Assisted dying legislation must wait until after UK election
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《英国医生杂志》
Legislation to allow assisted suicide and voluntary euthanasia in the United Kingdom has moved one step closer to being implemented, with the publication of a House of Lords select committee report last week. The report on Joel Joffe's Assisted Dying for the Terminally Ill Bill called for the issue to be debated early in the next session of parliament. This bill will not go any further as parliament is being dissolved for the UK general election, to be held on 5 May.
Although the committee was divided on whether the law should be changed, it recommended that a future bill on the issue should be considered by a committee of the whole house. The new bill is likely to apply only in England and Wales, as Lord Joffe recommended. This is a step forward from the last report, in 1994, when the lords concluded that the law should not be changed.
The committee examined the bill, which proposed that "a competent adult who is suffering unbearably as a result of a terminal illness to receive medical help to die at their own considered and persistent request." The committee heard from more than 140 witnesses and visited Oregon in the United States, the Netherlands, and Switzerland, places which allow some form of assisted dying.
The report identifies a number of key issues for any future bill. It recommends that assisted suicide and voluntary euthanasia be debated separately, allowing the possibility of a change in the law for one but not the other. It also emphasises the need to qualify the conditions for assisted dying to reflect clinical practice and to define them as objectively as possible, proposing the term "unrelievable suffering" rather than "unbearable suffering."
The report criticised the bill for being "relatively silent" about the procedures a doctor must follow to fulfil a patient's wishes, stating that any future bill should "make clear the actions which it would authorise a doctor to perform."
The report acknowledged that although some doctors support a change in the law, many are opposed, speculating that doctors would be more comfortable with assisted suicide than euthanasia.
Lord Joffe plans to draft a new bill after the lords' parliamentary debate. He said, "This decision demonstrates how far public and medical opinion has moved since the 1994 report of the previous select committee. Although no votes were taken by the committee, I know from discussions with a number of committee members that a majority of the committee support physician assisted suicide, as defined in the report."
The BMA continues to oppose a change in legislation and the Royal College of Physicians and the Royal College of General Practitioners took a neutral stance. Michael Wilks, chairman of the BMA Medical Ethics Committee, said that BMA opposition would continue for the time being because of concern about the rights of the vulnerable and about the effect on the doctor-patient relationship. He disputed differentiating between assisted suicide and voluntary euthanasia, saying that the BMA saw no moral difference.
Dr Wilks acknowledged, however, that society's view is changing: "If you compare this to the last time that the lords looked at this issue in detail then you have to conclude that this is a change from red to amber. There has been a gradual reduction in the majority within the BMA who are opposed. The shift of opinion in society that the Joffe report represents is mirrored in debates at the BMA."
Chief executive of the Voluntary Euthanasia Society Deborah Annetts said, "This report is a green light for a change in the law and we look forward to a new bill being introduced into the lords as a matter of urgency. Any future government must make time for this compassionate and eagerly anticipated legislation to be considered in full."
Julia Millington, political director of the ProLife Alliance, a European political party, disputed the need for further debate, however: "We are happy with the current status of the law and feel that, if anything, it should be reinforced."(Kathryn Godfrey)
Although the committee was divided on whether the law should be changed, it recommended that a future bill on the issue should be considered by a committee of the whole house. The new bill is likely to apply only in England and Wales, as Lord Joffe recommended. This is a step forward from the last report, in 1994, when the lords concluded that the law should not be changed.
The committee examined the bill, which proposed that "a competent adult who is suffering unbearably as a result of a terminal illness to receive medical help to die at their own considered and persistent request." The committee heard from more than 140 witnesses and visited Oregon in the United States, the Netherlands, and Switzerland, places which allow some form of assisted dying.
The report identifies a number of key issues for any future bill. It recommends that assisted suicide and voluntary euthanasia be debated separately, allowing the possibility of a change in the law for one but not the other. It also emphasises the need to qualify the conditions for assisted dying to reflect clinical practice and to define them as objectively as possible, proposing the term "unrelievable suffering" rather than "unbearable suffering."
The report criticised the bill for being "relatively silent" about the procedures a doctor must follow to fulfil a patient's wishes, stating that any future bill should "make clear the actions which it would authorise a doctor to perform."
The report acknowledged that although some doctors support a change in the law, many are opposed, speculating that doctors would be more comfortable with assisted suicide than euthanasia.
Lord Joffe plans to draft a new bill after the lords' parliamentary debate. He said, "This decision demonstrates how far public and medical opinion has moved since the 1994 report of the previous select committee. Although no votes were taken by the committee, I know from discussions with a number of committee members that a majority of the committee support physician assisted suicide, as defined in the report."
The BMA continues to oppose a change in legislation and the Royal College of Physicians and the Royal College of General Practitioners took a neutral stance. Michael Wilks, chairman of the BMA Medical Ethics Committee, said that BMA opposition would continue for the time being because of concern about the rights of the vulnerable and about the effect on the doctor-patient relationship. He disputed differentiating between assisted suicide and voluntary euthanasia, saying that the BMA saw no moral difference.
Dr Wilks acknowledged, however, that society's view is changing: "If you compare this to the last time that the lords looked at this issue in detail then you have to conclude that this is a change from red to amber. There has been a gradual reduction in the majority within the BMA who are opposed. The shift of opinion in society that the Joffe report represents is mirrored in debates at the BMA."
Chief executive of the Voluntary Euthanasia Society Deborah Annetts said, "This report is a green light for a change in the law and we look forward to a new bill being introduced into the lords as a matter of urgency. Any future government must make time for this compassionate and eagerly anticipated legislation to be considered in full."
Julia Millington, political director of the ProLife Alliance, a European political party, disputed the need for further debate, however: "We are happy with the current status of the law and feel that, if anything, it should be reinforced."(Kathryn Godfrey)