'This House Supports Assisted Dying'
Speakers:
Mr Oscar Dunn - Year 3 Medical Student, Hull York Medical School
Dr Greg Richardson - Consultant Child and Adolescent Psychiatrist, York
Mr James Challinor - Year 3 Medical Student, Hull York Medical School
Dr Jeff Clarke - Consultant Psychiatrist for Older Adults, Harrogate
The Terminally Ill Adults (End of Life) Bill is currently undergoing scrutiny in the House of Lords. If it becomes law, it will allow people in England and Wales with less than six months to live to seek a physician-assisted death.
But is it ever right that doctors should actively participate in ending life? How can this align with our ancient Hippocratic principle to ‘do no harm’?
Or is the relief of suffering and distress more important than treatment to preserve life? Does assisted dying simply offer modern compassionate medicine, and place patients at the centre of decisions about their own life?
We had a stimulating evening debating the ethics and reality of assisted dying - a topic of continuing importance to everyone involved in healthcare.
Notes from the evening are given below.
Please note that the opinions expressed are not necessarily those of the speakers or of York Medical Society and do not endorse any particular position.
Vote of thanks by Dr John Reid
The President introduced the debaters and explained the process.
Oscar Dunn (3rd year Medical Student HYMS) and Dr Greg Richardson (Retired Child Psychiatrist) would speak for the motion.
James Challinor (3rd year Medical Student HYMS) and Dr Jeff Clarke (Consultant Psychiatrist for the Elderly) would speak against the motion.
There was a blind vote of hands before the debate, with 3 choices: those in support of the motion, those who were against the motion, and those who were undecided. The results were not announced at this stage.
Oscar Dunn (for): He undertook a quick straw poll of the audience asking if the audience preferred to know how they would die or when they would die. Most opted to know when they would die, but he stated that studies suggest most people prefer to know how they would die.
He stated that thinking of death has been shown to increased racism, homophobia.
He related about this personal experience of his grandfather who died of MND in June 2022. He did not know if he was scared, and feels he may have wished an option on how he died.
James Challinor (against): He talked about the Voluntary Euthanasia Society in 1936. Assisted dying is actually assisted suicide; it is an active intervention to cause death.
He questioned what the right response to suffering is. He does not want or advocate for suffering.
In 1961 suicide was no longer an offence but assisted suicide remained an offence. Once there is assisted suicide, then coercion is possible, and can affect family friends and the Doctor.
He talked about the ‘Do no harm’ undertaking of Doctors, but medicines to cause death are poisons.
Under the bill, you have to have a prognosis of 6 months. This is very hard to predict.
He stated that assisted suicide does not give someone an easy death necessarily.
The RCPsych does not support assisted suicide. The UK has high quality palliative care, which leads to less requests for assisted suicide. But palliative care is under resourced. Assisted suicide risks undermining the value of human life. It would be better to work harder on symptom control.
Questions for the 1st two speakers:
Nick Bosanquet asked about the fact that assisted suicide happens as part of palliative care, when Drs take decision on End of Life Care.
David Chadwick Chaplain YDH: He commented that he came across quite a lot of people who were suicidal. Suicide is seen as evil, he feels it is an illness. Is suicide an evil?
Tim Hughes: Where did autonomy come in all this? He could relate to 6 patients in his career where Assisted suicide would have helped.
Greg Richardson (for): Death can be planned for and comfortable.
He has been well but has a “terror” of a difficult death.
He feels Autonomy is the top of his list of determinants.
Nobody should be coerced. He advocated Advanced directives and living wills. He commented that wishes need to be discussed with the family. He does not want his family to have their last memory of him is as a gibbering wreck.
But a Doctor should not administer any drugs.
The individual has to consider their family and family is paramount.
Jeff Clarke (against): He talked about ‘controlling’ death. He does not want to become ill. He talked about poisons to end life.
Autonomy This is said to be paramount, but gets altered by rules, and constraints and are ever present. ‘I may not want to wear a seat belt on occasion, but it is required’
Dignity has an intrinsic quality.
Euthanasia is the predominant model of assisted dying.
But where it has been enacted there is remit creep. Where people have to self-administer such as Oregon, there is less creep. Where Drs give injections. The evidence is that rates rise.
Assisted suicide does not reduce the incidence of unregulated suicide.
The evidence shows that Palliative care quality is reduced where there is assisted suicide.
Questions and Comments:
Is there free choice?
Jeff: Who can spot coercion? Why have you not considered assisted suicide?
Greg: I’ve been very lucky and do not want to be a burden.
Stuart Calder: The slippery slope is very real and backed by hard evidence.
Helen: In New Zealand: Patients can choose the method, including intra osseus injection., Families are distraught and there is a fall out from this.
After the questions had been answered, there was a repeat of the anonymous vote. This was reported as showing that the house had changed its views with less undecided and more members of the audience voting against the motion.
The President announced the results.
Before the debate: 14 members voted for, 15 against and 8 were unsure.
After the debate: 9 members voted for, 21 against and 3 still unsure.
Please note that the opinions expressed are not necessarily those of the speakers or of York Medical Society and do not endorse any particular position.