A Scottish Tale of Assisted Suicide

Many Scots believe that Liam McArthur, member of the Scottish Parliament for the Orkney Islands, just introduced a bill to legalise assisted dying/suicide. This is because the media promoted that misleading notion even before McArthur presented the recent 39-page consultation document with 4 pages of “outline” clauses.

Apparently a consultation document [CD] is required by the Scottish Parliament / Pàrlamaid na h-Alba as the first step towards a ‘Member’s Bill.’ I do not know if a draft bill would normally be appended at this stage, but McArthur’s CD is proposing the concept of an assisted suicide bill.

That acknowledged, the approval process will move quickly, so anyone wanting to oppose assisted suicide [AS] has to get stuck-in now to prevent this movement from succeeding — especially since the British Medical Association just voted for “neutrality” on the issue of assisted suicide. The first step is to complete the online survey before mid-December. Please also communicate with your MSP [member of the Scottish parliament] and if possible, show opposition publicly too. (Letter to the Editor, etc.)

Scots may search for their Member of the Scottish Parliament at: https://www.parliament.scot/msps/current-and-previous-msps

The survey link is:

https://www.smartsurvey.co.uk/s/AssistedDyingProposal/

Scots opposed to assisted suicide should be heartened by the success the Irish had against the Dying with Dignity Bill 2020.

Why reject Assisted Suicide?

If there is one practical argument against assisted suicide, it is the dramatic increase in regular non-assisted suicide which has occurred in the Netherlands and those US states which legalised AS.

There has been over 30% increase in ‘regular’ suicide in the Netherlands since they legalized Voluntary Euthanasia in 2001. The US states which legalised AS also have a significant increase in non-assisted suicide, in comparison to the States which did not.

By 2023 it will legal for Canadian doctors and Nurse Practitioners to euthanise people suffering from mental illnesses alone. (This IS the slippery slope.) Please, listen to ‘Lia’ Garifalia Milousis as she tells her poignant story.

“I’m the future version of myself who survived to tell you this.”

Misled Media

The media clearly believes that McArthur was presenting a draft A.S. bill. McArthur can claim that they should have read the CD properly, but that might be disingenuous seeing the June newspaper reports.

The CD states that there is no draft bill at least twice. (One line on page 6: “At this stage, therefore, there is no Bill, only a draft proposal for the legislation” and on page 19: “It is important to emphasise that the information below is only an outline of what is being proposed and consulted on, it is not a Bill.”) A cynic might wonder whether the disclaimers were meant to stay un-found, considering they were so deep in the 39 pages of text.

Politico article (June 21, 2021) By Andrew McDonald:

“Lawmakers in Scotland have embarked on a third attempt to legalize a form of assisted dying, with hopes high for a political breakthrough.”

“The bill — submitted Monday — is backed by a cross-party group of Scottish Parliament members (MSPs).”

BBC (5 July 2021):

“His bill aims to introduce the right to an assisted death for terminally ill, mentally competent adults.”

BBC headline (20 June 2021)

“Assisted dying bill to be lodged at Scottish Parliament.”

The Herald Scotland on 5 July 2021

“…after the new Bill was lodged by Liberal Democrat MSP Liam McArthur last month.”

Misleading Consultation

Allowing for the disclaimers in the CD, McArthur has done little to corrected the widely-held misinterpretation that there is a draft AS bill. That silence leads me to suspect that he is running to particular game-plan — he may be trying to present the bill as a ‘done-deal,’ which later would allow him free rein to write pretty much whatever bill he wants.

Even the subtitles in McArthur’s video link project a certain message: “…who now have access to safe and legal assisted dying.”

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During the video, McArthur promotes the myth which has been voiced by most every suicide advocate around the world: that A.S. is needed to avoid the dying from having a “prolonged and painful death.” Palliative Care does not ‘prolong life’ and it has been shown repeatedly (e.g. Oregon) that physical pain — or fear of pain — is an infrequent reason for people to request AS (and the vast majority not receiving proper palliation.)

Misleading safeguards

McArthur claims the Bill will have “vitally important safeguards…” but the CD indicates that he will mirror legislation in jurisdictions where safeguards have failed…spectacularly.

Canada:

Canada legalized AS & Voluntary Euthanasia [VE] in 2016 for people with “a grievous and irremediable medical condition (including an illness, disease or disability)” when their “natural death has become reasonably foreseeable.” In just 5 years, the condition: “reasonably foreseeable death” has been removed.

The Supreme Court of Canada stipulated in the 2015 Carter decision: “…assistance in dying in other situations, such as for “minors or persons with psychiatric disorders or minor medical conditions” would not fall within the parameters suggested in its reasons...” yet by 2023 it will be legal to euthanize people suffering from mental illnesses alone.

Oregon:

“N. Gregory Hamilton, M.D., Distinguished Fellow of the American Psychiatric Association, demonstrated how Oregon’s flimsy safeguards do not protect people with psychiatric and other mental health disabilities.”

“Linda Fleming, the first to use the WA state law, was divorced, had had financial problems, had been unable to work due to a disability, and was forced to declare bankruptcy. Yet the Director of Compassion & Choices of Washington said that her situation presented "none of the red flags" that might have given his group pause in supporting her request for death.” Clearly, financial duress.

The Netherlands:

“A doctor is under criminal investigation over a potential breach of Dutch euthanasia laws after slipping a sleeping drug into a woman’s coffee before asking family members to hold her down to allow the insertion of a drip through which a fatal dose could be administered…Should a prosecution be launched, it would be the first since Dutch laws on euthanasia were relaxed in 2002 to allow a doctor to euthanise a patient if it could be shown they were in unbearable suffering and making an informed choice to die.”

The outcome: “A doctor accused of failing to verify consent before performing euthanasia on a dementia patient has been cleared of any wrongdoing by a Dutch court.

Belgium:

“In Belgium, the rate of involuntary and non-voluntary euthanasia deaths …is 3 times higher than it is in the Netherlands. …A recent study found that in the Flemish part of Belgium, 66 of 208 cases of “euthanasia” (32%) occurred in the absence of request or consent.”

Misleading Conscientious Objection

McArthur’s statements in the ‘Conscience’ section [3.3] initially sound reasonable, till read carefully.

“It is recognised, however, that if the Bill becomes law it would be the patient’s legal right to request assistance, and a referral to another consenting doctor should be made if the initial doctor declined to assist the patient because of their personal beliefs.”

If this is put into legislation, every doctor will have to make a specific referral for A.S. on demand.

The real twist comes from the General Medical Council:

“Guidance from the General Medical Council on personal beliefs and medical practice states that doctors may practise medicine in accordance with their beliefs, provided that they act in accordance with relevant legislation and:

• do not treat patients unfairly.

• do not deny patients access to appropriate medical treatment or services.

• do not cause patient’s distress.

A doctor refusing to aid with the provision of A.S. — or failing to make a referral — might “cause patient distress” and be accused of “treating patients unfairly” by “denying access” to a legal service.

Doctors will be coerced into compliance.

Misleading poll

“…recent polling showed that over half the population in Scotland would consider travelling abroad for an assisted death if they had a terminal illness, or one which caused them incurable suffering.”

The question begs the answer: any rational person with “incurable suffering” would naturally “consider travelling abroad for an assisted death.” That is absolutely human. What HSS does not mention is that this scenario is moot for most receiving adequate palliation. Universal palliative-care would help many more people than assisted suicide.

Such a question and response is no surprise when one considers that the poll was commissioned by the Humanist Society Scotland (2017) and performed by the polling firm, Survation, on their registered panel of 1,016 Scottish adults.

Survation proudly states: “Our record with traditionally difficult to win campaigns sets Survation apart from the crowd and we count numerous policy successes as part of our research work…We understand how the industry works and use this to develop research that guarantees press coverage.”

Misleading links

McArthur mentions the HSS / Survation poll above in his consultation document. Curiously the appended web-link in the CD https://www.humanism.scot/wpcontent/uploads/2017/09/Assisted-Dying-Poll-Data.pdf brings you to an error message from the Humanist Society Scotland website: “Epic 404 - Article Not Found.”

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In contacting HSS and receiving a rapid response from Mr. Fraser Sutherland who advised that the correct link is:

https://www.humanism.scot/what-we-do/news/half-scots-travel-abroad-assisted-death-money/

That page links to the more relevant 3-page summary of the poll at:

https://www.humanism.scot/wp-content/uploads/2017/09/Assisted-Dying-Poll-Data.pdf

One wonders how many other links in the CD have similar problems.

Data collection

The on-line survey data will be collected by the Non-Government Bills Unit [NGBU] of the Scottish parliament. That is likely to be a neutral process but the NGBU do not receive e-mail or hard-copy / Royal Mail responses. Those are directed to McArthur, which provides a conflict of interest.

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McArthur has the discretion to eliminate certain responses:

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Even if the data is fully collated, McArthur has the discretion as to whether he releases the report or not (note “may” below.)

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Misleading comments

There is inadequate space to counter each misleading comment made by McArthur.

Below are two showing how this is indeed an issue “of transparency, accountability, safety and justice.”

• Trust in doctors

“First, assisted dying is associated with greater trust amongst patients and medical professionals. In countries where assisted dying is legal, trust in doctors is high. For example, research has shown that the country where doctors are most trusted is the Netherlands.”

Trust? Some elderly people go to hospital in the Netherlands with a card saying they are NOT to be euthanised without consent: unlikely “the most trusted.”

Then, a quick Google-search shows the following table at Statista.com indicating levels of trust of doctors in European countries. The Netherlands is high, but definitely not first.

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• Lack of Complaints

Disability Rights Oregon has said that they have never “received a complaint that a person with disabilities was coerced or being coerced to make use of the Act”

Dead people can’t complain…

Please read the case of Roger Foley in Ontario, Canada who wants to live but administrative staff attempted to coerce him into taking Medical Assistance in Dying (AS/VE.)

Alba gu bràth

Again, please call your Member of Parliament / Pàrlamaid na h-Alba. Search at:

https://www.parliament.scot/msps/current-and-previous-msps

Also, the survey on assisted suicide must be completed by mid-December:

https://www.smartsurvey.co.uk/s/AssistedDyingProposal/

Good Luck, Scotland!



Dr. Kevin Hay MRCPI MRCGP (inactive) FCFP

Kevin was born in the UK, graduated from University College, Dublin and now works as a family physician in rural Alberta, Canada. You can follow him on Twitter @kevinhay77