By Pam Duncan-Glancy
Glasgow Labour MSP
We are one step closer to making it easier for people in Scotland to die than to live.
That’s the reality of the assisted suicide bill passing its first stage at the Scottish Parliament.
Not only does this cause considerable fear and alarm for those covered by the wide definition in the bill – including myself – it also sends a worrying message to them that their lives are less worthy than that of others.
As a disabled person, I know this is not an uncommon assumption. There are countless occasions on which it has been assumed that my life is less worthy because I am unable to do all the same things that another person might be able to without support.
In a recent radio interview, I was asked if I have ever wanted to end my own life. The interviewer had no reason to ask this, other than the assumption that being disabled must mean I feel that way.
During the Covid-19 pandemic, my husband and I wrote letters to ask ‘please do not put a Do Not Resuscitate (DNR) order on us’.
This was not paranoia, but rather a reflection of the value society places on disabled people’s lives, with hundreds of DNRs dished out during the pandemic without any discussion with the patient or their family.
Societal attitudes are such that as a disabled person, you are seen as better off dead if you require support to go about your daily life. There is no-one for whom this bill is out of reach.
While disabled people endeavour to disprove these misconceptions, the fact that this devaluation of our lives could soon be enshrined in law is completely unfathomable.
I understand that some colleagues voted for more time to debate the proposals, but I stress to them that there are no safeguards in the world which would ensure that a person’s life is not ended unnecessarily as a result of this legislation. Or that a person does not feel the pressure of suicide as an option in a world that doesn’t support them.
“Societal attitudes are such that as a disabled person, you are seen as better off dead if you require support to go about your daily life”
However well-intentioned, any proposed ‘safety’ measures will ultimately prove insufficient.
“Any doctor who feels that they are able to adequately predict somebody’s prognosis in months and years is usually mistaken. I have seen three people this week who I thought were going to be dead but are not. It is very imprecise.”
Giving evidence to the Health, Social Care and Sport Committee, Dr Sarah Mills from the University of St Andrews set out the difficulty of estimating time until death.
With no way to ensure a reliable estimation, patients’ lives could be ended prematurely and unnecessarily, even with a requirement for a six-month prognosis.
There has rightly been considerable discussion around conscientious objection and provisions to ensure medical professionals can refuse to participate. This is crucial.
There is a risk, however, that if only those in favour of assisted dying take part, this could lead to bias and oversight risks.
Giving evidence at stage one, Marianne Scobie from Glasgow Centre for Inclusive Living set out these concerns: “That would shift the balance among doctors towards those who are for assisted dying, which would further compromise the doctor-patient relationship and erode trust in the medical profession.”
Many other well-intentioned proposals are also problematic because of issues with capacity in the healthcare system.
There are discussions about the need for comprehensive training, but questions remain as to whether an already overstretched workforce has the capacity to take this on – and how do you train someone to detect societal level coercion, internalised ableism or pressure?
“From the difficulty of defining and assessing coercion to the inherent complexity of assisting someone to die, there is no version of this bill that can truly be safe”
The Cabinet Secretary for Health and Social Care, Neil Gray, told the committee that training costs have not been properly factored into the bill’s financial memorandum.
Responding to the lead committee’s consultation, an NHS consultant said: “I would argue that if assisted dying is to be delivered within the current healthcare structures, then parliamentarians require to understand and debate the evidence of whether this is safely achievable.”
This cannot be achieved safely.
From the difficulty of defining and assessing coercion to the inherent complexity of assisting someone to die, there is no version of this bill that can truly be safe.
The key question I would urge colleagues to ask themselves as they consider the bill at stage two is this: in today’s society, can people truly access the essential services – such as healthcare, social care, housing, and education – which enable them to live full and healthy lives?
If the answer is no, then they should vote against the assisted suicide bill.