Dignity in Dying
Encyclopedia
Dignity in Dying is a United Kingdom nationwide campaigning organisation. It is funded by voluntary contributions from members of the public, and as of December 2010, it claimed to have 25,000 actively subscribing supporters. The organisation declares it is independent of any political, religious or other affiliations, and has the stated primary aim of campaigning for individuals to have greater choice and more control over end-of-life decisions, so as to alleviate any suffering they may be undergoing as they near the end of their life.
Dignity in Dying campaigns for the greater choice, control and access to a full range of medical and palliative services at the end-of-life, including providing terminally ill
adults with the option of a painless, assisted death, within strict legal safeguards. It declares that its campaign looks to bring about a generally more compassionate approach to the end-of-life.
Dignity in Dying points out that in the 2010 British Social Attitudes survey 82% of the general public believed that a doctor should probably or definitely be allowed to end the life of a patient with a painful incurable disease at the patient's request. This was further analysed to show 71% of religious people and 92% of non-religious people supported this statement. However, the group is opposed by anti-euthanasia organisations such as Care Not Killing
.
Alongside its campaigning work, Dignity in Dying, through its partner charity Compassion in Dying, is also an information source on end-of-life issues and a provider of advance decisions.
, the Medical Officer of Health for Leicester from 1901 to 1935, gave the Presidential address at the Annual General Meeting of the Society of Medical Officers of Health. In the address, he advocated the "Legalisation of Voluntary Euthanasia", which prompted considerable debate in Britain involving doctors, clerics and the wider public. Millard's proposal was that in the case of terminal illnesses the law should be changed "to substitute for the slow and painful death a quick and painless one".
The organisation was set up in December 1935 under the name of The Voluntary Euthanasia Legalisation Society (VELS). The initial meeting that set the society up was held at the headquarters of the British Medical Association
free of charge, despite the BMA not supporting the aims of the society. During the debate, the meeting was disrupted by 40 members of a Catholic youth association.
The foundation of the society followed an offer of £10,000 from Mr. O. W. Greene, a terminally-ill man in London. The initial offer was retracted and no posthumous endowment was left to the Society after Greene learned that the prospective Society would only be supporting legalisation of euthanasia for those with incurable conditions. The first chairman was C. J. Bond, a consulting surgeon at the Leicester Royal Infirmary; Millard was made the first Honorary Secretary. Other members of the Executive Committee were drawn from Bond and Millard's social milieu in Leicester, including Astley V. Clarke from the Leicester Royal Infirmary; Rev Dr R. F. Rattray, a Unitarian minister and principal of University College, Leicester; Canon F. R. C. Payne of Leicster Cathedral; Rev A. S. Hurn; Frederick Attenborough, also a former principal of University College, Leicster; and H. T. Cooper, the Honorary Solicitor of the Committee.
The society did not attempt to build a popular movement at first but attempted to build, according to Kemp, "a network of distinguished sympathisers able to influence policy at high levels". The society had a Consultative Medical Council and a Literary Group, and were endorsed by a variety of authors, progressive reformers, feminists and supporters of the Fabian Society
. Early supporters included Henry Havelock Ellis, Vera Brittain
, Cicely Hamilton
, Laurence Housman
, H. G. Wells
, Harold Laski
, George Bernard Shaw
, Eleanor Rathbone
MP, G. M. Trevelyan, W. Arbuthnot Lane, and a variety of peers including Lord Woolton of Liverpool (Conservative) and Lord Moynihan who had been the President of the Royal College of Surgeons.
The first attempt to pass legislation to make euthanasia legal in Britain was the Voluntary Euthanasia (Legalisation) Bill 1936 introduced to the House of Lords by Arthur Ponsonby. The debate was not split along party political grounds and the Government considered it "outside the proper range of Government intervention and to be one which should be left to the conscience of the individual members of the House". The Hunterian Society
held a debate on November 16, 1936 to debate whether "the practice of voluntary euthanasia would be unjustifiable", and the Bill was opposed by the British Medical Association
.
On 28 November 1950, the next attempt was made by Lord Chorley of Kendal, a Vice-President of the society, who brought a pro-voluntary euthanasia motion before the House of Lords. The motion was so widely condemned it was withdrawn without a division. According to N. D. A. Kemp, the attempt was an "ignominious failure", as were similar attempts to produce more liberal legislation generally on abortion
, homosexuality
and divorce
.
Following the death of the Honorary Secretary Killick Millard
and the resignation of Lord Denman, the President of the Society, and the deaths of two prominent supporters of the society, E.W. Barnes and Dr N.I. Spriggs, a new Honorary Secretary was found in R. S. W. Pollard who moved the society to be based in London from Leicester. The society also changed tactics: moving away from courting the medical and legal elites to trying to build up a mass movement to exert "grass-roots pressure" and efforts were made to bring up the topic in civic society groups like Rotary Clubs, local newspaper editorials etc.
From 1955 onwards, the 'Legalization' was dropped from the name along with the 'Voluntary' to make it the Euthanasia Society (although some sources place it at 1960). The Euthanasia Society placed adverts on the London Underground and on mainline railway services in the south of England, with the wording "The Euthanasia Society Believes that incurable sufferers should have the right to choose a Merciful Death". In 1960, the chairman, C. K. MacDonald died and was replaced by Leonard Colebrook. He was replaced temporarily by Maurice Millard. In 1962, he was replaced by the Unitarian minister Rev A. B. Downing, and in 1964, C. R. Sweetingham was made secretary. Prominent people who supported the society during the 1960s included the legal academic and president of the Law Reform Association Glanville Williams. Williams gave a paper entitled 'Voluntary euthanasia – the next step' at the Annual General Meeting of the society in 1955. Williams' ethical justification of euthanasia argued against the principle of double effect
and for a utilitarian approach to the questions in medical ethics including both voluntary euthanasia and abortion. His proposal would have allowed a physician to put as a defence to a homicide, assault or bodily harm charge that the person was incurably and fatally ill if the doctor was acting in good faith. These proposals mirror those of James Rachels
discussed below.
According to Kemp, the public association of euthanasia with eugenics and Nazi atrocities marred attempts in the 1950s to promote voluntary euthanasia, but such setbacks were short-lived. The next legislative attempt was started in 1967 with a bill drafted by Mary Rose Barrington, a member of the executive committee of the Euthanasia Society and barrister. Attempts were made to find an MP willing to introduce it to the Commons but eventually it was introduced to the Lords in 1969 by Lord Raglan, a member of the National Secular Society
.
The word 'Voluntary' was reinstated to the name in 1969 to become the Voluntary Euthanasia Society. It was also known as Exit (not to be confused with Exit International) from 1979 but this was reverted in 1982. During the period it was known as 'Exit', the secretary of the society, Nicholas Reed, was convicted of aiding and abetting a suicide. He was jailed for two and a half years, although this was reduced to 18 months on appeal. Reed had supported Mark Lyons, a seventy-year old man who provided pills and alcohol to a multiple sclerosis
sufferer. Lyons was given a two-year suspended sentence. The society had voted in 1979 to publish a "Guide to Self-Deliverance", a booklet which described suicide methods. This was challenged by the Attorney General in 1982 under s2 of the Suicide Act 1961
, and after a brief attempt to fight back against this, the distribution of the booklet was suspended in 1983.
After the name was changed back following the conviction of Reed and Lyons, Lord Jenkins of Putney introduced an amendment to the Suicide Act to introduce a defence for those who acted "on behalf of the person who committed suicide and in so acting behaved reasonably and with compassion and in good faith" but this was defeated 48 votes to 15.
In 1988, the Voluntary Euthanasia Society, as it was then, attempted to place a full-page newspaper advertisement in the Evening Standard
showing twenty-four young men with advanced emphysema
with the words "A day in the life of an emphysema sufferer" and accompanied by "We believe that he should have the right to choose a peaceful and dignified death." The British Medical Association
contacted the Advertising Standards Authority
to block publication of the ad, and a representative of the British Lung Foundation
condemned the advert, saying that "fears of patients with lung disease should not be exploited in this way."
In 1990, the group campaigned for the early release of Anthony Cocker, who was convicted of murder after killing his wife Esther after she begged him to end her suffering from multiple sclerosis
.
In 1992, the society supported Dr Nigel Cox, who was prosecuted and convicted for murder for shortening the life of a patient at the Royal Hampshire County Hospital
.
Dignity in Dying was the new name endorsed by members at the annual general meeting in 2005. Its current Chair of the Governing Board is Professor Nick Moore and its Chief Executive is Sarah Wootton. The name change was done to "get away from the suggestion that you can only achieve dignity in dying with euthanasia".
Dignity in Dying has a range of patrons, including people who have been associated with high-profile cases connected with Dignity in Dying's campaigns, such as Lesley Close (sister of John Close), Brian Pretty (husband of Diane Pretty
) and Heather Pratten. Other patrons include prominent individuals from the worlds of business, politics, the arts and religion, such as Terry Pratchett
, Jonathan Miller
, Patricia Hewitt
, Zoë Wanamaker
, Simon Weston
, Anthony Grayling and Matthew Wright.
The most recent legislative attempts have been made by Lord Joffe
who joined the society in the 1970s. The first bill was introduced in the 2003 session, and the Bill has been reintroduced repeatedly since. The Joffe Bill led to the formation of the anti-euthanasia group Care Not Killing
.
Dignity in Dying has a non-campaigning partner charity, Compassion in Dying, which carries out research to do with end-of-life matters, provides the general public with access to advance decisions and also works to provide information about a person's rights at the end-of-life. They are also associated with Healthcare Professionals for Assisted Dying, a group formed by Dignity in Dying supporter and general practitioner Anne McPherson.
In May 2011, Dignity in Dying noted the result of a referendum
in Zurich
, Switzerland
, which showed overwhelming support for assisted dying and voted to reject the restriction of assisted dying services in Zurich to the residents of the city. The organisation called the result a "brave decision" on the part of the Swiss people.
and increased funding and provision of hospice
care. It also campaigns for new legislation to permit assisted dying within strict safeguards, and promotes the concept and use of advance decisions in England
and Wales
. The group has repeatedly published opinion polls showing considerable public support for a change to the law on assisted dying, as well as showing support from doctors and disabled people.
Dignity in Dying's stated view is that everyone has the right to a dignified death. They interpret this to mean:
Dignity in Dying also outline how they go about their campaign:
Dignity in Dying also state that their proposals would alleviate a great deal of the stress and worry that approaching death can bring to a person, particularly one suffering significant pain from a terminal illness. The use of Advanced Decisions can help significantly but they also believe that if a right to an Assisted Death is available then the very knowledge of this fact can alleviate many of the worries an individual might have. Dignity in Dying supporters argue that the recent trends towards the use of the Dignitas clinic in Switzerland
and press stories regarding botched suicides and do-it-yourself advice would be stopped because individuals would know that when and if they wished to finally request an assisted death in the UK, it would be available as arranged. Indeed, studies from parts of the world that have legalised assisted suicide report that many plans put in place for an early death are not taken up as people end up dying naturally, with the peace of mind brought about by knowing that an assisted death was available if pain and suffering had got too much. For example, in the US state of Oregon
in 2007, it was reported that of the 30,000 deaths in the state that year, 10,000 people considered an assisted death, around 1,000 spoke to their doctor about it, 85 actually got a prescription and just 49 went on to have an assisted death.
Dignity in Dying are often opposed by some religious believers and groups such as Care Not Killing
. Many people of a religious persuasion take the view that all life is sacred and that only natural processes (and God
) should determine a person's death. Dignity in Dying simply argue that if a person does not wish to take advantage of a change in the law which would allow for an assisted death then that is down to personal choice. However it strongly opposes opponents who would try to deny an individual a right to a personal choice in the matter by blocking enabling legislation. Meanwhile, opponents argue that the introduction of the sort of legislation supported by Dignity in Dying can be a "slippery slope" towards more draconian measures. Dignity in Dying refutes this by pointing out that the will of Parliament would be paramount, and any change in the law would be subject to ongoing review once established.
Additionally, some disability
rights campaigners are concerned that an assisted dying law would lead to extra pressure on some disabled persons to seek a premature death, as they might consider their lives to be devalued; this is similar to the "slippery slope" analogy. The 2007 British Social Attitudes survey interestingly reported that 75% of people with a disability believed that a person with a terminal and painful illness from which they were certain to die should be allowed an assisted death.
Dignity in Dying point to other parts of the world that have some form of assisted dying or similar legislation, which they say is generally popular and supported by the majority. These include the Netherlands
and Belgium
in Europe
and Oregon
and Washington State in the USA. Some of these laws are different to those proposed by Dignity in Dying. It can be noted that Dignity in Dying support the legislation of assisted death, whereby a doctor prescribes a life-ending dose of medication to a mentally competent, terminally adult at the patient's request, and which the patient themself administers. This is different to assisted suicide, whereby somebody provides assistance to die to a person who is not terminally ill, and euthanasia, which they would generally see as a third party actually administering life-ending medication to a patient.
in The End of Life: Euthanasia and Morality supports voluntary euthanasia but argues that proposals put forward by Dignity in Dying and by other voluntary euthanasia supporters are often impractical. Rachels describes the proposal of the Euthanasia Society (as it then was) as requiring the person be over twenty-one, "suffering from a disease involving severe pain and of an incurable and fatal character" submitting an application with two medical signatories to a third-party 'Euthanasia Referee' who would interview the patient. If that person were satisfied, the patient would have to wait seven days and the euthanasia procedure would have to be done "in the presence of an official witness". Rachels argues that this procedure, along with a more complex one then proposed by the Euthanasia Society of America, were "unworkably cumbersome" and "so elaborate, and take so much time, that they are hardly conducive to the ‘quick and easy’ death that is the whole point of euthanasia... by the time he could go through it all, he might already be dead"
Rachels instead proposes that a better route to implementing legal euthanasia would be to provide a defence to homicide offences of mercy killing: "what would happen in court under this proposal is very much like what often happens now. Many juries are already functioning as though mercy-killing were an acceptable defence: when faced with genuine mercy-killers, they refuse to convict. The main consequence of my proposal would be to sanction officially what these juries already do."
. Essentially, they allow an individual to write down their wish to refuse life-sustaining treatment
, so that if they are no longer able to communicate they can be assured that doctors and other medical staff know what their wishes are and that they are legally binding. Additionally, a person can also state in their advance decision what life-sustaining treatment they do wish for, although doctors do not ultimately have to respect that request.
Dignity in Dying campaigns for the greater choice, control and access to a full range of medical and palliative services at the end-of-life, including providing terminally ill
Terminal illness
Terminal illness is a medical term popularized in the 20th century to describe a disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient within a short period of time. This term is more commonly used for progressive diseases such as...
adults with the option of a painless, assisted death, within strict legal safeguards. It declares that its campaign looks to bring about a generally more compassionate approach to the end-of-life.
Dignity in Dying points out that in the 2010 British Social Attitudes survey 82% of the general public believed that a doctor should probably or definitely be allowed to end the life of a patient with a painful incurable disease at the patient's request. This was further analysed to show 71% of religious people and 92% of non-religious people supported this statement. However, the group is opposed by anti-euthanasia organisations such as Care Not Killing
Care Not Killing
Care, Not Killing is an alliance of several organisations who are opposed to the legalisation of euthanasia or physician-assisted suicide in the United Kingdom.-Alliance members:The members of the alliance include:* British Council of Disabled People...
.
Alongside its campaigning work, Dignity in Dying, through its partner charity Compassion in Dying, is also an information source on end-of-life issues and a provider of advance decisions.
History
In 1931 Dr Charles Killick MillardKillick Millard
Charles Killick Millard was a British doctor who in 1935 founded the Voluntary Euthanasia Legalisation Society, a movement that campaigned for the legalisation of euthanasia in Great Britain.- External links:*...
, the Medical Officer of Health for Leicester from 1901 to 1935, gave the Presidential address at the Annual General Meeting of the Society of Medical Officers of Health. In the address, he advocated the "Legalisation of Voluntary Euthanasia", which prompted considerable debate in Britain involving doctors, clerics and the wider public. Millard's proposal was that in the case of terminal illnesses the law should be changed "to substitute for the slow and painful death a quick and painless one".
The organisation was set up in December 1935 under the name of The Voluntary Euthanasia Legalisation Society (VELS). The initial meeting that set the society up was held at the headquarters of the British Medical Association
British Medical Association
The British Medical Association is the professional association and registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association’s headquarters are located in BMA House,...
free of charge, despite the BMA not supporting the aims of the society. During the debate, the meeting was disrupted by 40 members of a Catholic youth association.
The foundation of the society followed an offer of £10,000 from Mr. O. W. Greene, a terminally-ill man in London. The initial offer was retracted and no posthumous endowment was left to the Society after Greene learned that the prospective Society would only be supporting legalisation of euthanasia for those with incurable conditions. The first chairman was C. J. Bond, a consulting surgeon at the Leicester Royal Infirmary; Millard was made the first Honorary Secretary. Other members of the Executive Committee were drawn from Bond and Millard's social milieu in Leicester, including Astley V. Clarke from the Leicester Royal Infirmary; Rev Dr R. F. Rattray, a Unitarian minister and principal of University College, Leicester; Canon F. R. C. Payne of Leicster Cathedral; Rev A. S. Hurn; Frederick Attenborough, also a former principal of University College, Leicster; and H. T. Cooper, the Honorary Solicitor of the Committee.
The society did not attempt to build a popular movement at first but attempted to build, according to Kemp, "a network of distinguished sympathisers able to influence policy at high levels". The society had a Consultative Medical Council and a Literary Group, and were endorsed by a variety of authors, progressive reformers, feminists and supporters of the Fabian Society
Fabian Society
The Fabian Society is a British socialist movement, whose purpose is to advance the principles of democratic socialism via gradualist and reformist, rather than revolutionary, means. It is best known for its initial ground-breaking work beginning late in the 19th century and continuing up to World...
. Early supporters included Henry Havelock Ellis, Vera Brittain
Vera Brittain
Vera Mary Brittain was a British writer, feminist and pacifist, best remembered as the author of the best-selling 1933 memoir Testament of Youth, recounting her experiences during World War I and the beginning of her journey towards pacifism.-Life:Born in Newcastle-under-Lyme, Brittain was the...
, Cicely Hamilton
Cicely Hamilton
Cicely Mary Hamilton , born Hammill, was an English actress, writer, journalist, suffragist, lesbian and feminist. She is now best known for the play Diana of Dobson's, with a setting in an Edwardian department store....
, Laurence Housman
Laurence Housman
Laurence Housman was an English playwright, writer and illustrator.-Early life:Laurence Housman was born in Bromsgrove, Worcestershire, one of seven children who included the poet A. E. Housman and writer Clemence Housman. In 1871 his mother died, and his father remarried, to a cousin...
, H. G. Wells
H. G. Wells
Herbert George Wells was an English author, now best known for his work in the science fiction genre. He was also a prolific writer in many other genres, including contemporary novels, history, politics and social commentary, even writing text books and rules for war games...
, Harold Laski
Harold Laski
Harold Joseph Laski was a British Marxist, political theorist, economist, author, and lecturer, who served as the chairman of the Labour Party during 1945-1946, and was a professor at the LSE from 1926 to 1950....
, George Bernard Shaw
George Bernard Shaw
George Bernard Shaw was an Irish playwright and a co-founder of the London School of Economics. Although his first profitable writing was music and literary criticism, in which capacity he wrote many highly articulate pieces of journalism, his main talent was for drama, and he wrote more than 60...
, Eleanor Rathbone
Eleanor Rathbone
Eleanor Florence Rathbone was an independent British Member of Parliament and long-term campaigner for women's rights. She was a member of the noted Rathbone family of Liverpool.-Life:...
MP, G. M. Trevelyan, W. Arbuthnot Lane, and a variety of peers including Lord Woolton of Liverpool (Conservative) and Lord Moynihan who had been the President of the Royal College of Surgeons.
The first attempt to pass legislation to make euthanasia legal in Britain was the Voluntary Euthanasia (Legalisation) Bill 1936 introduced to the House of Lords by Arthur Ponsonby. The debate was not split along party political grounds and the Government considered it "outside the proper range of Government intervention and to be one which should be left to the conscience of the individual members of the House". The Hunterian Society
Hunterian Society
The Hunterian Society, founded in 1819 in honour of the Scottish surgeon John Hunter , is a society of physicians and dentists based in London....
held a debate on November 16, 1936 to debate whether "the practice of voluntary euthanasia would be unjustifiable", and the Bill was opposed by the British Medical Association
British Medical Association
The British Medical Association is the professional association and registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association’s headquarters are located in BMA House,...
.
On 28 November 1950, the next attempt was made by Lord Chorley of Kendal, a Vice-President of the society, who brought a pro-voluntary euthanasia motion before the House of Lords. The motion was so widely condemned it was withdrawn without a division. According to N. D. A. Kemp, the attempt was an "ignominious failure", as were similar attempts to produce more liberal legislation generally on abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
, homosexuality
Homosexuality
Homosexuality is romantic or sexual attraction or behavior between members of the same sex or gender. As a sexual orientation, homosexuality refers to "an enduring pattern of or disposition to experience sexual, affectional, or romantic attractions" primarily or exclusively to people of the same...
and divorce
Divorce
Divorce is the final termination of a marital union, canceling the legal duties and responsibilities of marriage and dissolving the bonds of matrimony between the parties...
.
Following the death of the Honorary Secretary Killick Millard
Killick Millard
Charles Killick Millard was a British doctor who in 1935 founded the Voluntary Euthanasia Legalisation Society, a movement that campaigned for the legalisation of euthanasia in Great Britain.- External links:*...
and the resignation of Lord Denman, the President of the Society, and the deaths of two prominent supporters of the society, E.W. Barnes and Dr N.I. Spriggs, a new Honorary Secretary was found in R. S. W. Pollard who moved the society to be based in London from Leicester. The society also changed tactics: moving away from courting the medical and legal elites to trying to build up a mass movement to exert "grass-roots pressure" and efforts were made to bring up the topic in civic society groups like Rotary Clubs, local newspaper editorials etc.
From 1955 onwards, the 'Legalization' was dropped from the name along with the 'Voluntary' to make it the Euthanasia Society (although some sources place it at 1960). The Euthanasia Society placed adverts on the London Underground and on mainline railway services in the south of England, with the wording "The Euthanasia Society Believes that incurable sufferers should have the right to choose a Merciful Death". In 1960, the chairman, C. K. MacDonald died and was replaced by Leonard Colebrook. He was replaced temporarily by Maurice Millard. In 1962, he was replaced by the Unitarian minister Rev A. B. Downing, and in 1964, C. R. Sweetingham was made secretary. Prominent people who supported the society during the 1960s included the legal academic and president of the Law Reform Association Glanville Williams. Williams gave a paper entitled 'Voluntary euthanasia – the next step' at the Annual General Meeting of the society in 1955. Williams' ethical justification of euthanasia argued against the principle of double effect
Principle of double effect
The principle of double effect; also known as the rule of double effect; the doctrine of double effect, often abbreviated as DDE or PDE; double-effect reasoning; or simply double effect, is a set of ethical criteria for evaluating the permissibility of acting when one's otherwise legitimate act...
and for a utilitarian approach to the questions in medical ethics including both voluntary euthanasia and abortion. His proposal would have allowed a physician to put as a defence to a homicide, assault or bodily harm charge that the person was incurably and fatally ill if the doctor was acting in good faith. These proposals mirror those of James Rachels
James Rachels
James Rachels was an American philosopher who specialized in ethics.-Biography:Rachels was born in Columbus, Georgia, and graduated from Mercer University in 1962. He received his Ph.D. in 1967 from the University of North Carolina, Chapel Hill, studying under Professors W. D. Falk and E. M. Adams...
discussed below.
According to Kemp, the public association of euthanasia with eugenics and Nazi atrocities marred attempts in the 1950s to promote voluntary euthanasia, but such setbacks were short-lived. The next legislative attempt was started in 1967 with a bill drafted by Mary Rose Barrington, a member of the executive committee of the Euthanasia Society and barrister. Attempts were made to find an MP willing to introduce it to the Commons but eventually it was introduced to the Lords in 1969 by Lord Raglan, a member of the National Secular Society
National Secular Society
The National Secular Society is a British campaigning organisation that promotes secularism and the separation of church and state. It holds that no-one should gain advantage or disadvantage because of their religion or lack of religion. It was founded by Charles Bradlaugh in 1866...
.
The word 'Voluntary' was reinstated to the name in 1969 to become the Voluntary Euthanasia Society. It was also known as Exit (not to be confused with Exit International) from 1979 but this was reverted in 1982. During the period it was known as 'Exit', the secretary of the society, Nicholas Reed, was convicted of aiding and abetting a suicide. He was jailed for two and a half years, although this was reduced to 18 months on appeal. Reed had supported Mark Lyons, a seventy-year old man who provided pills and alcohol to a multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
sufferer. Lyons was given a two-year suspended sentence. The society had voted in 1979 to publish a "Guide to Self-Deliverance", a booklet which described suicide methods. This was challenged by the Attorney General in 1982 under s2 of the Suicide Act 1961
Suicide Act 1961
The Suicide Act 1961 is an Act of the Parliament of the United Kingdom. It decriminalised the act of suicide so that those who failed in the attempt would no longer be prosecuted....
, and after a brief attempt to fight back against this, the distribution of the booklet was suspended in 1983.
After the name was changed back following the conviction of Reed and Lyons, Lord Jenkins of Putney introduced an amendment to the Suicide Act to introduce a defence for those who acted "on behalf of the person who committed suicide and in so acting behaved reasonably and with compassion and in good faith" but this was defeated 48 votes to 15.
In 1988, the Voluntary Euthanasia Society, as it was then, attempted to place a full-page newspaper advertisement in the Evening Standard
Evening Standard
The Evening Standard, now styled the London Evening Standard, is a free local daily newspaper, published Monday–Friday in tabloid format in London. It is the dominant regional evening paper for London and the surrounding area, with coverage of national and international news and City of London...
showing twenty-four young men with advanced emphysema
Emphysema
Emphysema is a long-term, progressive disease of the lungs that primarily causes shortness of breath. In people with emphysema, the tissues necessary to support the physical shape and function of the lungs are destroyed. It is included in a group of diseases called chronic obstructive pulmonary...
with the words "A day in the life of an emphysema sufferer" and accompanied by "We believe that he should have the right to choose a peaceful and dignified death." The British Medical Association
British Medical Association
The British Medical Association is the professional association and registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association’s headquarters are located in BMA House,...
contacted the Advertising Standards Authority
Advertising Standards Authority (United Kingdom)
The Advertising Standards Authority is the self-regulatory organisation of the advertising industry in the United Kingdom. The ASA is a non-statutory organisation and so cannot interpret or enforce legislation. However, its code of advertising practice broadly reflects legislation in many instances...
to block publication of the ad, and a representative of the British Lung Foundation
British Lung Foundation
The British Lung Foundation is a British charity dedicated to promoting lung health and supporting those affected by lung disease.- About the British Lung Foundation :...
condemned the advert, saying that "fears of patients with lung disease should not be exploited in this way."
In 1990, the group campaigned for the early release of Anthony Cocker, who was convicted of murder after killing his wife Esther after she begged him to end her suffering from multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an inflammatory disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms...
.
In 1992, the society supported Dr Nigel Cox, who was prosecuted and convicted for murder for shortening the life of a patient at the Royal Hampshire County Hospital
Royal Hampshire County Hospital
The Royal Hampshire County Hospital in Winchester is a District General Hospital serving much of central Hampshire. It is owned and run by the Winchester and Eastleigh Healthcare NHS Trust...
.
Dignity in Dying was the new name endorsed by members at the annual general meeting in 2005. Its current Chair of the Governing Board is Professor Nick Moore and its Chief Executive is Sarah Wootton. The name change was done to "get away from the suggestion that you can only achieve dignity in dying with euthanasia".
Dignity in Dying has a range of patrons, including people who have been associated with high-profile cases connected with Dignity in Dying's campaigns, such as Lesley Close (sister of John Close), Brian Pretty (husband of Diane Pretty
Diane Pretty
Diane Pretty was a British woman from Luton who became notable after being the focus of a debate about the laws of euthanasia in United Kingdom during the early part of the 21st century...
) and Heather Pratten. Other patrons include prominent individuals from the worlds of business, politics, the arts and religion, such as Terry Pratchett
Terry Pratchett
Sir Terence David John "Terry" Pratchett, OBE is an English novelist, known for his frequently comical work in the fantasy genre. He is best known for his popular and long-running Discworld series of comic fantasy novels...
, Jonathan Miller
Jonathan Miller
Sir Jonathan Wolfe Miller CBE is a British theatre and opera director, author, physician, television presenter, humorist and sculptor. Trained as a physician in the late 1950s, he first came to prominence in the 1960s with his role in the comedy revue Beyond the Fringe with fellow writers and...
, Patricia Hewitt
Patricia Hewitt
Patricia Hope Hewitt is an Australian-born British Labour Party politician, who was the Member of Parliament for Leicester West from 1997 until 2010. She served in the Cabinet until 2007, most recently as Health Secretary....
, Zoë Wanamaker
Zoe Wanamaker
Zoë Wanamaker, CBE is an American-British actress. She has performed with the Royal Shakespeare Company; in films, including the Harry Potter series; and in a number of television productions, including a long-time role as Susan Harper in the sitcom My Family.-Early life and family:Wanamaker was...
, Simon Weston
Simon Weston
Simon Weston OBE is a former British Army soldier who became well known throughout the United Kingdom for his recovery and charity work after suffering severe burn injuries during the Falklands War.-Early life:...
, Anthony Grayling and Matthew Wright.
The most recent legislative attempts have been made by Lord Joffe
Joel Joffe, Baron Joffe
Joel Goodman Joffe, Baron Joffe CBE is a Labour peer in the House of Lords.Born in South Africa, he was educated at the University of Witwatersrand , and worked as a human rights lawyer 1958-65, including at the infamous 1963-4 Rivonia Trial, representing Nelson Mandela...
who joined the society in the 1970s. The first bill was introduced in the 2003 session, and the Bill has been reintroduced repeatedly since. The Joffe Bill led to the formation of the anti-euthanasia group Care Not Killing
Care Not Killing
Care, Not Killing is an alliance of several organisations who are opposed to the legalisation of euthanasia or physician-assisted suicide in the United Kingdom.-Alliance members:The members of the alliance include:* British Council of Disabled People...
.
Dignity in Dying has a non-campaigning partner charity, Compassion in Dying, which carries out research to do with end-of-life matters, provides the general public with access to advance decisions and also works to provide information about a person's rights at the end-of-life. They are also associated with Healthcare Professionals for Assisted Dying, a group formed by Dignity in Dying supporter and general practitioner Anne McPherson.
In May 2011, Dignity in Dying noted the result of a referendum
Referendum
A referendum is a direct vote in which an entire electorate is asked to either accept or reject a particular proposal. This may result in the adoption of a new constitution, a constitutional amendment, a law, the recall of an elected official or simply a specific government policy. It is a form of...
in Zurich
Zürich
Zurich is the largest city in Switzerland and the capital of the canton of Zurich. It is located in central Switzerland at the northwestern tip of Lake Zurich...
, Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
, which showed overwhelming support for assisted dying and voted to reject the restriction of assisted dying services in Zurich to the residents of the city. The organisation called the result a "brave decision" on the part of the Swiss people.
Activities
Dignity in Dying campaigns for patient choice at the end-of-life and supports palliative carePalliative care
Palliative care is a specialized area of healthcare that focuses on relieving and preventing the suffering of patients...
and increased funding and provision of hospice
Hospice
Hospice is a type of care and a philosophy of care which focuses on the palliation of a terminally ill patient's symptoms.In the United States and Canada:*Gentiva Health Services, national provider of hospice and home health services...
care. It also campaigns for new legislation to permit assisted dying within strict safeguards, and promotes the concept and use of advance decisions in England
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
and Wales
Wales
Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...
. The group has repeatedly published opinion polls showing considerable public support for a change to the law on assisted dying, as well as showing support from doctors and disabled people.
Dignity in Dying's stated view is that everyone has the right to a dignified death. They interpret this to mean:
- Everybody should be able to choose where they die, who else would be present at that time and the treatment options they would welcome or not.
- A person should have access to information on their end-of-life options from qualified experts and their carers, family and friends should also be able to access high quality care and support.
- Ultimately an individual should have the right to plan for and then take personal control over their own death, including the medication and pain relief they wish to receive or not.
Dignity in Dying also outline how they go about their campaign:
- They encourage their supporters to campaign for a change to the current laws so that a terminally ill, mentally competent adult who feels their suffering has become unbearable can opt for an assisted death, subject to strict rules and safeguards.
- They will lobby politicians and other decision makers, and look to educate legal and healthcare professionals and the public in general to support this drive towards obtaining a comprehensive national end-of-life strategy and working procedures.
- They would generally attempt to empower terminally ill people (and their families and friends) so that they can obtain a better experience as their end-of-life approaches, including access to information on current rights and such devices as Advance Decisions.
Arguments and opposition
One of Dignity in Dying's main arguments is that their proposals for a comprehensive strategy around the issue of assisted dying would provide safeguards and protection for an individual from, for example, the coercive pressures to die that some people believe can be exerted by families of the frail or relatively disadvantaged on occasions. Dignity in Dying argue that at the moment not only can unscrupulous people do this in a relatively unchecked way, but that the legal authorities can generally carry out investigations only after a person's death, whereas under their plans there would be safeguards and checks upfront to ensure a person was fully informed and counselled as to their rights and options and additionally protected from possible malign influences.Dignity in Dying also state that their proposals would alleviate a great deal of the stress and worry that approaching death can bring to a person, particularly one suffering significant pain from a terminal illness. The use of Advanced Decisions can help significantly but they also believe that if a right to an Assisted Death is available then the very knowledge of this fact can alleviate many of the worries an individual might have. Dignity in Dying supporters argue that the recent trends towards the use of the Dignitas clinic in Switzerland
Switzerland
Switzerland name of one of the Swiss cantons. ; ; ; or ), in its full name the Swiss Confederation , is a federal republic consisting of 26 cantons, with Bern as the seat of the federal authorities. The country is situated in Western Europe,Or Central Europe depending on the definition....
and press stories regarding botched suicides and do-it-yourself advice would be stopped because individuals would know that when and if they wished to finally request an assisted death in the UK, it would be available as arranged. Indeed, studies from parts of the world that have legalised assisted suicide report that many plans put in place for an early death are not taken up as people end up dying naturally, with the peace of mind brought about by knowing that an assisted death was available if pain and suffering had got too much. For example, in the US state of Oregon
Oregon
Oregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
in 2007, it was reported that of the 30,000 deaths in the state that year, 10,000 people considered an assisted death, around 1,000 spoke to their doctor about it, 85 actually got a prescription and just 49 went on to have an assisted death.
Dignity in Dying are often opposed by some religious believers and groups such as Care Not Killing
Care Not Killing
Care, Not Killing is an alliance of several organisations who are opposed to the legalisation of euthanasia or physician-assisted suicide in the United Kingdom.-Alliance members:The members of the alliance include:* British Council of Disabled People...
. Many people of a religious persuasion take the view that all life is sacred and that only natural processes (and God
God
God is the English name given to a singular being in theistic and deistic religions who is either the sole deity in monotheism, or a single deity in polytheism....
) should determine a person's death. Dignity in Dying simply argue that if a person does not wish to take advantage of a change in the law which would allow for an assisted death then that is down to personal choice. However it strongly opposes opponents who would try to deny an individual a right to a personal choice in the matter by blocking enabling legislation. Meanwhile, opponents argue that the introduction of the sort of legislation supported by Dignity in Dying can be a "slippery slope" towards more draconian measures. Dignity in Dying refutes this by pointing out that the will of Parliament would be paramount, and any change in the law would be subject to ongoing review once established.
Additionally, some disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
rights campaigners are concerned that an assisted dying law would lead to extra pressure on some disabled persons to seek a premature death, as they might consider their lives to be devalued; this is similar to the "slippery slope" analogy. The 2007 British Social Attitudes survey interestingly reported that 75% of people with a disability believed that a person with a terminal and painful illness from which they were certain to die should be allowed an assisted death.
Dignity in Dying point to other parts of the world that have some form of assisted dying or similar legislation, which they say is generally popular and supported by the majority. These include the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
and Belgium
Belgium
Belgium , officially the Kingdom of Belgium, is a federal state in Western Europe. It is a founding member of the European Union and hosts the EU's headquarters, and those of several other major international organisations such as NATO.Belgium is also a member of, or affiliated to, many...
in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
and Oregon
Oregon
Oregon is a state in the Pacific Northwest region of the United States. It is located on the Pacific coast, with Washington to the north, California to the south, Nevada on the southeast and Idaho to the east. The Columbia and Snake rivers delineate much of Oregon's northern and eastern...
and Washington State in the USA. Some of these laws are different to those proposed by Dignity in Dying. It can be noted that Dignity in Dying support the legislation of assisted death, whereby a doctor prescribes a life-ending dose of medication to a mentally competent, terminally adult at the patient's request, and which the patient themself administers. This is different to assisted suicide, whereby somebody provides assistance to die to a person who is not terminally ill, and euthanasia, which they would generally see as a third party actually administering life-ending medication to a patient.
Practicalities
James RachelsJames Rachels
James Rachels was an American philosopher who specialized in ethics.-Biography:Rachels was born in Columbus, Georgia, and graduated from Mercer University in 1962. He received his Ph.D. in 1967 from the University of North Carolina, Chapel Hill, studying under Professors W. D. Falk and E. M. Adams...
in The End of Life: Euthanasia and Morality supports voluntary euthanasia but argues that proposals put forward by Dignity in Dying and by other voluntary euthanasia supporters are often impractical. Rachels describes the proposal of the Euthanasia Society (as it then was) as requiring the person be over twenty-one, "suffering from a disease involving severe pain and of an incurable and fatal character" submitting an application with two medical signatories to a third-party 'Euthanasia Referee' who would interview the patient. If that person were satisfied, the patient would have to wait seven days and the euthanasia procedure would have to be done "in the presence of an official witness". Rachels argues that this procedure, along with a more complex one then proposed by the Euthanasia Society of America, were "unworkably cumbersome" and "so elaborate, and take so much time, that they are hardly conducive to the ‘quick and easy’ death that is the whole point of euthanasia... by the time he could go through it all, he might already be dead"
Rachels instead proposes that a better route to implementing legal euthanasia would be to provide a defence to homicide offences of mercy killing: "what would happen in court under this proposal is very much like what often happens now. Many juries are already functioning as though mercy-killing were an acceptable defence: when faced with genuine mercy-killers, they refuse to convict. The main consequence of my proposal would be to sanction officially what these juries already do."
Advance decisions
Advance decisions were enabled by the Mental Capacity Act 2005Mental Capacity Act 2005
The Mental Capacity Act 2005 is an Act of the Parliament of the United Kingdom. Its primary purpose is to provide a legal framework for acting and making decisions on behalf of adults who lack the capacity to make particular decisions for themselves....
. Essentially, they allow an individual to write down their wish to refuse life-sustaining treatment
Life support
Life support, in medicine is a broad term that applies to any therapy used to sustain a patient's life while they are critically ill or injured. There are many therapies and techniques that may be used by clinicians to achieve the goal of sustaining life...
, so that if they are no longer able to communicate they can be assured that doctors and other medical staff know what their wishes are and that they are legally binding. Additionally, a person can also state in their advance decision what life-sustaining treatment they do wish for, although doctors do not ultimately have to respect that request.
See also
- World Federation of Right to Die SocietiesWorld Federation of Right to Die SocietiesThe World Federation of Right to Die Societies is an international federation of associations that promote access to voluntary euthanasia.It is made up of 46 associations from 27 countries. It holds regular international meetings on dying and death....
- Assisted suicideAssisted suicideAssisted suicide is the common term for actions by which an individual helps another person voluntarily bring about his or her own death. "Assistance" may mean providing one with the means to end one's own life, but may extend to other actions. It differs to euthanasia where another person ends...
- Betty and George CoumbiasBetty and George CoumbiasBetty and George Coumbias were a Canadian married couple who sought to become the first husband and wife to complete simultaneous suicides with legal authorization. They were featured in John Zaritsky's 2007 documentary, The Suicide Tourist...
External links
- Dignity in Dying website
- Compassion in Dying website
- Exit website
- Jacob AppelJacob M. AppelJacob M. Appel is an American author, bioethicist and social critic. He is best known for his short stories, his work as a playwright, and his writing in the fields of reproductive ethics, organ donation, neuroethics and euthanasia....
. "Next: Assisted Suicide for Healthy People". Huffington Post July 16, 2009.