Jonathan Bellamy caught up with Dr Peter Saunders of Care Not Killing about the Sir Terry Pratchett lecture, the Panorama Poll and some of the dangers associated with assisted suicide and euthanasia.

Dr Peter Saunders

As the UK awaits the definitive DPP guidelines to assisted suicide, a group of MPs last week accused the BBC of 'promoting euthanasia' - having seen Sir Terry Pratchet's Richard Dimbleby lecture which called for a tribunal to give seriously ill people permission to get help to die and a Panorama programme on the story of Kay Gilderdale, who was cleared of attempting to murder her 31-year-old daughter Lynn after pleading guilty to assisting her suicide. With such emotive arguments being made Jonathan Bellamy decided to hear the other side of the argument from Dr Peter Saunders the Campaign Director for Care Not Killing.

Jonathan: Over recent months and years and particularly accelerating in the last few weeks, the topic of assisted suicide has been growing in awareness across the nation. First of all, when we talk about assisted suicide, what do we mean - what's the legal definition?

Dr Saunders: Well assisted suicide is where a person ends their life by taking poison themselves that someone else has helped them acquire. It's different from euthanasia where a doctor or someone else actually administers the lethal dose of medicine.

Jonathan: I see. Now let's pick up on one of the most recent things that's happened. BBC1's Panorama show suggested 73% of people now support assisted suicide for someone who is terminally ill. What do you think is behind public opinion seeming to grow to support and see assisted suicide as a good thing?

Dr Saunders: Well in fact that figure of 73% is pretty similar to what's been given in all recent polls over the last twenty years or so. These polls tend to be timed to coincide very much with high profile cases in the media and this particular poll followed the Inglis and Gilderdale cases in the courts and also other publicity around the Panorama programme and the upcoming release of the definitive DPP guidelines; so it's not surprising. With opinion polls it depends pretty much on the question you ask and if you ask these questions at critical times, you will get a response like this. In the same way a couple of years ago when Lord Joffe's bill on assisted suicide was going through the House of Lords, people were asked, if such a law was passed, do you think that people would feel under pressure to end their lives and a similar percentage of about 55% to 80% of people said yes; so I wouldn't read too much into it. I think that public opinion on these matters is always heavily influenced by media coverage at the time. I think also that if we went by all opinion polls - well 80% of people think the death penalty should be brought back in. So these critical decisions on public policy should be made in the context of a well-informed debate in parliament and not in response to the views of celebrities or in response to you know public opinion that's been built up by emotive cases.

Jonathan: Well that's always an issue really isn't it; because people can be led along by emotion without necessarily being given a clear case to evaluate. You mention high profile; this week Terry Prachett gave a televised Richard Dimbleby lecture on assisted suicide and Alzheimer's disease. In it he mentioned a number of times that in every other country or US state where euthanasia or assisted suicide was permissible, there was no evidence of abuse of patients. However, I understand there are reports from the Netherlands where they show an increase in what they call terminal sedation. Do you know anything about that?

Dr Saunders: Yes I do and this is the whole danger of celebrities that they can not be informed on the issues. What we're seeing now is the pressure to change the law as a result of celebrity endorsement of certain lifestyle choices.

If we look around the world I think there's a lot of cause for alarm. Oregon's the place most often quoted as showing no dangers and Oregon actually legalised assisted suicide back in 1997, so thirteen years ago. However, if you look at the statistics you'll find, over that period, there's been a fourfold increase in the numbers of cases of assisted suicide; that only less than one in twenty patients actually see a psychiatrist to determine whether there's any psychiatric illness which is having an influence on their decision. In fact one in six, according to a British medical report, is depressed at the time of taking their lives. So that's most worrying. There is also a lot of evidence of doctor shopping; people going to the doctors who are most likely to see to their request. Then there was the very distressing case of Barbara Wagner who was a woman with cancer who was seeking chemotherapy and got a letter from the Oregon health department telling her they couldn't pay for her chemotherapy but they would pay for her assisted suicide.

When we go into the Netherlands, the situation is even more worrying and both euthanasia and assisted suicide have been legally sanctioned in the Netherlands for about twenty five, thirty years or so. In other words, provided doctors followed certain guidelines, they couldn't be prosecuted. It's only been formally legalised there since 2001, but the statistics are very worrying indeed. If you look for example at the sheer numbers, we have not only in excess of two thousand cases of voluntary euthanasia a year and around five hundred cases of assisted suicide; but also every year since 1990, there's been around a thousand cases a year of involuntary euthanasia, where doctor's have taken the lives of patients without their consent, even though that's against the law. There have been no prosecutions whatsoever. Then more recently under the so called Groningen protocol, we see dozens of disabled children per year given euthanasia in the Netherlands. Then you mention terminal sedation; the way terminal sedation works in the Netherlands is that they give very very large anaesthetic doses of sedatives to people who are within days, weeks or even months of death, with the aim of rendering them unconscious and then either giving heavily sedative drugs like morphine or alternatively barbiturates to end their life; these are the drugs usually used in euthanasia; or alternatively they withdraw food and fluids. So it's a very worrying trend and Terry Pratchett, with all due respect, doesn't know what he's talking about. He should stick to fantasy fiction, which he's very good at, rather than trying to pronounce on issues of public policies where he's not well informed.

Jonathan: I imagine there are degrees of this as well. I mean, we're mentioning that 73% might support assisted suicide for those who are terminally ill, but if we look at the issue of abortion; back in 1967, Lord Steele, who was the architect of the abortion act said, that today abortion is being used as a form of contraception in Britain and admits he never anticipated anything like the current number of terminations when he led the campaign. Do you think that could happen with assisted suicide and the killing of the terminally ill and elderly?

Dr Saunders: I think it's a very interesting parallel and you're quite right that in '67 - we've got to remember that the abortion act came upon the back of the thalidomide disaster where children were being born with terrible deformities and that was part of what motivated it. At the time, even those who wanted to change the law and they were obviously in the majority in the end, were doing so for what we'd called the hard cases. They certainly didn't anticipate what we've got today; but now we have two hundred thousand cases of abortion a year. We've had almost seven million since the act went through in 1967. In the United States the numbers since their '73 act, is now past fifty million; and we've got around forty million cases of abortion every year throughout the world.

There's no doubting that once you change the law, you find you're on a slippery slope where the procedures carried out for more and more trivial reasons. I think that's what is exactly going to happen if the law changes on assisted suicide. We're already seeing this. We hear the campaigners saying; look this is just for the mentally competent adults who are terminally ill. Then we have Martin Amis coming along just the week before Terry Pratchett, another author, saying that we should have a euthanasia booth on every corner; that old people should be given a martini and a medal before their lethal injection. That we're facing a silver tsunami of elderly demented people who are going to be a burden on the state, you know and so on. Suddenly we've moved from mentally competent adults with terminal illness to people with dementia.

You'd be interested to know that in the last four years, Parliament's twice looked at this and have twice agreed not to change the law for reasons of public safety. That's because they believe that people who are disabled or elderly or terminally or chronically ill, will feel under pressure to end their lives, so as not to be a burden to relatives or carers or the state. As I say, when they've looked at it in the institutions and the House of Lords, the BMA and the Royal Medical Colleges and disability rights groups in particular have been strongly against any change in the law. There is historical precedent for this incremental creep or slippery slope that takes place. Once the public conscience changes, the danger is that people begin to regard something they would have previously seen as horrendous, as acceptable and then you get more and more and more.

I think we've got to remember that in Britain that we're sitting on the one hand on a demographic time bomb, where there are many many elderly people, disproportionately large numbered compared to those in the work force and we're also at a time of economic recession where many families are struggling and where the government is in a huge amount of debt. They say all you need for a holocaust is four things; you need a handful of doctors who are willing to do it, public opinion in favour, economic pressure and a law that allows it. The only thing we don't have in this country is the law that allows it. We're in very very real danger I think, that the generation that killed its children through abortion, could become very well the generation that is killed by its children through euthanasia. I think it's really that serious.