In Canada the euphemism they use is ‘maid’: medical assistance in dying (and I do mean euphemism rather than just acronym).
The last attempt in Parliament to introduce changes in our law to allow it was seen-off so decisively by the House of Commons in 2015, that I am surprised that this agenda has raised its head again so soon after its comprehensive defeat, and I am at a loss to identify anything significant that has happened to bring it back on to the political agenda. Nevertheless, it was debated in the Commons again last week (though no vote took place).
The one change that has taken place is that the Royal College of Physicians has moved from a stance of opposition to medical assistance in dying, to one of neutrality. This change was secured after a ballot of its members. Curiously, the rules for the ballot required a majority of 60% to maintain what was then the status quo (opposition to doctor assisted dying). At 43.4 % most physicians voted to keep the College’s opposition, 31.6% voted to have the College support it and Only 25% thought the college should be neutral. The College has therefore adopted the position taken by fewest of its voting members!
I wonder what consideration was given to how profoundly the proposal would change the nature of the medical profession. How will our attitude to doctors change when, in addition to healing, they also bring the instruments of death?
Suicide itself used to be against the law. Now some 5000 people commit suicide in the UK every year, of which it is estimated that about 400 do so because they have a terminal medical condition.
In the Netherlands by contrast, the annual number of doctor-assisted deaths is 21,000. Are we really ready for the scale of what is proposed?
I have every sympathy for those with a terminal condition but who do not have the means to visit the Dignitas Clinic in Switzerland, and who want to have the option of their doctor killing them when their condition becomes too painful and undignified to bear any longer.
The consequences of changing the law to accommodate them however, strike me a potentially much worse.
What begins as an ‘option’ may quickly become an ‘expectation’.
“After all, you wouldn’t want to become a burden, would you?”
A clinical director from Canada visited Parliament recently and made a presentation in the House of Lords at which I was present. One of the more worrying points that she made was her suggestion that palliative care budgets in Canada are being squeezed to fund the new medical assistance in dying service.
We are at our most expensive in terms of our consumption of healthcare in the last weeks of our lives. Think of the savings to be had for NHS budgets if only we could persuade more people to do the “decent thing”.
What a grotesque calculation!
Change the law however, and one day not so far off, we’ll end up making it.