On the face of it the decision by a national broadcaster to televise a programme about dying in peak viewing time seems a curious one, yet that’s what Channel Four has just done. It’s true that the programme featured Dame Prue Leith, who rose to much-loved national status because of her appearances as a judge on ‘Bake Off’, but that was fun. This programme was, quite literally, a question of life and death. It was about assisted dying. On one side of the debate was Dame Prue. On the other side was her son Danny Kruger, who happens to be a Conservative MP. Between them they encapsulated a vitally important issue that has increasingly preoccupied a growing number of people in this country over the past few years and may yet change the way we live… and die.
In simple terms, Dame Prue is a passionate supporter of changes in the law that will legalise assisted dying. Her son, who’s 48, chairs ‘Dying Well’, the all-party parliamentary that is opposed to it.
She sums up her position thus: 'It's my life. If I want to die, that's my right and I don't see why you should stop me.' He sums up his position: 'Assisted dying is not healthcare, it's an execution,'
One of the bizarre features of this debate is that, until relatively recently, suicide in this country was illegal. Quite how the law punished somebody after they had succeeded in killing themselves was never established and, obviously, never could be. So, in 1961 the Suicide Act was passed and it became legal to kill yourself. What remained illegal was to help somebody else do it. Specifically members of the medical profession.
That means, says Dame Prue, that the law drives desperately ill people one of three ways: ‘They can grin and bear it. They can commit suicide – which is very lonely. Or they can go to Dignitas, the Swiss assisted dying clinic. And who wants to travel to an industrial estate outside Zurich to die in a soulless room? Switzerland, suicide, or suffering? I think that's a lousy choice. I would rather die like most dogs die, with a lethal injection. Out in seconds, instead of suffering for months or years in agony.'
Her son is equally forthright: ‘You can dress it up by talking about doctors and syringes, but it is a deliberate decision to end a life. It's a very, very sinister scenario in which there is a cadre of state employees who decide who should live and who should die. We are incapable of doing this safely. In every jurisdiction where assisted dying is available, it is abused. There are people for whom we would regret it happening.'
His mother questions the number of cases in which assisted dying is abused. He answers with his own question: 'How many is acceptable?' At the heart of their argument is agreement on one core principle: everyone is entitled to a good death. What the pair are fighting about – and what divides much of the nation - is the best way to achieve this.
Prue Leith’s conversion to the cause of assisted dying came ten years ago when she watched her brother David dying in agony from bone cancer. His suffering was so great that his own daughter later admitted she had tried to summon the courage to suffocate him with a pillow. In one chilling moment Dame Prue said: 'His wife was sitting there, saying 'just die, just die….. I went to David's consultant and asked, 'Can't you give him more morphine?' He said, 'You realise morphine is addictive?'
'By then, my brother had three weeks to live. It was horrible. Wrong. It was humiliating and dreadful for a grown man to be reduced to weeping and begging for pain relief, and not getting it.'
Her son is, as you would expect, wholly sympathetic to the terrible plight of his uncle and the impact it had on his mother, but he suggests that she is not the best person to reach a judgement on assisted dying. After all, he points out, she is healthy and wealthy and is supported by a loving family and is, therefore, in a privileged position. He says he worries about more vulnerable people: those who are sick, lonely, poor or struggling with their mental health. It is they, he suggests, who might one day become the victims of a new law legalising assisted dying.
That’s because, he says, there will be a very small minority ‘who want to bump off relatives, or homicidal doctors, because we know they exist'. He also raises the fear that within the bureaucracy of the NHS, fragile lives might become a kind of currency to free up beds and other limited resources. Here’s how he puts it: 'There are lots of people, my mum for example, for whom assisted dying feels like a right anybody should have. Their concern is the legitimate fear of a very unpleasant ending… I respect that entirely.
However, he says, once we have ‘started down the road of allowing doctors to decide that some people are better off dead, you will inevitably end up expanding the criteria. People will find a way to include those for whom it was never intended. People might find themselves under pressure to take the option of assisted dying. There are many who feel themselves to be an expensive burden – whether that's on their family or the healthcare system.'
What is not in doubt is that public opinion in countries around the world is moving towards some form of assisted dying – including several states in America. One of the places visited in the Channel Four programme was Vancouver Island where, it was claimed, 7.5 per cent of all deaths today are by assisted dying.
As for this country, parliament has consistently voted against any change in the law but that may well change in the near future. Assisted dying is the subject of a Parliamentary Health and Social Care Committee inquiry and most observers believe MPs on the committee will prove sympathetic to a change in the law. Two years ago the British Medical Association changed its position. As for the wider public, a British Social Attitudes Survey, showed that 77 per cent of the public support assisted dying. The Church of England is divided. The Archbishop of Canterbury, Justin Welby, is against it and his predecessor Lord Carey is in favour.
For those who remain unconvinced the fear, as expressed by Danny Kruger, is that once we have started down the road of allowing doctors to decide that some people are better off dead, we will ‘inevitably end up expanding the criteria. People will find a way to include those for whom it was never intended. People might find themselves under pressure to take the option of assisted dying. There are many who feel themselves to be an expensive burden – whether that's on their family or the healthcare system.'
Prue Leith herself describes those objections as hypothetical because they are about what might go wrong. She wants a new law to be passed ‘quite narrowly so that when an adult who is in complete control of their mind and who is terminally ill wants assisted dying, they can have it…. 'It should not be beyond the wit of man and the experts involved to design a safe system.'
She concedes that some might slip through the net but argues 'there are multiple legitimate reasons why people want to end their lives, such as being a burden on your family'. She offers herself as an example. She told her son: 'If I was dying and you were having to stump up all your money for me, and your sister was having to look after me every day, and I was in pain and hating my life, then, yes, I'd want to save you from all of that.'
And here’s how she wants to die: 'With my family around me and a glass of red wine in my hand. A good claret would be nice.’
And what about you? Do you ever give any thought to your own death or that of your nearest and dearest? And if you do does the option of assisted dying appeal to you or appal you?
Do let us know.