Assisted dying: leading doctors call on Lords to back legalisation

Twenty-seven leading figures write to every peer urging them to back Lord Falconer's private members bill on assisted dying

Leading doctors have called for terminally ill patients who are suffering "unendurably" to be able to end their lives with doctors' help, in an 11th hour attempt to persuade the Lords to back such plans.

Twenty-seven senior figures, including 11 present or former presidents of royal medical colleges and a former NHS medical director, have written to every peer urging them to back Lord Falconer's bid to legalise assisted dying, which is due to come before parliament on Friday.

"We believe it would provide the option of relief to a small but significant number of patients who suffer unendurably during the terminal days or weeks of a difficult illness despite the best that palliative care can offer," they write.

More than 100 peers are already scheduled to speak in the debate, which will be the first on a bill to legalise assisted dying since 2006.

The doctors include Sir Richard Thompson, the president of the Royal College of Physicians, which represents the UK's 30,000 hospital doctors; Sir Michael Rawlins, the former chair of the National Institute for Health and Care Excellence (Nice), which sets standards in the NHS; and Dr Graham Winyard, who was the NHS's medical director in England from 1993 to 1999. All 27 have expressed their views in a personal rather than representative capacity.

The letter has been organised by Sir Terence English, a former president of the Royal College of Surgeons, who is also a patron of Dignity in Dying. The signatories ask peers to recognise "that the narrow scope of the bill does not allow for assisted suicide when the patient is not terminally ill, as is practised in Switzerland, nor for voluntary euthanasia, as in Belgium and Switzerland, where a doctor administers the lethal medication".

The doctors seek to refute one of the biggest objections to Falconer's private member's bill by stressing that it would "minimise the potential for coercion by others and ensure that the decision to end life is taken solely by the patient". The bill would allow adults in England and Wales with less than six months to live to receive help to end their lives. Two doctors would independently confirm the patient's state of health and that he or she had made an informed decision to die. One of the two doctors would then provide the drugs with which the patient would end their life, if he or she asked for them.

Rawlins said that as he would end his own life if he became gravely ill, everyone in that position should have the same right. "I strongly believe that, subject to appropriate safeguards, people whose lives have become intolerable from physical illness should be helped to die. I myself, under such circumstances, would most certainly seek to do so, and as a pharmacologist I would have the knowledge of how to do it. It would therefore be hypocritical of me to deny others the same opportunity."

Another signatory, Professor John Ashton, the president of the Faculty of Public Health, told the Guardian earlier this month that doctors should be prepared to act as "midwives" to help terminally ill patients die days or weeks early.

Assisted dying would empower patients, the doctors write. "We hope that assisted dying or, as some would have it, physician-assisted suicide for the terminally ill, will become legal and thereby allow dying patients who meet the criteria to have this degree of control over the final days of their life. The alternative is for them to have to consider a number of unpalatable options, including help from friends or relatives or travelling abroad to die without the advice and support of a sympathetic physician."

Lord Carey, the former Archbishop of Canterbury, revealed at the weekend that he had changed his mind on assisted dying. He said he now supported it "in the face of the reality of needless suffering. In strictly observing the sanctity of life, the Church could now actually be promoting anguish and pain, the very opposite of a Christian message of hope", he said.

The current archbishop of Canterbury, Justin Welby, however, has said Falconer's bill is "mistaken and dangerous". The church wants the peer to withdraw his bill and a royal commission to investigate the issue.

The Royal College of Physicians (RCP) and Royal College of GPs (RCGP) are both opposed to assisted dying. In their most recent surveys of their members' views, 73.2% of hospital doctors and 77% of family doctors said they were against legalising it.

Dr Maureen Baker, the RCGP chair, said: "Terminal illness is an extremely stressful time that causes many patients to become depressed and frightened. The college is opposed to a change in the law to permit assisted dying because it would be impossible to implement without eliminating the possibility that patients may be in some way coerced into the decision to die."

It is also worried that legalisation would be the start of "a slippery slope" which would lead to the right to an assisted death being extended to those who could not consent on grounds of capacity and those who are severely disabled.

Christian groups also criticised the dctors' intervention.

Alistair Thompson, a spokesman for the campaign group Care Not Killing, said: "These are a number of doctors who are contrary to the vast majority of the medical professionals who do not support assisted suicide and euthanasia. When it is discussed by doctors, as it was at the British Medical Association conference, it is always rejected. The letter is nothing new, and previous iterations of it haven't come to anything."

Andrea Minichiello Williams, the chief executive of Christian Concern, said: "This bill masquerades as compassionate but would quickly become an instrument of oppression of the most vulnerable in society. There is all the difference in the world between removing treatment and actively killing someone. Once that line is crossed we open the floodgates to cruelty and abuse.

We must not allow doctors to move from practising care to facilitating death. If we do, we break the bond of trust and place those who need doctors most at the greatest risk from them."

A Ministry of Justice spokesman said: "The government believes that any change to the law in this emotive area is an issue of individual conscience and a matter for parliament to decide, rather than government policy."


Denis Campbell and Dominic Smith

The GuardianTramp

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