Safeguards that would allow dignity in dying

Safeguards that would allow dignity in dying

We agree with Dr Sarah Wollaston MP (The harm in helping, 18 August) on the importance of palliative care being delivered in people's homes, and on the need to make it straightforward for people to make decisions about their end-of-life treatment. However, we cannot agree with her that suffering at the end of life must be endured by some in order to protect others.

Firstly, other jurisdictions in Europe and the US have legalised and regulated some form of assistance to die. While their laws differ in criteria and safeguards, none have been visited by the dire predictions that Dr Wollaston makes. Trust has not broken down between doctors and patients; there is no duty to die; and assisted deaths remain a small proportion of overall deaths. Dr Wollaston fails to set out why Britain would be different.

Secondly, while convenient to polarise the debate between autonomy on the one hand and greater protection on the other, informed decision-making actually allows for both. At present the law attempts to protect people by examining, and nearly always forgiving, the motives of loved ones who have helped someone to die. People would be better protected if the law allowed healthcare professionals to thoroughly examine the motives and decision-making capacity of a person who wishes to die, when they are still alive, and so ensure they are aware of all their care and treatment options.

Patient choice and patient safety at the end of life are not mutually exclusive. To suggest that they are is to impose a duty to suffer on some dying adults.
James Harris
Dignity in Dying

Like Dr Wollaston, I have also cared for patients who are dying, over half a century in my case. As she rightly says, "doctors do not always get it right", and yet, having made a very thoughtful and compassionate case for not changing the law on assisted dying, she still seems to be deciding for other people, patients and doctors, what is right or wrong for them.

Keir Starmer's prosecution guidelines, while being "humane and sensible", are still heavily weighted against dying patients getting the advice and professional help they need to die with dignity.

It is not for us doctors to decide what is right or wrong for others but for the general public through parliamentary debate to lay down guidelines for us all to work with.
Robert MacGibbon
(Retired GP), London

"Making assisted dying legal would alter the way society weighs the value of human life for ever," writes Sarah Wollaston. Might not assisted dying cause us to reassess the value of human life for the better? Are we to accept that going through depression, hopelessness, pain and exhaustion is a normal part of a human life, for ever? Once it becomes clearer how valuable a healthy human life is, perhaps more action might become possible against the various factors in our society which are detrimental to a healthy human life. At the moment, if a human being is breathing, it does not matter how little else works or how much suffering is present. It ought to matter.
Stephen Taylor
(Retired GP), Walsall

Polly Toynbee's column (Would you be happy to live like Tony Nicklinson?, 17 August) has persuaded me to seriously consider joining the Humanist Association. Our society has a long way to go when politicians and priests, because of their private religious beliefs, deny people such as Tony a merciful end to their lives. Those attempting to insulate themselves from the vicissitudes of a mortal existence by giving over their minds to a belief in the supernatural should leave the rest of us to get on with our lives – and deaths.
Les Farris
South Petherton, Somerset

What a confused and curious country we live in. It is perfectly legal for us to fight wars all over the world, support a vast arms industry and resolve to maintain and replace a nuclear weapons system that could trigger Armageddon. Alongside this we deny people who desperately want to die with dignity the right to be helped to end their suffering.
Jenny Hartland

Tony Nicklinson has expressed his wish to die fully and with great dignity, and has been very strong to go through all the procedures and take himself to court. This was not attempted suicide but a rational decision made by a sane man who has weighed all his options. Yet once again, the legal system has proved that it values the body over the mind: quantity of physical existence overrules quality of living experience.

Arguing that a change in the law would put the vulnerable at risk isn't good enough. The vulnerable will always be at risk – that is what vulnerable means. There are many precautions that could be implemented to ensure that no one would be coerced into ending their lives.
Emilie Lamplough
Trowbridge, Wiltshire

The Guardian's account of the high court ruling on Tony Nicklinson (Report, 17 August), together with a most moving and distressing image of Mr Nicklinson on the BBC News as he was advised of the failure of his petition, once again raises the question of why progress towards legally sanctioned euthanasia remains glacially slow in the UK. There is overwhelming public support for medically assisted termination of a life that is no longer desired, yet the periodic debates on the subject are all too often clouded by the pro-life groups whose views are invariably coloured by extreme religious conviction. Paul Tully, general secretary of one such organisation, may indeed "welcome" the court ruling, but might he be prepared to look Mr Nicklinson in the eye and explain to him the "value" of his existence? Mr Nicklinson, meanwhile, now faces years, or possibly decades, of further anguish and misery, unless he is prepared to starve himself to death. What defines "civilised" in this country?
Harry Foxley
Retford, Nottinghamshire