California man invites BBC to witness his death as MPs debate assisted dying | BBC News

Key Concepts:

• Assisted Dying/Assisted Suicide: The act of intentionally ending one's life with the assistance of a physician or other individual.
• Free Vote: A vote in which members of a legislative body are not bound by party lines and can vote according to their conscience.
• Mental Capacity: The ability to understand information, retain it, weigh it, and communicate a decision.
• Coercion: The act of persuading someone to do something by using force or threats.
• Palliative Medicine: Medical care focused on providing relief from the symptoms and stress of a serious illness.
• Safeguards: Measures put in place to prevent abuse or misuse of a system or process.

1. Legal Landscape of Assisted Dying:

• England and Wales: A bill proposing the legalization of assisted dying is under consideration. In November, MPs had a free vote on the proposals, with 330 in favor and 275 against. The bill requires individuals to be 18 or over, have the mental capacity to make the choice without coercion, and be expected to die within 6 months. The bill is still set to go through further scrutiny and could still fail to become law.
• Scotland: A separate bill is under discussion in the Scottish Parliament.
• Northern Ireland: The subject is not currently high on the political agenda.
• Isle of Man: Passed its own assisted dying legislation, expected to be given royal ascent soon.
• California: A law enabling people to choose to end their own life was introduced in 2016.

2. Case Study: Skip Riley in California:

• Skip Riley, a 79-year-old Vietnam veteran with terminal cancer, sought an assisted death at home.
• He experienced significant pain, medically controlled but with breakthrough pain.
• He desired a peaceful death surrounded by family, which he felt was not possible in a hospital setting.
• His wife, Norma Jean, fully supported his decision.
• Dr. Bob Hartman provided the lethal medication, a mixture of five powerful drugs that slow the heart.
• Skip was required to take anti-nausea medication 30 minutes before ingesting the lethal dose.
• He had the right to halt the process at any time.
• Skip died a week after filming, with his wife and sons present.

3. Perspectives on Assisted Dying:

• Support: Advocates emphasize individual autonomy and the right to a peaceful death, particularly for those suffering from terminal illnesses. Skip Riley's case exemplifies this perspective.
• Opposition: Some disability campaigners, like Ingred Tisha, express concerns that assisted dying devalues the lives of people with disabilities and promotes suicide assistance over suicide prevention.
• Medical Ethics: Dr. Vincent New Yen, a palliative medicine specialist, worries that physicians will be seen as killers rather than healers. He advocates for improved palliative care and support for vulnerable individuals.

4. Differences in Safeguards:

• California: The process for accessing lethal medication is relatively simple and quick, potentially taking as little as 48 hours. It's not compulsory for aiding dying patients to have a doctor present when they die. They can store the lethal dose at home under lock and key and use it when they're ready.
• England and Wales (Proposed): The approval process set out in the lead beater bill would take around a month.

5. Key Arguments and Evidence:

• Autonomy vs. Vulnerability: The debate centers on balancing individual autonomy and the protection of vulnerable populations.
• Quality of Life: Supporters argue that assisted dying can improve the quality of life for terminally ill individuals by allowing them to control the timing and manner of their death.
• Palliative Care: Opponents argue that resources should be focused on improving palliative care to alleviate suffering and provide support for those facing end-of-life decisions.

6. Notable Quotes:

• Skip Riley: "I just want to go out as peaceful as I possibly can with my family around me."
• Ingred Tisha: "The message that it sends to people with disabilities in California is that you deserve suicide assistance rather than suicide prevention when you voice a desire to end your life."
• Dr. Vincent New Yen: "I worry that the physicians are no longer seen as a healer as we are but rather than participating in the death of a person by killing them and we become a from a healer to a killer...The way that a society cares for its most vulnerable is the measure of its humanity."

7. Synthesis/Conclusion:

The debate surrounding assisted dying is complex and multifaceted, involving considerations of individual autonomy, societal values, and medical ethics. The case of Skip Riley illustrates the desire for a peaceful and dignified death, while concerns raised by disability advocates and medical professionals highlight the potential risks and ethical dilemmas associated with assisted dying. The legal frameworks and safeguards vary significantly across different jurisdictions, reflecting differing perspectives on this sensitive issue.