Monday, 29 September 2014

Why are the Home Secretary and Metropolitan Police allowing this man to operate in Britain?

Notorious Australian euthanasia campaigner Philip Nitschke has been in the news again.

Last week, it was reported that his organisation Exit International was establishing a London office to ‘cope with demand’ from UK citizens for assisted suicide.  

The group, which charges members a fee to access online information and attend workshops to discuss ‘peaceful’ methods of suicide, has attracted fierce criticism in Australia, where it was originally set up.

Its activities include:

  • Advising members on how to source  a lethal drug used to kill US Death  Row prisoners;
  • Selling test kits so members can check the purity and potency of this controlled Class B drug in their own homes;
  • Providing instructions on how people can gas themselves using a ‘DIY’ kit;
  • Giving tips on how those assisting a suicide might avoid prosecution.
Today it has been further reported that Nitschke has enraged victims of crime groups by his suggestion that killers serving life sentences should be able to choose the timing of their own ‘peaceful’ deaths behind bars.

Yesterday the Sydney Morning Herald reported that he is being investigated by police in every Australian state over his possible role in nearly 20 deaths in the past three years, all of them apparently suicides.

The latest investigation, by Victoria Police, concerns the death of a 55-year-old Geelong man who allegedly killed himself using a do-it-yourself kit bought though a company affiliated with Exit International, the pro-euthanasia organisation founded by Dr Nitschke. 

All of the deaths being investigated involved the use of the two suicide methods promoted by Dr Nitschke, the lethal drug, Nembutal or a nitrogen inhalant device.

Nitschke currently faces expulsion by the Australian Medical Association when its Northern Territory branch Council meets in November, after a move to suspend him last month failed after an error in the paperwork.

The Medical Board of Australia suspended him in July. The decision which used the board's emergency powers to  ‘protect  public health and safety’ came after he admitted in an interview with the ABC that he had supported a 45-year-old Perth man, Nigel Brayley, in his decision to commit suicide, despite knowing the man was not terminally ill.

The AMA has cited the same ‘adverse event’, saying Dr Nitschke's ‘professional behaviour … was not consistent with the high professional and ethical standards for the Australian medical profession promoted by the AMA’.

Documents obtained by The Sunday Age reveal there are currently five separate medical board investigations, one dating as far back as 2011, into Dr Nitschke's conduct.

Nitschke (aka Dr Death) is an extremist and self-publicist whose presence in the UK puts the lives of vulnerable elderly, depressed and disabled people at grave risk. 

The British Suicide Act, as amended in 2009, states that ‘an act capable of encouraging or assisting the suicide or an attempted suicide of another person’ is illegal, ‘whether or not a suicide, or an attempt at suicide, occurs’; the emphasis is on whether the accused ‘intended to encourage or assist suicide or an attempt at suicide’.

What Nitschke is doing must surely fall within the scope of these offences. The information shared by his organisation in his London seminars and on the internet is surely capable of encouraging or assisting people to commit suicide and his activities are clearly intended to encourage or assist people to commit suicide by offering them advice about the ‘best way’ of doing it.

Nitschke’s activities present a real and present risk to vulnerable members of the British public.

With the growing elderly population, failure of the care system and worsening economic situation a growing number of frail, disabled, ill and depressed people in Britain will be feeling under even greater pressure to end their lives, either for fear that they will not cope, or so as to be less of a burden to relatives.

They deserve better protection from suicide predators like Nitschke than they are currently getting.

Quite why the Home Secretary and Metropolitan Police allow him into the UK to conduct seminars and continue his activities remains a mystery but Britain deserves a full explanation.

Euthanasia deaths in the Netherlands continue their relentless rise

According to Dutch media reports today, euthanasia deaths in the Netherlands in 2013 increased by 15% to 4,829. This follows increases of 13% in 2009, 19% in 2010,18% in 2011 and 13% in 2012.

In fact from 2006 to 2013 there has been a steady increase in numbers each year with successive annual deaths at 1923, 2120, 2331, 2636, 3136, 3695, 4,188 and 4,829 – an overall increase of 151% in just seven years.

Almost 3,600 people were helped to die because they had cancer, the report said.

Euthanasia now accounts for over 3% of all Dutch deaths.

In total, there were 42 reports of people who underwent euthanasia because they suffered severe psychiatric problems, compared with 14 in 2012 and 13 in 2011.

Dementia was the reason behind 97 cases, mainly early stage dementia in which patients were able to properly communicate their wish to die.

There were five cases in 2013 where doctors were reprimanded for not properly following the protocol. None of these led to legal action.

But as alarming as these statistics may seem they tell only part of the full story.

On 11 July 2012, The Lancet published a meta-analysis study concerning the practice of euthanasia and end-of-life practices in the Netherlands in 2010 with a comparison to previous studies done in 1990, 1995, 2001 and 2005. 

The Lancet study indicated that in 2010, 23% of all euthanasia deaths were not reported meaning that the total number of deaths last year may not have been 4,829 but rather 5,939. 

The 2001 euthanasia report also indicated that about 5.6% of all deaths in the Netherlands were related to deep-continuous sedation. This rose to 8.2% in 2005 and 12.3% in 2010. 

A significant proportion of these deaths involve doctors deeply sedating patients and then withholding fluids with the explicit intention that they will die. 

As I have reported previously, although official euthanasia deaths are rising year by year in the Netherlands, these deaths represent only a fraction of the total number of deaths resulting from Dutch doctors intentionally ending their patients’ lives through deliberate morphine overdose, withdrawal of hydration and sedation. 

Euthanasia in the Netherlands is way out of control. 

The House of Lords calculated in 2005 that with a Dutch-type law in Britain we would be seeing over 13,000 cases of euthanasia per year. On the basis of how Dutch euthanasia deaths have risen since this may prove to be a gross underestimate. 

What we are seeing in the Netherlands is 'incremental extension', the steady intentional escalation of numbers with a gradual widening of the categories of patients to be included. 

previously described the similar steep increase of cases of assisted suicide in Oregon (450% since 1998), Switzerland (700% over the same period) and Belgium (509% in ten years from 2003 to 2012).

The lessons are clear. Once you relax the law on euthanasia or assisted suicide steady extension will follow as night follows day. 

Britain needs to take warning as debate on the Falconer bill continues.  

Sunday, 21 September 2014

Vicky Beeching’s challenge to evangelicals about same-sex marriage

Christianity magazine has just published an interview by editor Justin Brierley with British Christian singer-songwriter Vicky Beeching (left), who self-identified as ‘gay’ in a high profile ‘coming out’ on 14 August.

Beeching, who is a media personality in her own right and has over 52,000 followers on twitter, has listed over 70 almost exclusively positive media reports covering the event on her website.

Earlier this year she joined the group Accepting Evangelicals, who back same-sex marriage, as a patron.

At one level it is not at all unusual today for Christians to admit to feelings of same-sex attraction or to identify as ‘gay’.

Furthermore, those who do, perhaps unlike in earlier generations, are in my experience, generally now treated in evangelical churches with warmth, grace and understanding. Having said this I fully accept that this is not always the case and Vicky's own early experience bears out.  

I personally know many Christians who would describe themselves as either same sex attracted or having a homosexual or bisexual orientation.

In fact a number of prominent evangelical leaders, in order to help others, launched the Living Out website last November to share their testimonies about their own personal experience of same sex attraction and to explain how they had handled it.

But whilst the ‘Living Out’ leaders express their intention to remain committed to biblical teaching on sexual morality in practice (see my earlier post ‘Should ‘gay’ Christians be true to their feelings?’), Vicky Beeching says she intends to marry a same sex partner.

‘My goal is to find a soulmate and get married; that is what most of us are made to do. God said it is not good that people are alone.’

Furthermore she believes she can do this without relinquishing her claim to be an evangelical. This is what has attracted so much media attention.

‘People have told me that I don’t have the right to that name (‘evangelical’) any more as I’ve spoken in support of same-sex marriage, but for me evangelicalism is rooted in many things: loving the Bible; having a high view of scripture; a passion for social justice; wanting to share the good news about Jesus.  These are all things I hold true to. So I don’t see why there should be a black and white issue that casts me out.’ 

I do not doubt Vicky’s sincerity and indeed share her professed love for the Bible, passion for social justice and her desire to share the good news about Jesus. But I believe she has crossed a significant rubicon with respect to her expressed views and proposed actions on sexual behaviour. At the same time she has laid down a significant challenge to evangelical Christians and must not be simply ignored.

I’ve previously reviewed the Bible’s teaching on sexuality on this blog and Robert Gagnon and Ian Paul (see here and  here) have more recently published some helpful reflections responding to Beeching’s biblical arguments in support of her stand.

I’ve also previously listed on my blog six excellent resources giving an evangelical perspective on homosexuality.

In short, the Bible teaches that the only moral context for sex is within a life-long monogamous heterosexual marriage relationship. All sex outside this context constitutes sexual immorality (Greek porneia). This includes all sex between two people of the same sex whether legally 'married' or not. 

‘But among you there must not be even a hint of sexual immorality, or of any kind of impurity, or of greed, because these are improper for God’s holy people.’ (Ephesians 5:3)

‘It is God’s will that you should be sanctified: that you should avoid sexual immorality;  that each of you should learn to control your own body in a way that is holy and honourable….For God did not call us to be impure, but to live a holy life. Therefore, anyone who rejects this instruction does not reject a human being but God, the very God who gives you his Holy Spirit.’ (1 Thessalonians 4:3-8)

I am not intending to revisit this teaching in detail here. Rather, especially for those who accept the biblical teaching on this issue at face value, I want to look at what the Bible teaches about Christians endorsing or practising what it classes as sexual immorality.  I have deliberately included Bible quotes rather than just giving references as I am convinced that many evangelicals are genuinely not aware of what the Bible actually says. 

First, the Bible is clear that sexual morality is not a ‘secondary issue’ on which Christians may legitimately disagree and on which there are a variety of acceptable views. Rather continuing in sexually immoral behaviour can put one’s own salvation at risk:

‘Do you not know that wrongdoers will not inherit the kingdom of God? Do not be deceived: Neither the sexually immoral nor idolaters nor adulterers nor men who have sex with men… will inherit the kingdom of God.’ (1 Corinthians 6:9,10)

This is not to suggest that we are saved by good works. Rather it upholds the biblical teaching that genuine faith is evidenced in moral behaviour (more on this here). Furthermore, the Apostle Paul makes it clear that God views sex between two women in the same way that he views sex between two men.

‘Because of this, God gave them over to shameful lusts. Even their women exchanged natural sexual relations for unnatural ones. In the same way the men also abandoned natural relations with women and were inflamed with lust for one another. Men committed shameful acts with other men, and received in themselves the due penalty for their error.’ (Romans 1:26, 27)

The writer to the Hebrews makes it clear that God views those with a Christian testimony who willfully return to habitual sin very seriously indeed:

‘ It is impossible for those who have once been enlightened, who have tasted the heavenly gift, who have shared in the Holy Spirit,  who have tasted the goodness of the word of God and the powers of the coming age and who have fallen away, to be brought back to repentance. To their loss they are crucifying the Son of God all over again and subjecting him to public disgrace.’  (Hebrews 6:4-6)

‘If we deliberately keep on sinning after we have received the knowledge of the truth, no sacrifice for sins is left,  but only a fearful expectation of judgment and of raging fire that will consume the enemies of God... How much more severely do you think someone deserves to be punished who has trampled the Son of God underfoot, who has treated as an unholy thing the blood of the covenant that sanctified them, and who has insulted the Spirit of grace?’ (Hebrews 10:26-29)

‘If they have escaped the corruption of the world by knowing our Lord and Saviour Jesus Christ and are again entangled in it and are overcome, they are worse off at the end than they were at the beginning. It would have been better for them not to have known the way of righteousness, than to have known it and then to turn their backs on the sacred command that was passed on to them.’ (2 Peter 2:20,21)

Whilst the Bible is very clear that Christians should not judge those outside the church, dealing with those inside the church is a different matter altogether:

‘I wrote to you in my letter not to associate with sexually immoral people— not at all meaning the people of this world who are immoral, or the greedy and swindlers, or idolaters. In that case you would have to leave this world. But now I am writing to you that you must not associate with anyone who claims to be a brother or sister but is sexually immoral or greedy, an idolater or slanderer, a drunkard or swindler. Do not even eat with such people.’ (1 Corinthians 5:10-11)

It might be objected that Vicky Beeching, and others who share her views, have not yet moved from publicly endorsing same sex marriage (and all that it involves) to participating in it herself.

But the Bible is equally clear that teaching a specific sin is admissible is at least as serious as practising it:

‘Not many of you should become teachers, my fellow believers, because you know that we who teach will be judged more strictly.’ (James 3:1)

Jesus was very clear about the seriousness of leading young ones astray through false teaching:

‘If anyone causes one of these little ones—those who believe in me—to stumble, it would be better for them to have a large millstone hung around their neck and to be drowned in the depths of the sea.’ (Matthew 18:6)

The epistle of Jude warns about ‘ungodly people, who pervert the grace of our God into a license for immorality’ (1:4) and warns that ‘Sodom and Gomorrah and the surrounding towns gave themselves up to sexual immorality’  and ‘serve as an example of those who suffer the punishment of eternal fire’ (1:7).

In a similar vein the Apostle Peter warns that ‘if God did not spare angels when they sinned, but sent them to hell…’ and ‘condemned the cities of Sodom and Gomorrah by burning them to ashes, and made them an example of what is going to happen to the ungodly’ then ‘the Lord knows how to rescue the godly from trials and to hold the unrighteous for punishment on the day of judgment. This is especially true of those who follow the corrupt desire of the flesh and despise authority’. (2 Peter 2:4-10)

It is striking that in both these instances (both in Jude and 2 Peter) there is a specific reference to Sodom and Gomorrah where the sexual immorality involved was homosexual (see also Leviticus 18:22 and 20:13).

The Apostle John in Revelation records Jesus’ words to the seven churches. Two of them (Pergamum and Thyatira) he warns specifically about not tolerating teaching which endorses sexual immorality:

‘Nevertheless, I have a few things against you: There are some among you who hold to the teaching of Balaam, who taught Balak to entice the Israelites to sin so that they ate food sacrificed to idols and committed sexual immorality.’  (Revelation 2:14)

‘Nevertheless, I have this against you: You tolerate that woman Jezebel, who calls herself a prophet. By her teaching she misleads my servants into sexual immorality and the eating of food sacrificed to idols.’ (Revelation 2:20)

I was told recently by a Church of England Bishop that Scripture nowhere commands us to stop people teaching heresy (false teaching which puts personal salvation at risk) in the church. But it seems to me that this is exactly what Paul instructed Titus to do:

 ‘For there are many rebellious people, full of meaningless talk and deception, especially those of the circumcision group. They must be silenced, because they are disrupting whole households by teaching things they ought not to teach….’ (Titus 1:10-11) 

From the above Scriptures it is clear that:

1. All sex outside (heterosexual) marriage constitutes sexual immorality
2. Continuing in sexual immorality puts one’s salvation at risk (see also Revelation 21:8 and 22:15)
3. Teaching that sexual immorality is acceptable is very serious and deeply damaging
4. Tolerating such teaching is also contrary to the explicit teaching of Jesus Christ
5. Those who teach or practise such things whilst claiming still to be Christians should be subject to church discipline.

The implications are clear.

I do not know Vicky Beeching personally and as I have said earlier I do not doubt her sincerity. But my fear is that as a result of the warm affirmation she has already received for her endorsement of same sex marriage, including from many Christians, she is heading on a very dangerous and damaging course indeed – both for herself and for others.

I understand that she has so far ignored the sincere but serious warnings she has received from well-meaning Christian brothers and sisters.

We need to pray that she changes her course and that her teaching does not lead others astray. But more than this, those responsible for her pastoral oversight must ensure that her teaching is not tolerated in the church and that she is appropriately disciplined.

We owe it to our young people, many of whom will have been confused by what she is saying, and not least to Vicky herself. 

Monday, 1 September 2014

A great video on depression and an insight from one of the world’s greatest preachers who suffered from it

‘The Black Dog’ was Winston Churchill’s famous name for depressed mood. 

I was sent today a link to a YouTube video on depression which I had not previously seen, but which deserves much wider viewing.

‘I had a black dog, his name was depression’ is only four minutes long. Do take a look.

Millions have suffered with depression, amongst them many famous Christians. Charles Spurgeon and William Cowper are poignant examples.

I’ve previously written about some of the lessons we learn from Cowper about how to help those with depression and also blogged about a brilliant set of self-help books that will benefit both sufferers and those trying to help them.

There is also a very good CMF File, recently published, on depression and cognitive behavioural therapy (CBT).

But today I found this remarkable quote from Spurgeon (pictured above), which I reproduce here, where he describes how he learnt to see his depression as part of God’s providence and a harbinger of hope.

Charles Haddon Spurgeon (1834 – 1892) was a British Baptist minister who is regarded as one of the greatest preachers who ever lived. He has been called the ‘Prince of Preachers’ and is estimated in his lifetime to have preached to around 10,000,000 people.

He describes, in chapter 11 of Lectures to My Students, the way God used the episodes of depression in his life to refine him for future service.

‘This depression comes over me whenever the Lord is preparing a larger blessing for my ministry; the cloud is black before it breaks, and overshadows before it yields its deluge of mercy. Depression has now become to me as a prophet in rough clothing, a John the Baptist, heralding the nearer coming of my Lord’s richer benison.

So have far better men found it. The scouring of the vessel has fitted it for the Master’s use. Immersion in suffering has preceded the baptism of the Holy Ghost. Fasting gives an appetite for the banquet. The Lord is revealed in the backside of the desert, while his servant keepeth the sheep and waits in solitary awe.

The wilderness is the way to Canaan. The low valley leads to the towering mountain. Defeat prepares for victory. The raven is sent forth before the dove. The darkest hour of the night precedes the day-dawn. The mariners go down to the depths, but the next wave makes them mount to the heaven: their soul is melted because of trouble before he bringeth them to their desired haven.’

Thursday, 17 July 2014

Don’t make Oregon’s mistake and legalise assisted suicide – ten reasons why the UK should not follow suit

Lord Falconer’s Assisted Dying Bill, due for a second reading in the House of Lords on 18 July, is purportedly based on the US state of Oregon’s Death with Dignity Act (DWDA).

Dignity in Dying, the former Voluntary Euthanasia Society, who are backing Falconer, claim that everything is wonderful in Oregon. But is that really true?

In fact, far from being reassuring, the Oregon experience sounds a loud warning to the UK not to follow suit.

On 27 October 1997, Oregon enacted the DWDA which allows terminally-ill Oregonians to end their lives through the voluntary self-administration of lethal drugs, expressly prescribed by a physician for that purpose.

The Oregon DWDA also requires the Oregon Health Authority to collect information about the patients and physicians who participate in the Act, and publish an annual statistical report.

These annual reports are all available on the Oregon government website and there is plenty of other relevant information in the public domain to draw on.

In order to qualify under the Oregon Act, a patient must be an Oregon resident, 18 years of age or older, capable of making and communicating health care decisions for him/herself and have been diagnosed with a terminal illness that will lead to death within six months.

It is up to the attending physician to determine whether these criteria have been met.

A similar law came into effect in the neighbouring state of Washington in 2009. Annual reports can be accessed here.

So what can we learn about the Oregon/Washington model? Here are ten disturbing facts:

1. There has been a steady increase in annual numbers of people undergoing assisted suicide in Oregon

In 1998 there were 24 prescriptions written and 16 assisted suicide deaths. By 2012 these numbers had risen to 116 and 85 respectively. This is a 380% increase in prescriptions and a 430% increase in assisted suicide deaths in 15 years. The number of assisted suicide deaths in Washington State, increased by at least 43% in 2013.

How would this translate to the UK? There were 56.6 million people in England and Wales in 2012 but only 3.9 million in Oregon. So 85 assisted suicide deaths in a year in Oregon would equate to 1,232 in England and Wales (14 times that of Oregon).

2. The Oregon health department is funding assisted suicide but not treatment for some cancer patients

Barbara Wagner had recurrent lung cancer and Randy Stroup had prostate cancer. Both were on Medicaid, the state’s health insurance plan for the poor that, like some NHS services, is rationed. The state denied both treatment, but told them it would pay for their assisted suicide! ‘It dropped my chin to the floor,’ Stroup told the media. ‘[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?’ (Wagner eventually received free medication from the drug manufacturer. She has since died. The denial of chemotherapy to Stroup was reversed on appeal after his story hit the media.)

Despite Wagner and Stroup's cases, advocates continue to insist that Oregon proves assisted suicide can be legalised with no abuses. But the more one learns about the actual experience, the shakier such assurances become.

If AS were to be legalised in the UK end-of-life care would be likely to worsen under financial pressures because it costs on average £3000 to £4000 a week to provide in-patient hospice care, but just a one-off cost of £5 to pay for the drugs which would help them commit suicide. Cancer treatments like chemotherapy, radiotherapy or surgery cost much more. Do we really wish to place that temptation before families, NHS managers and Health Secretaries in cash-strapped Britain?

3. Patients are living for many years after having been prescribed lethal drugs for ‘terminal illness’ showing that the eligibility criteria are being stretched

The Oregon and Washington laws, like Falconer’s proposed law, have ‘six months to live’ criteria. But doctors’ estimates of lifespans can be wildly out. Consider Oregon resident, Jeanette Hall, who was diagnosed with cancer and decided to ‘do’ Oregon's law. Her doctor, Kenneth Stevens, didn't believe in assisted suicide and encouraged her to be treated instead. It is now 14 years later and she is ‘thrilled’ to be alive. This is Dr Steven's affidavit filed by the Canadian government in Leblanc v. Canada, now dismissed, discussing Jeanette. This is Jeanette's affidavit, also filed by the Canadian government in the same case.

The Oregon statistics record patients killing themselves up to 1,009 days after the first request for lethal drugs – almost three years – showing just how hard doctors are pushing the boundaries - and/or how bad they are at guessing lifespans.

4. The vast majority of those choosing to kill themselves are doing so for existential reasons rather than on the basis of real medical symptoms 

The main argument advanced for assisted suicide is unremitting pain. But the Oregon data show that those people citing ‘inadequate pain control or (even) concern about it’ constitute just 23.7% of cases overall. So what are the main reasons given for taking one’s life? In 2013 93% cited ‘loss of autonomy’, 89% said they were ‘less able to engage in activities making life enjoyable’ and 73% listed ‘loss of dignity’. These are not physical but existential symptoms.  But should lethal drugs be prescribed to people who feel their lives no longer have meaning and purpose?

The fact that almost a quarter of patients dying under the Act report inadequate pain control or concerns about pain also shows that palliative care provision in Oregon is unsatisfactory. But surely this is an argument for better care rather than AS.

5. Many people in Washington and Oregon give ‘fear of being a burden on others’ as a reason for ending their lives

I have frequently argued that any change in the law to allow assisted suicide or euthanasia would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed and would be most acutely felt at a time of economic recession when many families are struggling to make ends meet.

This fear is again borne out by the American data. In Washington in 2013, 61% of people opting for assisted suicide give the fear of being a burden to family, relatives and caregivers as a key reason. 13% cited ‘financial implications of treatment’. In the same year in Oregon the equivalent figures were 49% and 6%.

6. Fewer than three per cent of patients are being referred for formal psychiatric or psychological evaluation

In an article for The Telegraph, former president of the Royal College of Psychiatrists Baroness Sheila Hollins has voiced concern that proposals to license doctors to supply lethal drugs to mentally competent, terminally ill patients fail to take account of the complex process involved in assessing a patient's mental capacity. According to Baroness Hollins, assessing mental capacity ‘isn't like checking the oil or water level in a car’ or ‘the sort of thing that can be done in a single consultation, especially if the decision in question - as it is in this case - is one with life-or-death consequences.’

Commenting on the US State of Oregon, where less than 3% of cases were referred for a formal psychiatric assessment in 2013 she writes: ‘Researchers have found that some patients who have ended their lives under the terms of Oregon's assisted suicide law had been suffering from clinical depression. Depression impairs decision-making capacity, it is common in elderly people and it is treatable. But in some cases in Oregon it has not been diagnosed by the doctor who assessed the patient's capacity and prescribed lethal drugs. Oregon's law requires referral for psychiatric examination in cases of doubt but in some cases that has not happened.’

7. A substantial number of patients dying under the Oregon Act do not have terminal illnesses

In Oregon in 2013 16.9% of those killing themselves under the Act did not have cancer, heart disease, chronic lung disease or motor neurone disease but were classified as having ‘other illnesses’. What were these? A footnote in the annual report tells us that this ‘includes deaths due to benign and uncertain neoplasms, other respiratory diseases, diseases of the nervous system (including multiple sclerosis, Parkinson's disease and Huntington's disease), musculoskeletal and connective tissue diseases, viral hepatitis, diabetes mellitus, cerebrovascular disease, and alcoholic liver disease.’

Many of these conditions might be considered life-shortening but it beggars belief that all these cases were terminal (with less than six months to live). These are in the main chronic conditions, again falling outside the bounds of the Act.  And yet the doctors went ahead and signed the forms anyway – further evidence of how medical practitioners cannot be trusted to keep to the legal boundaries.

8. It is virtually certain that there is underreporting of assisted suicide cases in Oregon

The Lancet recently published a long awaited meta-analysis study which indicated that in 2010 in the Netherlands, 23% of all euthanasia deaths were not reported.  Could similar under-reporting be happening in Oregon? It is a virtual certainty.

Oregon officials in charge of formulating annual reports have conceded ‘there’s no way to know if additional deaths went unreported’ because Oregon DHS ‘has no regulatory authority or resources to ensure compliance with the law’.

The DHS has to rely on the word of doctors who prescribe the lethal drugs. Referring to physicians’ reports, the reporting division admitted: ‘For that matter the entire account [received from a prescribing doctor] could have been a cock-and bull story.  We assume, however, that physicians were their usual careful and accurate selves.’

So with an Oregon-type law like Falconer’s we can expect to see steadily increasing numbers of assisted suicide cases year on year in England and Wales, along with an unknown level of under-reporting.

9. Some doctors know the patient for less than a week before prescribing the lethal drugs

In order to assess whether a patient is being coerced or not, it surely must be necessary for the prescribing doctor to know them personally and understand their family situation. But in Oregon there were patients who knew their doctor for less than a week before he/she prescribed them the lethal drugs – further evidence of doctor shopping.

10. The presence of no independent witnesses in over 80% of cases is a recipe for elder abuse

In Oregon in 2013 there was no doctor or other healthcare professional present at the time of ingestion of the lethal drugs in 81% of cases. Also the duration of time that elapsed between the request for the drugs and the actual death ranged from 15 to 692 days with a median of 52 days.

During this time the drugs were kept at the patient’s home. But without an independent witness how can we be sure that the drugs were taken voluntarily and not administered forcefully or secretly by a relative with an interest financial or otherwise, in the patient’s death? If they struggled who would know? And any investigation into possible foul play would have to traverse the substantial hurdle of the key witness (the patient) being dead.

We know that in Britain, according to ‘Action on Elder Abuse’, there are half a million cases of elder abuse annually, many of which involve financial abuse by family members or close relatives. The Oregon law, and by implication Falconer’s proposed law, is a recipe for elder abuse of the very worst kind – killing for money.


The lessons from Oregon are clear. We should not go there. Keep Britain safe for vulnerable people.

Public support for Falconer’s ‘Assisted Dying’ Bill drops dramatically to just 43% when arguments against are heard

There is ample poll data showing that the majority of the British public support legalising assisted suicide (AS) in principle.

The former Voluntary Euthanasia Society (now rebranded Dignity in Dying) claims a figure of 80% although I have previously argued that such levels of support are uncommitted, uninformed and unconvincing.

However, there has been very little poll data gauging public attitudes in light of the various empirical and rational arguments against AS.  That is, until now.

An extraordinary new poll has demonstrated that public attitudes change dramatically once some of the key practical implications of AS are considered.

In a new Comres/CARE poll published today and reported by the Daily Telegraph respondents were presented with the following scenario:

‘A new Bill is due to be debated in the House of Lords which is designed to enable mentally competent adults in the UK who are terminally ill, and who have declared a clear and settled intention to end their own life, to be provided with assistance to commit suicide by self-administering lethal drugs. Two doctors would need to countersign their declaration and be satisfied that the person has a condition which cannot be reversed by treatment and is reasonably expected to die within 6 months.  In principle would you agree or disagree with this proposal?

73% agreed (38% strongly), 12% disagreed and 14% were in the ‘don’t know’ category.

So far there’s nothing that surprising. It would be odd for people not to be moved by some of the tragic stories of the ‘hard cases’ and to say they support a means of alleviating such suffering.
But then those who supported AS in principle were asked which of the following arguments would make them change their minds.  Each statement below was randomised throughout the survey in order to assess which argument moved opinion the most. 

The answers were truly astounding.

Overall 42% of those who originally supported the bill changed their mind on the basis of at least one of the arguments.

When these were added back into the original sample, aggregating all who opposed as a result of the arguments put to them, and incorporating all who still supported AS having heard each argument, they found the following:

43% support AS, 43% oppose it and 14% don’t know.

So hearing the arguments against AS causes support for AS to collapse from 73% to 43% - that is, to less than half!

Here are the arguments with the percentage change each cause on those who initially backed Falconer’s proposals.

1. The risk of people feeling pressurised into ending their life early so as not to be a financial or care burden on loved ones, as has happened in the US where more than six in ten of those requesting a lethal prescription in Washington State (where the law is similar to that proposed in the House of Lords debate) say that one of their reasons for doing so was not to be a burden on friends, family or caregivers

On hearing this 47% of those who originally backed Falconer’s proposals would still do so, but 28% would oppose him and 25% did not know.

2. Changes in the law to allow assisted suicide and/or euthanasia in other countries like Belgium, the Netherlands and Switzerland have led to a steady annual increase in the number of cases and spread of the practice to involve people with chronic but not fatal diseases, disabled people, children and those with mental illnesses and dementia

58% would still support, 21% would oppose and 215 didn’t know.

3. Concerns that end-of-life care would be likely to worsen under financial pressures because it costs on average £3000 to £4000 a week to provide in-patient hospice care, but just a one-off cost of £5 to pay for the drugs which would help them commit suicide

59% would still support, 15% would oppose and 27% didn’t know.

4. All major disability rights advocacy groups in Britain oppose a change in the law to permit assisted suicide including Disability Rights UK, SCOPE, UK Disabled Person’s Council and Not Dead Yet UK

63% would still support, 12% would oppose and 25% didn’t know.

5. Surveys consistently show the majority of doctors oppose a change in the law to permit assisted suicide, as does the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the British Geriatric Society and the Association for Palliative Medicine

65% would still support, 10% would oppose and 25% didn’t know.


Polls consistently show between 70% and 80% in support of AS.  However, the issue is clearly far more complex than a simple ‘support’/’oppose’ question can do justice to.  This polling strongly suggests that when offered evidence about the nature or source of opposition to AS, and some of the key arguments against it, this high level of support rapidly dwindles. 

The most powerful argument in swaying the public was that changing the law would place pressure on vulnerable people to end their lives for fear of being a burden on friends, family or caregivers, as has been the experience in the US state of Washington and Oregon.

In short, support for AS looks to be extremely soft and generally uninformed.

METHODOLOGY: ComRes interviewed 2,055 British adults online between 11th and 13th July 2014. Data were weighted to be representative of all GB adults aged 18+. ComRes is a member of the British Polling Council and abides by its rules.

Falconer bill is a recipe for the abuse of elderly and disabled people, says Care Not Killing

On the eve of the House of Lords’ debate on Lord Falconer's Assisted Dying Bill, Care Not Killing, an alliance of 40 organisations, has called on peers to reject the proposed legislation on grounds of public safety.

Campaign Director Dr Peter Saunders said, ‘This bill is a recipe for the abuse of elderly and disabled people. The pressure vulnerable people will feel to end their lives if assisted suicide is legalised will be greatly accentuated at this time of economic recession with families and health budgets under pressure. It will quite simply steer them toward suicide.’

‘Any change in the law to allow assisted suicide or euthanasia would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed.'

‘In Washington, where assisted suicide is legal under a law very similar to that proposed by Falconer, 61% of people opting for assisted suicide give the fear of being a burden to family, relatives and caregivers as a key reason.’

The 85 assisted suicide deaths in 2012 in Oregon would equate with a similar law to 1,232 in England and Wales (14 times that of Oregon) and the Oregon experience raises many other causes for concern:

·       There has been a steady increase in annual numbers of people undergoing assisted suicide in Oregon
·       The Oregon health department is funding assisted suicide but not treatment for some cancer patients
·       Patients are living for many years after having been prescribed lethal drugs for ‘terminal illness’ showing that the eligibility criteria are being stretched
·       The vast majority of those choosing to kill themselves are doing so for existential reasons rather than on the basis of real medical symptoms 
·       Fewer than three per cent of patients are being referred for formal psychiatric or psychological evaluation
·       More than ten per cent of patients dying under the Act do not have terminal illnesses
·       Some doctors know the patient for less than a week before prescribing the lethal drugs
·       The fact that almost a third of patients dying under the Act report inadequate pain control or concerns about pain shows that palliative care provision in Oregon is unsatisfactory
·       The presence of no independent witnesses in over 80% of cases is a recipe for elder abuse
·       According to research 25% of cases of assisted suicide in Oregon involve people who are clinically depressed 

Elder abuse and neglect by families, carers and institutions are real and dangerous and this is why strong laws are necessary. Action on Elder Abuse, for example, states that more than 500,000 elderly people are abused every year in the United Kingdom. Sadly, the majority of such abuse and neglect is perpetrated by friends and relatives, very often with financial gain as the main motive. It would be very naive to think that many of the elderly people who are abused and neglected each year, as well as many severely disabled individuals, would not be put under pressure to end their lives if assisted suicide were permitted by law.

Parliament has rightly rejected the legalisation of assisted suicide and euthanasia in Britain three times since 2006 out of concern for public safety - in the House of Lords (2006 and 2009) and in Scotland (2010) - and repeated extensive enquiries have concluded that a change in the law is not necessary.

All major disability rights groups in Britain (including Disability Rights UK, SCOPE, UKDPC and Not Dead Yet UK) oppose any change in the law believing it will lead to increased prejudice towards them and increased pressure on them to end their lives.

Persistent requests for euthanasia are extremely rare if people are properly cared for so our priority must be to ensure that good care addressing people's physical, psychological, social and spiritual needs is accessible to all.

The current law is clear and right and does not need fixing or further weakening. On the one hand the penalties it holds in reserve act as a powerful deterrent to exploitation and abuse by those who might have an interest, financial or otherwise, in the deaths of vulnerable people. On the other hand the law gives judges some discretion to temper justice with mercy when sentencing in hard cases. We should not be meddling with it.

The mark of a civilised society and the first function of government is not to give liberties to the desperate and determined but to protect the weak and vulnerable. 

Even in a free democratic society there are limits to choice. Every law limits choice and stops some people doing what they might desperately wish to do but this is necessary in order to maintain protection for others.