![Patient sitting on hospital bed, rear view.](https://media.guim.co.uk/de3e6bc711cc7715d040a70e954109f803642c43/0_72_2119_1271/1000.jpg)
Frances Ryan is right that the assisted dying debate is much more nuanced than it appears (I’m glad the debate on assisted dying is forging ahead. But few understand why it frightens so many, 29 February). The initial problem is that dying is a typically British muddle, stuck between outdated legal assumptions about healthcare and modern squeamishness about death. Patching yet more on to this won’t do.
I am running out of choices in my eight-year tussle with breast cancer, and I dream of a good death. But here’s what I’m urged to deliver: a will, but I’m safely dead by then. Two powers of attorney are legal essentials too, but why two? A letter of wishes can sit alongside my will to help my executors with issues such as funeral plans, but it has limited legal status. I am not sure how preferred priorities for a care plan fits in with the welfare power of attorney or the letter of wishes. Then there’s the advance decision to refuse treatment, and perhaps this includes the do-not-resuscitate notice. I’m meant to discuss these with my family and my healthcare team.
You already need a lawyer to have a chance of dying nicely. If assisted dying is introduced without clear thinking and well resourced systems, we will end up with many tragedies, whatever the good intentions of those on either side of the debate.
Davida Hamilton
Wetherby, West Yorkshire
• Frances Ryan’s point, that “it is hard to trust the state to help marginalised people to die when they fail to support them to live”, will strike a resounding chord with all families caring for someone with a disability. That a human life is precious because it is human forms the basis of our laws and justice system. Some of us have that understanding from a faith perspective, some not. It is, however, at the heart of this discussion.
Passing the assisted dying bill in Britain may well bring a sense of peace to some who are understandably very fearful of the process of dying, and it would presumably be a good financial option for the country. However, I have learned not to trust the state to care well for marginalised people during their lives, and I certainly do not want it acting as God at the end.
Clare Peck
Sheffield
• Frances Ryan writes that advocates of assisted dying say there will be “safeguards” in place to protect older and disabled people from abuse and coercion, but such safeguards may still permit a solution to some of the major problems faced by our society, including the provision of social care and the funding of the health service.
Many older people dread “being a burden”, but if assisted dying becomes not only socially acceptable but expected (subtly, over time) then they could come to believe – without any coercion – that they ought not to be a burden and reach for an easily available solution. Lonely people, too, who feel they “might as well die” could easily be persuaded that they should. After all, old age is a terminal illness, isn’t it? Not only would they no longer be an expense to the state, but the funding that at present goes into research into such things as Alzheimer’s or chronic pain management could be diverted into some of the government’s pet projects. Surely to the benefit of all reasonable people!
I wrote this letter in my head at 4.30 this morning when, for some reason – maybe because I myself will soon be considered old – I couldn’t sleep. But when I turned the radio on, I heard the news of Iris Apfel’s death at 102. She said that if God was kind enough to give you extra years, you should enjoy them. That attitude would certainly undermine my “modest proposal”.
Cate Gunn
Colne Engaine, Essex
• Thank you to Frances Ryan for her balanced article concerning assisted dying. There is an unrepresentative bias when celebrities such as Esther Rantzen have ready access to the media when no “celebrities” are sounded out to give an alternative viewpoint.
Frances rightly highlights the scandal of hospice care being largely dependent on charitable giving. Surely, fully funded quality palliative care available to everyone at point of need is a better answer than the quick-fix solution of assisted death. Human beings, however close to the end of life they might be, are not pets to be put down. A good death needs to be fully articulated and made available to all.
Rev Roger Chamberlain
Birmingham
• Your article on the health and social care committee’s report on assisted suicide and euthanasia says: “Opinion polls have shown that between 73% and 84% of the public support legalisation within strict guidelines” (Assisted dying law may soon diverge across British Isles, MPs warn, 29 February).
But most people don’t realise that “assisted dying” means the swallowing of large quantities of lethal drugs, which, data from the US state of Oregon shows, have significant complication rates, with some failures. With a lethal injection (in euthanasia), you stop breathing and die of asphyxia.
The report rightly says that we need clear terminology and honest, open conversations around dying and death. People need mental health support when receiving a devastating diagnosis, and specialist palliative care must be available wherever they are in the country.
Ilora Finlay
House of Lords