Diana Melly webchat for Dignity In Dying, Monday 26 March, 11am-noon

Thank you so much for your questions and keep up the conversations!

Diana x

hyper

I have a friend who is a hospital consultant and she tells me that doctors quite often commit suicide when they are terminally ill. They use potassium chloride, I think (I would have to double check!) which is undetectable in the blood stream and looks like cardiac arrest. If this is true - and I trust my friend - then it seems doctors are already making the choice in some cases. Incidentally my friend is a pretty devout Catholic but says she would do this if she were terminally ill and facing great pain and indignity.

So I wanted to ask - are you familiar with this and doesn't it seem unfair that doctors who can get hold of drugs can do it but not the rest of us?

I think it seems very unfair! If we had to do it ourselves we don't have the expertise of doctors and so might mess it up, as already happens with botched amateur suicides. There's lots written about how doctors approach their end-of-lives differently to their patients perhaps because they can see that sometimes a good death is to be welcomed.

When our GP came to see George when he had died, she looked at him and said "He looks so peaceful". I replied "Well he would. He's dead isn't he?". "Diana" she replied, "that was the best death I've ever seen."

getmehrt

There has been quite a lot of discussion of religion on this thread - so I'd like to ask what is Dignity In Dying's relationship to the various religious bodies in the country? have you approached them and if so what has their reaction been?

I don't know about Dignity in Dying's direct relationship with religious bodies, but I do know that there are many religious people who support assisted dying. Dignity in Dying has Rabbis and Revs as Patrons. Really it's about individuals and personal beliefs.

I'm not religious and wouldn't wish to be dictated to by a priest. George wasn't religious either and did not want to be told how to live, let alone how to die!

Annobel

I would like to ask Diana about the attitude of the medical profession to the idea of assisted suicide. I think I have heard that the BMA is against it as a policy but that individual doctors sometimes will unofficially give that little extra help to a dying patient.

Thank you Annobel. My father died in 1980 in a London hospital. The day he died he rang me up and said he'd told the doctor and the nurses that he'd had enough and wanted to be given an extra strong shot of morphine. He just wanted time to say goodbye to his children. He probably only had two or three days more to live at that moment but they would have been extremely unpleasant for him. We all know of doctors who are in favour of assisted dying; a doctor friend of mine said that if a close relation is dying, the magic words are "I hope you won't let him/her suffer unnecessarily". The doctor then knows you aren't going to sue!

It's interesting that recent polls show that doctors are split 50/50 on the issue of assisted dying, but that medical colleges like the BMA are opposed officially. I think that they should reflect their membership and have a neutral position. Healthcare Professionals for Assisted Dying is working to address this inaccuracy among medical colleges www.hpad.org.uk

hopefulgran

Do you think that assisted dying will have any impact on end of life care? one of my worries is that a change in the law might let the government off the hook from providing top quality palliative care and enabling a good non-assisted suicide death to those who need it.

That's also a very good question. In Oregon where assisted dying has been legal for over ten years, there is strong evidence that palliative care has improved significantly since their assisted dying law was put into effect. The UK has been recognised as having the best palliative care in the world and I think it will continue to be developed and resourced, even with assisted dying.
I think it's important to note that palliative care and assisted dying is not an either/or relationship and I'd like to see more cooperation between the two organisations.

I'm also involved with palliative care organisation and I'm speaking at one of the Dying Matters events in June (I think!). Dignity in Dying is also a member of the Dying Matters Coalition and conducts research into end-of-life care in general. For example its partner organisation Compassion in Dying works to inform people of their rights at the end-of-life, including exploring access to palliative care and Advance Decisions.

Riverwalk

Good morning Diana

Do you think people suffering from dementia, as opposed to physical illness, should be assisted to a quicker death by health professionals?

Good morning. This is the hardest question of all and I have to answer in a personal capacity because Dignity in Dying campaigns only for terminally ill mentally competent people.

Advance dementia is something we all dread. Me and my friends all say that we will help each other on our way, because i don't see the law ever being changed to grant those without mental capacity to have an assisted death. Although I would want an assisted death for myself in these circumstances, i don't see how the law can be changed safely to allow this.

George had dementia but luckily for him, not only did he die before it became advanced, but he trusted me to help him on his way if it became necessary. it's easy for me to say now because i didn't have to. He died at home in his own bed and without pain. But I like to think i would have helped him if I had to.

Advance Decisions will help with this as long as you keep them up-to-date because if you have dementia and you get pneumonia if your Advance Decision states that you've specified refusal of antibiotic treatment, your wishes should be respected. Just to make sure, i have also got a Lasting Power of Attorney regarding my health.

LydiaReid

May I ask where your figures come from Diana

Thanks Lydia. These polls are conducted by YouGov and British Social Attitudes which I understand are the most reliable and accurate polls out there. You can find a summary of these in this booklet, A Matter of Facts http://www.dignityindying.org.uk/includes/spaw2/uploads/files/A%20matter%20of%20facts%20May%202011.pdf as well as on YouGov & BSA websites.

sneetch

The big question with assisted suicide is how to protect vulnerable people. What is Dignity In Dying's position on this - are you confident that if the law is changed, there won't be abuse?

Thanks that's very important. My own view is that, in spite of the law, there have been many abuses of vulnerable people in the past. I firmly believe that with the safeguards recommended by Dignity in Dying and the Commission on Assisted Dying, vulnerable people would be more protected rather than less.
At the moment there are many cases of people wishing to die because their pain is intolerable and they attempt suicide alone and with disastrous results.

If you click on this link, you'll see an example of the lack of safeguards currently in place www.telegraph.co.uk/news/uknews/8828184/Sir-Patrick-Stewart-ignore-selfish-critics-of-assisted-dying.html

The safeguards I refer to can be found online in the report by the Commission and on DiD's website. I think at the moment there is serious abuse of people who are dying in pain, in spite of palliative care. Somebody who works in palliative care once said to me that one person pressured into an assisted death is one too many, and I said that one person dying in pain is one too many for me. However when it comes to potential abuse, I believe that the more it's in the open - the issues death and assisted death - the less abuse there'll be.

Greatnan

Thank you, Geraldine. Could we also ask if there is anything we can do to help apart from signing the various e-petitions and writing to MPs.

Talk to your friends and to your family. You might find that teenagers in particular are less anxious about this subject than older people, who sometimes accuse one of being gloomy. People find it difficult to talk about death. Talking about it more should make it easier although it shouldn't be part of every conversation! Registering your personal views with your family can better prepare you in the future against difficult decisions. And please make an Advance Decision while you can and while you're well.

If you'd like to help the campaign become a member of Dignity in Dying. You can sign up on their website www.campaignfordignityindying.org.uk. Advance Decisions are free and I got mine from Compassion in Dying's website www.compassionindying.org.uk