Voluntary Assisted Dying (VAD)

Voluntary Assisted Dying legislation has been introduced in SA and some other Australian states (Victoria, Tasmania, Western Australia. There is no current UCA national position on voluntary assisted dying, and each Synod would need to develop its own response to the legislation specifics in their own State which may vary significantly on important details (e.g. eligibility criteria, safeguards). This resource is a compilation of helpful resources as a catalyst for discussion in the SA Synod.

Introduction of Voluntary Assisted Dying Bill in South Australia

On 24 June 2021, the Voluntary Assisted Dying Act 2021 was passed by the South Australian Parliament. For the purposes of the laws of the State, the death of a person by the administration of a voluntary assisted dying substance in accordance with this Act will be taken not to constitute the death by suicide of the person.

Regulations to support the safe implementation of the legislation will now be developed and this is expected to be completed by 2023. 

The State Government is committed to supporting the introduction of a safe, accessible voluntary assisted dying scheme that gives South Australians with a terminal illness more choice at the end of life and ensures the integrity of the safeguards embedded in the legislation.

Voluntary assisted dying means administering a medication for the purpose of causing death in accordance with the steps and process set out in the legislation.

Voluntary assisted dying must be voluntary and initiated by the person themselves and is usually self-administered. Only those who are already dying from an incurable, advanced and progressive disease, illness or medical condition are able to access voluntary assisted dying.

Principles (Part 1, Section 8 of the VAD Act 2021)

(a) every human life has equal value;

(b) a person’s autonomy should be respected;

(c) a person has the right to be supported in making informed decisions about the person’s medical treatment, and should be given, in a manner the person understands, information about medical treatment options including comfort and palliative care;

(d) every person approaching the end of life should be provided with quality care to minimise the person’s suffering and maximise the person’s quality of life;

(e) a therapeutic relationship between a person and the person’s health practitioner should, wherever possible, be supported and maintained;

(f) individuals should be encouraged to openly discuss death and dying and an individual’s preferences and values should be encouraged and promoted;

(g) individuals should be supported in conversations with the individual’s health practitioners, family and carers and community about treatment and care preferences;

(h) individuals are entitled to genuine choices regarding their treatment and care;

(i) there is a need to protect individuals who may be subject to abuse;

(j) all persons, including health practitioners, have the right to be shown respect for their culture, beliefs, values and personal characteristics;

(k) every person has the right to make decisions about medical treatment options freely and not as a consequence of the suggestion, pressure, coercion or undue influence of others.

It’s a matter of life and death

Death has become taboo in our society, which inhibits end of life care planning and may result in a person’s wishes not being known, or not being followed. Many people prefer not to discuss death even with spouses and close family members. Many people prefer to plan for life rather than death. Many are overly optimistic about their hopes for a good death (e.g. access to high quality personalised care, not being alone, passing away peacefully in their sleep etc). 

Making sense of our lives means thinking about death. Life is the pathway you step on at birth and it leads to one thing, your death. Living is the process of dying. 

Philosophers like Martin Heidegger and Albert Camus thought death was a crucial, even defining aspect of our humanity. They understood that the philosophical dream of living a meaningful life includes the question of what a meaningful death looks like. More deeply, they encourage us to see that life and death aren’t opposed to one another: dying is a part of life. After all, we’re still alive when we’re dying so how we die impacts how we live.

The Ethics Centre was invited to make a submission on Assisted Dying. The questions raised were in the spirit of connecting the good life to a good death. Simon Longstaff, director of the Centre and author of the submission, writes, “It is not the role of The Ethics Centre to prescribe how people ought to decide and act. Our task is a more modest one – to set out some of the ethical considerations a person might wish to take into account when forming a view.”

The following key issues were explored, relevant to any discussion of assisted dying.

Does a good life involve suffering?

The connection between a good death and a good life

Who is eligible for assisted dying?

Does a good life involve suffering?

The most common justification for assisted dying or euthanasia is to alleviate unbearable suffering. This is based on a fairly universal sentiment. 

Longstaff writes, “To our knowledge, there is no religion, philosophical tradition or culture that prizes suffering … as an intrinsic good”.

Good things can come as a result of suffering. For example, you might develop perseverance or be supported by family. But the suffering itself is still bad. This, Longstaff argues, means “suffering is generally an evil to be avoided”.

There are two things to keep in mind here.

First, not all pain is suffering. Suffering is a product of the way we interpret ourselves and the world around us. Whether pain causes suffering depends on our response. It is a subjective experience. Nobody but the sufferer can really determine the extent of their suffering. Recognising this could suggest a patient’s self-determination is crucial to decisions around assisted dying.

Second, just because suffering is generally seen as bad, it doesn’t mean anything that aims to avoid suffering is good. We can agree that the goal of reducing suffering is probably good but still need to interrogate whether the method we’ve chosen to reduce suffering is itself ethical.

Whether pain causes suffering depends on our response. It is a subjective experience. Nobody but the sufferer can really determine the extent of their suffering.

A small minority of people who are dying experience suffering that is unacceptable and intolerable to them, even with the best palliative care. Prohibition of assisted dying for such people has resulted in significant pain and suffering and, in some instances, is resulting in them taking their own life prematurely and/or in distressing and traumatic ways.

The connection between a good death and a good life

It’s not always possible to treat someone’s suffering – whether using medicine, psychology, religion or philosophy. When there is no avenue to alleviate someone’s pain and anguish, Longstaff suggests “life can be experienced … as nothing more than an unrelenting and extra-ordinary burden”.

End of life care needs are different for everyone, and a system should be in place that caters to this wide variety of needs while upholding important safeguards to protect vulnerable people.

This is the context in which we should consider whether to help someone to end their lives or not. Although many faiths and beliefs affirm the importance and sacredness of life, if we’re thinking about a good, meaningful or flourishing life, we need to pay some attention to whether life is actually of any value to the person living it. 

As Longstaff writes: 

“To say that life has value regardless of the conditions of a person’s existence may justify the continuation or glorification of lives that could be best described as a ‘living hell’”. He continues, “To cause such a state would be indefensible. To allow it to persist without available relief is to act without mercy or compassion. To set aside those virtues is to deny what is best in our form of being.”

Many people want to feel engaged in their health care – to be treated as a person not a medical condition. This is also true for end-of-life care. While some patients are content to take a passive approach to their healthcare, people should have autonomy over their end-of-life care and the way they approach death. Many would argue people should have the ability to determine the course of their own actions and lives.

Some philosophers think autonomy has an intrinsic connection to dignity. What makes humans special is their ability to make free choices and decisions. What’s more, we usually think it’s wrong to do things that undermine the free, autonomous choices of another person.

If we see death as a part of life, not distinct from it, it seems like we should allow – even expect – people to be responsible for their deaths. As Longstaff writes, “since dying is a part of life, the choices people make about the manner of their dying are central considerations in taking full responsibility for their lives”.

Voluntary assisted dying, as defined and permitted by VAD legislation, is not permissive of passive euthanasia. That is, it cannot be ‘done to’ someone. A person must explicitly request and choose to enact voluntary assisted dying themselves; it cannot be requested or decided for them by another person (i.e. family member, doctor). In most cases, the person will administer the lethal dose of medication themselves. Voluntary assisted dying is not only the withdrawal or withholding of medical treatment at the request of the person who is dying. Rather, voluntary assisted dying is the choice of a person who is dying to request, access and take a lethal dose of medication according to the process outlined by the law.

Autonomy and Community Responsibility

Those who have welcomed Voluntary Assisted Dying legislation uniformly argue that at issue here is a person’s ‘moral right’ to choose how they will die: ‘It is, after all, the patient’s life, and as long as the patient is capable of reaching an informed decision, then who better to decide whether life is worth living? Doesn’t the patient have a right to ask for this help and, if a doctor is willing to give it, why should the law stand in the way?’ Here, individual agency is prized above all other concerns. This argument is theologically relevant because of the weight that religious traditions place on human persons being responsible for their own decisions.

Critics of this rationale warn of that ‘autonomy has become an imperative; that which we cannot control, our belief in autonomy teaches us to hate. Thus, we learn to hate our ageing bodies; and we learn to hate those others who are sick and dying. We even learn to hate those we would define as “permanently dependent”, exactly because they will always need our care’.

A theological defence of the moral right to choose argument underscores human responsibility for life before God. Indeed, at the very centre of the Christian story lies a voluntary act of giving up life for the other. Without such freedom, there would be no human life as we know it at all. It might be argued that assisted dying might not always be the ultimate form of individualism, but rather might be judged to be an act of responsible freedom and love for the other, a mode of glorifying God with one’s body (1 Cor 6:20). Of course, the counter argument here is that such a decision robs the other of the opportunity to themselves love and to bear together the burden of life’s uncertainties and ambiguities beyond the limits that one might choose to set for oneself.

Human responsibility for life is exercised not only before God. It is exercised also before and with others with whom one is called to ‘bear one another’s burdens’ (Gal 6:2). Assisted dying, by its very definition, is not a private matter. It involves, requires, and has an impact upon a wider public and society. It ought not, therefore, be reduced to being about a patient’s rights alone. In religious communities, for a person to claim the right to die as an individual right can be a form of individualism that contradicts the communal and relational nature of God and God’s people.

But what if the decisions made around death were undertaken not by the individual alone but rather with a community that was committed to bear the burden of the decision together? This would mean that whether or not the path led towards or away from voluntary assisted dying, there remains the opportunity to die accompanied by the presence, prayers, and confessions of others. For Christians, it offers the opportunity to die accompanied by those sacraments we have been rehearsing – Baptism and Eucharist. Baptism, that symbol of death with which the Christian journey begins; and Eucharist, where Christians remember and anticipate that the tragedy of the grave is not territory of which God is unfamiliar.

People from collectivist cultures/CALD backgrounds that emphasise family or community goals, needs and desires above those of the individual are likely to be challenged by Voluntary Assisted Dying legislation which gives primacy to individual autonomy.

Who is eligible for assisted dying?

The vast majority of us will not have the opportunity to choose or control our manner of dying. However, VAD legislation offers the possibility for some people to make more active and legal choices about the manner of their death where death is already inevitable and, in most cases, imminent. Voluntary assisted dying will only be available to people who meet strict eligibility criteria as assessed by two independent doctors, which includes having an advanced disease that will cause their death and experiencing suffering that is unacceptable to them.As such, voluntary assisted dying is a choice between two ways of dying, not a choice between life and death.

VAD Act 2021 Part 3: 26 (1 – 4) Criteria for access to voluntary assisted dying

The person must have
(c) decision making capacity in relation to voluntary assisted dying; and

(d) be diagnosed with a disease, illness or medical condition that

(i) is incurable; and

(ii) is advanced, progressive and will cause death; and

(iii) is expected to cause death within weeks or months, not exceeding 6 months; and

(iv) is causing suffering to the person that cannot be relieved in a manner that the person considers tolerable; and

(e) the person must be acting freely and without coercion.
(2) A person is not eligible for access to voluntary assisted dying only because the person is diagnosed with a mental illness within the meaning of the Mental Health Act 2009.
(3) A person is not eligible for access to voluntary assisted dying only because the person has a disability within the meaning of the Disability Inclusion Act 2018.
(4) Despite subsection (1)(d)(iii), if a person is diagnosed with a disease, illness or medical condition that is neurodegenerative, that disease, illness or medical condition will be taken to be expected to cause death within weeks or months, not exceeding 12 months.

VAD runs a risk of compromising the doctor-patient relationship and may increase the fear of doctors and hospitals, and change the fundamental role of doctors. Many support the idea of decisions being mediated by an independent panel, committee or ombudsman, which would share the burden of the responsibility for the decision, protect doctors from litigation, better protect patients from coercion (especially vulnerable patients such as those who are frail, elderly, or disabled), and be more likely to reach a better decision. The SA VAD Bill 2021 places this responsibility in the hands of the Chief Executive who will determine the application for a voluntary assisted dying permit. The Chief Executive may issue:

(i) a self administration permit; or

(ii) a practitioner administration permit; or

(b) may refuse to issue a voluntary assisted dying permit.

(see VAD Act 2021 Section 67 (1) and (2))

VAD is not likely to be a “slippery slope” to involuntary assisted dying that puts vulnerable people at risk. Studies in jurisdictions where assisted dying is legal have shown that vulnerable people are not more likely to access assisted dying than the general population.

Palliative care

VAD could mean doctors are more able to provide a ‘good’ death, that patients are able to have choices about their own pathway to dying, and that there may be improved communication about end of life and dying. 

VAD legislation is not an alternative to palliative care. A person who requests access to voluntary assisted dying is also informed about their treatment and palliative care options.

Those who oppose VAD believe that the ongoing improvement in palliative care allows patients to die with dignity. For most people, palliative care will give them the support needed at the end of life. Palliative care is predicated on holistic care – emotional and spiritual support along with physical treatment, palliation and pain management. Palliative care needs to be recognised as critical to alleviating suffering at the end of life and should be resourced accordingly by Government by prioritising more funding, staff and support services.

Although there are many examples of excellent end-of-life care, there is still significant variability in quality of care. The palliative care system is overburdened and needs more government support. The current shortfall in the provision of adequate end-of-life care needs to be addressed, which may require lobbying government and healthcare providers on the changes that can be made to end-of-life care provision so that high quality end-of-life care is available to all. 

Unconfirmed Minute from the 14th Synod Meeting of the Synod of Victoria and Tasmania
(note: there has not been an opportunity to prepare proposal in the Synod of SA in relation to the VAD Act 2021)

26 Response to Victorian Voluntary Assisted Dying Legislation (November 2017)
That the Synod resolved:
(a) To affirm that:
(i) life is a gift of God, and all human life, regardless of circumstance, is precious to and has dignity before God;
(ii) neither death nor life, neither suffering nor anything else in all creation will be able to separate us from the love of God in Christ Jesus our Lord (see Romans 8:38-39);
(iii) as followers of Christ and through God’s accompanying grace, fresh wisdom, peace and compassion can be birthed in the midst of suffering, which, without idolising suffering, is a deep and abiding mystery;
(iv) while death is the end of mortal life it marks a new beginning in our relationship with God (see Uniting in Worship 2; Funeral Liturgy);
(v) as followers of Christ we are called to spiritual discernment and responsibility as we journey through life and death; and
(vi) as the body of Christ we are called to be a loving and supportive community to people in need of care, including at the end of life.

(b) To affirm that, in the light of (a) above, palliative care be the primary means through which
end of life care is provided “for a person with an active, progressive, advanced disease, who
has little or no prospect of cure and who is expected to die and for whom the primary goal is to optimise the quality of life.” (see Palliative Care Australia: palliative care definition).

(c) To acknowledge that:
(i) it is a legal right, as of 19 June 2019, for all Victorians who meet the eligibility criteria and follow the process described in the Victorian Voluntary Assisted Dying Act 2017 to access voluntary assisted dying; and
(ii) most people will find palliative care and end of life services give them the support they need at the end of their life (see DHHS Fact Sheet on Understanding voluntary assisted dying).

(d) To recognise that within the Synod:
(i) there is a range of faithful Christian responses to voluntary assisted dying which are consistent with the affirmations in clause (a); and
(ii) exploring, accessing, and conscientiously objecting to voluntary assisted dying are all within the range of faithful Christian responses to the Victorian

(e) In the light of clauses (a), (b), (c) and (d) above, to give permission within Victoria to UCA institutions (Uniting VicTas and Uniting AgeWell) and the UCA-affiliated hospital group (Epworth HealthCare) to make voluntary assisted dying allowable within the context of their facilities and services for their patients, clients and residents, under the conditions described in the Victorian Voluntary Assisted Dying Act 2017.

(f) To request that the relevant UCA institutions (Uniting VicTas and Uniting AgeWell) and the UCA-affiliated hospital group (Epworth HealthCare) in Victoria ensure they develop and adopt clear policies and procedures that allow staff and volunteers to conscientiously object to participating in voluntary assisted dying, in accordance with the provisions outlined in the relevant legislation.

(g) To commit to the provision of a compassionate pastoral response to all people, including those who choose to explore or access voluntary assisted dying within Victoria and their families, associated with the Church, UCA institutions (Uniting VicTas and Uniting AgeWell) and the UCA-affiliated hospital group (Epworth HealthCare).

(h) To request equipping Leadership for Mission (eLM), in collaboration with the Synod Ethics Committee, to resource UCA ministers, lay leaders, chaplains, pastoral care workers and others who offer spiritual and pastoral support to people (and their families) who are exploring, accessing, or who have accessed voluntary assisted dying, including taking into account
i. engagement with First Peoples;
ii. diverse cultural and language needs;
iii. the range of faithful Christian responses; and
iv. the need for prayers and liturgical support for pastoral care and funerals, in consultation with the Assembly’s Transforming Worship Panel.

(i) To write to the Victorian Premier and relevant government ministers:
i. to call on the Victorian Government to increase resourcing for palliative care as the primary means through which end of life care is offered and delivered; and
ii. to encourage the Victorian Government to engage with First Peoples and culturally and linguistically diverse communities in resourcing the understanding of the Victorian Voluntary Assisted Dying Act 2017.

(j) To advise the Leader of the Opposition and shadow spokespeople of the action in (i) above.

Here is the pastoral letter from Moderator Denise Liersch, 25 July 2019, sent to ministers and congregations in Victoria and Tasmania following Synod’s decision on how it would respond to Victoria’s Voluntary Assisted Dying legislation. 

Dear sisters and brothers in Christ,

Over the last year, the Uniting Church in the Synod of Victoria and Tasmania has been considering the issue of Voluntary Assisted Dying. This conversation has continued over the years, with a variety of views expressed by members of the Church.

Anticipating that legislation might be passed in Victoria, the 2017 Synod requested a consultation process across the Synod. The aim was to bring to the 2019 Synod, a report and recommendations regarding the Church’s response to any potential legislation.

When legislation was passed in Victoria, it became more important to know how the Church in this Synod might respond to those who look to us for guidance. This includes members of congregations, ministers and pastors, members who are supporting loved ones and those who are personally considering voluntary assisted dying, as well as Uniting VicTas, Uniting AgeWell, and the Church- affiliated hospital group Epworth HealthCare.

Last week, members of the 2019 Synod of Victoria and Tasmania met together in careful consideration, discussion and prayer to discern our response to the Victorian Voluntary Assisted Dying Legislation. The Synod heard a wide range of strongly and faithfully held views, from various theological and cultural perspectives.

Synod members listened to each other, seeking the Spirit’s leading as they worked together as a Christian community in openness, honesty and respect. The original proposals were tested and reshaped, until we could decide together on the response of the Church in our Synod.

Together we affirmed aspects of our core Christian beliefs. We affirmed that life is a gift of God, that all life is precious to God, and has dignity before God, regardless of circumstances. We affirmed that the love of God in Christ holds us throughout all of our lives and in our dying, and that there is nothing that can separate us from the unbounded love of God. We affirmed the distinctive Christian theology and mystery of suffering. We are held within the love of God who enters into our sufferings, bringing grace and peace even in our darkest moments. We affirmed the calling of Christians to be discerning communities of love and care to others, in their journey through life and death.

We affirmed that palliative care is the primary way in which we support and care for those at the end of life, including their families, and called on the Victorian Government to increase resourcing for this.

We recognised that there is a range of faithful Christian responses to voluntary assisted dying which reflect these deeply held Christian beliefs. In relation to the very specific limitations of the 2017 Victorian Voluntary Assisted Dying legislation, we recognised that exploring or accessing voluntary assisted dying, as well as conscientiously objecting, are all faithful Christian responses.

In light of all this, permission was given to the relevant UCA institutions and associated hospital group within Victoria, to make voluntary assisted dying allowable for their patients, clients and residents, under the specific conditions of the legislation.

This decision honours the diversity of faithful Christian responses within our Church, and gives people the freedom to follow their own conscience in this matter. While this decision may be difficult or challenging for some members or communities of our Church, the resolution commits to respecting the range of faithfully held Christian responses.

Taking into account the range of cultural and language needs, and the range of faithful Christian responses, the Synod resolved to resource those who offer spiritual and pastoral support to people (and their families) who are exploring, accessing, or who have accessed voluntary assisted dying. Translations of this letter into other languages may also be available, if needed.

I encourage you to share this letter and the attached resolution (unconfirmed minute) with your congregations, faith communities, or organisations, that we may together explore what this means in our life of faith and witness to the grace and love of God in our midst.

May the grace and peace of Christ continue to fill us with God’s unbounding and renewing love.

Rev Denise Liersch
Moderator

Theological reflection
The life of faith is inescapably messy. While the Bible affirms the value of human life and witnesses to the promise that death is not the ultimate end, it does not remove life’s complexities or offer simple answers to the ethical challenges we face. Some of the most difficult of such challenges are those that relate to death. There are many long-held theological convictions in the Christian tradition that can inform our thinking about the complex issue of voluntary assisted dying.

For most Christians, the strongest theological argument against euthanasia is that it represents a direct affront to the sanctity of human life. All human life, it is argued, is a gift of the Creator and so is simply not ‘ours’ to end. The Catechism of the Catholic Church judges that ‘intentional euthanasia, whatever its forms or motives, is murder. It is gravely contrary to the dignity of the human person and to the respect due to the living God, his [or her] Creator’. By and large, Protestants share this view – that ‘it is for God and God alone to make an end of human life’.

But not all draw from this claim an absolute to be applied in all situations. Some argue that faith does not mean blindly following unassailable and predetermined laws but rather calls for listening for, discerning, and obeying God’s voice in every new situation. Here, human freedom is inescapably bound up with real risk, and with the responsibility to assess every situation and to make a real choice. This opens the door to the possibility that one might – in faith – make a responsible decision to end one’s life as an act of obedience. People of faith live, die, and make their judgements where no certainties abound and where they navigate concrete and immediate life with real limits, trusting that ultimately God alone takes responsibility for us.

Commitments to the sanctity of human life wrestle also with questions of life’s quality: Is life to be equated with mere existence, or is life defined by other realities in which the quality of a life becomes a critical factor? Are people of faith morally required to avail themselves of every available technology in order to postpone or to hasten death?

Life is certainly to be respected, but we must not make an idol of it. When life is preserved as an end in itself, with disregard for the quality of that life, then the result may serve an idolatry which has nothing whatever to do with religious obedience. Discerning when in fact this may be the case, however, is difficult.

Arguably, it is possible, even desirable, that theologians defend ‘not only the sacredness of human life but also the sacredness of death. Sometimes death is the best that life has to offer, the moment when we return the gift of our life to God. It might be argued that this represents the kind of decision that religious believers are free to make and to hasten as they face their own end. As Christians, we believe that our human physical life is not the end of all things but the continuation of our life with God, or the beginning of something different with God. Obviously, we do not know what that might be, but our faith points us to something beyond this present human existence.

Further reading

UCA Synod of Victoria and Tasmania response to the introduction of voluntary assisted dying legislation in Victoria: A report and proposals based on the Synod’s consultation and review process

Voluntary assisted dying is not a black-and-white issue for Christians – they can, in good faith, support it, by Rev Robyn Whitaker and Jason Goroncy, published online on The Conversation 2017.

It will take more than a change in the law to enable choice in dying by Dr Ros McDougall on the ABC website.

Two views on VAD and the Church, published in Crosslight 2019

VAD in Queensland, published on ABC website May 2021

End of life care and physician assisted dying project (UK) – three downloadable reports

Lainie Anderson article in The Advertiser, 17th August 2021

“When you spend time at SA’s Parliament House, two things become evident: there’s a healthy respect for religious institutions; and MPs as a cohort seem far more religious than the wider population. When former Labor ministers Jack Snelling and Tom Kenyon last month declared they were quitting the ALP to re-form the conservative Family First party, they cited the recent voluntary assisted dying debate as an example of religious views no longer having a voice among the major parties. 

When I say there’s a “healthy” respect for the state’s religious institutions in our state parliament, I mean it in the truest sense of the word: There’s respect but there’s no longer capitulation – and nor should there be in a secular democracy.

Many politicians who spoke on Labor MP Kyam Maher’s private member’s Bill talked of putting their own faith aside to respect the overwhelming views of constituents. As Health Minister Stephen Wade said: “While my Christian faith teaches me that euthanasia is not an option for me, in a pluralist society other people … should have the freedom to live their lives according to their values and their moral codes, as long as their actions do not cause harm to others.

The SA legislation has 70 safeguards to ensure it’s accessible only to terminally ill people with intolerable suffering at end of life. SA was the fourth state to pass similar legislation. And 80% of South Australians support it, including 75% of those identifying as religious.

Far from being ignored, conservative views constructively added to the SA legislation. In the other three states, individual doctors have the legislated right to conscientiously object to being involved but, for the first time in Australia, faith-based hospitals in SA also have a legislated right to conscientiously object. Institutional conscientious objection was not extended to faith-based residential aged care because under federal legislation that’s considered a person’s home, where everyone should be allowed choice.

It’s only fair to point out MPs on all sides of politics did not actively disrespect religious institutions or even religious views when voting with their conscience on voluntary assisted dying.

Some MPs visited terminal patients in hospital to hear their pleas for a better way to die. Many met families who watched loved ones suffer protracted, painful deaths. All received hundreds of letters detailing heartfelt, often tragic stories. Those MPs deserve our thanks for putting their personal views aside to make death more humane for the rest of us”.