Thursday, October 02, 2008

The Duty to Die: Part 3

One does wonder whether in Britain we are in the middle of a campaign to "liberalise the law" on assisting suicide or "assisted euthanasia".

In times of economic austerity which it looks as if we are facing and going to face in the near future, government spending cuts will become a reality. The rise in health spending will stop. Priorities in the National Health Rationing System will have to be set.

Today The Telegraph reported on the launch of a two-day judicial review at London's High Court in an attempt to force the Crown Prosecution Service to spell out exactly what actions would lead to a friend or relative being charged with aiding or abetting suicide.

"Debbie Purdy suffers from a progressive form of multiple sclerosis that will lead to the degeneration of her body.

When she feels she cannot go on she wants to be able to end her life at home, surrounded by her loved ones, but because of the country's "inhumane" law against assisted suicide she says she is unable to do so"

There is also today a widely disseminated report on the Dignitas Clinic in Switzerland which has operated in and around Zurich for 10 years and has claimed that it has "assisted" a total of 100 Britons to have been helped to die

"Patients who contact the centre, most of whom are terminally ill or suffering from chronic, painful diseases, discuss their wishes with staff to establish whether they should be allowed to die. ...

If they do decide to go through with the assisted suicide, the patient signs a document stating their wish in case it faces opposition, and are then taken to a flat owned by Dignitas after paying a fee of about £3,000.

The patient is given an anti-sickness drug, and half an hour later they inject themselves with a lethal dose of barbiturate.

They are filmed in order to prove they administered the drug themselves, with the video shown to police and a coroner after the death.

Less than five minutes after the injection, the patient slips into a coma and their heart then stops beating.

Dignitas staff check that the person is dead then call the police so the body can be removed and the cause of death established.

Last year Dignitas was evicted from its flat in Zurich after neighbours complained about dead bodies being taken in the lift and hearses parked outside, and has relocated to a business park in a nearby village."

Rather cold, clinical and inhuman. The name "Dignitas" is rather Orwellesque. There is precious litle dignity involved in such proceedings.

Both follow on from the recent reports that:

(1) the Ministry of Justice Press Office issued a news release that the Government intended to reform the law on assisting suicide so that it is "simplified ". See The Duty to Die: Part 2

(2) the proposal by Baroness Warnock that ethically, some people may be under a "duty to die". See The Duty to Die: Part 1

One hopes that the bishops of England, Wales, Scotland and Ireland will take full part in the debate if debate there is to be and make clear what the teaching of the Church is.

On a more hopeful note, one does wonder if the campaign (if it is a campaign) is going to succeed. For a start, elderly people have votes (unlike unborn babies). They have families. Everyone gets old and no one really wants to consider what may happen to one in twenty or thirty years time.

The Scottish Government, at least, has committed itself to raise the level of palliative care across Scotland.

In Patients will get right to spend last days at home The Herald reports that

"Terminally-ill patients will be given the right to die at home under the first comprehensive plan for end-of-life care in Scotland.

The action plan, which is being unveiled by Health Secretary Nicola Sturgeon today, promises round-the-clock community support so people do not have to spend their final days in hospital against their wishes.

Ms Sturgeon will pledge £3m of extra funding every year to support the commitment and £500,000 to kick-start improvements immediately. The move follows a survey of bereaved families by Scotland's official auditor which found almost one-in-five terminally ill patients did not die where they wanted to.

Dramatic differences in the level of palliative care available across the country was also highlighted by the Audit Scotland researchers and they discovered cancer patients receive 90% of specialist services while accounting for 30% of deaths.

Ms Sturgeon said: "People with any advanced, progressive or incurable illness should receive the best palliative care available.

"Our goal is excellent quality, integrated care - planned and delivered in ways which take full account of the needs and wishes of patients, families and carers."

Palliative care charity Marie Curie Cancer Care welcomed the plan and said it was committed to working with others to ensure the promises are turned into effective action.

Last year the charity released figures to The Herald showing how the level of care available to dying patients varied across the country. The data showed some health boards offering patients an average of 140 hours with specially-trained nurses, while others reached an average of 40 hours.

Marie Curie also said demand for their home-care nurses often burst the budget agreed with NHS managers.

The amount of money the Scottish health service currently spends on palliative care is unknown, according to Audit Scotland. This is because much of it is provided by people such as GPs and district nurses as part of their routine work.

About £59m was spent on specialist palliative care in 2006/07, and almost half of this money came from the voluntary sector."

This measure, although small, deserves to be applauded. Hopefully the policy will be successful and a model of its kind. This may be the first sign that the importance of palliative care is being recognised by politicians and that similar measures will be taken in other parts of the United Kingdom. If adopted, these measures should counter act the insidious measures proposed by those who advocate that the law on "assisted suicide" should be "liberalised" and that there may even be a duty on people to die for reasons associated with economy.

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