Newsmaker: Death by choice - Deborah Annetts, Chief executive, Voluntary Euthanasia Society

Indira Das Gupta

Deborah Annetts is sure that her days are numbered as the chief executive of the Voluntary Euthanasia Society (VES) - not because she isn't doing a good job, but because her job will soon be done. She is adamant that it is only a matter of time before there is a change in the law that will allow terminally ill patients to end their lives with dignity at the time of their own choosing. "I believe there will definitely be a change in the law in my lifetime," she says. "The Royal College of Physicians and the Royal College of GPs have dropped their opposition, and the General Medical Council has said it can produce regulation."

Certainly, when you examine the evidence, there seems to be overwhelming support for such a change. According to a poll commissioned by the society and conducted by NOP earlier this year, a staggering 82 per cent of the population would support it.

Of course, the Government isn't always inclined to listen to public opinion.

However, politicians may be more inclined to listen to the medical profession.

The society published the results of an online survey last week as a Lords select committee began discussing a bill proposed by Lord Joffe that would enable doctors to help terminally ill patients to die. The survey showed that 45 percent of doctors believe it should be permissible to help end patients' lives when they are terminally ill and in unbearable pain. The same proportion also believe that other doctors are already helping patients to die.

On the face of it, then, the case for the bill seems irrefutable. But it is not as cut and dried as Annetts suggests. The society's own research clearly shows that the majority of doctors still do not support a change in the law. When questioned, 53 per cent said they did not believe a doctor should directly help a person to die under any circumstances. Commenting on the society's poll, the chairman of the British Medical Association's ethics committee, Dr Michael Wilks, said: "Physician-assisted suicide has been debated many times by the BMA, and on every occasion the membership has decided against calling for a change in the law."

Despite glossing over the 53 per cent figure, Annetts presents her arguments with the clarity and logic of a former employment lawyer. Her legal experience was in fact instrumental in her decision to join the society. She says: "I studied Philosophy at university (St Hilda's College, Oxford), so I've always been interested in the relevant issues, and having studied and practised law, I realised just how crucial it is to the whole debate."

Although Annetts does not have any loved ones who have had to deal with terminal illness, she has seen the immense suffering it can cause. "I will never forget a woman I met as an NHS management trainee who had bone cancer," she says, "She was obviously in great pain and she was given morphine for the pain, which made her hallucinate. She was a very religious woman and kept shouting that the devil was coming to get her. She was in such distress, it was as if she were being tortured.

"I'm not saying that she would have wanted help to die, but I'm convinced she would have wanted the choice. That's what the VES is about, choice."

At present, a doctor who directly helps a terminally ill patient to end his or her life can be charged with murder, which carries a mandatory life sentence. A doctor, who, in effect, assists suicide by providing the means for a patient to kill themselves, for example, by deliberately leaving pills by the bedside with instructions on a fatal dose, can be charged with assisting suicide, which carries a maximum tariff of 14 years.

Lord Joffe's bill would legalise both and is based on the model that exists in the US state of Oregon, where doctor-assisted deaths do not carry a penalty.

"It is important that both are decriminalised," explains Annetts. "Diane Pretty, who was a close friend of mine, would not have been physically capable of ending her own life." Pretty, who suffered from motor neurone disease, fought a legal battle to allow her husband to help her commit suicide, but lost.

By calling for the legalisation of assisted suicide, Lord Joffe's bill actually goes one step further than the Oregon model, as doctors there are not allowed to physically assist patients to die. More than 200 patients have opted for assisted suicide since it was legalised in 1997, and Nick Gideonse, a local doctor, claims that the the law has worked extremely well.

Those against Joffe's bill argue that it would open the door for another Harold Shipman and allow doctors to end patients' lives with impunity, putting the vulnerable at risk. But Annetts believes that the opposite is true. "It's already happening, but it's happening underground," she claims. "Doctors make the decision to withdraw treatment every day - we know this goes on - and assisted dying is no different to withdrawing treatment. We want it to be transparent so that people can be held accountable."

Annetts is all too aware that one of the main obstacles she faces is convincing her opponents that a change in the law would not be open to abuse. Joffe's bill stipulates that a number of conditions should be met for voluntary euthanasia to be considered the best course of action. The patient should be terminally ill with no more than six months to live, and competent - factors which should be determined by two doctors. A practising solicitor and a fourth person should then vouch that the patient is sane and all four should then sign a legally binding document, which would also be signed by the patient. In the case of someone with motor neurone disease, or other comparable illness, a mark of consent would suffice.

The VES believes that such strict regulations would protect patients and stop them being put under pressure.

The proposed safeguards have clearly not been enough to convince BMA members, however, and they show no sign of changing their minds. It looks as if Annetts could be in her job for longer than she thought.

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