Written evidence submitted by Dr Graham Winyard (ADY0498)

Analysis of the diagnoses of UK residents obtaining assisted deaths in Switzerland: implications for the scope of legislation.

Research briefing for the Health and Social Care Committee on assisted dying from

Dr Graham Winyard. Retired public health physician and former Deputy Chief Medical Officer.

Dr Colin Brewer. Retired psychiatrist, formerly lecturer and research fellow Birmingham University dept. of psychiatry and director of Westminster Hospital’s community alcoholism treatment service, inter alia.

A response to Q.2 in the terms of reference: “What can be learnt from the evidence in countries where assisted dying/assisted suicide is legal?”

The failure of the UK legislatures to respond to the public’s overwhelming support for the legalisation of assisted dying forces dozens of UK citizens to travel to Switzerland each year to obtain medical assistance to bring their suffering to a peaceful end. Their plight has played a central role in campaigns to change the law with a clear assumption that this would remove the need for such journeys.  

However, all the Bills to legalise assisted dying presented to the Westminster Parliament to date restrict eligibility for an assisted death to people who have a terminal illness from which they can be “reasonably expected to die within six months”.[1] We have analysed the diagnoses of UK residents who had an assisted death (AD) during periods between 2005 and 2022 at all three of the Swiss organisations that provide this service to non-residents of Switzerland to try to determine what proportion of them would have met that requirement.  This is the first study involving all of the Swiss organisations and this briefing note gives the committee an early sight of our key findings:

• Patients with cancer represented only 25% of the total, in contrast to 70+% in Oregon or Australia.[2] 

• More than half the patients would not be expected to die from their condition within a year, and would be clearly ineligible for a UK-based assisted death under legislation stipulating a six-month prognosis. (This would have also been true for the two individuals, Tony Nicklinson and Paul Lamb, whose Supreme Court challenges remain landmark cases.)

We are submitting our study to a peer-reviewed journal. When it is published, we shall be happy to provide more detailed information if the committee wishes.

MAIN MESSAGE. Any future legislation imposing a 6-month prognosis requirement on eligibility for assisted dying would not help the majority of the people who currently seek an assisted death in Switzerland. UK patients who have slowly progressive or non-progressive conditions will continue to experience months or years of intolerable and increasing suffering.

We are co-chairs of the clinical advisory group of My Death, My Decision.