The following correction was printed in the Guardian's Corrections and clarifications column, Tuesday October 11 2005
In the article below, we said that the British Medical Association had struck a doctor off the list of registered practitioners. The BMA is the professional association for doctors; the General Medical Council is the regulating body responsible for registration. We think we are an open country now, and when it comes to sex and drugs perhaps we are. But when it comes to dying we are a scared, prudish people, and that means a cruel people. Western medicine has pushed our average life span ever further. It means vast numbers of us ending our lives dying not of diseases that once killed but of dehydration in hospital beds in awful agony, bodily machines kept alive for too long. The law prohibits doctors from speeding that final departure, no matter how much pain is suffered, no matter what the patient wishes. So far, we have turned our eyes away, pretended not to know. Today, in the Lords, this may be about to end. It is a truly important moment for modern Britain.
Two Guardian writers have, within the past year, given personal testaments about the reality of modern death. The paper's editor, Alan Rusbridger, wrote that his father had wanted help dying: "Our last precious times together were clouded by his growing pain and sense of betrayal - he blamed me and my brother for our failure to persuade the doctors to carry out his wishes. He said: 'They wouldn't treat an animal like this.' " Polly Toynbee's mother said something strikingly similar, having begged for enough pills to end her nights of pain and sleeplessness, telling her daughter: "If I was a cat, you'd take me to the vet and put me down."
These are not the sentiments of a few parents whose children happen to be journalists. This is the desperation of uncountable numbers of people who have lived good lives and find themselves undergoing bad deaths; people who were in control, and then at the end were left angry, helpless and in pain. This is the stark reality. It is an issue we have to talk about, and this afternoon in the Lords, with 75 peers queueing up to speak, that is finally happening.
The journey to today's debate has been a long one, but unless you understand it, not much else makes sense. It begins 11 years ago, when the Lords committee on medical ethics decided that assisted dying should remain illegal. This was before a spate of difficult and tragic cases, among them Diane Pretty's struggle to be allowed help to end her life, rejected by the European court of human rights, and before what one peer describes as "the sorry spectacle of terminally ill patients dragging themselves in desperation to Zurich to be assisted to die".
Two years ago the human rights lawyer and former head of Oxfam Lord Joffe introduced a private member's bill to legalise assisted dying for the terminally ill. He argued that the current law causes profound and unnecessary suffering to many people, that it is out of tune with public opinion and that it is not working anyway, since 3% of doctors, according to a BMA survey, have helped a terminally ill patient to die.
Lord Joffe's bill was referred to another Lords select committee, which reported in April this year. Three members of the committee that sat 11 years ago, Baronesses Jay, Warnock and Flather, now support Lord Joffe's bill. Perhaps the most significant piece of evidence that has changed their minds is the experience of other countries that have introduced similar legislation and that the committee visited.
The big worry has always been that legalising assisted dying would somehow put pressure on terminally ill people to go quickly, perhaps because of the effect on their families; that it would oblige people to have themselves killed - what the churches call a "moral watershed" for western society. But according to the Remmelink report, commissioned by the Dutch government after assisted suicide was legalised there in 2002, there was no evidence whatever of a "slippery slope" towards non-voluntary euthanasia, and no evidence of pressure on vulnerable people. The system in the Netherlands is now supported by 85% of the Dutch population and the vast bulk of the medical profession there.
Members of the Lords committee looking into the Joffe bill also travelled to Oregon, which has similar laws. With no evidence of a slippery slope there either, the committee called for today's debate and suggested that a new bill on assisted dying be introduced and immediately sent to a committee of the whole house - in essence, fast-tracked.
The three baronesses are not the only ones to have changed their minds in a decade. The Royal College of Physicians, which was hostile, has also moved, to a new position of neutrality. So has the British Medical Association, though recently it was still obliged to strike off a doctor who took pills under his own name to help a friend who was dying of prostate cancer. In fact, I haven't been able to find a single relevant professional body that has moved the other way since the debate began. As to public opinion, a YouGov poll two months ago found that 87% thought people should have the right to decide when they die, and to ask for medical help in dying.
That is the background to today's confrontation in the Lords, which is as important a contest between individual liberty and finger-wagging authority as any in recent times - vastly more important to millions of people than foxhunting, for instance, which engorged so much political time. On one side, evidence and public commonsense. On the other, the frantic fears and religious prejudices of the churches and their allies.
Yesterday the Bishop of Oxford argued that "it is quite wrong to emphasise autonomy as the overriding feature of what it is to be a human being"; mutuality and interdependence were more fundamental. This sounds good. What it means is that abstract notions about other people's attitudes matter more than your painful death.
No. This is about treating individuals as adults, and trusting people to take the most important decisions themselves. It is always possible that some selfish, cold or greedy relative will want to hasten the death of an elderly or terminally ill person, and will try to use a new law to do it. A few doctors have killed in the past, far beyond the quiet acts of genuine mercy that used to be common.
But law should not be made on the basis of a tiny number of rogues, or even the abstractions of a bishop. Against that must be set the millions of free people who only want to go gentle into that good night, and have a right to it. There comes a time when the duty to keep alive at all costs comes close to a right to torture. Let us hope the Lords look frankly at what we are doing.
