After a weekend’s rest and refection I’d like to record some thoughts about the debate on the assisted dying bill which has been a concern for many, many people. I received a lot of letters from people in Edinburgh East asking me to either oppose or support the bill. There were passionate views held on both sides with the majority favouring a change in the law.
The first point is to consider why Scottish MPs might bother with the debate at all – the proposals were after all just for England and Wales and the Scottish Parliament has had its own discussion on the matter here.
There are two reasons I feel it was right to take part. Firstly, there would have been a direct implication for people in Scotland. The proposals had a 12 month residence requirement and only applied to people with less than six months to live. However, someone in Scotland given a terminal diagnosis and told they had two or three years to live would have had the option of moving to England to end their life early during the very worst stages of their illness. Many people have friends and family in England, and of course in some cases – say from Dumfries to Carlisle – the distance to travel is not great.
The other reason it mattered is that the legal situation applying to 90% of the population in Britain would have had a very great effect on the debate in Scotland the next time it comes up.
The debate was lengthy, considered and for the most part articulate and without rancour. It’s worth reading the full transcript in Hansard if you have an interest. About 40 people spoke and the same number were unable to get in the debate as time was limited to four and half hours. The balance of contributions was against changing the law and opinion was divided across all the parties. I’d guess about half of our own group of 56 SNP members took part in the vote – divided about 60/40 against the bill.
For my own part I am a humanist and central to my moral beliefs is that we should each have dominion over our own bodies. That means I was in favour of the very limited changes that were being proposed that would have allowed physicians to assist their patients in ending their lives if they were (a) terminally ill with less than six months to live, (b) making the decision with a clear mind as signed off by a high court judge and (c) able to administer the lethal medicine themselves. It’s worth noting that the bill wouldn’t have helped a whole range of people who did not meet these criteria – those suffering paralysis or “locked in syndrome”, or those who had loss of mental faculty.
Some of the arguments against the bill were specious – such as the repetitive claim that this was the thin end of the wedge. These people were essentially arguing against what was not in the bill. Any changes in the legislation would have been brought back to parliament, and given the attention which this debate has received and the passion it engenders I think it pretty unlikely that anything would slip through unnoticed.
Another was that somehow this bill crossed a Rubicon and sanctioned doctors taking lives for the first time. It became clear in the debate that there was no Rubicon here. Indeed, even the opponents of the bill suggested that doctors already administer lethal doses of morphine to terminal patients, it’s just that their intent in doing so is to relieve pain rather than cause death.
A number of members, particularly those with a medical background, argued that better palliative care was needed for terminally ill people. But no-one disagrees with that, and it’s a false argument to set that up as a reason to not allow people the choice to end their life prematurely if they are six months from the end.
There were better arguments against. Many were concerned that people could be put under pressure to end their lives by unscrupulous relatives anxious at seeing their inheritance frittered away. Now, no-one can say that this couldn’t happen; there are some wicked people out there. But the proposals would have meant that a vulnerable person would have had to have convinced a judge that they were making their own free decision. And the proposers would have been willing to consider further safeguards had the bill made it to committee stage.
The evidence from elsewhere where there is rigorous monitoring of the decisions indicates that this is unlikely to be the case. In Oregon where limited assisted dying has been legal since 1998, it accounts for less than a quarter of one percent of all deaths. The measure is a choice available and only a small number of people exercise it.
Religion played a big part in this debate. Colleagues in my own party and others who have a religious faith were concerned that assisting people to die ran counter to their beliefs in the sanctity of life given by God. I respect that view and will always defend anyone’s right to hold their belief. I understand why such beliefs would determine how people would live their lives and the choices they make. It would mean that measures such as assistance to die – even if legal – would never be used by them. I think what we need to consider is whether those religious beliefs should be used to restrict the choices of other people who do not share them.
In the end the proposals were defeated by three to one: a much bigger margin than anyone expected. As I saw it that vote did not reflect the balance of the argument and I think a large number of people were set against being persuaded by evidence. It is a shame that parliament has cut off any further discussion on this. The debate won’t stop in the real world and it will probably now fall to the courts to take society forward on this.
And of course, the greatest inequity of all remains; as Tory MP Kit Malthouse put it there is already a business class carriage to an assisted death for those that can afford passage to Switzerland. The problem, as ever, is that those who have least are also the ones denied a choice.
I appreciate that it is a bit of a mind field , and with two disabled daughters myself , I am concerned that society would judge their lives to be less worthy and would want their right to life be respected. However I am a firm believer in choice , I know how much my father would hate to be fully dependent on others for his care, it should be his choice to end his life before his life becomes intolerable for him. The politicians are there to represent the views of the public and I believe around 70% are in favour of passing a bill.
My husband died recently from Pancreatic Cancer --It is a terrible disease where the sufferer loses their appetite and eventually cannot eat at all .
My husband did receive Hospice Care which was excellent .However eventually the long drawn out process of seeing my husband suffer so much ,also I could not accept the argument against Starving to Death as I felt he had -The argument being, that you only starve to Death if you are actually hungry -and that my husband did not feel hunger. still does not satisfy me .
I actually do have religious beliefs -and was also a trained nurse before retiring -therefore understood all the rules -but when it came to my husband of over 48 yrs of marriage whom I dearly loved -the situation was altogether different.
My husband knew he was terminally ill and fought well for 4 months - I believe now that when it really comes to the point where there really is no hope and suffering is beginning to happen that maybe my husbands life could have been shortened by a week as I still do not sleep well and often wish I could have been able to do more or should have been braver in speaking out .
I would like to say that as a Nurse I worked in the field of Learning Disabilities for 20 years and believe strongly that people with disabilities MUST be valued and appreciated in every way So there is a fine line in this sort of subject -but for people who really are at the very very end of life with days to go -then I have perhaps altered my opinion somewhat on this subject.
When one has seen a dear relative in the late stages of stomach cancer which has spread to the bowel, seeing that person in great pain which even high dosages of morphine cannot ease (due to metastasization of cancer to the liver), when that person is vomiting faecal matter... for days...in agony, distress and - well, the word 'indignity' does not do this event justice: one must, surely, put personal/religious matters to one side and allow the decent thing to occur: a doctor cannot give/allow extra morphine to a patient suffering in this way (it has no effect for one thing) so the law needs changed to give people in such horrific end-of-life states a calm way out.
This debate must carry on: the suffering certainly will.
Thanks for your input, Tommy.
Thanks for these notes, Tommy. Like the contributors above, I've witnessed close family members - my sister and then my father - suffer dreadfully in the later stages of their terminal illnesses. They both clearly expressed a wish to end their suffering long before they finally died. I sincerely wish that option had been legally available to them.
Some doctors do eventually administer opiates at levels which mean recovery is unlikely. This puts them at serious risk of prosecution. It also puts consenting next of kin and death certifying doctors in a terrible position of collusion at an already extremely stressful moment. The law as it stands is already being flouted.
It's time that the basic human right of choosing when to end an intolerable life was respected. I appreciate that legislation on this matter is difficult to frame but it's imperative that our laws in this field catch up with the needs of a secular society. We do not permit religious adherents to legally impose their beliefs on the rest of society in any other way, so let's end their grip on this subject sooner rather than later.
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