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Setting the Record Straight ASSISTED DYING: SETTING THE RECORD STRAIGHT. August 2015 DISPELLING THE MYTHS. year over 300 terminally ill people end their own lives at home, often 82% in distressing circumstances,3 and OF THE GENERAL around 1,000 lives per year are ended by doctors illegally at the PUBLIC patient’s request.4 Allowing these practices to continue, unregulated and behind closed doors, is no substitute for 79% a safeguarded assisted dying law. OF RELIGIOUS The Supreme Court has warned Parliament to address this issue and PEOPLE a majority of Peers in the House of Lords have voted in support of Lord Falconer’s Assisted Dying Bill. The Assisted Dying Bill builds on the 86% law in Oregon, USA, which has been OF DISABLED operating safely since 1997. It is not PEOPLE based on the laws in Belgium or the Netherlands, which were much wider in scope from the outset and contain SUPPORT THE fewer safeguards than the Assisted CHOICE OF Dying Bill; comparison to these laws ASSISTED DYING is misleading. FOR TERMINALLY Terminally ill people deserve the 1 compassion and protection of a ILL PEOPLE . safeguarded law. They also deserve an informed, evidence-based debate n assisted dying law is when lawmakers are determining needed. The current law what end-of-life choices should be Adoes not work: every two available to them. In order for this to weeks somebody from Britain be achieved, some common myths travels to Dignitas to die,2 every must be dispelled. 2 Assisted dying: Setting the record straight VULNERABLE PEOPLE. MYTH POTENTIALLY that this can reflect patients’ own VULNERABLE PEOPLE, feelings, rather than how caregivers SUCH AS OLDER PEOPLE view them. Caregivers find positive OR DISABLED PEOPLE, meaning in caring for terminally ill WILL BE AT RISK UNDER family members who have requested AN ASSISTED DYING LAW. assisted dying.7 Where assisted dying is legal there is no evidence that potentially Under the proposed Bill, two doctors vulnerable groups such as the would be required to independently over-85s, disabled people, people assess the person making a request, of lower socio-economic status and including exploring the reasoning those with mental health problems and motivations for a request. The are adversely affected.5 The current person would be able to change their law does not contain any safeguards mind at any point. to protect vulnerable people who seek assistance to die. MYTH AN ASSISTED DYING LAW WOULD BE THE START MYTH IN OREGON AND OF A SLIPPERY SLOPE. WASHINGTON, WHERE In Oregon, where an assisted dying ASSISTED DYING IS LEGAL, law has operated safely since 1997, “FEELING A BURDEN” IS there have been no cases of abuse REGULARLY CITED AS A of the law and no widening of its REASON FOR A REQUEST. initial, limited scope. Assisted deaths Patients who request assisted dying in Oregon account for just 0.3% of in Oregon and Washington give total deaths.6 several reasons for their choice - burden falls low on the list. The Assisted Dying Bill contains additional safeguards to the Oregon The key reasons for requesting law, including the oversight of a High assistance to die in both States are Court judge and a clause which loss of autonomy (c.90%), being would allow the Act to be reviewed at less able to engage in enjoyable a later date. activities (c.88%) and loss of dignity (c.79%).6 Burden is less frequently Those opposed to assisted dying cited (40% in Oregon and 59% in often cite the wider eligibility criteria Washington), with research showing of the laws operating in Belgium and www.dignityindying.org.uk 3 the Netherlands, but these have depression (weight loss, fatigue, always been much wider in scope loss of appetite etc.), there was no than the Assisted Dying Bill and do evidence to suggest these people not therefore represent a slippery had depression.9 slope. The law you enact is the law you get. MYTH ASSISTED DYING IS SUICIDE, LEGISLATING FOR MYTH MENTAL CAPACITY IT SENDS A DANGEROUS CANNOT BE RELIABLY MESSAGE TO SOCIETY AS ASSESSED. A WHOLE. Doctors routinely assess mental capacity as part of their day-to-day I am not suicidal. I do not want to duties. Determining mental capacity die. But I am dying. And I want to die already plays a key role in end-of-life on my own terms. decision making, such as the right to refuse treatment. Brittany Maynard, who had an assisted death under Oregon’s The Assisted Dying Bill ensures that Death with Dignity Act in November if either assessing doctor had doubts 2014, aged 29. about a person’s capacity to request an assisted death then they would Dying people who want to control make a referral to an appropriately the manner and timing of their death trained specialist. If they lacked are not suicidal. During Committee capacity they would not be eligible stage of Lord Falconer’s Assisted for assistance. The Royal College Dying Bill, peers voted 2 to 1 against of Psychiatrists is neutral towards a an amendment which inserted the change in the law on assisted dying. word suicide into the wording of the Bill, on the grounds that it did not MYTH IN OREGON, PEOPLE accurately reflect the assisted dying WITH DEPRESSION HAVE process. HAD AN ASSISTED DEATH. A level of sadness is normal in terminally ill patients.8 Research from Oregon found that whilst some requesting patients presented some of the symptoms associated with 4 Assisted dying: Setting the record straight PUBLIC SUPPORT. MYTH THE GENERAL MYTH RELIGIOUS PEOPLE PUBLIC IS DIVIDED ON THE ARE OPPOSED TO ISSUE OF ASSISTED DYING. ASSISTED DYING. The general public overwhelmingly 79% of religious people support a supports a change in the law on change in the law on assisted dying.1 assisted dying. The largest poll ever A number of senior religious figures on this issue shows that 82% of the such as the former Archbishop public back the proposals set out in of Canterbury Lord Carey and the Assisted Dying Bill.1 Archbishop Desmond Tutu have spoken out in support of the choice Polling shows that when presented of assisted dying. with both sides of the argument, opposition to a change in the law MYTH DISABLED PEOPLE does not rise.10 ARE OPPOSED TO ASSISTED DYING. The Ministry of Justice has 86% of disabled people support acknowledged “the substantial assisted dying.1 Disabled people majority of people agree the law are not eligible for assistance to die should be changed”, noting that under the Assisted Dying Bill unless “there have been several other they are terminally ill and meet surveys of varied statistical merit all of the other eligibility criteria. but none of these has reported a A number of well-known disabled majority opposed to change.”11 people including Professor Stephen Hawking have spoken out in support of assisted dying legislation. www.dignityindying.org.uk 5 MYTH THE MEDICAL MYTH TERMINALLY ILL PROFESSION IS OPPOSED PEOPLE DO NOT WANT TO ASSISTED DYING. THE CHOICE OF ASSISTED 57% of doctors feel that assisted DYING. dying legislation with upfront An in-depth study to examine the safeguards would be the best way views of those who were ‘close to to protect terminally ill patients death’ found overall support in favour who want to die and 37% of of a change in law on assisted doctors believe there are already dying,15 and research with people circumstances where healthcare with motor neurone disease found professionals in the UK are actively that the choice of assisted dying assisting terminally ill patients to would bring reassurance, even for die.12 Furthermore, 40% of GPs those that did not consider it an would want the choice of assisted option for themselves.16 dying for themselves.13 The BMA has never surveyed its membership on assisted dying; it has no remit to speak on behalf of its members on this issue. In fact, 56% of GPs think that medical bodies should adopt a position of neutrality on assisted dying.14 57% The Royal College of Nursing, Of doctors feel assisted Royal College of Psychiatrists, dying legislation is the Royal Pharmaceutical Society and best way to protect Royal Society of Medicine all have a terminally ill people who neutral position on the issue. want to die. 6 Assisted dying: Setting the record straight MEDICAL PRACTICE. MYTH IF ASSISTED DYING MYTH ASSISTED DYING IS WERE LEGALISED, IT CONTRARY TO MEDICAL WOULD BE SAFER TO ETHICS AND WOULD REMOVE IT FROM MEDICAL VIOLATE THE HIPPOCRATIC PRACTICE SO THAT OATH. DOCTORS WOULD NOT BE The Hippocratic Oath is generally REQUIRED TO KILL THEIR considered incompatible with PATIENTS. contemporary medicine and has If a request for assisted dying is widely been replaced by the approved, the dying person would Declaration of Geneva. In contrast administer the life-ending medication to the claim that assisted dying is themselves. To use the word “kill” is a violation of the Hippocratic Oath, therefore inappropriate. many healthcare professionals actually consider being prevented Doctors are already required to from respecting the wishes of dying make complex decisions about people in conflict with their medical patients’ end-of-life care; this ethics. includes discontinuing futile treatment and respecting patients’ A conscientious objection clause requests to refuse treatment, both of in the Assisted Dying Bill means which may hasten death. Diagnosing those who did not want to consider a a terminal illness, assessing mental request could choose not to. capacity and providing palliative 57% support and information all require MYTH DOCTORS ARE NOT the expertise of a suitably qualified WILLING TO PARTICIPATE professional. IN ASSISTED DYING, SO A LAW WOULD NOT BE ABLE Evidence from jurisdictions where TO WORK IN PRACTICE.
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