Closed petition Assisted Dying - allow individuals of capacity their own end of life choices

Ministers responded

This response was given on 1 October 2018

Assisted dying is a complex and sensitive issue requiring further in depth consideration by the Council of Ministers, drawing on the extensive work undertaken in other parts of the British Isles.

Ministers acknowledge the importance and significance of ensuring that people are able to end their lives with dignity and that services must be available to support this. The nature of end of life care and its relationship to what the petition calls 'assisted dying' is complex and one that is ethically and morally sensitive and therefore is guided by our personal values and beliefs. As a community, we place a high value on health and quality of life; this is no less so as our lives come to an end.

There is already choice in how we are treated, including choice over how and where we die. From the 1st of October, we have laws to support advance decision making around care so that our wishes as to our treatment in the event of future health events are known and can be fulfilled. Jersey has also adopted a multi-agency, cross-service ‘Gold Standard Framework’ to deliver consistently high quality care for people nearing the end of life. However, people suffering a terminal illness have the right to refuse treatment and, if they do so, their doctors have a duty to provide care with the aim of relieving the symptoms of their illness and to do their utmost to control any distress and pain.

The role of our doctors is to ensure good medical care within the guiding ethical principles of 'first, do no harm' whilst ensuring that their patients benefit from the best evidenced-based approaches to end of life care. In particular, palliative care aims to enable people who are dying to live well until the day they die, minimising pain and other distress whilst supporting families throughout. In this way palliative care, in participation with patients and their families, is already controlling the experience of dying and providing the best possible end of life care to the terminally ill.

The practice and clinical codes of conduct that guide our health care professionals are incompatible with models of 'assisted dying'. Any doctor actively assisting a patient to die would risk the removal of their General Medical Council licence to practice and be acting contrary to the basic 'do no harm' principle that underpins clinical practice. It is unsurprising therefore that the medical professional bodies and the majority of practising doctors surveyed in the UK are opposed to legalisation of 'assisted dying'.

The wider international debate raises many important and fundamental issues about medically assisted dying. Key issues include: clear eligibility criteria including conditions and prognosis; a framework to protect the vulnerable; assessment of free will and the absence of coercion; continuity of care; and where decision making responsibility should lie.

We acknowledge and take account of the situation that much of the debate in other jurisdictions has been informed by polarised positions whilst at the same time being underpinned by shared values of care, choice and compassion. It is these shared values that we should now draw on in first reviewing our own current laws around end of life to understand if a change is needed and if so what options exist to bring about change.

Due to the complexity, sensitivity and gravity of the issue, this should first be considered in more depth by the Council of Ministers, with the necessary time provided to prepare an informed discussion, drawing on the extensive work undertaken in other parts of the British Isles. The Minister for Health and Social Services intends to bring this matter before the Council of Ministers to undertake this initial consideration (before the end of January 2019).

Response by: Deputy Richard Renouf, Minister for Health and Social Services