‘To die peacefully at home after a full life surrounded by loving relatives or friends can be so moving and life affirming’

WHEN Keir Starmer was director of the Crown Prosecution Service some years ago he made the unprecedented announcement that the service would not prosecute anyone who had helped their loved one who was ready and wished to die in appropriate circumstances.

This was only when there was no issue of public concern or interest such as the involvement of doctors, nurses, etc.

This decision was welcomed by those of us who have been campaigning for a change in the law to enable Physician Assisted Dying, PAD, before and ever since.

In the past parliament has failed to pass a new law often relying on the medical profession which was against such a law at that time.

This has now changed and the majority of professional bodies have voted in favour or at least to remain neutral believing that the decision should be made by the population through parliament.

On Monday parliament called for proper parliamentary time for that debate with a free vote.

After the hearing, Sarah Wootton, chief executive of Dignity in Dying, said: “Today’s debate has put beyond doubt that assisted dying reform is coming to the UK. MPs from every major party have backed law change, with many changing their minds.

“Right across the House MPs called for proper parliamentary time for debate and a free vote – notably, even from those opposed to reform. This follows promises from both the Prime Minister and Leader of the Opposition to ensure a full debate on assisted dying in the next Parliament.

“The message heard today by dying people and their families up and down the country couldn’t have been clearer: Parliament is listening, at last.”

Dignity in Dying is a campaigning group that believes the right law for the United Kingdom is one that allows dying people, with six months or less to live, the option to control their death.

It does not support a wider law.

Its supporters believe that dying people are not suicidal – they don’t want to die but they do not have the choice to live. When death is inevitable, suffering should not be.

Along with good care, dying people deserve the choice to control the timing and manner of their death.

To have this choice we all need to have had sensitive and relaxed conversations at any appropriate time in our lives, in advance, particularly when we have an established terminal illness.

A GP, however sympathetic, is not necessarily the best or easiest person to have these discussions.

After all, we consult a doctor to get reassurance of recovery from our symptoms. To encourage hope.

As a retired GP myself I have so often had to wait for the right time to have frank discussions with either the patient or, indeed, caring relatives. Sadly it is often too late.

There is the frustration of learning on a Monday that a patient has been admitted to hospital as an emergency over the weekend only to die in an inappropriate place; in transit, on a trolley, in a corridor, or in an acute bed in A&E.

To die peacefully at home after a full life surrounded by loving relatives or friends can be so moving and life affirming.

To facilitate this we need a law to enable the choice of how we die when assistance is needed.

In practice in countries where it is legal physician assistance is often not needed in the end but patients all say that knowing that it has been an option if symptoms become intolerable has been a comfort.

And we need to have a culture to be able to have difficult, honest, conversations about death and dying throughout our lives at times when we want them.

We need the space and time to have them.

I welcome the decision of parliament to have open debate about a change in the law and congratulate those individuals and organisations who have worked so tirelessly to get to this momentous and historic place.

• Robert MacGibbon FRCGP is a retired GP who lives in Kentish Town.