The Commission on Assisted Dying
Today the Commission on Assisted Dying launches its final report. This is the culmination of a long journey and a year of consultation, which the Demos research secretariat has coordinated on behalf of the Commissioners.
The public consultation by the Commission on Assisted Dying has included a call for evidence that received more than 1,200 written responses, six public evidence hearings, at which the Commissioners heard evidence from 46 experts and members of the public with relevant personal experience, and international research visits to four jurisdictions that permit assisted dying: the Netherlands, Belgium, Oregon and Switzerland. Demos also undertook original independent research on behalf of the Commission to investigate the link between suicide and physical illness in the UK, and held interviews and focus groups with groups considered to be potentially vulnerable to a change in the law on assisted dying, including older people, terminally ill people, disabled people and people with learning disabilities. Demos also interviewed six palliative care nurses to explore their views and commissioned two original briefing papers from Professor Penney Lewis and Isra Black at Kings College London’s Centre of Medical Law and Ethics and from the European Association of Palliative Care.
Following this extensive research programme, the Commission has published its final report today, concluding that the current legal status of assisted suicide is inadequate and incoherent, and recommending that UK Parliament should consider a new safeguarded framework to permit terminally ill people (defined as those who have a progressive, incurable condition that is likely to lead to their death within 12 months) to end their own life with a doctor’s assistance. This would ensure that people need not continue to suffer unnecessarily at the end of life, if they felt that end of life care could not meet their needs, or end their life alone to prevent a loved one from being prosecuted for assisting their death. It could also prevent doctors from acting covertly to end their patients’ lives, putting themselves at risk of prosecution and increasing the likelihood that non-voluntary euthanasia might take place. Professor Clive Seale’s research, which he presented to the Commission, found that around 0.2 per cent of deaths attended by doctors in the UK currently constitute voluntary euthanasia, whereby ‘following a request from a patient, a drug is administered with the explicit intention of ending life’. This amounts to approximately 1,000 deaths each year in England and Wales.
The Commission’s report also concludes that in parallel with any legal change on assisted suicide, the Government would need to take action to tackle inequalities in end of life care, to ensure that high quality end of life care is available to all who need it. These improvements could include developing community services to ensure that people can die at home if they wish to, providing appropriate training in end of life care for all health and social care professionals involved in this area of work and making sure that all health and social care services meet the minimum requirements outlined in the national standards inspected by the Care Quality Commission.
In making these recommendations, the Commission seeks to debunk the myth that the legalisation of assisted dying might in some way undermine palliative care provision in the UK. In fact, the independent research that the European Association of Palliative Care provided to the Commission concluded that palliative care is currently as well developed in European countries that allow assisted dying as in those that do not, and that ‘the idea that legalisation of euthanasia and/ or assisted suicide might obstruct or halt palliative care development thus seems unwarranted.’ The experts that the Commissioners met with during their international research visit to Oregon also confirmed this view, observing that the legalisation of assisted dying in Oregon has actually increased access to end of life care for many people, as a person who requests an assisted death is always referred to hospice care as first port of call, before their request is explored any further.
The Commission on Assisted Dying is independent from Demos and its findings are entirely its own. That being said, the Demos research secretariat has worked alongside the Commissioners throughout their research and we wholly support their findings and the framework they have devised. We feel privileged to have hosted and assisted with such a important piece of research and we hope that this research will help to move the assisted dying debate forward, bringing us closer to resolving one of the most controversial public policy issues of our time.