I think the objective of the briefing was to stimulate an article on roughly the lines that you see before you: roughly, that is, but not exactly. Sometimes you begin a discussion with a general prejudice to agree with someone – and then, as the conversation goes on, you find yourself prey to misgivings.
The young woman from Dignity in Dying was charming and persuasive, but as we talked about the exact terms of the Bill, I started to worry that it might indeed pave the way for something unintended – something ugly and distressing: not exactly a culture of death, but a world in which it was simply too easy to opt for this state-approved self-extinction.
The problem lies in the first couple of paragraphs, where the Bill defines those who would be eligible to take the “medicine” (a euphemism if ever there was one) or to have it administered to them. They must be someone who has a terminal illness and who “as a consequence of that terminal illness is reasonably expected to die within six months”. Now I am sure that infinite care has gone into the drafting of that phrase, but it surely encompasses a potentially very wide group of people.
Many hundreds of thousands of people, old and young, find themselves living on with terminal illnesses – cancers and other afflictions – for a very long time; and obviously a great many will prefer life to the alternative. It goes without saying that many are capable of taking continuing interest and pleasure in their lives. But it is also true of those people that their conditions could deteriorate quite quickly – and that they could die within a relatively short space of time.
In other words, there are a large number of people whose deaths would not come as a huge surprise to a doctor – and who could therefore be described as people who could “reasonably be expected to die within six months”. I would like to see this language tightened up, so that the category of those who might be eligible for the “medicine” is not as broad as it currently seems. Surely it cannot be beyond the skills of the parliamentary draftsmen to amend the phrase slightly, so that assisted dying could be provided only to those who “could not reasonably be expected to survive more than six months”.
You may say there is not much difference between the two categories. I think the difference is very significant. It is the difference between the strong possibility of death within six months, and the overwhelming probability of death within six months. It is the difference between the category of those who could very well be claimed by the Reaper at any time within the next six months, and the category of those who are clearly not going to survive much longer. This change would restrict the number of those eligible for assisted dying – though obviously it would still greatly expand the possibilities for alleviating suffering at the end of our lives.
I think it right to be cautious, because we are proposing to make a very big change in our approach to death and dying: giving people much more of a right to choose when to die, and above all giving the state an obligation to help us consciously to do away with ourselves, if certain conditions are satisfied.
I am sure it is a change the public broadly supports, and one whose time has come. But life is precious and our psychology fragile. Those suffering terminal illnesses can easily find themselves under pressure – external or internal – to make decisions from which, obviously, there is no going back.
If we are going to take this step, we should make it a small one, and see how it goes. I would like to see the Falconer Bill apply not to all those who might well die in the next six months, but only to those whose lives are overwhelmingly likely to be very near the end.
