Left Image – Shutterstock: Scottish Parliament, Edinburgh; Right Image – Shutterstock: Halfpoint
Blogpost by Liam Gibson
The Bill to legalise assisted suicide in Scotland is on track to make rapid progress through the Health, Social Care and Sport Committee of the Scottish Parliament. Tuesday, 4 November saw Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill begin Stage 2 deliberations with crucial votes on safeguards, palliative care and the criteria for eligibility.
MSPs have tabled 287 amendments with proposals on related issues grouped together for consideration. On the first day of voting, 14 proposals which would have tightened the law were roundly rejected. Most of these received the support of only one or two votes from the 10-member committee, while some gained no support at all. A few were withdrawn, and several that were contingent on the adoption of rejected proposals fell without being put to a vote. Four amendments supported by Mr McArthur were agreed to without a division.
Perhaps the most significant change was the decision to raise the minimum age at which someone can request assisted suicide from 16 to 18. An attempt by Labour MSP Claire Baker to restrict eligibility to those over 25 years of age failed. Ms Baker argued that it is now widely acknowledged that the areas of the brain responsible for decision-making and impulse control continue to develop until roughly this age. This would have made the Bill, she said, consistent with the benchmark set by the Scottish Sentencing Council’s guideline for young people.
People under 25 are generally considered to have a lower level of culpability because they are less able to weigh the consequences of their actions. Mr McArthur, nevertheless, insisted that 18 was the customary legal age of majority, while chillingly the Conservative MSP, Dr Sandesh Gulhane, noted that some 13-year-olds were considered mature enough to make their own medical decisions; an argument that helped to legalise assisted dying for children in the Netherlands.
Efforts to introduce a requirement for a six-month terminal prognosis also met with defeat. Unlike the Bill going through Westminster, there is no time-frame set on when someone can access assisted suicide; instead the criteria is having an “advanced and progressive disease, illness or condition from which they are unable to recover”.
Independent MSP Jeremy Balfour, who had initially proposed a three-month timeframe, expressed his concern that there was nothing in the Bill to stop someone who had just received a terminal diagnosis from ending their life while they might still have many meaningful years or even decades ahead of them.
Reacting sharply against this line of reasoning, Dr Gulhane told Mr Balfour off for having used the term assisted suicide. In a tone that was both condescending and reproachful, he lectured Mr Balfour, saying: “It’s important that we, as parliamentarians, don’t tell the people what meaningful life is.”
Defending his Bill, Mr McArthur correctly pointed out that predicting life expectancy is extremely difficult and often inaccurate. However, without any hint of irony, he claimed that in jurisdictions where assisted suicide was practised without a stipulated timeframe, it was only accessed at the end of life. (Data from the US shows that people given a six-month prognosis often outlive their doctor’s expectations. It is impossible to say how many more would have lived much longer had they not chosen death.)
Amendments to require a palliative care plan to be put in place before a patient was provided with a lethal prescription were also dismissed by Mr McArthur. He insisted that the introduction of assisted suicide in other jurisdictions had encouraged a broader conversation about palliative care and added that some people would not wish to have palliative care anyway.
The Labour Party’s Pam Duncan-Glancy moved a similar proposal to guarantee the provision of social care for those who needed it. This was aimed at ensuring people, especially those with disabilities, would not be pressured into assisted suicide when their circumstances made it difficult for them to cope. Lack of adequate social care has become a major factor driving record levels of assisted suicide in Canada.
In what would have meant a radical restructuring of the Bill, Conservative MSP Murdo Fraser argued that there should be no place within the National Health Service for a death service that would inevitably damage the relationship between doctors and their patients. The NHS, he said, was established after the Second World War to save lives, not end them. He therefore called for an independent and entirely separate entity to be established. Unsurprisingly, not one member of the committee supported his proposal.
Although it did not defend the inviolability of human life, Mr Fraser’s amendment managed to highlight the flawed ideology of the assisted suicide lobby. The supporters of Mr McArthur (like those of Kim Leadbeater) wrongly view assisted suicide as just another healthcare option to be provided to those who wish to choose it. However, so-called assisted dying has no therapeutic value and overturns the Hippocratic tradition that has shaped medical ethics since the fifth century before the birth of Christ.
While many of the representative bodies of the UK medical profession have adopted a neutral stance on the issue, the American Medical Association still regards “Physician-assisted suicide as fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.” [AMA Code of Medical Ethics Opinion 5.7. https://www.ama-assn.org/delivering-care/ethics/physician-assisted-suicide]
Similarly, the World Medical Association’s Declaration of Venice on Terminal Illness states: “When addressing the ethical issues associated with end-of-life care, questions regarding euthanasia and physician-assisted suicide inevitably arise. The World Medical Association condemns as unethical both euthanasia and physician-assisted suicide.” [WMA Declaration of Venice on Terminal Illness WMA General Assembly, Pilanesberg, South Africa, October 2006, Handbook of WMA Policies D-1983-01-2006]
The committee’s deliberation of amendments will continue next week, and while Mr McArthur can be pleased with how the process has gone so far, it is clear that many MSPs still have grave concerns about the Bill’s lack of precision and the potential threat to vulnerable groups.
If you’re reading this and haven’t yet donated to SPUC, please consider helping now. Thank You!
