Information on assisted dying overseas

info@dignityindying.org.uk - 020 7479 7730

“As a doctor for over 35 years, I became increasingly aware of the failure of even the best care to deal with the suffering of some patients. The present clinical, ethical, and legal fudge - and a law which is discredited in practice - is dangerous for patients and also for professionals.”Professor Raymond Tallis, Dignity in Dying Patron
“Having seen my father die, it became very clear to me that we as society need to grasp the nettle and deal with this contentious issue in a way that is humane and acceptable to the majority of right thinking people.”Matthew Wright, Dignity in Dying Patron
“My work as a cancer physician inevitably brought me into contact with dying people. I think that assisted dying is an important choice to be offered in the rare situations where doctors are unable to control unbearable symptoms.”Dr Lisa McDonald, Dignity in Dying Patron
“I endorse the work of Dignity in Dying because I believe passionately that any individual should have the right to choose, as far as it is possible, the time and the conditions of their death. I think it's time we learned to be as good at dying as we are at living.”Sir Terry Pratchett, Dignity in Dying Patron
“Having been a member of Dignity in Dying for thirty years I fully support the campaign to ensure that all people have, what they consider to be, a good death. The option of an assisted death at the end of life would provide the choice and control we all deserve.”Miriam Karlin OBE, Dignity in Dying Patron
“My mother, Dr Anne Turner, chose to have an assisted death in 2006 at Dignitas in Zurich. Once my mother had been accepted for an assisted death, she was able to enjoy her life for the remaining time she had, greatly reassured that she would be spared further suffering.”Sophie Pandit, Dignity in Dying Patron
“My wife, Diane Pretty, had the terminal illness motor neurone disease and wanted to receive medical assistance to die with dignity. During the last weeks of her life, Diane was in considerable pain and distress. The very thing she'd fought through the courts to avoid.”Brian Pretty, Dignity in Dying Patron
“I support Dignity in Dying because I care about suffering and want the law changed so that those who presently suffer terrible deaths will in future have the option to end their suffering through ending their lives at a time and in the manner of their choice.”Lord Joffe, Dignity in Dying Patron
“Knowing that most of us, it seems, want the freedom to choose when and how to end our lives so as to avoid, for ourselves and our families, the harrowing consequences of a messy, drawn-out and painful deaths, that choice must be enshrined in a framework of law.”Professor Eric Bolton CB, Dignity in Dying Patron
“Being incapable of helping a loved one to die when they are at the end of their life, suffering and asking for help is undignified and wrong, and I know this having witnessed it myself at close hand.”Zoe Wannamaker, Dignity in Dying Patron
“My brother John Close died with help from Dignitas in May 2003, aged 55. Motor Neurone Disease had robbed John of almost everything which defined him as human, but the knowledge that he would be in control of his death was a source of great comfort to both of us.”Lesley Close, Dignity in Dying Patron
“Over many years, I have become convinced of the need for a change in the law to protect people with terminal illness who have made the painful decision to seek help in dying. This is why, once I left government, I joined Dignity in Dying and will go on supporting their campaign until we succeed.”Rt Hon Patricia Hewitt MP, Dignity in Dying Patron
“I wish to be treated as a responsible adult and believe that people should be legally able to register their wish for an assistance with suicide, if needed. I support Dignity in Dying primarily to help change the law on assisted suicide.”Sir Michael Holroyd CBE, Dignity in Dying Patron
“It is because we believe in the dignity and value of life that we hope for a good death. This is what Dignity in Dying hopes to permit and I passionately support its aims. To linger on against my will on a half-life is no life at all.”A.N Wilson, Dignity in Dying Patron
“As someone who helped her son to die when he could no longer face the suffering caused by Huntington's disease, I understand fully the need to have a safe, regulated right to die system that takes the pressure off family. After all, who would let their loved ones die alone?”Heather Pratten, Dignity in Dying Patron
“My father, who was suffering from cancer and no longer wished to live, died as he chose: in peace and dignity, with my mother beside him. I passionately hope that, if I too were terminally ill, and was finding life unbearable, I could be allowed to die at a time of my choosing.”Rosemary Brown OBE, Dignity in Dying Patron
“I see it as almost inevitable, that society will become more understanding, and more sophisticated, about assisted dying. As with suicide, it is right to strive to find better options, but when the alternatives have run out it must surely be wrong for society to insist that people suffer.”Nick Ross, Dignity in Dying Patron
“I believe that decisions about the timing and manner of death belong to the individual as a human right. I believe it is wrong to withhold medical methods of terminating life painlessly and swiftly when an individual has a rational and clear-minded sustained wish to end his or her life.”Professor A C Grayling, Dignity in Dying Patron
“As a child there existed in my mind a nagging fear about this thing called death. As I have become older, I want to give an assurance to the people I love that the circumstances of their death will be 'good', to be celebrated, and their final hours will be reflective of life well lived.”Jo Brand, Dignity in Dying Patron
“I believe that the exercise of free will concerning the end of life, and the timing of the end of life, is an essential human freedom. I believe that while religious dogma may dictate or limit the choice of believers it should not be imposed on others.”Rabbi Dr Charles Middleburgh, Dignity in Dying Patron

Assisted dying
Overseas

A number of countries have enacted legislation to provide terminally ill people with the choice an assisted death, within legal safeguards. These safeguards have protected vulnerable people [1] whilst ensuring that terminally ill patients do not have to suffer unnecessarily against their wishes.

Research also shows that in these countries, palliative care is making great steps forward whilst working alongside the assisted dying laws. If we look at the USA, the state of Oregon - which allows assisted dying - is consistently found to provide amongst the best palliative care in the USA. Currently, 88% of those who receive prescriptions under assisted dying legislation in Oregon receive hospice care [2]. Furthermore, health professionals' skills, knowledge and communication with dying patients have improved in places with assisted dying legislation [3]. Experiences in other countries demonstrates that assisted dying legislation can clearly work alongside established health care methods and systems [4].

International update:

Belgium

The Belgian Act on Euthanasia was passed in May 2002. The law allows adults who are in a "futile medical condition of constant and unbearable physical or mental suffering that cannot be alleviated" to request voluntary euthanasia.

Luxembourg

In February 2008, the Luxembourg Parliament approved a Law on the Right to Die with Dignity. This allows a person who is suffering unbearably from an illness, and is mentally competent, to request medical assistance to die.

The Netherlands

The Netherlands introduced assisted dying legislation in 2002. Patients who have an incurable condition, face unbearable suffering and are mentally competent may be eligible for voluntary euthanasia or assisted dying.

There are about 3,500 cases of assisted dying or voluntary euthanasia a year.

Since the legislation has been in place rates of non-voluntary euthanasia (i.e. doctors actively ending patients' lives without having been asked by them to do so) decreased from 0.8% of all deaths in 1991 (1,000 deaths) to 0.4% in 2005 (550 deaths).

Oregon (USA)

The Oregon Death with Dignity Act has been in place for 10 years. It gives terminally ill, mentally competent people the option of an assisted death. Recent research from the Journal of Medical Ethics concluded that in Oregon there is no evidence of abuse or the so-called 'slippery slope'.

The numbers using the Act to die are low and steady - and in ten years just 341 people have been assisted to die, but many more have taken comfort from knowing the option is there.

Switzerland

Voluntary euthanasia is forbidden in Switzerland. However, Article 115 of the Swiss Penal Code exempts people who assist someone to commit suicide, if they act with entirely honourable motives.

Washington (USA)

Washington state voted in favour of an assisted dying law modelled on the Oregon legislation (the vote took place alongside the presidential election November 2008).

58% of Washingtonians voted in favour of a change in the law in a voter initiative - the law will not come into effect instantaneously, and may face challenges (as the Oregon law did when it was endorsed in a similar voter initiative).

And pressure for change continues in other countries:

France

There was a public outcry following the case of Chantal Sebire, a mother of three, who had a rare and extremely painful form of cancer, and was refused an assisted death in February 2008.

Following Chantal Sebire's death, President Sarkozy ordered a study of possible amendments to the law. Several senior French politicians have said they favoured a right to assisted dying.

Spain

Minister of Justice Mariano Fernandez Bermejo recently met with campaigners for a change in the law on assisted dying in Summer 2008. He has since said that the Ministry will study the possible reform of the law.

Footnotes

1. Independent research has found no evidence to justify the grave concerns about the negative impact of assisted dying legislation on potentially vulnerable groups. Researchers carefully examined data from Oregon and the Netherlands and assessed the use of assisted dying legislation for a number of potentially vulnerable groups. The researchers concluded there was no evidence to support claims that assisted dying legislation would have a negative impact on these people - Margaret P Battin, Agnes van der Heide, Linda Ganzini, Gerrit van der Wal, Bregje D Onwuteaka-Philipsen, 'Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in vulnerable groups', Journal of Medical Ethics 2007; 33:591-597

2. Annual Report on Oregon's Death with Dignity Act, Department of Human Services, March 2007

3. Ganzini et al, 'Oregon Physician's attitudes about and experiences with end-of-life care since the passage of the Oregon Death with Dignity Act', JAMA, 285;18, May 9 2001, 2363-2369. Goy et al, 'Oregon hospice nurses and social workers' assessment of physician progress in palliative care over the past 5 years', Palliative and Supportive Care 2003, 1, 215-219

4. Bernheim et al, 'Development of palliative care and legalisation of euthanasia: antagonism or synergy?', BMJ 2008, 336: 864-867