Bob Scott’s speech at the launch of Margo MacDonald’s Assisted Suicide Bill Humanist Society Scotland • November 2013 For countless years, doctors have looked upon care of the dying as a duty and a privilege and during the course of my professional lifetime there has been remarkable progress in this field. Despite that, for many people, understandable fears about being a burden on loved-ones or loss of personal dignity still remain. Ultimately, it is for the patient to decide if their suffering has become intolerable. However, the administration of a drug, or the withholding of treatment, on compassionate grounds, with the purpose of hastening death, is currently illegal, even if the intention is to bring the patient’s unbearable suffering to an end. At present, any intervention by a doctor to achieve that has to be clandestine and information on the scale of its use is difficult to obtain. Nevertheless, independent research indicates that it does occur; and to a significant extent.. A 2002 survey of 1000 Scottish healthcare workers found that 40 of them had assisted suicide, either by providing drugs or giving advice (1), and in 2009 independent research (2) indicated that at least 1 in every 500 deaths in the UK which had been attended by a medical practitioner were the result of voluntary euthanasia by the doctor. That equates, approximately, to somewhere between 50 and 100 deaths per year in Scotland. It is beyond reasonable doubt that unreported and unregulated assistance given by doctors to speed the dying process does take place in this country and it is disingenuous to suggest otherwise. Following the conviction of Harold Shipman, the General Medical Council produced several documents on end-of-life care. These included guidelines on the response doctors must give, should patients make requests for assistance to end their lives, or even wish to discuss the matter. They were explicitly forbidden from doing so. As a result, some dying patients suffer against their wishes or take matters into their own hands. It has become harder to achieve an easy death. We are conditioned to look upon suicide as a mistake and a tragedy; and rightly so. Coming about as the consequence of either serious mental illness or profound emotional disturbance, how could it not be? It is the few remaining suicides that constitute the real challenge to our understanding, those which are undertaken by sane individuals who have calmly decided to end their lives because of an incurable illness and intolerable suffering. The intuitive response to that particular behaviour is to lump them in with the others. This conflation should be resisted, for not all suicides are the same. Although it cuts across the grain of our conditioning, some may be justifiable. There is a need to recognise that such action can be appropriate even if, and here comes the difficult bit, that conclusion runs contrary to our personal beliefs. Showing tolerance towards the measured conduct of others, of which we do not approve, is the hallmark of a civilised people. We should not deny individuals the opportunity of making that choice, nor condemn them for seeking relief. A society that allows its members to take control over all aspects of their lives, including its end, truly has come of age. Experience gained elsewhere in the world, where legislation already exists similar to what is being proposed here, has shown that the law in this area can work safely and effectively. Understandable concerns, including potentially vulnerable individuals being exploited by unscrupulous relatives; or the trust patients place in their doctors being damaged; or the possibility of overwhelming numbers of patients coming forward to seek assistance, have all proved to be unfounded. This Bill brings clarity to a complex matter. It tells doctors in Scotland what can properly and legally be done to help their patients and, crucially, it puts the individual in charge of their own destiny. It represents an enlightened response to an unmet need. I sincerely hope that our legislators will grasp the opportunity to allow that to take place. The Assisted Suicide Bill (Scotland) is to be welcomed. Dr Bob Scott (1) J Med Ethics 2004; 30 :441-446 doi:10.1136/jme.2003.005090 Euthanasia: above ground, below ground : R S Magnusson (2) Seale C (2009) End-of-life decisions in the UK involving medical practitioners. Palliative Medicine 23: 198-204 Share on: FacebookTwitterLinkedInPinterestEmail ×
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