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Occupational Therapy and Assisted Dying

Posted Nov 03 2008 9:02pm
image by AHook

As an occupational therapist who has worked in a palliative care environment for around 10 years I have always believed that individuals who have capacity should be able to choose when and how they die based on the view that can’t be easy to admit that life is so bad you want to die; but it must be even harder to know that you can’t kill yourself and have to ask for help but be refused.

I was really interested therefore to hear Baroness Finlay speak against the now rejected Assisted Dying Bill at the COT conference in Harrogate recently. I expected her to present a number of emotive case studies describing people who wanted to die but who are now glad to be alive and I expected her to say that good palliative care negates the need for assisted dying. I also expected her to refer to medical ethics and to suggest that some patients would want to die for fear of feeling burdensome. She presented all of these convincing arguments and more besides, however it was her description of the implications of assisted suicide for occupational therapists that stopped me in my tracks.

The Assisted Dying Bill suggests that in order to meet the criteria for assisted suicide a person must have a terminal illness and consider them self to have intolerable suffering. They must also have the capacity to make this judgement and to request the right to die, but capacity cannot be taken at face value. The responsibility for determining mental capacity lies with health care professionals and Baroness Finlay suggests that this may include occupational therapists.

Could I or anyone else really assess the quality of a person’s life and then judge whether or not it constituted intolerable suffering? Is this even possible? If I concurred with the patients view does this mean they have capacity and can be allowed to die? What if they have a better day tomorrow? What if I am wrong?

It is with some regret that I have to conclude that although I still believe in a person’s right to choose when and how to die, I honestly don’t think I could help them do it. Until these issues and more are resolved, I do not believe the Bill should be passed.

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