Attempt to close assisted suicide debate unhelpful

There are certainly positive reports about Oregon’s approach to assisted dying, but these are not the only opinions available and anyone interested in looking at the issues in more depth may find the following website of interest. If the information it presents is accurate, then it is very unfair to denounce Mr Meadowcroft for spreading misinformation. The site is

http://www.patientsrightscouncil.org/site/oregon/.

The issue of assisted suicide is being presented by campaigners as a simple matter of personal choice and a simple matter of adopting Oregon-style legislation. I wish it were that simple and I have to confess to having very ambivalent feelings about it.

I agree that we should not shy away from discussing an issue simply because it presents complex ethical, legal and practical challenges. However, many of those campaigning for this change seem to have a shaky grasp of some of the implications of the arguments they are using.

It certainly doesn’t seem reasonable to argue that anyone should be allowed to die in pain and suffering and yet that is precisely what the campaign for assisted dying is inadvertently doing.

As Mr Wilson rightly says, pain and suffering are highly subjective and it may be the case that palliative care is not always completely effective in relieving that pain and suffering. I have not yet seen any statistics as to how many people in Guernsey actually do die in pain, but assuming that this does sometimes occur, it could be an argument for legalising assisted suicide.

The campaigners do seem to be aware of the risk that vulnerable people may be unduly influenced by others to take the decision to end their life and so are in agreement that there should be safeguards against this. It is suggested that the choice should only be available to those over 18 who are deemed to have the mental capacity to make the decision and who specifically ask for assisted death. This effectively means that it is considered permissible to allow children and adolescents, those with severe learning disability or mental health issues to die in pain and suffering because we cannot be sure that such people have the capacity to make an informed choice. Or are we in some way assuming that these people do always respond positively to palliative care?

The simple freedom of choice argument becomes further complicated by the necessary involvement of professionals who will be expected to assess mental capacity and to judge whether a person will only have six months to live. The issue of capacity is complicated by the fact that many terminally ill patients may have additional depression and anxiety as a result of their condition and may already be taking medication which might affect their decision-making ability.

Life expectancy is notoriously difficult to assess with complete accuracy. Indeed, estimates can sometimes be inaccurate by months or even years.

Several people have put forward the argument that assisted suicide gives the choice to the patient – this may be the case, but it places a significant amount of the responsibility for the decision on the medical profession.

There are also major ethical questions that the States have to consider. HSC already has to take difficult decisions on the cost-effectiveness of new drugs. Adding legalised suicide into the equation can complicate those decisions further. Some drugs may extend and improve the quality of life for a terminally ill patient without offering a long-term

cure.

Medicaid in Oregon apparently declines to fund some of these drugs but will fund assisted suicide. I’m not sure if that is any less ethically unacceptable than simply not providing the drugs, but it certainly doesn’t seem more acceptable either.

I understand why many people are campaigning for assisted suicide, but I do think Doug Wilson and the ‘dignity’ campaign should not be trying to shut down debate from those who have reservations about going down this route by suggesting that any scepticism about the Oregon model is ‘misinformation’.

CATHERINE HALL,

Vale.