New guidance on end of life decisions

Patients who are approaching the end of their life need high quality treatment and care that support them to live as well as possible until they die, and to die with dignity. It seems that more and more people are making their preference not to have their lives prolonged under certain circumstances clear in the form of “living wills”. This can leave their medical carers in a potentially difficult situation both legally and ethically. Assisted suicide or assisted death; euthanasia (voluntary or otherwise) or the right to take your own life (the nomenclature changes depending on your stance), seems to be rarely out of the papers these days, with the arguments for and against raging to and fro across the letters pages, blogs and online comments sections. Baroness Campbell, who has spinal muscular atrophy, is a high profile and impassioned campaigner against the relaxing of the laws on assisted suicide. She told the Daily Telegraph last year that she felt the time had come to speak out. In a speech opposing the former Lord Chancellor, Lord Falconer’s attempt to relax the law on assisted dying, she told her fellow peers that reform would lead to state-assisted dying: to a situation in which doctors could encourage people with disabilities to end their lives. Baroness Campbell commented: “Those of us who know what it is to live with a terminal condition are fearful the tide has already turned against us. If I should ever seek death – and there have been times when my progressive condition challenges me – I want to guarantee that you are with me, supporting my continued life and its value. “The last thing I want is for you to give up on me, especially when I need you most. Assisted dying is to abandon hope and ignore the majority of disabled and terminally ill.”1

The former Lord Chancellor’s proposed amendment to the Coroners and Justice Bill, which would have allowed people to help someone with a terminal illness to travel to a country where assisted suicide is legal, was rejected in a free vote by 194 to 141. However, although the Bill was rejected, Baroness Campbell also raised concerns over clinical decision-making, which remain as pertinent today – and warned against the dangers of making “assumptions” about whether or not a disabled or terminally ill person’s life should be prolonged. She described how her husband was forced to show doctors photographs of her receiving an honorary doctorate in law from Bristol university to “prove” the quality of her life, when she was admitted to hospital after being taken ill with pneumonia. Although she had been rushed to hospital at the brink of death with acute respiratory problems at least once during each of her 50 years, on this occasion she was rushed to a hospital where she was not known and was unable to communicate her wishes. The doctors wrongly assumed that she would not want to be resuscitated, when in fact she had a very strong desire to live. In her view, the hospital would have allowed her to die if her husband had not been present to fight for her wishes.1

High profile campaigners