Assisted Dying Killed off in Scotland

Members of the Scottish Parliament have overwhelmingly rejected Margo MacDonald’s Assistance in Dying Bill, by 85 votes to 16 – which is about as crushing as I think you can get.  The Scotsman reports Nicola Sturgeon as saying that

I find myself particularly concerned and fundamentally concerned about the difficulty I think would always and inevitably be present in determining that someone choosing to end their life had not been subjected to undue influence.

– which is, I think, a coded way of saying that she was worried about people being pressurised into opting for assistance.  Indeed, if you look at the transcript of Wednesday’s debate, that is a point she articulates much more clearly:

I am fundamentally concerned about the difficulty that will, I think, always and inevitably be present in determining that someone who has chosen to end their life has not been subjected to undue influence. That is the fundamental reason why I will vote against the bill

Fair dos – I think that this worry is frequently overstated, but it is at the same time one of the more serious objections to attempts to legalise assistance in dying.  Meanwhile, according to the Scotsman article,

Labour’s Michael McMahon, the convener of the parliament’s cross-party groups on palliative care and disability, branded the proposals “dangerous and unnecessary”.
He said: “Society needs to know that you can’t have both physician-assisted suicide and palliative care. In reality you can only have one or the other.”

This is a report of what McMahon said at this point in the debate.  And it is not, and never has been, anything like a serious objection to assisted dying; and so I can only echo Ophelia Benson’s comment: Eh?  Why on Earth should there have to be a choice between providing these two things?  Of course more palliative care would be great if that’s what people want.  That’s not incompatible with assisting in the death of those who want that.  The two don’t come close to intersecting.

Indeed, at an earlier point in his speech, McMahon all-but-admitted that they don’t intersect:

Fundamentally, though, palliative care has nothing to do with euthanasia and physician-assisted suicide.

Right.  So there’s no reason why the availability of one should influence the availability of the other.  Yet, he carries on,

[i]t has been made absolutely clear to me that the fact that physician-assisted suicide is currently illegal allows palliative care professionals to discuss death and dying freely with patients. In fact, the question, “Have you ever thought that life is not worth living?” is one that palliative care professionals often ask, and frank discussions about such subjects are an essential part of end of life care and helping people to move past suicidal thoughts. Changing the law to legalise assisted suicide could cause patients to see such discussions as a cue to consider ending their life, and would therefore prevent professionals from providing that integral component of palliative care to patients.

I honestly can’t make sense of this.  If asking patients whether their life is worth living doesn’t coerce them to shorten them now, it’s not clear why it would in the future; and if it would in the future, it’s not clear why it doesn’t pressure them into refusing treatment, nutrition or hydration now.  And I can’t see the mechanism by which the availability of assistance would prevent the delivery of care.

Oh, well.  In fairness, it’s no surprise that the Bill has been defeated – and really not much of a surprise that it’s been defeated so heavily, either.  The writing was pretty much on the wall from a couple of weeks ago when the Committee scrutinising the Bill published its report.  For example, paragraph 78 indicates that

The Committee considered this proposal in the context of preserving a balance between an individual’s right to exercise autonomy and the interests of society as a whole. Most members of the Committee believe that the wider societal concerns should prevail in the context of the Bill and do not accept the principle of autonomy as argued by the member in charge [that is, MacDonald herself – IB].

Sadly, the report doesn’t (as far as I can see) define the “wider social concerns” or how they are to be measured or compared against other considerations – and that seems to be an important omission.  But this isn’t the place to carp about that sort of thing.

(One last point is worth raising, though: in her speech introducing the Bill, MacDonald points to anti-Bill materials that had been distributed by its opponents:

Care Not Killing says: “The Bill will”— not maybe, might or could— “put large numbers of sick or disabled Scottish people at risk.”

From whom?  The penalties will remain unchanged for smothering someone, even when asked to do so by the person wishing to end their life, or for helping them to drink a lethal dose of opiates.

Even qualified and registered medical professionals, doctors and consultant nurses will require to follow the procedures laid down or they, too, will be breaking the law and will face prosecution.  This tacky little card dismisses those safeguards as “illusory”.

I’ve mentioned in passing here before my hunch that, if there is fear among the vulnerable about assisted dying legislation, it is seeded by the anti- lobby.  MacDonald’s claim only deepens my hunch.  Of course, for the moment, that’s all it is.  But it’s proving hard to shift.)

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