I have lived in two countries which permit assisted dying.
I think we have to be very aware, that if you allow assisted dying, that it immediately creates (once a terminal diagnosis has been given with less than six months to live) two formal categories with distinct rules and regs attached to both:
Category A : those who want to live until they meet a natural end,
Category B: those who want to be assisted to die.
Those two formal distinct categories are created out of the necessity within the health care system to not mix the two up, and because, once a terminal diagnosis has been pronounced, and the patient usually has less than six months to live, it’s two distinctly separate health care teams that step in, at the very end anyway.
(Patients can change their mind at any time right up to the very end though as to which category they want to be in.)
Anyway two different sets of strict regulations and laws develop around each category as it is important obviously that both are extremely well regulated.
We must all be very aware therefore that this distinct categorisation creates problems for the category who wish to die naturally, because whereas previously, a family or hospital doctor would use their personal judgement and knowledge of that patient and their circumstances, to administer morphine or whatever at the end to ease pain and distressing symptoms; owing to the necessary strict legislation surrounding the above categorisations, doctors are no longer allowed that same autonomy, and are fearful of prosecution.
They now have to stick to limits of drugs permitted by the legislation surrounding category A patients, for fear of falling unwittingly in to using limits only permitted for category B.
Beware everyone please, this can occasionally lead to uncomfortable and sometimes unnecessarily painful deaths for those opting for category A.
I have twice personally witnessed doctors refusing requests from palliative care nurses to write prescriptions for more, and heavier painkillers, for patients dying of specific diseases, for example, Parkinsons and cancer.
Therefore, although I am in favour of assisted dying in principle, and think it can bring huge relief to the terminally ill, I am very wary of how it works in practice, especially as the problematic issues mentioned above, occurred in very well resourced, professional and sympathetic care contexts.
Also, I agree with others, that if assisted dying becomes widespread and normalised, we will perhaps have less and less reason and motivation to develop drugs and care practices that assist the elderly and disabled to live as good a life as they can despite significant challenges. Or devote sufficient resources to help them, when there are so many other pressing funding requirements.
Think about the priority that the UK government gives to social care now! It’s always at the bottom of the heap. And care workers, who incidentally have to take 37 exams to do their very responsible job, are paid some of the lowest wages in the country. Care is not valued as it should be and I fear elderly, unwell, disabled, or socially isolated patients, will fall under subtle or not-so-subtle pressure to “not place a burden on others”.
In summary, and this is a very hard thing to wrestle with, although assisted dying may be a caring thing to provide, and significantly reduce worry, pain and distress to terminally ill patients, for whom I have the greatest sympathy, I am not convinced that assisted dying is good for society as a whole.