Catholic Medical Quarterly Volume 64(3) August 2014


Opposing a change to  the law on assisted Suicide:
CMA, CMF, and many other organisation oppose assisted suicide

The CMA,  working with  Care Not Killing , and many  other organisations  working, with  Care Not Killing are opposing the Assisted Suicide Bill  which  went before Parliament. Below, is a Care Not Killing briefing paper on assisted suicide and the bill.  Care Not Killing is a UK-based alliance of individuals and organisations which brings together disability and human rights groups, healthcare providers, and faith-based bodies, with the aims of:

  • promoting more and better palliative care;
  • ensuring that existing laws against euthanasia and assisted suicide are not weakened or repealed;
  • influencing the balance of public opinion against any further weakening of the law.

The CMA is one of the organisations that  support and fund Care not Killing

What’s  wrong with  a change to  the law on assisted Suicide?

This briefing paper has been prepared by  Care Not Killing to  assist  better understanding of the issues around assisted suicide.

General arguments against the legalisation of assisted suicide

  • Any change in the law to allow assisted suicide would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed
  • The pressure people will feel to end their lives if assisted suicide is legalised will be greatly accentuated at this time of economic recession with families and health budgets under pressure. Elder abuse and neglect by families, carers and institutions are real and dangerous and this is why strong laws are necessary
  • Experience in other jurisdictions, such as Belgium, the Netherlands and the US American states of Oregon and Washington, shows that any change in the law will lead to ‘incremental extension’ and ‘mission creep’ (Don’t use the term ‘slippery slope’ which implies a passive process) as some doctors will actively extend the categories of those to be included (from mentally competent to incompetent, from terminal to chronic illness, from adults to children, from assisted suicide to euthanasia). This process will be almost impossible to police.
  • The present law making assisted suicide illegal is clear and right and does not need changing. The penalties it holds in reserve act as a strong deterrent to exploitation and abuse whilst giving discretion to prosecutors and judges in hard cases. It has both a stern face and a warm heart
  • Persistent requests for euthanasia are extremely rare if people are properly cared for so our priority must be to ensure that good care addressing people's physical, psychological, social and spiritual needs is accessible to all. Patients almost always change their minds about euthanasia when they experience good care (Note that this argument is inadequate on its own as it is trumped by the autonomy argument so if you use it use other arguments as well)
  • Hard cases make bad law. Even in a free democratic society there are limits to human freedom and the law must not be changed to accommodate the wishes of a small number of desperate and determined people
  • British Parliamentarians have rightly rejected the legalisation of assisted suicide and euthanasia in Britain three times since 2006 out of concern for public safety - in the House of Lords (2006 and 2009) and in Scotland (2010) - and repeated extensive enquiries have concluded that a change in the law is not necessary
  • The current law is working well. The number of British people travelling abroad to commit assisted suicide or euthanasia is very small (150 in ten years) compared to numbers in countries that have legalised assisted suicide or euthanasia. With an 'Oregon' law we would have 1,200 deaths a year and with a 'Dutch' law 13,000
  • If assisted suicide or euthanasia is legalised any 'safeguards' against abuse, such as limiting it to certain categories of people, will not work. Instead, once any so-called 'right-to-die' is established we will see incremental extension with activists applying pressure to expand the categories of people who qualify for it
  • The vast majority of UK doctors are opposed to legalising euthanasia along with the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society
  • All major disability rights groups in Britain (including Disability Rights UK, SCOPE, UKDPC and Not Dead Yet UK) oppose any change in the law believing it will lead to increased prejudice towards them and increased pressure on them to end their lives
  • Public opinion polls can be easily manipulated when high media profile (and often celebrity-driven) 'hard cases' are used to elicit emotional reflex responses without consideration of the strong arguments against legalisation
  • We have seen with the Abortion Act how easily legislation giving doctors the power to end life can be abused. What was intended to be a restrictive law has led to over 8 million abortions since 1967 with about 98% being technically outside the intentions of the Act and virtually no prosecutions for abuse

Specific critiques of Lord Falconer’s Assisted Dying Bill

Lord Falconer’s Bill licenses doctors to assist qualifying assisted suicides. Death takes place after 14 days by self-administering ‘medicine’ in presence of an ‘assisting health professional’

A person qualifying under the auspices of the bill must:

  • have a clear and settled intention to end his or her life
  •  aged 18 or over and resident in England and/or Wales for one year
  • have been diagnosed with a terminal illness (‘inevitably progressive’) & ‘reasonably expected’ to die within six months
  • have made and signed a witnessed declaration countersigned by two doctors who must examine the patient and both record and confirm ‘terminal illness’, ‘mental capacity’ and ‘clear and settled intention’ without ‘coercion or duress’ and be satisfied they are informed of ‘palliative, hospice and other care available’.

Specific problems with the Bill include the following:

  • The Bill essentially licenses doctors to end life by dispensing lethal drugs. It therefore carries all the weaknesses already seen in the Abortion Act (ie. allowing for elastic definitions, fudged paperwork, subjective judgements)
  • The determination of ‘terminal illness’, ‘mental capacity’ and ‘clear and settled wish’ are all very difficult to ascertain clinically even in skilled hands and are open to elastic definitions and the pushing of boundaries
  • Many of the so-called ‘safeguards’ in the bill were previously rejected as unsafe when they appeared in Lord Joffe’s Assisted Dying Bill in 2006
  • The bill does not require the patient to be ‘suffering’ in any way and yet is being promoted on grounds of ‘compassion’. This is illogical as many of those included within its eligibility criteria are not suffering and many not included are suffering
  • The bill is being promoted on grounds of ‘autonomy’ but only applies to mentally competent, terminally ill adults. It is thereby at its very heart discriminatory and will be ripe, once passed, for challenge and extension under equality legislation
  • The certifying doctors are not required to know the patient in question
  • There is no psychiatrist involved in the determination of ‘mental capacity’
  • There is nothing about ‘approved premises’ in the bill meaning that assisted suicide could be carried out anywhere and everywhere
  • Although the bill requires the two authorising doctors separately to examine the person and the person’s records the declaration form authorising the assisted suicide does not require them to say that they have done so
  • Execution, reporting and oversight provisions for authorised assisted suicides are all left for the Secretary of State and Chief Medical Officer to provide. In other words the bill lists eligibility criteria for assisted suicide (terminally ill, mentally competent, settled wish etc) but no real safeguards against abuse which can be properly scrutinised by Parliament.


For further information

Care Not Killing -

Assisted Dying Bill -