By Dr. Peter Saunders
Editor’s note. Dr. Saunders is a former general surgeon and is CEO of Christian Medical Fellowship, a UK-based organization with 4,500 UK doctors and 1,000 medical students as members.
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 [Member of the Scottish Parliament’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.
Editor’s note. This appeared on Dr. Saunders’ blog.