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If the assisted dying bill passes, GPs will be left on a slippery slope

Lord Falconer’s Bill to legalise assisted dying is to be debated for the first time in the House of Lords this Friday. Proponents of the Bill state that there is no need to be concerned about the ‘slippery slope’ of increasingly lax legislation in favour of assisted dying, because the Bill has been drawn up with safeguards to prevent this from happening.

Certainly in its current form there are considerable restrictions on when the new law could be enacted, but it is these very restrictions that make it as inherently unstable as a uranium atom – it may take some time for it to decay, but decay is inevitable unless we are prepared to maintain an ethically-unjust position ad infinitum.

There is a thin line between giving ill people the power to end their lives, and leaving them vulnerable to a self-inflicted obligation to do so.

For those who hold autonomy as the trump card in ethics, the current legal situation is unpalatable, while others argue that the protection of society sometimes needs to override personal choice. Both sides are motivated by compassion for the suffering and the vulnerable and the ethics are difficult.

The Falconer Bill would change this forever and create a new ethical tension that will eventually prove irresistible. Autonomous choice would be given, but only to a few; the law only applies to those who are mentally competent, able to administer the fatal drugs themselves and terminally ill with less than six months to live.

The Bill will only increase the inequity for patients such as Tony Nicklinson. He had locked-in syndrome and suffered just as much as someone who is terminally ill, but never had the prospect of an end in sight – he would not have been able to take advantage of this change to the law.

The case of Oregon is often cited as proof that the slippery slope need not exist, since the law has not changed in this US state in 17 years. This may well be that case, but will their situation will remain unchanged forever? Even if we were to emulate the US position in the UK, could we accept such an ethical incongruity in perpetuity?

Maybe Americans can sustain this conflict, but I suspect our mind set is closer to that of our European neighboursin the Netherlands and Belgium, where the right to die has been extended to all regardless of prognosis, capacity or ability to administer the drugs themselves.

Are those in favour of the Bill really going to be happy with where this legislation will leave us? Will they ignore the pleas of those like Tony Nicklinson? Will they really say ‘this far and no further?’ I very much doubt it.

When we debate this bill we must consider not only the legislation before us, but where it might lead 5, 10 or even 20 years from now – and for that vision of the future we must look not across the Atlantic, but closer to home in Europe. 

Dr Martin Brunet is a GP in Guildford and programme director of the Guildford GPVTS. You can tweet him @DocMartin68.