Assisted suicide bill an enlightened response

August 13, 2013

Margo Macdonald’s bill is to be welcomed. It signals an enlightened response to an unmet need and deserves our support, writes HSS celebrant and former GP, Bob Scott in The Herald

It can confidently be predicted that opponents of a change in the law will trot out well-worn canards. These include the risk that altering the law regarding suicide will damage the trust patients invest in doctors and lead to a slippery slope of slaughter of the vulnerable. Yet jurisdictions that have successfully installed such procedures include Switzerland, The Netherlands, Belgium, Oregon and Vermont; areas of the world where a descent into anarchy has not followed amendments to their laws.

Drawing on the experience gained during 35 years as a general practitioner and six as a funeral celebrant with the Humanist Society Scotland, I offer the following observations:

Doctors have always viewed the relief of unnecessary suffering at the end of life as their duty. This is satisfactory for all concerned. However, over the past few years it has become harder to achieve an easy death. Mainly due to the General Medical Council’s response to the actions of serial killer Dr Harold Shipman, an unwelcome change in the attitude and behaviour of the medical profession has taken place. Doctors are increasingly reluctant to administer generous doses of certain drugs which can be of great value. Many GPs no longer routinely carry injectable morphine. Fears that their motives will be misunderstood, or anxieties that self-righteous individuals may alert regulatory authorities, have intimidated compassion. A pervading culture of blame and litigation conspires to undermine and dismantle what used to be unexceptional.

That loss is lamentable and keenly felt, most of all by those in greatest need. Be wary of these changes. Do not comfort yourself with the deception that, should it be required, your own doctor will see you right in the same way that her predecessors quite possibly helped your parents. He almost certainly will not.

When recounting what they witnessed during the final illness of their loved one, bereaved relatives frequently declaim they would not allow such suffering to be endured by their pet dog or cat. Such comments unwittingly reinforce an already powerful prohibition; for, were a vet to permit an animal under their care to be subjected to the end-of-life experiences commonplace among their human cousins, their license to practice could be revoked.

George Orwell was disturbingly accurate when he described a natural death as something slow, smelly and painful. Nonetheless, when it comes to dealing with problems, palliative care can unquestionably be of great value. However, palliative care can in practice also inadvertently extend the duration of the dying process. Much suffering at the conclusion of life remains unrelieved. Distress resides mainly in the mind of the victim and what is tolerable for one is insufferable for another. What humanity is there to be found in refusing a fellow human being access to the means of avoiding unbearable anguish?

For several years various organisations in Switzerland have offered assisted suicide to foreign nationals who satisfy certain requirements, including the ability to pay for their services. However, once the cost of travel to Zurich and hotel accommodation are added to these fees, there is little change left over from £10,000. This puts it well beyond the reach of many in Scotland. As a result, it is difficult to regard assisted suicide in Switzerland as other than a prerogative of the wealthy. Can it be right to deny control over the final phase of their life to an individual just because they are too poor to pay for a one-way ticket to Dignitas?

Maintaining the status quo while ignoring the activities of the few who are able to enjoy the luxury of choice would be one way for our legislators to deal with this awkward question. It is to be hoped that, come voting time, a majority of MSPs will take a more rational approach.

Margo Macdonald’s bill is to be welcomed. It signals an enlightened response to an unmet need and deserves our support

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