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


Letter from Marie Curie Cancer Care

  Marie Curie Cancer Care is grateful for the opportunity to respond to the call for evidence from the Select Committee on the Assisted Dying for the Terminally Ill Bill.

  1.  Marie Curie Cancer Care was founded more than 50 years ago and provides palliative care services to patients in both community and hospice settings across the United Kingdom. The Charity also conducts scientific and palliative care research and delivers palliative care education to healthcare professionals. It is the largest provider of hospice beds and specialist palliative care outside the NHS and this year will serve more than 23,000 cancer patients and around 1,000 people with other life-limiting illnesses such as motor neurone disease, multiple sclerosis and HIV/Aids.

  2.  Marie Curie Cancer Care has been opposed for some time to any change in United Kingdom legislation relating to euthanasia or physician assisted suicide (PAS). The Charity endorsed the statement on voluntary Euthanasia published in 1997 by the National Council for Hospice and Specialist Palliative Care Services (National Council).

  3.  Marie Curie Cancer Care has not recently sought the opinions of its approximately 3,000 clinical staff on these issues. The Charity is aware that recent consultations by the National Council and others have revealed that a complete spectrum of opinion may be held by healthcare professionals who specialise in palliative care. This diversity of view probably reflects the range of opinion which is found in society in general.

  4.  The recent report of the House of Commons Health Committee on Palliative Care identified that the "taboo nature of the subject of death was a recurrent theme of the inquiry. A general reluctance to discuss the topic informs much of society and perhaps accounts in part for the problems people encounter in negotiating choices in this area." The Charity believes that it is vitally important that issues concerning how society cares for those who are approaching the end of life are considered and discussed in a public forum. Currently, debate is largely based on opinion poll findings and influenced by very fervently held and expressed opposing views. Marie Curie Cancer Care strongly supports the call from the National Council and others for a delay in legislation until the results of robust research into all aspects of euthanasia and PAD are available and have been widely debated in society.

  5.  There are some aspects of the current Bill on which the Charity would wish to comment specifically.

  6.  Clause 15 on pain relief is wholly unnecessary. The right to the administration of pain relief is acknowledged and well established in clinical practice and should have no bearing on the consideration of PAD. There is absolutely no need for a conscientious objection clause 7(2) in relation to the administration of pain relief. It would be unprecedented that a therapeutic course of action required an act of legislation. The Committee might wish to consider whether a comment on the need for all health care professionals to have more education in the use of analgesics would be helpful.

  7.  Marie Curie Cancer Care is concerned about some definitions of terms within Section 1.2. These are either inconsistent with current common usage, for example, a distinction is usually drawn between euthanasia, an act committed by one individual upon another, and PAD, when a physician assists a person to die, or risk being inconsistent with other legislation, for example the definition of competence.

  8.  The Bill places emphasis on the need to inform the patient of the availability of palliative care, although it is not clear about how this should be done. The inference that palliative care is an alternative to PAD is misleading and inappropriate. It risks reinforcing the erroneous belief that palliative care is only concerned with the process of dying instead of recognising that involvement with palliative care practitioners throughout the course of an illness could prevent or reduce any suffering produced by that illness.

  9.  The Bill places an enormous potential burden on palliative care practitioners, and doctors in particular, in requiring that they respond to a request for PAD within a two week timeframe. This demand on specialist time and facilities risks disadvantaging other patients who may be in greater immediate need of these services and is ethically unjust and inequitable. Marie Curie Cancer Care supports the call of the National Council for Hospice and Specialist Palliative Care Services for a greater investment in all forms of palliative care services which could benefit a far larger number of people that those who are likely to pursue a request for physician assisted dying.

2 September 2004



 
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