55 Comments

• Richard Dean 7th Jun '14 - 10:47am

  So what?
  LibDems aren’t going to have the power anytime soon to make this effective, and it’s not an issue that’s anywhere near top of the electorate’s list of priorities.

• malc 7th Jun '14 - 11:26am

  Completely agree with the 82% as long as the necessary controls were in place. However, having witnessed the deaths of my sister and elderly parents over the last few years I’d be amazed if you could get two doctors to see the patient. I’m afraid a fair few doctors have little or no time for those terminal patients dying at home and it’s the district nurses and family that provide all the care. Perhaps it would be better to give district nurses, who are more actively involved in caring for the terminally ill – and see them on a daily basis – more of a role.

• ATF 7th Jun '14 - 11:54am

  @Richard Dean

  I agree to an extent, but like PR, Lord’s Reform etc I’m glad that there are such fundamental, Liberal values that run through the party that hold us together even when we disagree about the leadership and the like. I very much respect those who disagree with assisted dying and have very valid concerns, but to me such a core Liberal value should be that it our life and not the state’s.

• Helen Quenet 7th Jun '14 - 12:20pm

  People who are anti this idea frequently cite the ability of modern medicine to make dying pain free, in my own Father’s case a couple of years ago, this did happen and he had a good death. However, for myself there are two criteria that I have told my family about . If I were unable to read a book or didn’t care any longer what the Everton score was than that would not be “life” for me and I would not want to go on. Those criteria would be very different for every individual and would have to form part of the safeguards. To know that you will be able to die well with your family around you would be a huge comfort for so many people.

• T-J 7th Jun '14 - 12:35pm

  @Richard Dean

  You don’t need to be in power or in office to bring major issues that do actually matter to people, even small minorities, to a debate in Parliament.

  And sometimes you can even win that debate, even from a third party position.

• Richard Dean 7th Jun '14 - 12:52pm

  @T-J.
  Ok, so you’re not interested in getting LibDems elected.
  Doesn’t that just explain the unfolding LibDem catastrophe?

• T-J 7th Jun '14 - 1:05pm

  @Richard Dean

  Nice straw man you’ve got there.

  I’m not for being in government for the sake of being in government. I’m for getting liberal ideas and policies into action whenever and wherever possible.

  Something that this coalition has really not been a huge success at doing. Until the party can accept that and deal with it constructively, instead of pretending that 75% fantasies are real, the catastrophe will continue to unfold.

• ATF 7th Jun '14 - 1:28pm

  Worth remembering at this stage what David Steel was able to do regarding aboration when we didn’t have a chance in hell of governing.

• Dave Page 7th Jun '14 - 1:40pm

  Let’s not forget that the rich already have this option – if you’re able to afford a flight to Dignitas (and not too ill to travel) you can end your life at a time of your choosing, with as many friends and family as can afford to be with you.

  I lost my father to cancer just over a year ago, and from the terminal diagnosis he repeatedly expressed his desire to be allowed to die on his own terms. The palliative care team were amazing and did everything in their power, but his death was still messy and undignified and not what he wanted.

• Stephen Hesketh 7th Jun '14 - 2:18pm

  “82% of Lib Dems back giving terminally ill adults the option of assisted dying”

  @Richard Dean 7th Jun ’14 – 10:47am
  “So what? LibDems aren’t going to have the power anytime soon to make this effective, and it’s not an issue that’s anywhere near top of the electorate’s list of priorities.”

  Somewhat over-dismissive view Richard.

  First point I refer you to ATF’s posting re David Steel’s Abortion Bill.

  Second point You are simply wrong. This is a long overdue change to which around 73% of adults in England and Wales subscribe. The same YouGov poll found that 13% did not think that Falconer’s Bill should become law, with 13% undecided.
  http://www.dignityindying.org.uk/assisted-dying/lord-falconers-assisted-dying-bill/

  To this I add Equal Marriage and opposition to FGM.

  This is why Liberal Democrats are vital to informed debate and progressive change in a fair, free, open (and secular) society.

• Richard Dean 7th Jun '14 - 3:49pm

  @Stephen Hesketh
  No, I’m not wrong. However many people may subscribe to that view, it’s not anywhere near the top of most people’s priorities in terms of choosing who to vote for. Noone seems to disagree that the priorities are

  > the economy
  > the eu
  > immigration
  > the nhs

  and probably education, and related fees. If the LibDems want to be a political party, then they of course want power, and these are the things they should be focussing on. Otherwise, they are nothing more than a pressure group, and probably won’t really be vital to anything much.

• Richard Dean 7th Jun '14 - 4:02pm

  @Stephen Hesketh
  Come to think of it, maybe that’s what the LibDems now need to do, split into two parts:

  > a LibDem Party whose primary rule would be to focus on policies that win elections, and
  > a LibDem Pressure Group focussed on policies in all areas, and lobbying all parties for support

  Such a split could provide everyone with choice and some degree of satisfaction. It could avoid the present confusion where people favouring one role find themselves criticized for not favouring the other.

• Stephen Hesketh 7th Jun '14 - 5:59pm

  @Richard Dean 7th Jun ’14 – 3:49pm
  Sorry Richard for thinking that Governments exist to reflect societal changes in addition to the (highly selective) macro-political list you mention.

  Would 73% of adults in England and Wales subscribe to any given proposal on your list? I think not. The fact that such a high percentage support this outcome in a narrow policy field suggest to me that it is a change that won’t be long in coming.

  We can and will debate the other things at length.

• Stephen Hesketh 7th Jun '14 - 6:10pm

  @Richard Dean 7th Jun ’14 – 4:02pm
  If that were ever to happen, it would certainly leave you spoilt for choice over which to criticise!
  Could I also point out that once again your non-Lib Dem underbelly is showing!

• Richard Dean 7th Jun '14 - 6:22pm

  @Stephen Hesketh
  Political parties exist to get elected. Pressure groups exist to persuade people who have been elected to support their point of view. You’re wanting the LibDem Party to become the LibDem Pressure Group. Well, the simple solution is to split the two. Free the Pressure Group to do its thing with everyone, with all parties and none, and free the Party to focus on the issues that most matter to most of the electorate.

• Malcolm Todd 7th Jun '14 - 7:08pm

  Richard Dean
  The only political party that “exists to get elected” is the Tory Party. Other parties exist in order to put into effect policies and principles that its members support. “Getting elected” (by which I, but perhaps not you, mean something rather wider than “becoming a/the governing party”) is one very important way of achieving that but it is not the only one and it is certainly not what this party exists for.

• Richard Dean 7th Jun '14 - 7:11pm

  @Malcolm Todd.
  You must be very happy then, you’re not getting elected!

• David Allen 7th Jun '14 - 7:23pm

  Richard Dean, a party that wants to get elected should have a bit of empathy with the general public. It should understand that it should pay attention to a whole raft of issues which may not always make the headlines, but matter to people. How they die might, I suggest, be something quite a few people might care about. If you dismiss it as an issue that can be ignored because it won’t win votes, you might find, paradoxically, that that’s a jolly good way of losing votes!

• Richard Dean 7th Jun '14 - 7:38pm

  @David Allen

  Yes, you might. So you ask voters what is important to them, and what is more important and what is less important. And this has been done, and many people seem to agree that the list of things I provided really are what are more important. That’s the Dem in LibDem.

  I don’t know whether anyone has asked voters why they’ve lost interest in LibDems, but the very obvious split between idealists and representatives can’t have helped much. Having a Party that is focussed on providing LibDem solutions to the main concerns of the electorate, and a separate Pressure Group that was focussed on developing general LibDem approaches, might work much better than the present arrangement.

  For one thing, a focus on the electorate’s concerns might have avoided the errors made in the early years of this parliament, when LibDems agreed to policies which were not what the electorate wanted.

• Helen Tedcastle 7th Jun '14 - 7:38pm

  Firstly, Stephen Tall’s comment that Caron Lindsay’s article with video was balanced does not bear scrutiny. The video was hyped up from the start and no arguments were given to oppose the Assisted Dying Bill. She even provided link to the ‘Dignity in Dying ‘ website! What about Care Not Killing’s website or the petition from Not Dead Yet, the disabled rights alliance?

  Secondly, some of the comments above which express concerns about so-called ‘safeguards’ are right. This should give real and genuine cause for concern and pause for thought.

  Unfortunately, it is clear from the increase in assisted suicides in Belgium that initial ‘cast iron safeguards’ have been eroded progressively in recent years, to permit assisted suicides in children under twelve and disabled, non-terminally ill twins.

  In Oregon, the US State on which Lord Falconer bases his Bill, there has been a huge 318% increase in assisted suicides since its introduction in 1998, with documented cases of disabled and elderly patients being pressurised to end their lives.

  For me, as one of the 11% of members registered on LDV who are against assisted suicide, I oppose the Falconer Bill because safeguards will inevitably be eroded (look at some of the above comments – six months is too long a time to wait – some want to kill themselves at a year before diagnosed time of death). There will always be doctors who are willing to test the law – it is happening in Belgium already, where the slippery slope is in place and being enacted every day.

  Assisted Suicide is not a choice once it becomes acceptable and culturally ‘normalised’ for the terminally ill. I don’t want my elderly parents ever to feel a burden and want to kill themselves to give me freedom or an inheritance. This is a problem with elderly in South Korea where suicide is a cultural ‘norm.’

• Stephen Hesketh 7th Jun '14 - 8:08pm

  @Richard Dean 7th Jun ’14 – 6:22pm
  Richard you are making an entire false distinction between political parties (who, almost by definition, have elements of the pressure group in them) and Pressure groups who may, or may not recognise their cause being best advanced by this or that political party).

  Regarding my own commitment to the Liberal Democrats as a campaigning movement and political party, those who know me would be unlikely to share your analysis of me. Just for the record, I am not a member of any group other than the Liberal Democrats and my views are represented very nicely by the words of our preamble thank you. Nor do I seek to impose my views on the personal and private lives of others. Live and let live!

  Your view that in supporting the right of terminally ill individuals to choose the time and manner of their own death is in some way not entirely mainstream Liberal Democrat is entirely wrong also.

  As Stephen Tall’s headline states “82% of Lib Dems back giving terminally ill adults the option of assisted dying”.

• Richard Dean 7th Jun '14 - 8:20pm

  On the topic …
  I think Helen’s point is very valid: “Assisted Suicide is not a choice once it becomes acceptable and culturally normalised”. In effect, an expectation will develop that terminally ill people, and maybe others who healthy people find awkward, will “choose” suicide. Social expectations are equivalent, of course, to social pressures.

  On the party/pressure group…
  All that Stephen Hesketh is saying is that he wants the Party to be subservient to the Pressure Group. Well, 2.6% support is what you get for that. Much better would be if the Party focussed on providing LibDem solutions to the electorate’s main concerns, and a separate Pressure Group focussed on wider LibDem proposals.

• Stephen Hesketh 7th Jun '14 - 8:59pm

  Richard, I will not be responding to your deliberately stupid comments regarding my clearly stated position and the functioning of political parties and pressure groups any further. Good night!

• Stephen Hesketh 7th Jun '14 - 9:31pm

  Helen Tedcastle 7th Jun ’14 – 7:38pm
  Hi Helen
  On the face of it and without knowing more about the individual cases, the examples you cite from Belgium are certainly concerning and go much further than I would wish to. Regarding the Oregon example, I believe we should make it a criminal offence to pressurise (or even encourage) others to take their lives, assisted or not.

  For me this is about people who are terminally ill or suffering from conditions such as locked in syndrome as in the tragic case of Tony Nicklinson who ultimately seems to have died of despair following the failure of his legal appeal. This was simply not a humane or civilised end to the life of a fellow human being.

  In a modern secular state it must be possible to find a middle way between those who wish to follow the teachings of a faith and those who do not. Between those who would not choose an assisted death under any circumstances and those, like myself, who merely seek it to be available as an option should all else fail.

  I do not pretend to know a great deal on this topic other than seeing elderly parents and grandparents die under very different circumstances. This includes amazing palliative care and NHS failures. If I ultimately suffer from terminal cancer etc, I would hope to approach the end in the care of a hospice or Macmillan nurses but for me the thought of suffering as did Mr Nicklinson would be very disturbing, cruel and unacceptable for both me and my loved ones.

• Phyllis 7th Jun '14 - 9:45pm

  Oh dear, this is a very difficult issue. On the one hand I share Helen’s concerns about ‘normalising’ suicide and also about subtle pressures for people not to be a ‘burden’ . I also share her concerns about people with depression. However like Stephen I also despair if a world in which people like Tony Nicklinson had to literally starve himself to death. Surely in this day and age we can help people who find themselves in such circumstances to die a dignified death without compromising other vulnerable people. Surely we must.

• Helen Tedcastle 7th Jun '14 - 11:08pm

  Stephen Hesketh
  I appreciate your very thoughtful comments on this issue.

  I think it is possible to be non-religious and be against assisted suicide, because there are very good arguments to suggest that safeguards do not prevent abuses to the law. The evidence is there to show that the law is tested frequently by pro-assisted suicide doctors in Belgium and Holland, for example the case of non-terminally ill twins who found a doctor to give them life-ending doses. Their reason for death was they were going blind. The assisted suicide law in Belgium is supposed to allow only terminally cases to receive doses that can kill but it is frequently bent by doctors.

  The Tony Nicklinson case is very sad but I don’t know enough about the type of care he received or whether he was diagnosed with severe depression. I think he had lost hope and was overcome with a ‘death-force’, which is understandable but this for me, this is a failure of care not family but social care support and so not an argument for assisted suicide.

  If the law changed for all as a result of one or two hard cases, we could end up with vulnerable people being pressurised to opt for death and Assisted Suicide becomes ‘normalised’ for elderly terminally and disabled people – this is a worse outcome for society, I think.

• Graham Martin-Royle 8th Jun '14 - 12:43am

  @Helen Tedcastle: Just because you don’t like the idea of assisted suicide is no reason to deny other people the right to it.

• Richard Dean 8th Jun '14 - 1:05am

  @Graham Martin-Royle. Just because you do like it is no reason to force others to accept it.

• daft ha'p'orth 8th Jun '14 - 2:44am

  @Graham Martin-Royle
  I’m not sure the idea of assisted suicide should be an idea that anybody ‘likes’. Believes to be merciful and appropriate in some circumstances, possibly, but ‘likes’?

  @Helen Tedcastle
  I’m as far from religious as you can get without actually being Richard Dawkins. Even so, I am concerned that the normalisation (not so much the legalisation… normalisation, applicability to a wide range of circumstances) of assisted suicide would lead to people choosing to die for what are fundamentally stupid reasons like money or the sort of unhappiness that comes with limited social interaction and poor social care.

  I do understand why assisted dying becomes desirable for, as Stephen Hesketh says, people who are terminally ill or suffering from conditions such as locked in syndrome – deterioration without hope of recovery. But mental health issues such as depression, either combined with physical conditions or chronic depression alone, are concerning reasons to help someone commit suicide. Many people who have suffered depression will recognise that sense of genuinely not wanting to go on – wanting and looking for a way out – as well as the days when that feeling began to fade.As someone who’s seen this struggle up close, and wondered what might have happened had a way out presented itself, I want to see people encouraged to fight for recovery.

  This mustn’t become a Liverpool Care Pathway type of situation (don’t say it’d never, ever happen).

• jedibeeftrix 8th Jun '14 - 10:39am

  @ RD – “Political parties exist to get elected. Pressure groups exist to persuade people who have been elected to support their point of view. You’re wanting the LibDem Party to become the LibDem Pressure Group.”

  This cannot be said to often.

  Are the lib-dems no longer a broad-based political party seeking government through manifesto mandate, and instead chosen to become a narrow and sectional pressure group designed to influence public opinion and thus shape political debate from the outside?

  That way lies oblivion for the lib-dems in what is an adversarial political society (not just an adversarial electoral system).

• Helen Tedcastle 8th Jun '14 - 11:34am

  @ Graham Martin-Royle: ” Just because you don’t like the idea of assisted suicide is no reason to deny other people the right to it.”

  You are right. I do not ‘like’ the idea of assisted suicide but daft ha’p’orth is right. It is not something to ‘like’ is it?

  I couldn’t never ‘like’ the real possibility that people who are at their most vulnerable will be pressurised to die because of their fears of being a burden on others. This has happened and is happening in Belgium, Holland and the state of Oregon. Otherwise how do you explain the massive increases in the numbers of assisted suicides in these jurisdictions and the widening of cases to children and the non-terminally ill? This is also why I believe that assisted suicide is a false choice.

• Richard Dean 8th Jun '14 - 11:49am

  Assisted suicide could, of course, be a cheap solution to some of the government’s more difficult problems.
  http://www.aljazeera.com/programmes/101east/2014/06/when-battle-comes-home-20146212174768681.html

• David Allen 8th Jun '14 - 5:29pm

  Helen Tedcastle,

  “Unfortunately, it is clear from the increase in assisted suicides in Belgium that initial ‘cast iron safeguards’ have been eroded progressively in recent years, to permit assisted suicides in children under twelve and disabled, non-terminally ill twins.”

  How did this come about, Helen? Was the “progressive erosion” something which was against the law, but allowed by officials anyway? Or did the Belgians make a democratic decision to widen the permitted scope for assisted suicide?

• Richard Dean 8th Jun '14 - 5:51pm

  @David Allen
  You can find some information in the following link. It tends to support the claim that initial guarantees are progressively eroded. http://www.dw.de/belgium-approves-assisted-suicide-for-minors/a-17429423

• daft ha'p'orth 8th Jun '14 - 6:14pm

  @David Allen
  http://eol.law.dal.ca/?page_id=236 suggests that clear and strict guidelines are key to getting it right. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070710/ gives an idea of the progression of events (warning: note errata, also note that this paper has generated considerable controversy and an angry if not particularly informative smackdown, so pinch of salt please; if I could find a better open-access overview I would give you that instead).

  That paper, suggests that what may be partly legislative is also being pushed forward by broad interpretation and application. The Dutch law requires only that a person be “suffering hopelessly and unbearably.” “Suffering” is defined as both physical and psychological, which includes people with depression. In Belgium, the law ambiguously states that the person “must be in a hopeless medical situation and be constantly suffering physically or psychologically.” By 2006, the Royal Dutch Medical Association had declared that “being over the age of 70 and tired of living” should be an acceptable reason for requesting euthanasia. Note however that whilst the latter has indeed been proposed, 79% of Dutch people disagree with the idea (see http://jme.bmj.com/content/early/2013/11/29/medethics-2012-101304.abstract?sid=9059eeee-522e-4d23-b59a-86fb6ed43df0 ) – it doesn’t seem to have gone far as yet, but the Pereira paper is correct that this has been seriously proposed.

  So yes, legislatively the Netherlands, for example, went from
  ‘not legally’ to
  * ‘not legally but we will turn a blind eye’ to
  * ‘legally, under a very specific set of circumstances’, to
  * ‘also we will not prosecute under certain other sets of circumstances’, as with the Groningen protocol (children), to
  * ‘actually, the law can be taken to include psychological suffering (not just progressive dementia, but also depression)’ to
  * ‘how would it be if you could just press your off switch at any point post the age of 70?’
  So obviously the boundaries are being tested; I don’t think it’s unfair to call that an ‘erosion’, although we should keep in mind that it may not continue to erode indefinitely.

• daft ha'p'orth 8th Jun '14 - 6:27pm

  @David Allen
  Also http://www.nrc.nl/nieuws/2014/01/02/in-the-netherlands-nine-psychiatric-patients-received-euthanasia/

  “Over sixty percent of Dutch GPs and specialists who took part in a study at the end of 2012 stated that committing euthanasia on psychiatric patients was “inconceivable”. An opinion poll carried out by the Royal Dutch Medical Association (KNMG) in 2011 highlighted the fact that 52 of the doctors questioned believed that the Euthanasia Act did not permit this. ”

  And yet…

  “Another patient who received euthanasia in 2013 was a healthy 63 year-old man. He worked for a governmental organisation and all he did was work. He had never been on holiday. He also used to do volunteer work in his free time. He had already tried and failed to commit suicide once and did not want to go through that again. He also did not want to affect other people. The patient had been treated for depression for many years. However, this had not helped. Now, due to his age, he was close to retirement and wanted to die. […] The man organised a farewell drink for his colleagues, the evening before his passing, in a café they regularly go to for lunch. His colleagues had been informed of his decision a few days in advance[…]”

  That right there is a slippery slope.

• David Allen 8th Jun '14 - 7:01pm

  Richard Dean, the example you give cannot reasonably be stigmatised by the phrase “progressive erosion”, which hints at something having gone wrong or been manipulated in an underhand way. Parliament voted for a change. They presumably concluded that if an adult could be spared unbearable suffering, it was discriminatory not to provide the same compassion to a dying child. Note that from your source, the child must “be in a hopeless medical situation of constant and unbearable suffering that cannot be eased and which will cause death in the short-term.”

  Daft haporth, some of the cases you describe cause me more concern. Not all of them.

  For example, you implicitly criticise the extension of the principle to psychological suffering, but if we read the Belgian criterion it says “must be in a hopeless medical situation and be constantly suffering physically or psychologically”. So, terminal cancer and constant pain, OK: terminal cancer and constant depression, OK: terminal cancer and frequently miserable or terrified, not OK to permit euthanasia. I wouldn’t call that over-permissive.

  As a second example, you mention Dutch doctors who would favour “being over the age of 70 and tired of living” as a criterion, but you also say that a massive majority of the public disagree and that the proposal has not been taken forward. To me, that suggests that there is robustness against “erosion”: some people will always advocate extreme ideas, but they don’t get accepted.

  However – your final example from Holland is much more worrying. Apparently the Dutch law requires “unbearable suffering” but unlike Belgium, not also “a hopeless medical situation”. That I agree is far too open. Nobody in that situation is in a truly hopeless position. Spontaneous psychological recoveries can occasionally happen, and whereas doctors aren’t often wrong when they diagnose terminal cancer, they can certainly get it wrong about psychological conditions. So on that question I agree with you.

  Shouldn’t it be possible to work through cases like this, set some rigid and restrictive criteria, and stick to them?

• daft ha'p'orth 8th Jun '14 - 7:21pm

  @David Allen
  I’m not equally concerned by all those examples either. Like I said, it’s normalisation, not legislation, that bothers me. Nonetheless…

  You are assuming that ‘hopeless medical situation’ means ‘terminal cancer’. I don’t know what’s included under that heading. I did not bother looking into that earlier, but I can find examples online of the Belgian law being used to justify euthanasia in cases of chronic depression, so I take it that, as in the Netherlands, the definition has been interpreted to as covering both physical and mental suffering. In short, you can have ‘a hopeless medical situation’ of ‘chronic depression’.

  The current argument seems to be trending towards: if the person would probably try to commit suicide anyway, then you might as well hold their coats and pass the pot of poison (or, as in Belgium, give them a lethal injection). That’s a long way from ‘rigid and restrictive criteria’.

• Voter 8th Jun '14 - 7:22pm

  “Nobody in that situation is in a truly hopeless position.”

  I think this just shows how little depression is understood by the general public. It is not far from the old statement “depressed people should just pull themselves together”.

  Do you ask people to just produce more white blood cells as well and get cross when they seem to be unable to do so?

• daft ha'p'orth 8th Jun '14 - 7:23pm

  excuse me: ‘interpreted as covering…’

• daft ha'p'orth 8th Jun '14 - 8:03pm

  And by the way, http://news.nationalpost.com/2013/11/24/suicide-with-the-approval-of-society-belgian-activist-warns-of-slippery-slope-as-euthanasia-becomes-normal/ <- discusses the law in Quebec, which also covers 'constant and unbearable physical or psychological pain'.

  @Voter
  I understand depression reasonably well, for reasons I am not prepared to go into here. I certainly understand it well enough to know that one who is suffering from suicidal depression is not in a position to accurately evaluate their own chances of recovery! In the Belgian example above, the woman was on medication which can cause suicidal ideation. She was (obviously) contemplating suicide. She had been turned down by various psychiatrists, who told her that her depression was treatable. She kept shopping around until she found one who could be induced to say that, yes, she was eligible for euthanasia. Sounds like what she needed was treatment – like you ordinarily would, when someone shows up and persistently says 'I am suicidal'.

  The worst part about all this for me is seeing the value judgements from third parties, that dismissive attitude of what chance do these folks have of a proper life? In principle euthanasia is about relief from pain, but in practice it so rapidly seems to become about the judgement of society. It is as if the moment you fall into depression or need someone else’s help to wipe your butt is supposed to be the moment you should bow out, rather than the moment where society should take care of you for a change and help you find a way to live with the person that you are. I appreciate that sometimes there really is no hope for the future. I’m just not sure I draw the line where current practice in these countries would like it to be.

• David Allen 8th Jun '14 - 8:39pm

  Voter “I think this just shows how little depression is understood by the general public.”

  I think that’s rude and uncalled for. I believe assisted suicide should be permitted but only in very clear-cut situations. Of course there is such a thing as chronic depression which sufferers cannot “snap out of”. However, that is not invariable. There can be dispute as to whether a condition is treatable or not. There can be occasional recoveries from situations previously judged hopeless. So I believe that chronic depression alone should not be sufficient to permit euthanasia. That does not mean that I am ignorant of its nature, thank you.

• John Broggio 8th Jun '14 - 8:57pm

  Surely it wouldn’t beyond the wit of some legal & medical minds coming together to create a list of illnesses that are not terminal in & of themselves? That’d rule out the vast majority of those suffering purely from psychiatric illnesses from being able to have an assisted suicide.

• Helen Tedcastle 8th Jun '14 - 9:05pm

  @ Daft ha ‘p’ orth Your comments here are very important and highlight the real problem of confusing the symptoms of severe depression and wish for death in presenting patients. This is highlighted not only in the cases you cite in Belgium/Holland but in numerous cases at Dignitas eg: the case of a woman of 89 who chose to commit assisted suicide not because she was ill but that she lamented the rapid social changes brought about by technology.

  Why on earth did a doctor pass this woman for this form of euthanasia?

  It proves that cast iron safeguards and criteria just do not safeguard people either from themselves or from people who are prepared simply to go along with a culturally ‘normalised’ exit by suicide.

  The case of the non-terminally ill 46 year old twins in Belgium is also concerning – they went through three doctors before finding a fourth who was prepared to bend the so-called safeguards to kill them. Assisted -suicide-Doctor shopping is quite common in Belgium – is this a good exercise of personal choice? Is this what we want to see happen in Britain as a sign of our cultural advance?

• Richard Dean 8th Jun '14 - 9:33pm

  I think the 89-year old and the twins are actually examples of the system working well. What is more of concern is the possibility of abuse, the effect of cultural normalization turning into pressure on vulnerable people (including children and old people), and the possibility of sliding too far down the slippery slope.

  Why would there be any ethical reason to refuse the 89-year old’s request. But a similar request from a 29-year old? Where would one draw a line, and should one draw one?
  http://www.dailymail.co.uk/news/article-2598102/They-say-adapt-die-At-age-I-adapt-Retired-teacher-89-ends-life-Swiss-euthanasia-clinic-disillusioned-modern-life.html

  The twins shopping trip surely confirmed their strong desire to have assisted suicide, and there wasn’t any question that they weren’t in sound mind? They were deaf and had learned they were going blind too, and didn’t want to live like that. One can readily imagine how horrible that must be. Would there really be any reason to refuse their request?
  http://www.dailymail.co.uk/news/article-2261985/Belgian-twin-brothers-killed-doctors-choosing-euthanasia-able-again.html

• daft ha'p'orth 8th Jun '14 - 10:12pm

  @Richard Dean
  “They were deaf and had learned they were going blind too, and didn’t want to live like that. One can readily imagine how horrible that must be. Would there really be any reason to refuse their request?”

  This is exactly what I’m talking about. “Oh, how horrible your disability is! Why don’t we put you out of your misery?”
  One of my closest friends is blind and increasingly deaf and works very successfully with a massive organisation in NYC; I should perhaps ask him if he’d like a trip to Dignitas? Living as a deafblind person is far from easy and yes,it is a terribly severe adjustment, and yes, they are relatively prone to suffering from depression, but it really is possible for a deafblind person to interact with the world and to live an active and happy life. You might find this useful: http://www.deafecho.com/2011/11/an-open-letter-to-deafblind-people-out-there/

  As for the 89-year-old, why does her age mean that there no ethical objection against her request? Would you be so kind as to clarify?

• Helen Tedcastle 8th Jun '14 - 10:19pm

  Richard Dean ” I think the 89-year old and the twins are actually examples of the system working well.” I am rather surprised by this comment Richard. How are the cases of non-terminally people who are allowed to die in jurisdictions where people are only allowed to commit suicide due to unbearable suffering which leads to inevitable death, examples of a success?

  I’m afraid they are rather examples of two shifts going on: the slippery slope and the bending of safeguards by ‘flexible’ reinterpretation. These are two insidious side effects of assisted suicide.

  David Allen: ” Was the “progressive erosion” something which was against the law, but allowed by officials anyway? Or did the Belgians make a democratic decision to widen the permitted scope for assisted suicide?”

  Both. Bending the rules and testing the boundaries and a recent change in the law to allow children under twelve with terminal illnesses to commit suicide with the consent of their parents. Belgium is sliding further and further into cultural normalisation of assisted suicide for terminally ill people. pressure and expectation replaces any notion of ‘choice’ in this situation.

• Voter 8th Jun '14 - 10:33pm

  “In the Belgian example above, the woman was on medication which can cause suicidal ideation”

  This is not relevant to the point I was making which was that there seems to be an assumption that depression is something that can always be easily treated.

  There is a significant portion of people who do not get relief from treatement.

  If you do not believe me, consult an actual doctor on the subject, not a priest. Read a website about the condition.

  The motivation for changing policy should be to better reflect the problems people face, rather than the judgement made by some that depressed people will “snap out of it” and thus we should rule it assisted dying, perhaps motivated by religion not science

• Helen Tedcastle 8th Jun '14 - 11:03pm

  @ Voter: I agree with you completely that depression cannot easily be treated and is not always diagnosed by doctors because they are not always trained to spot the symptoms. This is why for me, it is quite likely that either misdiagnosis or lack of effective treatment on-going support, gives rise to the desire for a solution like assisted suicide.

  To be fair to daft ha ‘p’orth, I think they were not trivialising depression in their comment.

  Finally, I ‘m not quite sure where the criticism of religion is coming from, as this has not been raised by anyone so far as part of their comments. In depression and mental health issues more generally, one needs to call upon the help and understanding of all parts of our society.

• daft ha'p'orth 8th Jun '14 - 11:17pm

  @Voter
  ‘Read a website…’ Helpful, thanks.
  The immediate point I was making is that this woman very likely would have ‘snapped out of it’, your words not mine, as if there is in any depressed person’s life a single instant when some kind of ‘depression switch’ goes from ‘suicidal’ to ‘just fine’. Secondly, it should be very blatantly obvious that you will not know if you will get relief from treatment unless you go through all the relevant treatments first. Someone who is wandering around every doctor in town going ‘please tell me you’ll help me die’ needs treatment. This lady is not on the face of it a good example of the diagnosis you describe, which is probably why most doctors she asked said no, you need treatment.

  If on the other hand someone has been through all the treatments that should be available and has had all the support there should be available (not the treatments and support that merely happen to be available, because this country is not good at treating mental illness) and still despite everything is not responding whatsoever to treatment? Then maybe just maybe, possibly, arguably, we could have a serious debate about whether or when suffers from treatment-refractory “untreatable” depression are to be covered by assisted dying legislation.

  I’m an atheist, if you were paying attention above, so your dig at the priesthood simply suggests short-term memory issues. Atheism doesn’t imply that one believes that human life is cheap.

  @Helen Tedcastle
  No, I take depression very, very seriously. I want to see it treated seriously, too.

• Richard Dean 8th Jun '14 - 11:17pm

  @Helen
  I mean that, for the case of the twins, there was a pretty clear situation of severe and probably unrelievable distress, and no indication at all that their choice was not their own.

  I’d forgotten about the effects of the 89-year old’s medication, which certainly complicates matters. Many medicines have adverse side effects in terms of mood, and some medications for depression seem to make it worse, so this is a much more tricky area for many people: how can we say that it’s the person talking rather than the drug? Depression is complex and the number of attempted suicides in the UK is surprisingly high. http://www.webmd.boots.com/depression/guide/depression-recognising-signs-of-suicide

  Another issue from the 89-year old’s story was that, by saying “people are becoming more and more remote” she was complaining about loneliness rather than technology. This is a serious and widespread feeling amongst many old people, and provision of social care should, in my view, be a higher priority compared to provision of assistance to suicide. http://www.nhs.uk/livewell/women60-plus/pages/loneliness-in-older-people.aspx

• daft ha'p'orth 8th Jun '14 - 11:46pm

  @Richard Dean
  ” This is a serious and widespread feeling amongst many old people, and provision of social care should, in my view, be a higher priority.”
  I agree, no matter what happens with assisted dying legislation.
  And regarding the person talking versus the drug (or neurochemistry) talking – yes to that too.
  The story of the twins is odd in that the description of their plight suggests that they were not given a great deal of support in developing the skills that deafblind people use.

• Helen Tedcastle 9th Jun '14 - 12:19am

  @ daft ha ‘p’ orth: ” No, I take depression very, very seriously. I want to see it treated seriously, too.” Exactly. That’s what I thought.

  @ Richard Dean: ” I mean that, for the case of the twins, there was a pretty clear situation of severe and probably unrelievable distress, and no indication at all that their choice was not their own.”

  No doubt but that doesn’t mean that a. they should have been euthanised in a hospital b. that their request is a valid request.

  Let’s remember the context – these 45 year old men were going blind and obviously distressed. However, they were not terminally ill, which is the main reason give for the administration of euthanasia in Belgium. If this case is ‘unbearable suffering’ then what else constitutes such suffering? It opens a further can of worms and proves beyond all doubt that there is such a thing as a slippery slope of normalisation and acceptance of people dying, because they suffer.

  Did anyone bother to support them? Did they get help for depression or their change of lifestyle? I suggest not – they took the one way ticket out of this life with the help of the flexible law of Belgium and a willing doctor who interprets the law very widely.

  Who is next? The elderly – too old and ‘tired’ to have a reasonable life so are a ‘burden’, the disabled, the very young sick and so on. When does an apparent ‘free choice’ become a desperate cry for help or an expectation? These are the crucial questions.

• Richard Dean 9th Jun '14 - 12:30am

  @daft ha’p’orth
  Yes, one problem is indeed that, by providing assisted suicide, society may have less motivation to give distressed people the (costly) support they would need to come through and be happy again.

• Nigel Cheeseman 18th Jul '14 - 1:39pm

  I remember many years ago having a discussion about this with someone who expressed the wish that when they feel like they’ve had enough, they’d like to be able to decide when to go. I’d not given the subject any thought prior to that; I was in my twenties. The fellow I was talking to was probably in his late thirties or forties and in good health, not prone to depression, simply expressing his personal view. Since then, I’ve taken the view that if someone wants to die, what right has anyone else to prevent them? I do not mean, by saying that, to support extreme examples like someone trying to kill themselves because they’ve lost their job. In the circumstances, however, of someone of sound mind, having lived a fulfilling life and deciding that they would like to go painlessly, while in full control of their faculties, why should we not afford them that right? I have read no adequate argument yet why we should not make this the case.

  Does anybody out there who supports this principle have serious misgivings about coercion? My feeling is that all the people dragging up examples of vulnerable relatives being obliged to die for fear of being a burden are opposed in principle in any event.

  Finally, if you believe that everything should be done to preserve life, that’s fine, but you should not have the right to inflict the painful consequences of your opinion on others.