Assisted dying would create new dilemmas at the end of life. Doctors would be concerned about the certainty of the diagnosis. For example, I recall an elderly man who was confidently diagnosed by a specialist team as having inoperable pancreatic cancer and given weeks to live. He would have met the Assisted Dying Bill criteria, but years later he is still playing golf; the diagnosis was wrong. Doctors would be concerned about assessing people’s mental capacity to take such an irrevocable decision. The standard tests assess a person’s ability to take a decision, not whether the decision itself is reasonable or based on realistic assumptions. Doctors would be concerned that a person might be pressurised in subtle or concealed ways.
In the Netherlands the law requires that the doctor believes that the person faces unbearable and hopeless suffering and that there are no reasonable alternatives. There is no such requirement in the Assisted Dying Bill. A doctor might be asked to end the life of a person who, although believed to be terminally ill, was not suffering and where palliative care would be expected to alleviate future suffering. Even doctors who find assisted suicide morally acceptable would find ending the life of such a person difficult.
The Bill would legalise physician-assisted suicide but not euthanasia. The deliberate killing of a person with the intention of avoiding suffering would remain illegal. A health professional could assist someone to self-administer the medicine but the final act must be taken by the person herself. Consider the position of a nurse attending a home to carry out an assisted suicide. The patient cannot swallow the medication so she sets up a syringe driver. The patient is too weak to press the button and requests that the nurse does it. But if the nurse presses the syringe driver button, that would be euthanasia, therefore illegal, and would expose her to the risk of an accusation of murder. The line between assisted suicide and euthanasia can be a fine one.