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Choosing to Die: Newsnight Debate

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That documentary seems set to trigger a new debate about assisted


dying. Is it a human right to decide how and when we die? Is it


moral to help someone? Should it be legal in this country? We are going


to sue over all of that in the next half hour. Our six guests all have


The Bishop of Exeter has a daughter with Down's syndrome and opposes


assisted dying because we should protect the vulnerable. The


disability rights campaigner Liz Carr tried on camera to persuade a


quadriplegic man not to kill and staff. David Aaronovitch has


written of his desire to end his own life when the time comes.


Debbie Purdy went to court to protect her husband from


prosecution if he accompanies her to Switzerland so she can die.


Dinah Rose QC represented the Director of Public Prosecutions,


the other side of the argument in that case. Also with us is Dr Erika


Preisig, who works for Dignitas, and whom you saw in the film.


Talking briefly about the film before we consider the broader


issues, did any of you change your mind as a consequence of what you


saw? It was remarkable, what one saw in that film. Did anybody


change your mind? I did not change my mind, but my expectations


changed. I expected I would they be able to welcome the film as a


contribution to an important debate, but I became concerned and


disturbed by. It was very one-sided. There was a nod to a hospice care


but no showing the alternative ending. There was no indication


that the two principles, Peter and Andrew, need not have been living


the life they were leading. I questioned the whole ethical basis


of the programme at the end. I felt that Peter and indeed his wife and


indeed Terry Pratchett had been caught up and become trapped in the


storyline of the programme. I felt there was a deeply coercive


atmosphere in that room at the end, and I felt emotionally blackmailed


by it. What did you think, Debbie Purdy? I thought the arguments were


really important. There was nothing that made me change my mind, as you


would imagine. But I think it raised some very important


questions. For instance, the cost of not talking in this country, of


not being able to have the protection... This country, we


decide what people need as protection. We should not have to


be relying on these was or anybody else. -- the Swiss. We should be


able to confirm that in our country. Did you rethink any of your


assumptions? It is quite interesting, because the bishop


felt great emphasis on his pre- existing beliefs, and so did I,


from the other direction. Although I do think that the trend and the


way in which people are moving is very much towards a much greater


degree of autonomy and self- decision about matters of debt, as


in other things, what I think the film did for me was give absolute


and real emphasis to what this decision actually meant. To see


people, sentient people making that kind of decision in the


circumstances they did, it was not just moving. It was deeply human. I


think the way in which the bishop has to characterise it is necessary


for him to maintain his own position, because actually what you


really had was people making a decision they were qualified and


only they were qualified to do. the people we saw were articulate,


they were people of means. There was no reference whatsoever to the


week, the vulnerable, the poor. are talking about the film. We will


come to those issues in a moment. Ms Kama did you can take your


views? -- reconsider. Well, like everyone here, I'm not going to say,


I have seen the light, I am going to Dignitas! I know, it is strange!


But I do think that it was yet again broke assisted suicide. I


think that is what it is, propaganda. Actually, I'm very


upset at the BBC. I know they have been called the cheerleaders of


assisted suicide, and I think that is right. I and many other disabled,


older and terminally ill people are quite fearful of what legalising


assisted suicide would do and would mean. Those arguments are not being


debated, teased out, the safeguards are not being looked at. Until we


have a programme that does that, I will not be happy to move on to the


wider debate. Did you feel the case was fairly presented? It was fairly


presented, but a lot of important things were missing, for me. Depart


that Liz said, we should see the legal side, what has to be done to


protect other people, to protect people who do not want to go. This


is very, very important. We have exact regulations in Switzerland to


assist some of them. We will explore them late in the programme,


but first a little more from Terry Pratchett, made his film to help


establish whether he would be able to die in a manner and that a point


of his own choosing. I asked him whether the experience of watching


others do what he wants to be able to do had clarified things. Terry


Pratchett, having seen what Dignitas is about and assisted


dying is about, have you changed your views at all? I believe it


should be possible for someone stricken with a serious and


ultimately fatal illness to choose to die peacefully, with medical


help, rather than suffer. And your views did not change. No. Do you


think the same freedom applies to somebody who has an unendurable, in


their judgment, condition? There is a human right to die. You think


there is? All rights are contingent on all other rights. I would have


been shocked if Peter Smedley was determined to die with his wife


absolutely in tears and begging him. I think the mind of the marriage


had made up its mind, and Peter was going to go to Dignitas. He did not


want to go to Dignitas. His wife did not want him to go to Dignitas.


But he went to Dignitas because that was the only game in town.


Almost the same sort of thing was said by Andrew, the young man. I


think, in his case, is there is a real tragedy. You have mentioned


the two guys who decided to end their lives. You have not mentioned


the cabbie in the hospice who were users is very memorable phrase, he


says to you, let's try another role of the dice. Yes. Anybody might


come to that conclusion, having been in a suicidal frame of mind


previously. Yes. And what is your question? Which judgment the


respect? I respect Peter's judgment. Killing yourself is not something


to be encouraged, is it? Good heavens, no. No. We do not


encourage it because... Because of all sorts of ideas about the


sanctity of life. What about the dignity of life? His lack of


dignity a sufficient reason to kill yourself? I am sure, for some


people, it would be. We have been talking predominantly about debts


of older people, or very old people. If the law were to change, to be


changed to allow assisted suicide, should there the something in the


law that says that there is a cut- off point, in age below which you


are not allowed to make this judgment? Let's call at the age of


consent, I think. I think we have to do it like that. At the age of


consent... Who do not really mean the age of consent, do you? A


teenager thing? I think we have to say that. You could pick it. I


personally would be very upset if someone I thought of as a child was


assistant to die. Thank you very much.


Right, David Aaronovitch, this question of conflicting rights. A


right to dignity and life and death, and a right to live, they conflict


at times, clearly. Yes, they can conflict. You can decide that your


life is intolerable. Now, you may make the argument that he might


change your mind. You can make all kinds of speculative arguments


about what would, May, could happen under different circumstances, but


it seems to me that, by and large, speaking to America about this


before the programme, about the actual number of assisted suicides


way it is legal, 200 in the entire population. There really is not any


evidence that people, given this capacity, rush out en masse in


order to be able to take it. You have the most deliberative... It


may be that for other people who do not go through the process, knowing


that it is available gives them some form of consolation.


indeed that was admitted in the film, the doctor at the Dignitas


Clinic said, lots of people come here and then never come back.


think Terry makes a very important distinction. Talking about the


dignity of life, I prefer dignity to Saturday. Dignity is about


what's giving work to every human life. It has to bear on every human


life, and my problem with the emphasis on choice is that it is


all right for us here, who are fat choice, but takes someone like my


daughter, whose experience of life is having somebody else making


choices for her. She has just had her house sold around her with very


little choice. It leaves you with a poor sense of self-esteem and self-


worth. What pommie gives dignity of life is to say that each of us has


a value. -- what for me. It is not an instrument of thing. It is part


of community and social relationships. I want to see more


emphasis on supporting people in living than assisting them in dying.


Erica, you are a religious person. Yes. How do you reconcile what you


do with your religious conscience? I had a lot of different


experiences, very positive experiences with religion. When my


father died, he was very religious, he had a stroke and could not talk,


so I could not talk to him and ask him, how can you do this? You have


no conflicts? And I had a priests, as I just told you, I had a priest


who came for an assisted suicide, a priest from England, Catholic. I


was talking with him for a long time about how he could do this,


being a priest. He was there for the first talk with me, he was


convinced that he would do it. We talked to let go there again after


two days, and he said, he said he had an inspiration, and his duty to


come here was not to go into an assisted suicide yet, it was to


come and tell me that I am doing the right thing, that I should go


on with my work. And he went home after the second talk. He did not


go to the assisted suicide. He did come back a few months later and


went into the assisted suicide. Things like this happen to me and


give me a lot of strength and a lot of knowledge that it might be OK,


what I am doing. We commissioned an opinion poll, and there is a clear


difference between those people who think that this is a legitimate


thing for somebody to decide to do if they have a terminal illness and


those who have an incurable illness. Where, for you, lies the


difference? What I was going to see -- say is actually ask you, if


somebody is terminally ill, they have started the process of dying.


They are not going to be cured. They can potentially be suffering


enormously, and for an assisted death, it is not life-or-death. It


is a horrible death for a good death, and that is something that I


know the main campaigner in this country, dignity and dying, is only


in favour of changing the law to allow terminally ill people to be


able to request an assisted death. That is really interesting, because


on the Terry Pratchett documentary, not one of those people were


terminally ill. He is not. M&S is not terminal. But nobody was going


to die within the next... Peter, I am sorry, his last name has gone


from me. He just wanted to die at He to go to swilts land. He not


only had to know he was going to die in a way he wasn't prepared to,


also, maybe he would have chosen not to die at that point if he was


able to die in this country. So he changed the law for people. We


change the law for those few. This is a minority incidence, people who


want to be assisted to die. Absolutely. Why change the law,


unless it can be fully safeguarded? What is it you're worried about if


the law is change snd If we legalise euthanasia or assisted


suicide, I worry the ultimate punishment of prison will be taken


away. For the majority of people, for families, this is a hugely


emotive issue. I don't want people to die painfully. I'm worried about


the coercion that goes on in old people's homes, places like


Winterborne. That is a real anxiety if we change the law. One of the


things I find interesting is the way this argument plays out on both


sides of line. On the one hand it is said there may be pressure put


upon people to kill themselves. From what Erika says, it would be


difficult to get away with that?. Right at the end, it really worried


me, I realise we saw probably an edited version. Peter lifted a


glass of poison and said "when do I take it?" many doctors are pre-


counsellors present at that point would have thought, hang on, there


is a moment of hesitation here. The answer was "do whatever you want."


I think you're Reading into something that isn't there. Erika,


you talk to people who come. Have you ever talked to them and felt,


perhaps you do want this but you're too early and nonetheless been


willing to help? I send quite a few home. It is not right people who


come to Switzerland never go home again. 10% of the people who come


to Switzerland are sent back home. Quite a lot never ever get the


green light. I can't accept it. who are you to decide? I'm not God.


No. The big problem is, with Peter, he went too early. For me he went


too early. Then why did you help him? If he wasn't British I would


have sent him home. At least for Christmas and his birthday. He had


not a terminal illness but an illness which cannot be cured. He


was getting very much worse with symptoms that you can't see from


the outside. He was getting worse with swallowing, breathing and


speaking which shows that the illness is starting to get worse. I


couldn't send him home because he was so much afraid of not being


able to come again without help. That is the problem. Let me hear


from you, Liz. I'm quite frightened as a lot of disabled people are, in


the current climate, assisted suicide should never have an


economic situation. In the current climate it can't help but be


economic. The cost of social care, the cuts in terms of the NHS. What


concerns me, there's more and more pressure. You can ask somebody, do


you want to die, they'll say, yes, they do. Is that to protect their


family where they worry about being a burden or not having the right


palliative care. We debate again and again the right to die. But


what about the right to live and support those people? That's very


important. There could be an economic problem. That is for


instance, everybody we seagoing to Switzerland, there is a financial


implication. Personally, going to Switzerland, I have a credit card I


keep blank in order to make sure I can. If I had children I'm not sure


I could do that. But there is a massive difference between... I


think we need to suss further people who are not terminally-ill.


I think it is so immediate that people who are terminally-ill do


not want to travel to Switzerland. They have to go earlier, it might


be a week, a month, a year earlier than they would have to if it was


in Britain. Nobody in that programme seemed to be terminally-


ill. They could lift the cup. They could do it them elves. But they


have to be able to do it themselves. Lifting a cup isn't terminally ill.


You and I are disabled. Terminally- ill people are lifpb... Dignity in


dying are confusing the issue around disabled peopleland...


want to move on to the law. People often talk about committing suicide


as if it is committing an offence. But it is illegal to help someone


kill themselves. No-one has been prosecuted for doing that. Quite


lines were issued intending to clarify the law in this area. Did


the Director of Public Prosecutions succeed? In the past nine years, it


is believed over 150 people have travelled from Britain to


Switzerland to end their lives at Dignitas. So far, no-one who's


helped, who's assisted in suicide has been prosecuted. Yet England's


1961 Suicide Act clearly states any assistance is illegal. So, what the


law forbids, the interpretation, up to now, has permitted. On some


readings, the legal regime in England and Wales prohibits


assisted suicide while allowing more scope for it to happen without


prosecution than almost anywhere else. On what's truly and starkly a


matter of life and death, nothing is simple. Back in 2002, Newsnight


were the first journalists to reveal what Dignitas was about. We


sawed Ludwig Minnelli and his assistant. She was still coming to


terms with her job back then. Somebody has to do it. Since then,


Britain's going to Dignitas have risked prosecution. So Debbie Purdy,


who wanted to know if her husband could be in jeopardy, was delighted


when the Law Lords said the Director of Public Prosecutions


needed to clarify the position. The Director of Public Prosecutions


was said people would be less likely to be prosecuted if they


only gave reluctant encouragement or assistance. The law says the


Director of Public Prosecutions could have restricted the criteria


to only those going to Switzerland. He's depaelt with suicides in


England and Wales. He's dealing with proximate assistance, much


closer to the final act which causes death. Forks, we could be


talking about providing medication, say you have some leftover pills


from another illness and you provide that medication to your


friend or relative. And that's OK? Well, that's the sort of assistance


covered by President policy. seems the Director of Public


Prosecutions opened the door far wider than originally intended. He


planned to restrict assisted suicides only to those with


terminal illness or with a degenerative physical disability.


But disability groups protested saying they were being picked out,


discriminated against. It was to stem fierce the disabled would be


targeted for euthanasia that restrictions based on physical


condition were dropped. Almost by accident, it's left a policy which


is arguably more liberal than anywhere else. The I canesting laws


are most liberal in northern Europe. In Belgium and the Netherlands


assisted dying and euthanasia where doctors administer the poison are


legal. The patient has to be facing unbearable suffering with no hope


of improvement. Luxembourg also legal ieszed euthanasia and asaysed


suicide. In Switzerland, those say cysted must not be making a profit.


Only Washington and Oregon allow assisted dying. The patient has to


be suffering an incurable disease expected to kill them within six


months. In the House of Lords, Lord Joffe's tried and failed to


introduce bills legalising assisted dying. It should limited to a


restrictive group of terminally-ill patients who are suffering and have


made an informed decision that they want to end their lives.


Baroness Campbell says that's dangerous. An atheist, since birth


she's had terminal muscular atrophy. She was labelled in hospital a few


years ago do not resuscitate. they say to me now thanks God there


wasn't a law in this country because I'd be dead now. You say


people come out of that despair? Absolutely, yes. What of the man


who interprets the current law? You're getting Chris sighsed by


both sides at the moment? Most people think given the framework


within which we operated, we arrived at a very good set of


guidelines. They have been welcomed by many people. I think they are in


the right place. Most people agree with that, I think. It was a very


difficult taste can. There's no immediate prospect of the law


changing. But are the guidelines a kofrp pies that works? --


compromise that works. Dinah Rose, do you think these guidelines work?


I think it depends on what you mean by work. There is a problem with


the approach the House of Lords adopted. We have a situation where


on the statute book there's legislation which says it is a


criminal offence to assist in suicide. Where it is accepted the


Director of Public Prosecutions cannot give you immunity from


prosecution and you simply have a list the factors which will be


taken into account whether or not there will be prosecution. Debbie


periody didn't really get what she wanted. There's no guarantee but on


the other hand, you have a questionable result in terms of the


rule of law. Is it really for judges or for the Director of


Public Prosecutions to decide to amend primary legislation. It is


not satisfactory at all. One thing is clear under these guidelines,


the one group of people who cannot be involved in assisting suicides


are doctors? On the whole, the law as it stapbts are clear and the --


stands are clear. You think they work? At present, suicide is not a


crime but the law ultimately is not there to constrain individual


choice. It is there to constrain third party action and complicity


in another person's death. That remains illegal. There may be


circumstances which can be taken into account. But the law remains


clear and is there to protect the vulnerable. It seemed to me, the


very basis of English law, it should protect the most vulnerable


expression to the deepest values our society holds. What do you


think of it? Particularly this aspect of doctors not being allowed


to be involved. Makes a botcheded job more likely? Yes. I agree


entirely that the lawyers who are not elected, who are appointed or...


The thing is they are the only people who've had the courage to


stand up and say this law is older than me and I would take a guess it


is older than most of us. What we are going to do is make it relevant


in today's society with today's countries like Switzerland,


Luxembourg. Making it legal for assisted dying. Politicians haven't


kept up. Lawyers and judges have been the only people who have been


prepared to defend my rights and the thing is, what you said about


the rights of individuals... My right to life and the quality of my


life is the most important thing to me. And who else but you can


decide? I would hope we can agree on that but this is based on the Si


sichings of assisted dying. I'd like to talk about good dying. I


challenge the BBC to do a similar documentary tracking somebody like


the cabbie through to a good death. We've done documentries about the


good dying. You say with the cabbie, I'm with him but... It is not


expressing his personal choice. is The cabbie even said, it is your


decision to make. It becomes difficult to police. Ultimately,


law has to be concerned with the most vulnerable. Within that, I'm


sure it is possible to work for a good death for us all. Assisted


dying is not... We don't have it at the moment of the under your system


we don't have good deaths now. think we can work more for it.


Dying, terminally-ill is painful stuff. It is emotional and emotive.


It is hard to come to reconciliation. It is not about an


issue about personal morality. It is about public safety and security.


Unless there can be a law on the statute books that can protect


everybody who is vulnerable... there's no such thing. We don't


have capital punishment for that very point. Erika, earlier you say


there's something about the way the law operates in this country that


is really unsatisfactory?. Switzerland, there are guidelines.


I have listed them here. I would like to give them to you. Thank you.


It is very important we have guidelines. Why can't you respect


Debbie? Give her the way of death she wants. And we respect you.


think Debbie can have that death. We try to put as much money in


hospices and palliative care as we can. Palliative care is very


important. Most people imagine 200 people go into assisteded suicide


in Switzerland. Most go into death with palliative care. And that's it.


It is a minority issue. Very 45ly suffering people... Can I say


something about your argument about the weak people? Your daughter


wouldn't be able to defend herself. She wouldn't be able to go in


assisted suicide. She must be of sound mind. But Terry Pratchett


himself said although he's clear where he's going, developing a code


of safeguards is extraordinarily difficult. This won't stop as an


issue. There will be a need to change the law. I remember


homosexuality was the age of consent was standardised from 21 to


16, same as for heterosexuals. So many people often the same teem


that I hear now are saying, there's going to be all sorts of men


waiting round corners waiting to corrupt our young people. What


about the vulnerable and weak? It hasn't happened. The point is we


are old enough, we are intelligent enough and we have politicians who


are bright enough to make sure that the guidelines that the protections


that are put in place in a proper, thought-outlaw, are good enough to


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