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July 30, 2017

Private Eye Medicine Balls 1448 July 14,  2017
Filed under: Private Eye — Dr. Phil @ 11:49 am

Assisted Dying (Part 2)


“There seems to me to be significantly more justification in assisting people to die if they have the prospect of living for many years a life that they regard as valueless, miserable and often painful, than if they have only a few months left to live.” So said Lord Neuberger in the Supreme Court in 2014. A 54 year old UK citizen called Omid T, who has an incurable but not terminal disease called Multiple System Atrophy, is currently challenging the law in the hope of being allowed to die.


Omid was born in Iran and came to the UK aged 12 in August 1975. He married in 1990, has three children and worked as a property developer until about 2008, when the first signs of MSA appeared. His speech became slurred and walking and writing got progressively harder. He is now largely confined to my bed with a urinary catheter and needing help with all his personal care. He separated from his wife in 2015 and doesn’t want his friends and family to see him suffering nor remember him as he is now. In 2015, he tried to end his life by taking an overdose. As Omid puts it; ‘I don’t have the ability to take my own life anymore and I don’t want to botch it up again anyway.’ But he does want to die, in a safe and painless way at home, and as soon as possible. If his slowly progressive illness were to run its course, he risks months or years of suffering and an unpleasant, undignified death – the thought of which causes him huge distress. And he gains no joy, value or purpose from his life.


In 2014, the Supreme Court ruled on a challenge by Paul Lamb and Jane Nicklinson, whose husband Tony was denied an assisted death, to the ban on assisted dying in England. The majority of the Court decided that while they did have the legal power to consider the ban, Parliament ‘should have the opportunity to consider the issue first’. Lord Falconer’s Assisted Dying Bill was defeated in the House of Lords in 2014. In September 2016, another Assisted dying Bill was defeated in the House of Commons by 338 votes to 118. A further Assisted Dying Bill is to be debated in the House of Lords but there is no date yet set for the second reading. Given either House’s reluctance to vote for assisted dying, it would appear Omid’s chances are slim. However, all of these Bills deal with those with a terminal illness and 6 months or less to live.  Omid’s life is likely to be shortened by his illness, but he is not terminally ill. He is of sound mind, living a very restricted and joyless life that he ascribes no value to, with no possibility of cure and the certainly of further grim deterioration over time. His legal case could be stronger, not weaker, than those with terminal illnesses.


MD’s gut feeling is to support assisted dying for both terminal illness, and incurable illness where the sufferer is of sound mind and clearly wants control of the means and timing of their death. However, any such law must also protect those with incurable diseases who wish to fight for every last breath. MD knows of one extraordinary man with Motor Neurone Disease whose entire day consists of getting dressed. The process takes hours, but he enjoys looking his best and being tilted up in his bed for a couple of hours before the lengthy process of undressing starts. Every day is near identical, and for many would be a living hell. But not for him. He refuses to give in to his illness.


There are clear legal safeguards that appear to be successful in other countries to protect the vulnerable and those who wish to fight to the finish. In the discussions MD has had with patients with incurable illnesses, many want a change in the law that allows them to die peacefully and painlessly at a time of their choosing, but a few express the concern that even with legal safeguards, they would ‘feel’ more vulnerable, as if they were expected to opt for a course of action that was now legal. Any change in the law would need to address these concerns. The most ‘way out’ public assisted dying campaigner – Australian Dr Philip Nitschke – believes that everyone over 50 of sound mind has the right to judge the merits and value of their life, and should have the right to a dignified assisted suicide at a time of their choosing. Would you feel more or less secure in such a society?


Omid’s case would allow proper scrutiny of evidence and experts from other countries where assisted dying is currently legal in clearly defined circumstances, and how the safeguards operate. In his situation, MD would probably want an assisted death too, but you can never be sure until you get there. You can support and follow Omid’s case at