Select Committee on Assisted Dying for the Terminally Ill Bill Minutes of Evidence

Memorandum by the British Assocation of Social Workers

  1.  The British Association of Social Workers (BASW) is the largest professional association for social workers and social care staff in the UK. The Association has 10,000 members employed in frontline, management, academic and research positions in all social work settings who share a commitment to ethical practice and the best possible standard of service for all those who require social care support.

  2.  The Association shares the concern expressed by the Voluntary Euthanasia Society that present UK law concerning assisted dying does not effectively serve the interests of persons challenged by terminal illness and their relatives and informal carers or those providing health, social or pastoral care to such individuals. We therefore welcome this Bill and the constructive debate it is likely to give rise to. We are pleased that the Bill embodies a statutory right to pain relief and palliative care and promotes choice. Everything possible must be done to alleviate avoidable pain and suffering.

  3.  This is a complex issue and debate within the Association suggests that the views of social workers mirror those found elsewhere in Britain reflecting our diverse perspectives on the sanctity of life, religion and other influences. Essentially there are three main groups, those who believe that our right to control how and where we end our lives should be paramount, those who consider that to enshrine such a right in law would give rise to unacceptable pressure on some of us to seek assistance to die prematurely when faced with terminal illness and unbearable pain and those who have not really thought through the issues. We are glad that the Bill acknowledges that some people will remain strongly opposed to assistance to die and makes provision for conscientious objectors.

  4.  However, as social workers we believe that one of the most important issues is the right of all individuals to be informed and consulted about the likely course of their illness, the implications of any treatment decision and their place and manner of dying. Existing UK law militates against such dialogue with the result that significant decisions may be made by health professionals and well meaning relatives and not shared with those concerned.

  5.  Such occurrences and the spectre of desperate individuals either suffering in silence or traveling a distance to another jurisdiction are wholly unacceptable and therefore on balance we are inclined to support this Bill subject to rigorous testing of the proposed safeguards to minimise the possibility of unacceptable pressure being placed on any individual to opt for assistance to die when they might not otherwise have done so.


Qualifying Conditions

  6.  We consider that the Qualifying Conditions afford reasonable safeguards to persons wishing to be assisted to die. However, we would suggest that Para. 2(2) should be reworded as follows:

    "Having been informed by the patient that they wish to be assisted to die the attending physician shall:—"

    Delete Paragraph (a) and (b) then becomes the new (a).

Offer of Palliative Care

  7.  We consider that Paragraph 3 might be extended to exclude the attending and consulting physicians from providing the specialist advice and palliative care even if they are qualified to do so.

Declaration made in Advance

  8.  Paragraph 4(6). We are more than a little concerned that an actively involved social worker or other social care worker may not be a member of the medical care team and despite similar considerations arising would be competent to witness the declaration. Very significant practical difficulties will arise for some terminally ill individuals in securing individuals to witness their declaration if the proposed legislation precludes those family members and professionals working most closely with them. Whilst we can appreciate that the draft legislation seeks to eliminate the possibility of conflicts of interest we do not consider such an arrangement to be unduly onerous for professional care staff or relatives. Indeed in situations where such individuals have been very actively involved in arriving at a decision it would seem logical for one of them to witness the declaration rather than somebody more independent.

  9.  We would suggest that the Bill should make provision for a right of appeal against a decision by the Attending or Consultant Physician that the qualifying conditions are not met.

  We hope that these brief comments are helpful to the Select Committee and would be pleased to provide any additional information that may be required.

British Association of Social Workers

September 2004

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