Tuesday September 19 2023, 12.01am, The Times
Sir, You report that 632 Britons have died in suicide clinics in Switzerland and that up to 650 dying people end their own lives every year in the UK (thetimes.co.uk, Sep 15). But is the situation in Switzerland any better? Since 1998, a staggering 12,747 Swiss citizens have died by assisted suicide. Recently published research has found that, over the same period, cancer was mentioned as a factor in 3.8 per cent of “conventional suicides” in Switzerland. This contrasts with data from the Office of National Statistics which found that, in 2019 in England and Wales, 1 per cent of deaths caused by suicide mentioned cancer as a factor. Furthermore, in Switzerland the percentage of cancer-associated suicides has remained stable over 20 years (between 3.6 per cent and 4 per cent), despite the number of assisted suicides doubling every five years.
There is no evidence from anywhere in the world that changing the law on assisted suicide helps to prevent unassisted suicide among dying people. It simply leads to more self-initiated deaths.
Professor David Albert Jones
Director, Anscombe Bioethics Centre, Oxford and professor of bioethics, St Mary’s University, Twickenham
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Sir, The arguments in favour of legalising assisted suicide are powerful, especially when backed by stories of individual suffering, such as those related by Janice Turner (“Why I changed my mind about assisted dying”, Sep 16). However, for many of us who have worked in hospital medicine, there are other stories that need to be heard too. Such as that of the elderly woman who thanked me, weeks later, for ignoring her desperate pleas to end her life, and the HIV-Aids patients who were terminally ill with all kinds of horrible tumours and infections in the 1980s and 1990s. For many of the latter, the arrival of protease inhibitors, powerful antiretroviral drugs, changed their prognosis overnight from imminently terminal to chronic and from hopeless to hopeful. The point is, as Turner herself illustrates, people can change their minds and for all sorts of reasons. But it’s hard to change your mind when you’re dead.
The Rev Dr James K Torrens
Inverness
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Sir, Janice Turner writes that the experience of her mother’s death, where a doctor said that because she was on an opioid she could not be prescribed a sedative, led her to change her views to support legalisation for assisted dying. This distressing case highlights that education and training in palliative care can be grossly inadequate. There is no clinical guidance that says dying patients should not receive an opioid and sedative together, if the combination is clinically indicated, and with skilled titration. As a palliative care doctor I have prescribed this combination many times. Arguments around legalisation for assisted dying obscure the more pressing concern: that high-quality palliative care must be available to everyone who needs it. Sadly, in Janice Turner’s mother’s case, it appears that it was not.
Katherine Sleeman
Laing Galazka professor of palliative care, King’s College London
