In 2009, campaigner and MS sufferer, Debbie Purdy, won a historic case, clarifying that her husband would not be prosecuted if he assisted her in her venture to end her life at the Dignitas clinic in Switzerland [Ref: Metro]. While assisted suicide remained illegal in the UK, this case seemed to lay the ground-work for further reform. In January 2012, a report, published by the Commission on Assisted Dying, recommended the legalisation of physician assisted suicide for the terminally ill in the UK [Ref: Guardian]. These proposals have since begun to gain support amongst prominent MPs [Ref: Huffington Post]. Proponents of assisted dying aim to give people the ability to control their destiny, but there is also concern that loosening the law could lead to an increasing prevalence of assisted suicide and even open the door to euthanasia. These fears were for some reinforced by the public support garnered by the Tony Nicklinson case. Suffering from locked-in syndrome, Nicklinson pleaded with the High Court to allow a physician to administer him with a lethal injection (an act that would constitute voluntary euthanasia) as he was unable to end his life himself [Ref: BBC News]. While many within the assisted dying lobby agreed Nicklinson’s request was a step too far, they maintain that new legislation should be brought in for the terminally-ill. This they suggest would also allow the practice to be publicly regulated. However, critics, both secular and religious, continue to see it as a slippery slope and instead emphasise the value of life and argue for a focus instead on palliative care. Ultimately, the debate is a moral one which, aside from the legal and medical issues, asks us to decide whether it is ever right for doctors to assist someone in bringing about their own death.

What are the terminological distinctions I should be aware of?
When a doctor indirectly assists a patient to die by prescribing a lethal amount of medication for them to use to commit suicide, it is known as physician assisted suicide or physician assisted dying. When a doctor directly assists a patient to die by administering lethal medication at the patient’s request it is known as voluntary euthanasia. In practical terms some argue that assisted dying and voluntary euthanasia are indistinguishable, but many feel there is less moral responsibility involved, on the part of the doctor, in physician assisted suicide.

Should the law change?
The changes to the law proposed by the Commission on Assisted Dying would permit patient assisted dying but not voluntary euthanasia. They seek to allow a doctor to give a prescription for lethal drugs to a legally competent patient suffering from terminal illness, under the proviso that they had been given all the medical options and were under no obvious pressure from others in making their decision [Ref: Guardian]. Proponents often refer to the fact that while many of the 160 Britons who ended their lives at Dignitas since 2002 were accompanied by friends and family [Ref: Daily Mail], no one to date has been prosecuted [Ref: Human Truth]. Furthermore, according to a recent survey, two-thirds of the population are in favour of legalising assisted dying [Ref: BBC News]. This, they argue, represents a dramatic shift in the sentiment of the judiciary and the public which should be mirrored in legislature. Opponents, however, feel this could prove to be a slippery slope. Given the huge amount of support Tony Nicklinson’s case attracted, disability campaigners are concerned that new legislation may eventually lead to voluntary euthanasia. In a society where the disabled and elderly are not treated as equal citizens, a ‘right to die’ would, in their minds, endanger their right to live, especially in times of economic crisis and cuts to healthcare spending. Pointing to what they deem successful changes in legislation in Belgium, Holland, Switzerland and the US state of Oregon, proponents retort that stringent safe guards would ensure the vulnerable were protected.

Would a change in the law undermine the role of doctors?
Despite the evident shift in public opinion on this issue, many doctors remain concerned about assisting people to die. In June 2012, a member of the British Medical Association forwarded a motion that they rescind their opposition to reform, yet the vast majority voted to maintain their position, one member stating that it was important that doctors ‘never walk away from their patients’ [Ref: BBC News]. Advocates counter that a major part of a doctor’s role, particularly in terminal cases, is to ease pain.

What are the moral arguments?
The most straightforward argument in favour of assisted dying is that the right to die at the time and in the manner that one wishes follows directly from the right to choose how one lives. Opponents retort that life should be preserved at all costs, that suicide should always be discouraged and that pain and depression can be eased by palliative care. A number of commentators are also concerned about a change in social values, for example, the idea of courage changing from resilience in the face of adversity to ‘giving up’ or ‘letting go’. The concept of dignity is crucial to the debate: opponents insist that dignity must not be reduced to ‘bodily integrity’ whereby life is seen as no longer worth living once someone is no longer able-bodied. In contrast, advocates argue for ‘dignity in dying’ and very often see assisting someone to die as an act of kindness and compassion.