Assisted dying is a dangerous idea

It's both legitimate and mandatory for doctors to assist people to die well – that is to use modern drugs and up-to-date techniques (both of which are very different from even 20 years ago) to help terminally ill people deal with their illnesses and die with peace and dignity.

This is what modern palliative medicine is all about; and Britain is a world-leader in such care.

However, what is usually meant by the euphemism "assisted dying" is something very different – asking doctors to bring the lives of terminally ill patients to a premature end.

This practice, which has been legalised in only a handful of countries without palliative care services of comparable quality to ours, is both illegal and contrary to good medical practice.

It is opposed in Britain by all the Medical Royal Colleges and the British Medical Association (BMA), and surveys of medical opinion indicate that, even if it were to be made legal, only a minority of British doctors would be prepared to it carry out.

Legalising "assisted dying" is both unnecessary and dangerous. In previous generations, it was not uncommon for people to die in pain or with other distressing symptoms unrelieved.

But, over the last 25 years, the science of palliative medicine and palliative care has advanced by leaps and bounds.

In Britain, unlike most other countries, palliative medicine has been a recognised clinical speciality, like oncology or paediatrics, for more than 20 years, with lengthy and extensive training for practitioners. We have specialist palliative care departments in major hospitals and many hospices.

Like many other parts of the NHS, palliative care is under-funded and therefore not evenly spread across the community. But the Government is now investing more in this area of care, and there is no reason today why any terminally ill person should have to die with unrelieved pain or other symptoms.

Those who want to see "assisted dying" legalised recognise this. They say they support investment in palliative care.

Their focus has therefore shifted in recent years from advocating "assisted dying" as an escape from uncontrollable pain and other symptoms of terminal illness to arguing for it simply as an extension of patient choice.

In the words of the main pressure group, Dignity in Dying (formerly the Voluntary Euthanasia Society), "no amount of good palliative care can address some patients' concerns regarding their loss of autonomy, loss of dignity and loss of control".

It also states that "control and choice are foundations of a dignified death". Margo MacDonald, a member of the Scottish Parliament who plans to introduce a euthanasia Bill north of the border, recently publicised her views on BBC TV's Panoramaunder the title I'll Die When I Like.

On Sunday night, BBC1 also screened a programme called A Short Stay in Switzerland about "assisted dying" in a Swiss clinic, starring Julie Walters.

Make no mistake, what is driving the case for "assisted dying" is not the relief of symptomatic suffering. It is rather the promotion of personal autonomy and control. It is this new focus on autonomy that makes legalising "assisted dying" dangerous as well as unnecessary.

While a small minority of terminally ill people want "assisted dying", the overwhelming majority don't. They want good symptom control and proper care.

Many of them think about "assisted dying" when in low spirits and even discuss it with their doctors. But most of these thoughts and discussions do not have serious intent behind them.

They are attempts to seek reassurance that their worst fears will not be realised and that they will not be abandoned; and the cries for help can be made safely in the knowledge that they will not be taken at face value by their doctors.

Dying people also commonly worry about the care burden they are placing on their families or about funds.

Almost invariably, with proper care and sensitive support, these bleak phases pass.

Legalising "assisted dying" would change all this. It may provide a facility for a resolute few to obtain assistance to end their lives at a time and in a manner of their choosing, but it would withdraw from the majority of dying people the protection which the law now gives them.

Many might seriously wonder whether, if "assisted dying" is a legal option, they have a duty to their families to end their lives quickly, and others might well feel inhibited from exposing their innermost thoughts for fear of being taken at their word.

The "safeguards" we have seen in recent "assisted dying" Bills are purely theoretical. They assume applicants with clearly thought-out intentions and doctors with limitless time and knowledge of their patients. They do not reflect the often-harsh circumstances of terminal illness or the stresses of clinical practice.

Moreover, if personal autonomy and personal perceptions of suffering are to be regarded as the keystone of "assisted dying", the way is clear for such a law to be extended beyond terminal illness to encompass much larger numbers of people with illnesses which are not terminal but chronic or disabling.