IVF clinics reported to be destroying embryos with minor conditions; a ‘genetic breakthrough’ which could help treatments for breast cancer to be tailored to individual need; a mother who forced her son to fake illness being sent to prison; a manager of a home accused of giving elderly residents overdoses of drugs; a powerful torch being trialled in the detection of malignant tumours; patients who travel to Switzerland to die in Zurich’s suicide clinic potentially facing a £30,000 death tax; the novelist, Martin Amis, recommending ‘euthanasia booths’ on street corners where elderly people could end their lives with ‘a Martini and a medal’; a girl of 5 who suffered brain damage during labour being awarded £1.25m by an Essex Trust … enough! enough!

Not surprisingly given my overt interest in the topic (Crucial Decisions at the End of Life and Right to Die) I want to home in on the matter of assisted death. Yes, again! Because it’s been a big week for this topic. Lots of column inches; lots of airtime devoted to it.

In 2007 Tom Inglis fell out of an ambulance in which he was being treated following a pub fight. He sustained brain damage and was paralysed. This week (my blogging week ie) his mother, Frances Inglis, was jailed for life for killing him with an overdose of heroin – on the second attempt. She really really intended to kill him this time, no doubt about that. She posed as his aunt to get admittance to his nursing home, she was armed with a syringe and £200 of heroin, she wedged an oxygen cylinder and a wheelchair against the door and poured strong glue into the lock to delay anyone entering for as long as she could. But, ‘you cannot take the law into your own hands and you cannot take away life however compelling you think the reason,’ said the judge, before telling her she must stay in prison for at least nine years. Outside the court Tom’s brother praised her courage and love. He asked, how could it be legal to withhold food and drink to allow a patient to die slowly, but not legal to end suffering in a quick and calm way. But a crucial point here is that Tom wasn’t requesting death himself. And at least one doctor predicted that he would eventually recover many of his faculties.

Kay Gilderdale’s daughter, Lynn, did request that she could end her ‘miserable excuse for life.’ She’d had ME for 17 years, she was in excruciating pain, and she’d had a premature menopause at the age of 20. Kay provided her with the means to do so. The 31-year old injected herself with the heroin, her mother topped it up with more of the same plus sleeping pills and antidepressants and injections of air into her bloodstream. She too really really intended her daughter to die. But this week she has been acquitted of the charge of attempted murder. Nevertheless she will have to live for the rest of her life with the memories and knowledge of what she has done.

On the same day that Frances Inglis was sentenced to nine years in prison, three senior judges were deciding that an Asian businessman, Munir Hussain, should walk out of prison, his sentence for grievous bodily harm (after beating a burglar with a cricket bat) replaced with a suspended sentence. Justice, compassion, mercy, upholding the law … all the reasons are trotted out for the differing penalties.

But what would you instinctively do if you found a menacing burglar threatening your family? What would you do if your daughter/son was lying in torment, physical and/or mental and begging for your help? Or if you were on the jury deciding the fate of a mother who has deliberately killed her child?

So-called ‘mercy killing’ raises powerful emotions. Campaigners are re-doubling their cries for a change in the law. The current attempts to do so hinge around cases where people are wanting to end their own lives because of terminal illness or intolerable suffering. Similar arguments; important circumstantial differences. But the potential consequences of such a change are sobering too. Doctors under pressure to speculate as to the time left to give credence to the ‘terminal illness’ (the Lockerbie bomber case springs to mind), disabled lives categorised as inferior and worthy of terminating, patients under pressure to end their lives before they become a burden or inconvenience, a slippery slope to euthanasia of the unwilling … You’ll have read the lists too.

Many people face the dilemma of deciding between two tragic choices, not just the few who hit the headlines. Some of them contacted Any Questions? and Any Answers? this week each with their own painful story. I’ve heard many more. I’ve been personally involved in such cases. Some families go ahead and break the law, some think it would be right to but can’t bring themselves to perform the act, and others believe life is sacred and not to be cut short by human hand. And opinion is fierce on both sides.

Independent MSP, Margo MacDonald, found the same thing when she listened to people caught up in these difficult questions, and her appreciation of the fine nuances is reflected in her proposed End of Life Assistance (Scotland) Bill published this week. It’s hedged about with safeguards:
- a minimum age of 16
- at least 18 months registration with a GP in Scotland
- late stage terminal illness or a degenerative condition or permanent incapacity
- intolerable life
- agreement by two medical practitioners
- a psychiatric assessment of capacity to decide
- 2 witness signatures
- a cooling off period of two days.
She’s a persuasive campaigner and her own situation (she has Parkinson’s disease) gives her a strong platform. But no-one knows how her parliamentary colleagues will react (this is not a vote-winning cause) and without their support it can’t even get through to the next stage. But if it does become law then Scotland could become the first part of the UK to legalise assisted suicide, so it’s a critical issue.

MSPs are expected to vote on this Bill in the autumn – a free vote so they can go with their conscience and not along party lines. Keir Starmer, the Director of Public Prosecutions, is due to issue new guidelines on assisted suicide within the next eight weeks.

Which way would YOU want them all to go?

Because assisted suicide hit the headlines again this week, big time, and some of my readers have contacted me about it. Prompting me to offer a couple of comments.

First the Royal College of Nursing officially withdrew its opposition to seriously ill patients seeking help to end their lives. It’s important to note that the RCN is not saying it approves the practice; full stop. Of the roughly 30% of their members who participated in their recent consultation exercise, 49% supported assisted dying; 40% opposed it. What the College is recognising is the variation in opinion amongst the health care professionals who work most closely with very sick patients, and the public mood.

The plan now is to issue guidance to help nursing staff to have a properly informed discussion with those who broach the subject with them. I just hope this process won’t take too long. What about all those patients and families who read the headlines; misread the signs; and confront unprepared nurses?

And there’s another issue which isn’t often raised. Nurses are certainly very close to terminally ill patients, but they aren’t the ones who actually do the deed or write the prescription. Important distinction.

The RCN news coincided with a poll in The Times – carried out a week after the conductor Sir Edward Downes and his wife died at the Dignitas clinic on July 10 – which found that 74% of people (well, Times readers anyway) want doctors to be allowed to help their patients in this way. If you’re one of the people who say assisted suicide should be legal, ask yourself: would you be willing to carry it out? Actually help someone to die, I mean. And if you wouldn’t, can you justify requiring others to do so?

Now today the Law Lords have issued a milestone ruling. Debbie Purdy, a lady with Multiple Sclerosis who has been campaigning for clarification of the law on assisted suicide has, they say, the right to know if her husband will be prosecuted if he helps her end her life. Guidance must be provided. The Director of Public Prosecutions has promised to issue an interim policy later this year. Ms Purdy herself says, this is not about a right to die but a right to live longer; if her husband is able to help her she will not be forced to end her life prematurely to protect him.

As I say, a serious week. Major challenges. Worrying questions. No easy answers.