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The debate over assisted dying legislation has intensified as medical experts warn it could lead to premature deaths among individuals who may still have years left to live. Activists have expressed concern, highlighting the inherent difficulty in predicting how long terminally ill patients will survive.

 

As Kim Leadbeater's Assisted Dying Bill heads to the Commons, campaigners argue that the government’s policy of reviewing benefits for terminally ill individuals after three years is an admission that prognosis is not an exact science. Under the Department for Work and Pensions (DWP) guidelines, terminally ill individuals must be expected to die within 12 months or less to qualify for fast-tracked financial support. However, the DWP reviews such cases every three years, acknowledging that the initial life expectancy predictions may often be incorrect.

 

In July 2021, the DWP updated its regulations, extending the eligibility window for terminal illness benefits from six months to 12 months, but still keeping the three-year review in place. This has raised concerns about the accuracy of life expectancy estimates, particularly as Ms. Leadbeater’s bill may define terminal illness as having a prognosis of six to 12 months. 

 

Experts in palliative care and oncology caution against placing too much faith in these timeframes. Professor Katherine Sleeman from King’s College London explained: "It is not possible to accurately determine someone’s prognosis as a number of months, say six months or 12 months." She noted that doctors rarely give precise timelines, and that predicting death is often more accurate in the final days or hours rather than months ahead. According to Prof. Sleeman, the DWP’s data demonstrates this uncertainty, as many people outlive the 12-month prognosis by years.

 

"There is nothing special about six months when it comes to terminal illness, or 12 months for that matter," Prof. Sleeman added. "Why are we not talking about four months or eight months? This is an arbitrary line in the sand." She warned that such arbitrary predictions could lead to dangerous consequences if used to justify assisted dying.

 

Baroness Finlay of Llandaff, a former professor of palliative medicine, echoed these concerns, stating, "Predicting life expectancy is impossible." She shared her own experience of patients living well beyond their expected timelines, sometimes for years.

 

Dr. Chris Parker, a senior oncologist, provided a real-world example, saying that he saw a patient just that morning who had been told ten years ago he had terminal cancer. "He’s now alive and well," Dr. Parker said, highlighting the unpredictability of life expectancy. He warned that some patients might opt for assisted dying under the belief they have only months left to live, but in reality, they could have enjoyed years of good health. "I have little doubt that some patients would choose assisted suicide if it was legal, because they were told they had less than six months to live, but in truth, if they had not had assisted suicide, would have lived for years and enjoyed a good quality of life," he said.

 

This lack of certainty is supported by data from Oregon, where assisted dying has been legal for terminally ill patients since the late 1990s. In 2022, one patient lived more than five years after making their first request for assisted suicide. In other cases, patients have survived over four years beyond their predicted death date.

 

Despite these concerns, some prominent figures, like Dame Esther Rantzen, advocate for the legalization of assisted dying. She has called on the public to contact their MPs and encourage them to support the bill, which she believes could be "carefully legalised." However, even her case illustrates the challenges in predicting life expectancy. Diagnosed with stage four lung cancer 18 months ago, Rantzen believed last Christmas would be her last. As Dr. Matthew Doré, a palliative care consultant, noted, "She may get another one!" He questioned how many people in Rantzen's situation might have chosen assisted dying 18 months ago, not knowing they would live much longer than expected.

 

The debate around assisted dying continues, but medical professionals and data alike highlight the danger of relying on uncertain prognoses to determine who should have the right to die. As Prof. Sleeman and others suggest, this is an area where a cautious approach is necessary, as even the best doctors cannot predict the future with precision.

 

Based on a report from the Daily Telegraph 2024-10-17