Choosing to Die: Newsnight Debate Newsnight


Choosing to Die: Newsnight Debate

Jeremy Paxman speaks to Terry Pratchett about his documentary, and a panel of studio guests debate the controversial issues surrounding assisted dying.


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That documentary seems set to trigger a new debate about assisted

:00:10.:00:15.

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

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

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

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

:00:29.:00:33.

assisted dying because we should protect the vulnerable. The

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disability rights campaigner Liz Carr tried on camera to persuade a

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quadriplegic man not to kill and staff. David Aaronovitch has

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

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Debbie Purdy went to court to protect her husband from

:00:46.:00:50.

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

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Dinah Rose QC represented the Director of Public Prosecutions,

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

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

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Talking briefly about the film before we consider the broader

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

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

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

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

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contribution to an important debate, but I became concerned and

:01:31.:01:36.

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

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but no showing the alternative ending. There was no indication

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

:01:44.:01:48.

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

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

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

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

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

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

:02:13.:02:17.

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

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would imagine. But I think it raised some very important

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

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

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

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

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

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assumptions? It is quite interesting, because the bishop

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

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

:03:05.:03:09.

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

:03:09.:03:13.

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

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

:03:18.:03:23.

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

:03:23.:03:26.

people, sentient people making that kind of decision in the

:03:26.:03:32.

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

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

:03:37.:03:40.

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

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really had was people making a decision they were qualified and

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

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

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

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

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

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

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

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

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

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

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older and terminally ill people are quite fearful of what legalising

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

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

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

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

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

:05:00.:05:08.

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

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

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

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

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

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

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

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

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Pratchett, having seen what Dignitas is about and assisted

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

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should be possible for someone stricken with a serious and

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ultimately fatal illness to choose to die peacefully, with medical

:06:07.:06:15.

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

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

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

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

:06:37.:06:47.
:06:47.:06:51.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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assistant to die. Thank you very much.

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

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

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

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

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

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

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

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before the programme, about the actual number of assisted suicides

:09:50.:09:54.

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

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

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

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

:10:06.:10:10.

that it is available gives them some form of consolation.

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

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

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think Terry makes a very important distinction. Talking about the

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

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

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

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

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daughter, whose experience of life is having somebody else making

:10:45.:10:49.

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

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

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

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

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of community and social relationships. I want to see more

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

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

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

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experiences, very positive experiences with religion. When my

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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difference between those people who think that this is a legitimate

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

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

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

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

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

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

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

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

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

:13:44.:13:48.

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

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

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

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

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

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

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

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

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

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

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

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the law is change snd If we legalise euthanasia or assisted

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

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

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

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

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

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

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

:15:30.:15:36.

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

:15:36.:15:41.

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

:15:41.:15:45.

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

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

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

:15:55.:16:04.

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

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

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

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

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

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

:16:28.:16:33.

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

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

:16:40.:16:47.

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

:16:47.:16:52.

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

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

:16:58.:17:02.

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

:17:02.:17:07.

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

:17:07.:17:10.

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

:17:10.:17:17.

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

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

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

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

:17:36.:17:40.

the current climate, assisted suicide should never have an

:17:40.:17:44.

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

:17:44.:17:49.

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

:17:49.:17:53.

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

:17:53.:17:58.

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

:17:58.:18:03.

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

:18:03.:18:06.

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

:18:06.:18:12.

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

:18:12.:18:15.

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

:18:15.:18:19.

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

:18:19.:18:24.

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

:18:24.:18:29.

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

:18:29.:18:34.

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

:18:34.:18:39.

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

:18:39.:18:45.

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

:18:45.:18:50.

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

:18:50.:18:56.

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

:18:56.:18:59.

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

:18:59.:19:03.

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

:19:03.:19:12.

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

:19:12.:19:22.
:19:22.:19:23.

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

:19:23.:19:27.

dying are confusing the issue around disabled peopleland...

:19:27.:19:34.

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

:19:34.:19:40.

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

:19:40.:19:46.

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

:19:46.:19:54.

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

:19:54.:19:57.

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

:19:57.:20:00.

is believed over 150 people have travelled from Britain to

:20:00.:20:05.

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

:20:05.:20:11.

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

:20:11.:20:15.

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

:20:15.:20:24.

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

:20:24.:20:28.

readings, the legal regime in England and Wales prohibits

:20:28.:20:32.

assisted suicide while allowing more scope for it to happen without

:20:32.:20:36.

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

:20:37.:20:46.

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

:20:46.:20:53.

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

:20:53.:20:58.

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

:20:58.:21:04.

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

:21:04.:21:09.

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

:21:09.:21:15.

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

:21:15.:21:18.

when the Law Lords said the Director of Public Prosecutions

:21:18.:21:27.

needed to clarify the position. The Director of Public Prosecutions

:21:27.:21:34.

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

:21:34.:21:38.

only gave reluctant encouragement or assistance. The law says the

:21:38.:21:43.

Director of Public Prosecutions could have restricted the criteria

:21:43.:21:49.

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

:21:49.:21:52.

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

:21:52.:21:56.

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

:21:56.:22:02.

talking about providing medication, say you have some leftover pills

:22:02.:22:05.

from another illness and you provide that medication to your

:22:06.:22:12.

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

:22:12.:22:14.

covered by President policy. seems the Director of Public

:22:15.:22:18.

Prosecutions opened the door far wider than originally intended. He

:22:18.:22:22.

planned to restrict assisted suicides only to those with

:22:22.:22:27.

terminal illness or with a degenerative physical disability.

:22:27.:22:33.

But disability groups protested saying they were being picked out,

:22:33.:22:37.

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

:22:37.:22:40.

targeted for euthanasia that restrictions based on physical

:22:40.:22:45.

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

:22:45.:22:48.

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

:22:48.:22:53.

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

:22:53.:22:58.

assisted dying and euthanasia where doctors administer the poison are

:22:58.:23:05.

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

:23:06.:23:13.

of improvement. Luxembourg also legal ieszed euthanasia and asaysed

:23:13.:23:21.

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

:23:21.:23:25.

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

:23:25.:23:30.

be suffering an incurable disease expected to kill them within six

:23:30.:23:36.

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

:23:36.:23:42.

introduce bills legalising assisted dying. It should limited to a

:23:42.:23:47.

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

:23:47.:23:53.

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

:23:53.:24:00.

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

:24:00.:24:07.

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

:24:07.:24:14.

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

:24:14.:24:19.

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

:24:19.:24:24.

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

:24:24.:24:28.

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

:24:28.:24:32.

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

:24:32.:24:37.

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

:24:37.:24:41.

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

:24:41.:24:45.

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

:24:45.:24:51.

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

:24:51.:24:56.

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

:24:56.:25:02.

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

:25:02.:25:08.

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

:25:08.:25:11.

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

:25:11.:25:16.

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

:25:16.:25:19.

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

:25:19.:25:23.

Director of Public Prosecutions cannot give you immunity from

:25:23.:25:27.

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

:25:27.:25:32.

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

:25:32.:25:36.

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

:25:36.:25:40.

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

:25:40.:25:44.

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

:25:44.:25:49.

Public Prosecutions to decide to amend primary legislation. It is

:25:49.:25:53.

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

:25:53.:25:58.

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

:25:58.:26:05.

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

:26:05.:26:13.

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

:26:13.:26:18.

crime but the law ultimately is not there to constrain individual

:26:18.:26:22.

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

:26:22.:26:29.

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

:26:29.:26:34.

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

:26:34.:26:39.

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

:26:39.:26:44.

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

:26:44.:26:50.

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

:26:50.:26:54.

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

:26:54.:27:01.

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

:27:01.:27:07.

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

:27:08.:27:12.

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

:27:12.:27:17.

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

:27:17.:27:25.

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

:27:25.:27:31.

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

:27:31.:27:36.

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

:27:36.:27:41.

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

:27:41.:27:49.

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

:27:49.:27:55.

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

:27:55.:28:02.

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

:28:02.:28:09.

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

:28:09.:28:13.

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

:28:13.:28:19.

challenge the BBC to do a similar documentary tracking somebody like

:28:19.:28:29.

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

:28:29.:28:38.

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

:28:38.:28:43.

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

:28:43.:28:47.

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

:28:47.:28:50.

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

:28:50.:28:56.

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

:28:56.:29:00.

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

:29:00.:29:09.

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

:29:09.:29:13.

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

:29:13.:29:18.

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

:29:18.:29:22.

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

:29:22.:29:26.

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

:29:26.:29:33.

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

:29:33.:29:37.

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

:29:37.:29:42.

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

:29:42.:29:46.

is really unsatisfactory?. Switzerland, there are guidelines.

:29:46.:29:52.

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

:29:52.:29:57.

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

:29:57.:30:03.

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

:30:03.:30:09.

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

:30:09.:30:15.

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

:30:15.:30:21.

important. Most people imagine 200 people go into assisteded suicide

:30:21.:30:26.

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

:30:26.:30:36.
:30:36.:30:36.

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

:30:36.:30:41.

something about your argument about the weak people? Your daughter

:30:41.:30:49.

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

:30:49.:30:55.

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

:30:55.:31:00.

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

:31:00.:31:06.

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

:31:06.:31:15.

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

:31:16.:31:20.

homosexuality was the age of consent was standardised from 21 to

:31:20.:31:25.

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

:31:25.:31:30.

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

:31:30.:31:35.

waiting round corners waiting to corrupt our young people. What

:31:35.:31:39.

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

:31:39.:31:45.

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

:31:45.:31:49.

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

:31:50.:31:56.

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

:31:57.:32:06.
:32:07.:32:07.

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