Choosing to Die: Newsnight Debate Newsnight

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