Sarah J got Dr Peter Saunders' response

Peter: Yes, diagnosis can be wrong. We've heard on the news where they're talking about cancer of the pancreas. That's a condition which usually has a very poor outlook, but you get patients surviving some of them many years, and almost always those are proven not to have cancer of the pancreas at all. That's one example of where we get diagnoses' wrong as well as prognosis forecasts about how long people survive.

The main problem with legislation allowing for assisted suicide as we've seen in the other jurisdictions; the other countries or States of the US that have legalised it, is the potential for abuse. If you do change the law, what inevitably happens is that you put pressure on vulnerable people to end their lives. I'm talking about people who are perhaps depressed, disabled, elderly or sick with chronic illnesses. Many people in that situation already feel that they're a burden upon relatives, carers, or perhaps even on a society short of resources and that they have to do the decent thing by ending their lives so as not to be a burden. This is the problem that the right to die can so easily become the duty to die. It's this concern about pressure on vulnerable people that's really led parliament to reject all legislation of this kind in the last five or six years. We've also seen from the House of Lords report just a few years ago that if we had an Oregon type law in Britain, we'd be looking at 1,200 deaths a year. If we had a Dutch type law, we'd be looking at 13,000 British deaths a year from euthanasia assisted suicide. What we've got at the moment in Britain are about 20 people a year going to the Dignitas facility in Zurich Switzerland to end their lives there, where it is legal. That's a very low number and what that tells us is that the law here is working well. It provides a strong deterrent to abuse through the penalties and at the same time it gives a lot of flexibility and discretion to judges and prosecutors so that they can really tender justice with mercy and show compassion in hard cases. That's what we really need, a law that's got a stern faith but at the same time has got a kind heart. Our view is that the law isn't broken and therefore doesn't need fixing. Even though the law is not perfect, it's a good balance which protects vulnerable people and stops abuse and yet is compassionate.

Sarah J: Are you suggesting that in the present situation, although assisting someone in suicide is illegal, that there is some flexibility that the whole situation would be taken on board before there were any decisions about whether there was a punishment or conviction?

Peter: We've seen about 150 cases of British people going to Switzerland in the last 10 years; of those maybe about 40 or 50 of those have come to the attention of the police and they've investigated and the Director of Public Prosecutions has reviewed those, but hasn't actually convicted anybody. A couple of years ago he published the criteria by which he decides whether or not to do it and the key issues seem to be whether the person was wholly motivated by compassion or not and then he errs on the side of not prosecuting. We are very wary of the dangers of legalisation by stealth where you have a law and you don't enforce it and then you encourage abuses. At the same time it has to be said that the number of cases in Britain is still very small despite this degree of compassion. That's because the law does hold penalties in reserve, so you can theoretically go to prison for up to 14 years for assisting a suicide. If you carry out a euthanasia where you actually kill the patient rather than helping them to kill themselves, then that's treated in the same category as murder in Britain; so that carries a mandatory life sentence. Stiff penalties are there in order to protect vulnerable people, to deter abuse and they work well.

Sarah J: It sounds like many people have been saying the Falconer report hasn't been appropriately put together and there's been a lot of bias in the research and the suggestions are inappropriate. What's the feel of how government's going to respond to this and whether there's going to be any change?

Peter: The Prime Minister David Cameron is opposed to a change in the law, as was the last Prime Minister Gordon Brown, and also Alex Salmon the head of the Scottish parliament is opposed. The leadership of all of the main parties, with the exception perhaps of the Liberal Democrats, have been against any change in the law. There's not the stomach in parliament to change the law, particularly at a time of economic recession when many families are struggling and the health budget's been cut; when in a sense the pressure people might feel to end their lives is even greater. I don't think there's any parliament that would want to contemplate doing this. In fact the only way the law could be changed in England and Wales is for another bill to come through parliament and the last ones have been rejected. Of course the issue's not going to go away and there's a very well financed carefully orchestrated campaign going on to change the law, which is backed by a lot of media people and celebrities, so we'll always hear of more pressure to change it. Even if a private members bill does appear in parliament in the next few months, I suspect it will be blocked for the reasons I've outlined.

Sarah J: Would one argument be that having aided suicide takes off something of the financial difficulties that the NHS could be going through?

Peter: If you look at good palliative care, or good care in a nursing home, you're probably looking at a thousand pounds a week or more. If you're looking at chemotherapy or surgery or radiotherapy for cancer then you may be looking at many thousands of pounds a week. You put that up against £5 for a glass of barbiturate to kill yourself, then that's not really a temptation we want to put before health ministers or hospital administrators who wanted to save money. I think within families as well, they say where there's a will, there's an anxious relative because you see an inheritance dwindling; you're perhaps in debt yourself and some people sadly in some families in Britain do see elderly people, disabled people, people who are sick as a burden consuming money. That's why the law is there. Elder abuse is real, it does happen and sometimes in good families. Often elder abuse involves concerns about finance and again that's the reason why the law has to be there to offer the right protection to people.

Sarah J: What can people do when they're in that chronic state of pain? What are the different options available to them?

Peter: A lot of people have fears and anxieties about the whole dying process and these can be accentuated by stories that may have been passed down in the family about loved ones of past generations, or even that they'd witnessed, or they might hear stories on television that worry them. In reality and having looked after many dying patients myself, those anxieties are largely not experienced and practiced. In fact a lot of the push for a change in the law is coming from what we might call the worried well. When people are terminally ill and they experience what good care can provide, requests to end their lives are actually very rare indeed.

We believe that our priority should be to look after people properly. To provide for their physical, psychological, social and spiritual needs. It's not just about physical pain, which certainly in the case of cancer can all be substantially relieved if not got rid of altogether. It's also about spiritual suffering; questions of meaning and purpose and loss that people have to be helped to cope with and come through. For many people, it's these questions that are the really big ones. We know that many dying people also suffer from depression, which can be treated effectively. We think that's the priority. Provide good care for people then you'll find very few want to end their lives and those very few that do, we have to say at the end of the day, well we cannot change the law for a few determined desperate people because the bottom line has to be public safety.