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Dr Ann McPherson: In her own words

In an exclusive interview with Pulse, Dr Ann McPherson - who is dying from pancreatic cancer - explains why she believes the law on assisted suicide should be changed.

In an exclusive interview with Pulse, Dr Ann McPherson - who is dying from pancreatic cancer - explains why she believes the law on assisted suicide should be changed.

I feel there are lots of issues to do with assisted dying. First of all it should be assisted dying not assisted suicide. I feel quite strongly about that. Suicide has all sorts of connotations that dying does not. Secondly I don't think having assisted dying precludes having good palliative care which the palliative care lobby seem to think it does. I think we need to make sure there's good palliative care, and I have had good palliative care, but however good it is sometimes one still wants assisted dying. I've certainly had patients who have felt that and I don't believe that other doctors haven't either.

I've been a GP for 40 years and there must have been about six or seven patients who told me they would want an assisted death. Not a lot, and whether they all used it I don't know, but there were certainly several – three in the last five years – who definitely wanted it.

None of them were really able to have an assisted death. And they had very good palliative care, that wasn't the issue. One of had a tumour and actually wasn't in pain, but she had become paraplegic as a result of everything and she just didn't want to carry on living. She'd had enough, it wasn't that she wasn't having good palliative care she had just decided 'I want to die now'. Now, why couldn't she be helped? The sanctity of life – and she was a Christian – doesn't preclude that you can be helped to die.

I think we should respect that. I had a letter recently from someone saying they liked my article, they didn't agree with it and they were sure I would agree to disagree. And I absolutely do. They have the choice of what to do but I don't have the choice of what I want to do. That seems to be wrong.

I don't believe that it's not possible for us to have a law, especially for terminal illness – I think there are issues and I wouldn't pretend there aren't but it shouldn't be beyond the wit of us to be able to get a law which allows people to have an assisted death but is not abused or put in a position were they feel forced to die.

In countries where the law allows that, you haven't got hundreds of people wanting it but it's a choice that we should not only respect but enable. It would make me at the moment feel much happier if I felt that at some point I felt that I could say 'I've had enough of this'.

I don't feel that the BMA and the RCGP represent the whole of the profession's views. If you look at the number of emails and letters I've had as a result of my article, they don't represent the profession's view at all. Lots of people have said 'I absolutely agree with you' or 'I've had patients who have wanted an assisted death'. If you look at how the BMA formed their position it was done through an AGM, it wasn't done with everybody voting who are members of the BMA. I'm sure there will be different views but at the moment one view prevails and that seems, to me, wrong. If patients want to talk about it why shouldn't we be able to talk about it?

I've had many letters from GP and doctors; some I knew, some I didn't know.

I think it will happen in the end because the groundswell of people will make that happen. I feel the palliative care lobby is not always quite honest about what they can offer. One certainly can say 'you won't get pain' but you may not get the quality of life you feel you can live with. And they'll admit that privately but they won't stand up and say it publicly.

I've always felt that people should have the right to assisted dying. I do feel there are times when the law should allow them to do that. Obviously it's been brought into much sharper focus going through it myself. I've had a will for years – I had breast cancer 15 years ago and made a will saying what I wanted then – but obviously having pancreatic cancer and being terminally ill now does make it much more real. The whole debate has moved on recently and that also makes me feel very strongly.

I wouldn't say I know the answers and I don't know whether I would like an assisted death but at the moment I feel like I would like the option. That's very important and very different from the certainty with which some groups are saying 'it will be abused', or 'what about vulnerable old people?'. We ought to be able to accommodate that.

In her reply to me letter in The Lancet Baroness Finlay said 'suicide is always tragic'. Well, assisted dying is not always tragic because it may be that having your family around you, and them understanding what you want and why, and being to choose your death in the way you wanted is not tragic. Actually it's very positive. And that's why I feel so strongly that is should be called assisted dying rather than suicide.

Good palliative care is very important and one wants to make sure everyone has good palliative care. But I don't think it means there should be assisted dying. The two things are very separate.

We should look at people who are terminally ill first – I would have more worries about people who have had a head injury or things like that. There are issues where it's not so clear cut. But I think someone who is definitely dying, say of cancer, I can't see there's an argument against them being helped at a time when they feel they want it.

Of people on the Dignitas list I think about 50% of them have spinal conditions and you can understand someone with motor neurone disease or something wanting an assisted suicide. But I don't want to go to Switzerland. I want to be in my own home surrounded by my own things. I don't want to feel I have to go off somewhere else.

I'd like the law changed. I'd like a proper debate within the medical profession. I'd like people to be given – I hate the word choice because it's been rather abused within the health service – but I'd like people to know what they have got that option if they want, And no-one's forcing you. I'd like people to have very good palliative care. But I'd like this to be part of the palliative care menu. I see it is part of it, not one thing or the other. We all have different experiences and we should respect them, that's not what's happening to me in my position or the people I've had letters from.

I'm sure many GPs have been in a position where patients have asked them to help them to die. They can't do that because that's against the law and since Shipman it's become much more difficult. When you ask GPs, they will have increased the morphine or the sedation and helped people die in a sense. And some people say that's good enough and you should leave the law how it is. But I think one wants to say to GPs that this is an issue that isn't going to go away and they need to listen to what patients are saying and be able to support those who want this in a practical way at the same time as making sure they know how to give and deliver very good palliative care.

In the House of Lords you have someone who runs a hospice and very strongly in favour of palliative care being able to carry a lot of credence – quite rightly in some ways – but carrying more credence than someone like me. I don't have a seat in the House of Lords but I have looked after many people in this position and I myself am in this position and I don't think our voices are being heard.

I think there should be a proper debate. If you have a third or a half of the profession saying one thing and the rest another, that's important. But at the moment the BMA coming out strongly one way is not a debate. I gather the president and secretary of the RCGP are very anti this change in the law. They shouldn't be speaking for us. That's their personal view, that's not based in evidence. It gets all muddled up with religion and other very strongly held vested interests.

Sometimes GPs say 'oh well, no-one's every said that to me' but have you allowed them to say it? Have you listened and has the patient felt able to say it?

Dr Ann McPherson Dr Ann McPherson

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