Scottish Liberal Democrat MSP for Orkney, Liam McArthur, last month proposed a bill which would enable competent adults who are terminally ill to receive the necessary assistance to end their lives. This perennial and highly emotive issue is raised periodically and will simply not go away.
The matter is far from straightforward and is about as divisive as it gets but it does feel that, on this occasion, the country is at a crossroads with change potentially likely, given the groundswell of apparent support from the public. Naturally, it is not supported by all and as recently as July this year, an ensemble of some 200 medical professionals voiced their concern.
In their letter to the Scottish Government, they state…
“The shift from preserving life to taking life is enormous and should not be minimised. The prohibition of killing is present in almost all civilised societies due the immeasurable worth of every human life.
“Everyone has a right to life under Article 1 of The Human Rights Act 1998 such that no one should be deprived of that life intentionally.
“Some patients may never consider assisted suicide unless it was suggested to them. The cruel irony of this path is that legislation introduced with the good intention of enhancing patient choice will diminish the choices of the most vulnerable.
“As health care professionals, we have a legal duty of care for the safety and wellbeing of our patients”. They have a point and perhaps significantly so in relation to Art.2 ECHR and the right to life, which is also often regularly cited as reasons why ‘capital punishment’ should never be reintroduced.
I accept that this is an issue not without considerable problems – moral and ethical as much as legal. Assisted suicide is not a private act. Nobody chooses assisted suicide in isolation. Assisted dying is a matter of public concern because it involves one person facilitating the death of another. Friends, relatives, healthcare staff and society will all be considerably affected by the wider ramifications of the process.
This is not, however, the first time that Holyrood has looked at legalising the issue of ‘assisted dying’.
The first proposal, initiated by the late Margo MacDonald (below), was voted down by 82-16 in 2010. A not inconsiderable majority. Although another decisive defeat followed in 2015, the 82-36 vote marked a doubling in support among MSPs. Whilst still a major defeat, support was clearly growing. And that was 6 years ago. Much has changed since then and the dreaded pandemic will doubtless have had a significant effect on opinion.
Before someone would be allowed to go through with an ‘assisted death’, they would need to satisfy several criteria, including having two doctors independently confirm that their illness is, of course, terminal; that they are ‘compos mentis’ (in the sense that they have the necessary mental capacity to understand all the implications of and agree to an assisted death), and that they are not being coerced or pressurised into it. In the US state of Oregon, 60% of those ending their lives last year cited the fear of being “a burden on their families and friends ” and a further 7.4 per cent cited financial worries as reasons for seeking death. Both of which are of concern as these are not the intentions behind any proposed legislation. Rather it is the prevention of pain and suffering.
Clinicians would also have to make sure the patient is fully briefed on all other options, such as palliative or hospice care.
Perhaps most significant of all is that the person themselves would also have to administer the life-ending medication , as it would remain a criminal offence for one person to directly end another’s life.
Those who want to see this introduced say it will give people the ability to choose to have a safe and compassionate death rather than enduring a prolonged and painful death.
Meanwhile those campaigning against it say it will undermine palliative care and the risks are too high. Perhaps the fragility of the NHS at this time, in the main as a result of the COVID crisis, adds further complications to an already highly contentious debate.
However, worldwide, it is not an issue without data and evidence available.
In the USA, assisted dying is an option in the states of Oregon, Washington, Vermont, Montana, District of Columbia, California, Colorado, Hawaii, New Jersey, Maine and New Mexico. The Australian states of Victoria, Western Australia, Tasmania and Queensland all allow assisted dying, and a bill for South Australia was approved by the Upper House in May – it has now been passed to the Lower House for consideration. It is also legal in Canada and New Zealand is set to legalise assisted dying in November after a referendum last year. Perhaps in many ways surprisingly, an assisted dying bill is currently in the pre-legislative phase in Ireland.
The most well-known example of legalised assisted dying is probably Switzerland, which has allowed it since 1942. Indeed, nearly 350 British people have travelled to the Dignitas Clinic in that country.
The proposal by Mr. McArthur is a ‘consultation’ and, as such, the views of as many people as possible are sought. The link to the consultation is – https://www.smartsurvey.co.uk/s/AssistedDyingProposal/ – and you can have your say on this most delicate of issues.
It would not be my style, as you know, to shirk away from any issue so I, too, will state my opinion.
I think it should be allowed. With a morass of conditions and restrictions, naturally and under the most careful supervision. But I have seen many a relative and friend die in considerable distress. Whilst palliative care is superb in this country, the mental health and anguish that many terminally ill individuals suffer is monstrous. Having a channel where that can be legitimately avoided would be a positive step, in my view and in line with society in 2021.
That will not be a universally popular opinion and, as ever, my views are never to be treated as being above criticism. I welcome politely stated contrary views to this (and any) article I have written.
Yet another horrible issue to discuss. But, a necessary one alas.
Stay safe all.