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    U.K. mulls assisted suicide law

    Clashes over an attempt to allow the terminally ill to end their lives flared today as a bill to legalise assisted dying began its second reading in the House of Lords.

    Crossbencher Lord Joffe told peers that patients should not be forced to endure unbearable pain "for the good of society as a whole" as he opened the debate on his right-to-die legislation.

    But the former human rights lawyer faces a long day of hostility both outside and inside the chamber - including from the archbishop of Canterbury, Dr Rowan Williams, who is due to speak in the marathon debate expected in the Lords today.

    Opponents say the bill does not include safeguards to protect people suffering from depression, and could put pressure on the terminally ill to end their lives prematurely. Supporters of the bill say that an amendment being tabled today by the Liberal Democrat peer Lord Carlile to delay the measures for six months is in effect a wreaking amendment.

    Disabled opponents gathered in a nearby room to launch the Not Dead Yet campaign in protest at the proposals, while supporters of the Catholic church-backed Care Not Killing organisation began a day of protests.

    The group, which represents more than 30 charities and healthcare groups, warned that the Joffe bill would put the old and sick under intolerable pressure to end their lives, not least because of severe pressures on health and long-term care services.

    It will later hand in a petition at 10 Downing Street signed by more than 100,000 people demanding an end to attempts to change the law.

    Despite the vocal protests, a new poll has found three-quarters of people in favour of the controversial right-to-die bill.

    The government refused to say at this stage whether it would support the bill in the commons, citing a position of "neutrality" over the issue. A Department of Health spokeswoman said it would "wait and see" what happens in the Lords first......

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    July 25, 2009 -- The Royal College of Nursing is to meet Scottish MP Margo MacDonald to discuss proposals on legalising assisted suicide after the organisation dropped its five-year opposition to the policy. MacDonald, who has Parkinson's disease, is planning to introduce a bill to legalise assisted suicide in Scotland in the autumn. She said discussions with the nurses' organisation would be extremely useful. "The RCN recognises that there is a public mood to deal with choices at the end of life," she told the BBC. "They recognise that their members will be asked by patients about it because very often the relationship between the nurse and the patient is perhaps the closest one."

    The Royal College of Nursing has opposed assisted suicide since 2004, but adopted a neutral stance yesterday after a recent consultation in which almost half (49%) of its members said they supported the policy, while two out of five (40%) said they were against it. It is to issue detailed guidance to nurses. Dr Peter Carter, RCN chief executive, told the BBC Radio 4 Today programme that the organisation recognised that assisted suicide was a complicated issue. He said the shift to the neutral stance would allow nurses to talk to patients about it if they were questioned, but added: "That must not be confused with us being proponents of assisted suicide."

    He called for authorities to clarify the law on assisted suicide. Currently, anyone who assists someone to take their life faces up to 14 years in prison, although no one has yet been prosecuted. Earlier this year the appeal court rejected a legal challenge by Debbie Purdy, a multiple sclerosis patient, who wanted a guarantee that her husband would not be prosecuted for helping her to travel to Switzerland to take her life. The House of Lords is expected to rule on her case next week.

    The move comes as a poll found that 74% of people want doctors to be allowed to help terminally ill people end their lives. The survey in today's Times found that six out of 10 people said they wanted friends and relatives to be able to help their dying loved ones to take their own lives, without fear of prosecution. The poll also found that only 13% supported a blanket right to assisted suicide regardless of the individual's health, while 85% said it should be legal only "in specific circumstances".

    In July doctors at the British Medical Association stuck by their opposition to assisted suicide, having briefly adopted a neutral stance several years ago. The Christian Nurses and Midwives organisation said today it regretted the RCN's policy shift. Secretary Steve Fouch said it sent out the wrong signals "at a time when there is growing anxiety about how we will care for the elderly and severely disabled in the future".

    The latest moves follow high-profile cases involving Britons using the Dignitas clinic in Switzerland. On July 10 renowned conductor Sir Edward Downes and his wife Lady Joan died together in the Zurich clinic which has helped more than 115 people from the UK to commit suicide since it was founded in 1998.

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    July 26, 2009 -- The organisation representing Christian nurses has attacked the Royal College of Nursing's decision to drop its five-year opposition to allowing assisted suicide. Christian Nurses and Midwives said the RCN's policy shift would send "the wrong signals to the vulnerable".

    "While we welcome the consultation process, by the RCN's own admission, only half its membership were reached, of those less than 1% responded, and less than half of those expressed a desire to shift policy either in favour or towards neutrality," said Steve Fouch, CNM secretary. He said that the CNM did not believe that the profession should step back from actively opposing changes to the law.

    A Populus poll yesterday showed that six out of 10 people questioned wanted friends and relatives to be able to help people who were dying to kill themselves, without fear of prosecution. In July, doctors maintained their opposition to assisted suicide following several cases involving the Swiss Dignitas clinic. Earlier this month, conductor Sir Edward Downes and his terminally ill wife, Lady Joan, decided to die together in Zurich.

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    July 27, 2009 -- Doctors should not talk about assisted suicide with patients even to tell them about travelling to a country where it is legal. The warning comes from a doctors defence organisation in the wake of the move by the Royal College of Nursing to drop its opposition to assisted suicide. The Medical Defence Union, which represents half of UK doctors, reminded members that assisting a suicide is illegal in England and Wales and that they should not give advice to patients to help them travel abroad to take their own lives. Ian Barker, MDU solicitor, said: “As a result of the RCN stating in news reports that it wishes to ‘engage in a debate’ with its nurse members about assisted suicide and the recent media interest in this issue, our members may be approached by patients for advice about ending their life with the help of an assisted suicide group abroad. We are reminding them that they could face a criminal investigation if alleged to have assisted with the act - even if that assistance was in the form of advice to the patient. Even if criminal proceedings do not follow, the GMC may still decide to investigate the doctor’s fitness to practise. The best thing a member can do if they are asked for help in these circumstances is to phone us for specific advice and not to engage in a discussion with the patient.” In 2008, the Director of Public Prosecutions decided that it would not be in the public interest to prosecute the parents of Daniel James after he travelled to Dignitas, the Swiss assisted suicide clinic, to commit suicide. The MDU points out however that, in its view, this decision was case specific and does not change the legal position for doctors caring for a patient.

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    July 28, 2009 -- Michael Irwin, a doctor who helped a man with cancer to kill himself at the Dignitas clinic, has asked police to arrest him and make him into a martyr. The former UN medical director and head of the Voluntary Euthanasia Society said he wanted to highlight the fact that people who help loved ones commit suicide at the Swiss clinic face the threat of 14 years in prison. Dr Irwin, 77, is to be interviewed by police, and plans to hand over a diary and chequebook counterfoil for £1,500 proving that he committed a criminal offence. He said that the money was used to fund the death in February 2007 of Raymond Cutkelvin, a 58-year-old businessman from London who had incurable pancreatic cancer. "It's so wrong that people have to travel abroad to die when they could die here at home with dignity," Dr Irwin said. "I say to the police 'arrest me' ... I've done this before and I would do it again if someone is terminally ill." Last year Surrey Police decided not to charge Dr Irwin after he admitted helping May Murphy, who suffered from multiple system atrophy, kill herself at Dignitas. The doctor has said that over the next six months he also intends to help another terminally ill man in his eighties end his life at the clinic. Dr Irwin's latest attempt to be prosecuted will increase pressure on the Government to clarify what should happen to people who assist a suicide. While such assistance is against the law and could be punished with a jail sentence of up to 14 years, no one has ever been prosecuted for giving it. At least 115 Britons have travelled to Switzerland, where assisted suicide is legal, to die at Dignitas. The Director of Public Prosecutions, Keir Starmer, QC, last year explained that he would not prosecute the parents of Daniel James, a rugby player who ended his life after becoming paralysed. However, Debbie Purdy, an MS sufferer from Bradford who wants the option of an assisted death, lost a challenge in the Court of Appeal in February to make him provide more precise guidance on when people would and would not be prosecuted. On Thursday the House of Lords will give its verdict on a further appeal by Mrs Purdy for clarification on whether her husband could be jailed if he helps her commit suicide. Mr Cutkelvin's partner of 28 years, Alan Rees, was arrested last week on suspicion of aiding his suicide. He was bailed until September pending further enquiries.

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    July 29, 2009 -- A groundbreaking change in the law on assisted suicides could become inevitable tomorrow when the UK's highest court delivers its judgment in the case of Debbie Purdy, whose long legal fight has put her at the centre of the controversy. Purdy, who has multiple sclerosis, claims that uncertainty as to whether her husband – the Cuban violinist Omar Puente – would face prosecution for assisting her suicide abroad breaches her human rights. She will learn tomorrow whether the law lords agree with her and demand a clarification of the law. Experts said they think she has a strong chance of success, despite two previous court rulings that went against her, and said the case could become a turning point in the increasingly heated debate over assisted suicide, with profound implications for the prosecuting authorities, the police and parliament. In some recent cases, the police have gathered evidence of potentially criminal assistance by relatives, but prosecutors have chosen not to pursue the cases.

    "If Debbie Purdy wins, the law lords will be saying that you can't have a crime which is enforced only on the whim of the director of public prosecutions," said Lord Falconer, a former lord chancellor who supported an amendment to the law on assisted suicide. "And once he has set out clear principles that there would be no prosecutions for compassionate assistance, then the law has effectively been changed." Other supporters of a change in the law on assisted suicide said that a victory for Purdy would lead to more far-reaching changes that could force parliament to introduce new legislation. "If Purdy is successful I think parliament would have to act," said Sarah Wooton, chief executive of Dignity in Dying, which has supported her case. "The DPP would have to publish a prosecuting policy with criteria for and against prosecution. What this would really do is distinguish between compassionate assistance and malicious encouragement, rather than this blanket 'everything is illegal' approach. Surely parliament would need to react to that."

    Opponents of a change in the law agreed that the decision, the last to be decided by the law lords before they become justices of the new supreme court in October, could have radical consequences. "If the House of Lords were to hold in her favour, then it would dramatically change the basis on which the public prosecution service operates," said Lord Carlile, one of a majority of peers who recently opposed changes to the law on assisted suicide. He said tomorrow's decision could lead to an unworkable situation for prosecutors. "If this is applicable to assisted dying, why is it not applicable to assisted fraud, self-defence, provocation and many other situations in which people might wish to contact the prosecutorial authorities and find out whether what they do is a crime or not? It would completely change the relationship between the prosecution service and the public and would actually make the service in my view very difficult to run."

    The judgment comes after months of public debate about assisted suicide, with increasing numbers of British people travelling to Switzerland to use the facilities of the Swiss charity Dignitas. On Tuesday it emerged that a GP who helped patients to end their lives at Dignitas was being questioned by the police. Dr Michael Irwin, from Surrey, said that he expected to be arrested and wanted to become a "martyr'' to highlight the plight of relatives facing jail for assisting the deaths of loved ones. Earlier this month the double suicide of renowned British conductor Sir Edward Downes, 85, and his wife Joan, 74, also fuelled calls for parliament to change the law. The death of the couple, who were described as having deteriorating health when they ended their lives at Dignitas, is still the subject of a police investigation. But despite investigating scores of cases where friends and relatives have travelled to Switzerland to assist suicides, there has not been a single prosecution for the offence – which carries a maximum sentence of 14 years' imprisonment.

    "There are likely to be many similar cases in future, not least from among the 725 British members of the Swiss charity Dignitas," Lord Pannick QC, the barrister representing Purdy, told the law lords during the hearing last month. "It is very unsatisfactory from the point of view of consistency and avoiding arbitrariness to have these decisions taken … without guidance in the form of a policy." Last week the Royal College of Nursing, which previously opposed assisted dying, moved to a neutral position, prompting speculation that opinion in the medical profession is changing. Although the British Medical Association continues to oppose a change in the law, a recent motion at its annual conference was defeated by only a narrow margin, with 44% of members supporting a change. "There is strong support for a change in the law," Falconer said. "Most people would think compassionate assisters should not be prosecuted for taking their loved ones to Switzerland." "I am hopeful about tomorrow," said Wooton. "The previous courts were personally sympathetic but rule-bound, but the law lords' approach seemed indicative of a different state of mind."

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    July 29, 2009 -- It is “dangerous” for the Royal College of Nursing (RCN) to adopt a neutral stance on assisted suicide, says a leading Peer. Baroness Audrey Emerton, who is a fellow of the RCN questioned its recent claim to neutrality in light of news that it plans to engage in talks with MSP Margo MacDonald, who is behind the push to legalise assisted suicide in Scotland. She also points out that the policy change from opposed to neutral was based on consultation responses from just 0.3 per cent of the membership. And of those, 40 per cent were opposed to the idea. “To base a serious shift in the college’s stance on the opinions of 0.3 per cent of the membership is nothing short of irresponsible”, the Baroness said.

    Lady Emerton expressed outrage at the suggestion by the RCN’s general secretary that a neutral stance would enable nurses “to engage in dialogue” with their patients on assisted suicide. She said: “Let us put the spin aside and be clear what this means. Encouraging or assisting suicides is a criminal offence in this country, as it is in most others. Were a nurse to be convicted of such an offence, that would of course put into question his or her fitness to practise. Some people may not find this position to their liking, but we simply cannot have nurses — or anyone else for that matter — engaging in ‘dialogue’ about something that is against the law. For the RCN Council to imply anything different is, frankly, dangerous.” She added: “The only dialogue on this subject that nurses can engage in with patients is to point out that assisting suicides is illegal and that they cannot have any part in it. Nurses are as bound by the law on not assisting suicides as is any other citizen and they should remember that.” Lady Emerton points out that it is not uncommon for those who are involved in healthcare to have seriously sick patients ask for help dying, but, she claims these are invariably a cry for help or reasssurance rather than a serious request. “Sometimes the underlying issue is not even their health but something like money or personal relationships”, she added.

    Lady Emerton warns: “There is a possibility that the college is planning to go further on the issue of neutrality, by talking to the MSP Margo MacDonald about her proposals for legalising assisted suicide in Scotland.” The Baroness continues: “We should all be concerned about these developments. I say this not only because I oppose the legalisation of assisted suicide, which I believe would put thousands of vulnerable sick people at risk of self-harm, but also because it looks very much as though the RCN Council is using a microscopic sample of nursing opinion to steer the college on to a politically controversial course. My experience of many years spent in the nursing profession tells me that the majority of nurses remain opposed to helping their patients to kill themselves and are more concerned with improving their healthcare. If the college is to convince its members that it is not using them for its own political purpose, it should carry out a far more searching consultation”, she added.

    A proposal to legalise assisted suicide in England and Wales for those wishing to end their lives abroad was rejected in the House of Lords earlier this month. A disabled Peer, Baroness Campbell of Surbiton, made a moving speech appealing to the House to reject the amendment, warning that many vulnerable patients would be at risk if the law was weakened.

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