Monday, 3 February 2014

A catalogue of reasons why Margo Macdonald’s Assisted Suicide Bill should be rejected

An opinion piece in The Guardian on Saturday by the Editor of the Daily Mail in Scotland, Kevin McKenna, provides a powerful critique of Margo MacDonald MSP’s Assisted Suicide (Scotland) Bill.

Mr McKenna highlights that, although Ms MacDonald’s Bill contains safeguards and claims to ensure that only terminally ill people or those suffering from deteriorating progressive conditions can seek assistance with dying, it may encourage those suffering from depression to take their life.

Mr McKenna reinforces this point by noting that Ms MacDonald’s proposed Bill mirrors the Oregon model which, when passed into legislation, led to a 450% increase in assisted suicides, 20% of which involved depressed individuals.

He continues by challenging the view upon which support for assisted suicide hinges - that we should ‘alleviate the suffering of a fellow human being in extremis’ - with the example of sufferers of locked-in syndrome (LIS).

McKenna highlights that, contrary to the assumption that most LIS sufferers must have reached a stage where life is simply not worth living anymore and should be put out of their misery, the largest-ever study of chronic LIS patients found that almost three-quarters were happy and that only 7% had suicidal thoughts.

He also suggests in the piece that Ms MacDonald campaign instead for a minimum quality of palliative care for everyone in Scotland who requires it at the end of their lives. 

Last week Marilyn Golden, Senior Policy Analyst with the Disability Rights Education & Defense Fund (DREDF) in the United States published a blog in which she neatly summarised why legislation allowing assisted suicide is so dangerous. Here’s her list of reasons which is equally applicable in the UK:

1. Assisted suicide is a deadly mix with our profit-driven healthcare system. At $300, assisted suicide will be the cheapest treatment. Assisted suicide saves insurance companies (and governments) money.

2. Abuse of people with disabilities, and elder abuse, are rising. Not every family is a supportive family! Where assisted suicide is legal, such as in Oregon, an heir or abusive caregiver may steer someone towards assisted suicide, witness the request, pick up the lethal dose, and even give the drug—no witnesses are required at the death, so who would know?

3. Diagnoses of terminal illness are too often wrong, leading people to give up on treatment and lose good years of their lives, where assisted suicide is legal.

4. Where assisted suicide is legal, no psychological evaluation is required or even recommended. People with a history of depression and suicide attempts have received the lethal drugs.

5. Financial and emotional pressures can also make people choose death for fear of being a burden upon others. Legislating increases these pressures.

6. Legalising assisted suicide is unnecessary. Everyone already has the legal right to refuse
treatment and get full palliative care, including, if dying in pain, pain-relieving palliative sedation.

7. There are no true safeguards against abuse. Where assisted suicide is legal, the safeguards are hollow, with no enforcement or investigation authority.

8. Prejudice against disabled people is already widespread and their quality of life underrated.  Will doctors and nurses fully explore their concerns and fight for our full lives? Will they get suicide prevention or suicide assistance?

This debate is primarily about autonomy versus public safety. The current law we have is clear and right. Through its blanket prohibition of assisted suicide it provides a strong disincentive to abuse and exploitation whilst allowing prosecutors and judges discretion in hard cases. It has both a stern face and a kid heart and does not need changing.

Scottish legislators should give the same short shrift to Macdonald’s latest bill as they gave to her last by overwhelmingly rejecting it

I'm grateful to Whitehouse Consulting for drawing my attention to the McKenna article above.


  1. 1. That doesn't justify mandatory suffering because of a small minority (under 15%) of the British public. If it wasn't for the bishops in Parliament and the well-funded anti-compassion movement, the law would have been changed over a decade ago. Besides, the law is patient-centred and patient-driven. Your appeal to fear is nonsense.

    2. Irrelevant. Patient choice must remain paramount. You're also assuming that no abuse occurs. The double effect doctrine is the perfect way to murder an unwanted relative, since it can only be administered without patient consent. The current system is a quagmire of non-reporting, deceit and a complete lack of accountability.

    Point 3 is missing.

    4. If assisted suicide is not legal, patients are forced to take their lives sooner than planned. Palliative care is not a panacea (nor will it ever be such).

    5. Really, now? IIRC, the short-lived law in the Northern Territory and the law in Oregon require psychiatric assessments. Besides, a two-week waiting period is more than reasonable, especially since no waiting period is required to remove a ventilator at a patient's request.

    6. Once again, you're assuming this doesn't happen now, that a blanket prohibition is enough to prevent abuse. It isn't. The double effect is a loophole so blatant you could fly the US air force through it.

    7. There is no moral or practical difference between sedated self-starvation and assisted suicide. By advocating the former but not the latter, you make your hypocrisy and lack of compassion abundantly clear.

    8. There are no safeguards NOW. All a doctor needs to do to get away with murder is up the morphine gradually without patient consent. Legalising assisted suicide will mandate consent and protect patients.

    9. Nothing is stopping the disabled from seeking help and support to prevent suicide now, so your point is a complete and utter red herring.

  2. congratulations guys, quality information you have given!!!


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