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.
SPECIFIC COMMENTS
ON THE
CONTENT OF
THE DRAFT
BILL
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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