Going back to last week when I mentioned the controversial topic of assisted death, I want to talk more about it. Having witnessed loved ones with terminal illnesses suffer as they approached their final days, I am a supporter of assisted death, as long as it is properly controlled and monitored. I believe, in certain circumstances, people should have the right to control the end of their life.

A recently-published report by the House of Commons cross-party Health and Social Care Committee found evidence that in countries where it is allowed, assisted death has led to better end-of-life care.

One of the newest countries to make it legal is Canada (2016). Reader Lynn Catena lives there and explained that they refer to it as ‘MAID’ (medical assistance in dying): “It is not yet available to dementia patients, and the criteria is such that your prognosis must be terminal or you are living with a debilitating illness for which there’s no cure.”

Including people with dementia could be an ethical minefield unless tightly controlled. The person in question would have to make the decision to be helped to die while they still have the mental capacity to do so, which could be years before the event. Having said that, in the Netherlands, you can sign a declaration in advance, stating your wishes before the illness robs you of your capacity. I’m unsure who makes the final decision as to ‘when’ is the right time, but I presume it is a joint discussion between the medical professionals and the person’s loved ones. I knew a Dutch man in his 70s who was diagnosed with a form of dementia that was going to progress quickly. Rather than suffer the descent into an unquestionably difficult existence, he wanted to take control of the way he died. Because he knew exactly when and how it was going to happen, it gave him and his loved ones the time to prepare and say goodbye properly, as well as precious peace of mind that he would not be subjected to a prolonged period of suffering. He passed away peacefully surrounded by his family.

In the Netherlands, assisted dying has been legal since since 2002 and there are ten other countries around the world where that is also the case. The UK is not yet one of them, and the Health and Social Care Committee's report found that assisted death was linked to improvement in end-of-life support in the countries where it is legal. It also resulted in extra state investment in palliative care. Hospices in this country are terribly underfunded, and they survive only because of their constant charitable fundraising. Any extra investment by the state has to be welcome.

Dame Esther Rantzen, who has stage four cancer, believes that people should have a choice about "the way we want to end our lives". She is angry that she has to travel to Switzerland’s Dignitas clinic to exercise her choice and is glad that the new report has assuaged fears that palliative care could be damaged by introducing assisted dying. "There isn't the slippery slope that so many are worried about," she says.

The Dutch approach does seem very well scrutinised and transparent, meaning that abuses of the system are rare, and the individual is at the centre of all decisions. Two independent doctors, who do not know each other, are required to approve the request, ensuring that the person has the mental capacity to make the decision, and has not experienced any external pressure to do so. The individual then has to wait 12 weeks from the time of the request until their chosen date and, of course, can change their mind at any time. Importantly, every case of assisted death is scrutinised afterwards by an ethicist, another doctor and a lawyer to make sure all guidance has been followed in the proper way. Their findings are then published in an annual public report, with any shortcomings or abuses openly acknowledged and addressed.

What I find most interesting is that the number of people using the procedure has remained steady for most of those 20 years at around 0.4 per cent of total annual deaths. This demonstrates that fears of relatives and health professionals gleefully starting to bump people off early are unfounded.

With all that in mind, I’m eager to find out what you think!

Contact me via my webpage at countrymansdaughter.com, or email dst@nne.co.uk.