Scottish politicians will soon consider new member’s legislation on ‘assisted dying’ for people with a terminal illness. Holyrood has rejected proposals of this kind twice before. Here are seven reasons why I believe it must do so again.
1) ‘Assisted dying’ would not be implemented in a vacuum
Inequalities in healthcare and wider society would be translated into a system of doctor-assisted death for people with terminal illnesses. For example, consider the issue of poverty. People in deprived areas are more likely to present with late stage cancer, and less likely to access good end-of-life care and mental health support. They’d be more eligible for ‘assisted deaths’ than middle class Scots. Is this conducive to a just society?
2) The idea of people having a ‘choice’ is simplistic
A whole range of internal and external factors will skew people’s decision for or against an ‘assisted death’: loneliness, depression, relationship breakdown, perceived worthlessness, coercion. Proponents say “safeguards” will avoid people being improperly influenced, but safeguards always fail – there is no human system without error. In the context of ‘assisted dying’, error means irreversible, unjust deaths. Are such deaths a price worth paying?
3) Claims being made are inaccurate
Assisted suicide campaigners claim that dying people have a terrible choice between continued suffering, suicide, or a trip to an overseas clinic. This is inaccurate. Palliative care is effective. I’ve spoken to very senior medics who describe fearful, and very sick, patients who wanted to die receiving help through a range of compassionate interventions (medical, psychological, spiritual) to die a dignified, natural death. In very tragic cases where people feel that they are suffering intolerably, they are often victims of inequality, unable to access specialist forms of care and support. I would argue that the solution to this is better care, not a fatal prescription.
4) The ‘slippery slope’ is real
Campaigners often dismiss arguments about a ‘slippery slope’ out of hand, but this is illogical. Many nations that passed narrow, prescriptive laws now have permissive ones. Once a ‘right to die’ is realised for a category of individual, other people will demand this right, and sue. Proponents of ‘assisted dying’ say a Scottish law won’t become permissive. On what basis? Do they possess a crystal ball? The only guarantee against future extension of legislation is not to legislate in the first place. If we do, we open a Pandora’s Box.
5) Assisted deaths aren’t ‘dignified’
I’ve noticed that proponents of ‘assisted dying’ are never put on the spot concerning the deaths they advocate. They expect the public to accept at face value that assisted deaths are “dignified”. But they fail to articulate how, exactly, people die. Expert medics I know say the oral drugs given to patients in other countries are experimental, can lead to awful complications, and take hours to days to work. Is this dying well? It sounds to me like suicide through a fatal overdose – an awful event.
6) What about suicide prevention?
Vast swathes of the media have accepted campaigners’ claims that ‘assisted dying’ is not suicide. Why? Suicide is defined as a person choosing the timing and manner of his or her death. Is this not what ‘assisted dying’ is? It is dangerous to approach this whole debate on the unsubstantiated premise that we are not talking about suicide, and imply that suicide prevention isn’t relevant. Surely it is a serious thing for a culture to be considering legislation that would allow despairing people to end their lives with help from medics in a context where medics are supporting despairing people not to end their own lives. How, as a culture, can we say suicide is a tragic event, whilst also validating it?
7) Historic concerns remain
In past debates, UK legislators have always decided that ‘assisted dying’ is too dangerous. In my mind, nothing has changed. We owe it to the vulnerable and oppressed in society not to open them up to new, and grave, dangers. In fact, protecting these groups is more vital than ever in the current context of rising financial and social inequality. We can do better in Scotland.