have horrible consequences when they don’t go to plan. This is coupled by the fact that patients can’t seek advice from their healthcare professionals to let them know they are considering it, as healthcare professionals would be acting outside of the law. Suicide attempts can be earlier than an individual would like while they still have the ability. Many carry out attempts alone, out of fear of implicating friends and family.
The current law allows someone to refuse treatment and/or to refuse food and water, which some choose to do to as the only way to bring about the end of their life and put an end to their suffering. 8

9. The current law is broken
It’s unjust
In 2016 every eight days someone travelled to Dignitas in Switzerland to have an assisted death
There is significant cost to travelling abroad for an assisted death – financial, emotional and physical
Often those who travel die earlier than would have liked, in unfamiliar surroundings, and fear for their loved ones on their return
Why should only those who can afford it have a good death?
Why should only those who have the knowledge, or the support of family members, have choice and control while others have to suffer in the UK?
Dignitas is a Swiss organisation based near Zurich that helps people with incurable illnesses to die and regularly features in the British media. The name Dignitas is now synonymous with the campaign for law change and the right to die. Around a 1,000 Britons are members of Dignitas in the UK. 47 Britons died there in the last year, which is a steady increase since 2002 bringing the total to well over 300. There are one or two other clinics in Switzerland where Britons travel to.
While it is true that over 350 people have travelled to Dignitas to date, which equates to one person every 8 days in the UK travelling abroad to die – this is only the tip of the iceberg. As a recent Freedom of Information request has shown that for every one person travelling abroad to die there are a further 10 terminally ill people ending their own lives here in the UK, often alone behind closed doors.
Travelling abroad to die is no easy feat, there is significant paperwork and medical records to get hold of from your doctor, who are often ill trained and equipped to provide any advice to their dying patients. Moreover, the costs are significant, such a trip to Switzerland could cost upwards of £10,000.
Many who make plans to die at Dignitas fear for their loved ones who they take with them, as it is possible that they will face a criminal investigation upon their return to the UK. Although no one has yet been prosecuted for accompanying their loved one to Dignitas.
Finally, those people that do make the decision to travel to Dignitas are often forced to go before they are ready, while they are still fit and well and able to travel. If an assisted dying law existed in this country they would be able to die with all their loved ones around them at home, rather than on an industrial estate in a foreign country. 9

10. The current law is broken
It’s outdated and unclear
We are a liberal society that values personal freedom
We allow people to starve themselves and refuse treatment, but not end their lives peacefully
We pride ourselves on a free NHS and yet lawmakers think that paying £1000s to travel to Switzerland is a solution to the problem
There is silence – healthcare professionals cannot speak to their patients and organisations cannot provide advice
… and yet we don’t give people choice over their death. Britain was beaten by Canada to be the first commonwealth country to introduce an assisted dying law. Australia is likely to follow this year.
2) Within the current law you have the right to refuse treatment, or refuse food and hydration. However, people who take the option often have a long and protracted death, suffering from pain and lacking dignity.
3) It undermines the fundamental principles of our healthcare system that it should be available to all and free at the point of arrival
4) Many healthcare professionals won’t even allow a conversation about assisted dying to take place, for fear of breaking the law or breaching General Medical Council guidelines which can lead to them being struck off. This lack of dialogue could mean that a GP, for example, wouldn’t be aware of any plans a patient had to end their life at home or abroad. This makes it harder to safeguard vulnerable patients from coercion, or discuss different options for end of life. 10

11. Challenging the law Through Parliament Through the courts
2014: Lord Falconer’s Assisted Dying Bill introduced to House of Lords and had majority support but ran out of time
2015: Assisted Dying Bill introduced by Rob Marris to House of Commons – rejected 3:1
Through the courts
2017: Noel Conway case – ongoing
2014: Tony Nicklinson case – lost
2009: Debbie Purdy case – won
2002: Diane Pretty case – lost
Lord Falconer’s Assisted Dying Bill (House of Lords)
It was tabled as a Private Member’s Bill in the Parliamentary session. The Bill completed it’s First and Second Reading as well as Committee stage. After which it ran out of time to be debated before Parliament was dissolved for the May 2015 General Election. Two thirds of the House of Lords voted in favour of the Bill. The debates were the longest and most well attended private member’s bill debates in HoL history.
Rob Marris Assisted Dying Bill (House of Commons)
This came not long after Lord Falconer’s Bill, again as a Private Member’s Bill. Rob Marris is a Labour MP who was drawn top of the ballot for a PMB and then decided to introduce an Assisted Dying Bill, so there wasn’t much forewarning. MPs had a free vote (so the party whips didn’t tell them which way to vote) as it was deemed a ‘matter of consciousness’.
Legal cases
There have been several high profile legal cases, including Tony Nicklinson, Debbie Purdy and Diane Pretty. They were all individuals seeking to change or clarify the law on assisted dying. Diane Pretty lost her case, which was asking whether her husband would be free from prosecution if he helped her to die. Debbie Purdy was asking for a clarification in the law, if her husband helped her to travel abroad for an assisted death, which she was granted with the Director of Public Prosecution issuing on guidance on compassionate assisters. This was a pivotal case, but has also highlighted the problems within the law – that prosecutors are prepared to turn a blind eye.

12. Noel Conway’s legal case
Noel Conway has terminal motor neurone disease and wants the choice and ability to die with dignity.
Dignity in Dying is supporting him as he seeks a judicial review of the current law prohibiting assisted suicide.
“If I let nature take its course, I could effectively become entombed in my own body … or I may die by suffocation or choking.” Noel Conway
Noel is dying. He needs help to breath, eat, dress and fears that his dying moments will be spent in pain, suffering and lack of dignity.
67 from Shrewsbury
Noel has less than 12 months to live so may die before the case is closed.
He is arguing that the prohibition of assisted dying is contrary to his human rights under the Human Rights Act.
He is seeking a judicial review to ask for a declaration of incompatibility (between the current law and his human rights)
The papers were issued in January The case went to the High Court for a hearing in mid-year and from there to the Supreme Court, as had happened with the previous case (Tony Nicklinson). Ultimately though, only Parliament can change the law, not the Supreme Court.
The case is still not resolved and Noel is still fighting, although much weakened. The ideal outcome would have been for a majority of the Supreme Court judges to declare the law is incompatible with Noel’s human rights and that Parliament needs to address this by introducing an assisted dying law.

13. Assisted dying laws work abroad
Assisted dying legislation exists in several US states including Oregon, California and Washington DC.
Canada (June 2016), the Netherlands, Luxembourg, Belgium and Switzerland have legislation which allows people to seek assistance die.
A number of countries have passed laws to provide terminally ill people with the choice of an assisted death. The law Dignity in Dying proposes is very similar to the law currently in place in Oregon in the USA – as of June 2016 this law exists in California too as well as the states of Washington, Vermont, Montana, and more recently in Colorado and Washington DC,
Oregon (USA)
 The Oregon Death with Dignity Act has been in place for 19 years. It gives terminally ill people choice within upfront safeguards. Research from Oregon shows no evidence of the so-called ‘slippery slope’ or a negative impact on vulnerable people. There have been no cases of abuse of the law in Oregon.
The numbers using the Act to die are low and steady – and in 19 years just 991 people have been assisted to die (about 0.3% of all deaths) but many more have taken comfort from knowing the choice is available to them.

14. Public support
82% of the general public support a change in the law on assisted dying
MPs voted 3 to 1 against Rob Marris’ Assisted Dying Bill in September 2015, despite overwhelming public support.
MPs said during the debate that the status quo is less dangerous than changing the law: this is not true as the current situation does not have any safeguards.
MPs say they didn’t have enough time to understand the Bill.
Politicians are influenced by some of our vocal opponents.
Politicians do not accurately represent the views of the British people
Populus poll from 2015 – biggest survey of British attitudes towards assisted dying polled over 5,000 people. However, politicians are not aware that so many people support a change in the law. They are our representatives – so we need to hold them to account!
 Recent private polling of MPs by Dignity in Dying has suggested that they are not aware of the support among the British public for a change in the law. There is a correlation between MPs who are opposed to change and those that [also] think that their constituents do not support it. Without activists lobbying their MP it is difficult to communicate the real and significant support that exists among the general public for law change. Without many people building a relationship with their MP and telling them their compelling personal reasons for changing the law it may be difficult for them to see why it is so important to their constituents.
They are often misinformed – as some believe that the status quo is safer than a proposed law – when this isn’t the case, as the current law does not protect vulnerable people. The safeguards in assisted dying law such as assessment by two doctors and a High Court Judge approval - and the openness this would create (allowing proper informed discussion with healthcare professionals) far better protects those who might be vulnerable to coercion.
Although lots of our supporters sent MPs and Lords letters of support of assisted dying, some received similar levels of letters in opposition from a vocal minority, giving the impression that public opinion is more divided (e.g. 50:50 when in actual fact it’s 80:20) We need more people to demonstrate their support. 14

15. ‘Professional’ support
Inter-faith leaders for Dignity in Dying (IFDID) has over 50 members from different denominations.
Healthcare Professionals for Assisted Dying (HPAD) has over 1,000 practicing, retired and student members covering a broad range of professions, from nurses to surgeons, GPs to psychiatrists.
Disabled Activists for Dignity in Dying (DADID) does what it says, in the face of opposition from groups which say they represent members.
Professional and membership bodies do not accurately represent the views of their members 15

16. What do we do next? The team at Dignity in Dying will . . .
continue to challenge the courts, like the Noel Conway case
challenge the British Medical Association to move to a neutral position
put pressure on MPs through the growth of our local campaign movement, public support and media priority and by building a powerful network of supportive MPs in Parliament and
work with MPs to introduce another Bill, and another . . .
until the law is changed, hopefully before 2035
The BMA, the Church and the disabled lobby have a disproportionate influence over politicans and the public.
We must continue to persuade MPs to recognise the need for an Assisted Dying law, so that when a new Bill is introduced, we know that there will be enough support for it to pass.

17. Choice, dignity and compassion
This is deliberately left blank for you to add your own words to sum up the talk. If you shared a personal story at the start, refer back to remind everyone. 17

18. For more information and to get involved contact Dignity in Dying
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