The liberal view (Robert Wishart)

Dear Robert, you may be disappointed with Tavish Scott’s less liberal view, but since our MSPs are elected to take on board the views of the public I suspect this might have something to do with it. The Assisted Suicide (Scotland) Bill was launched 14/11/13 despite the majority of individuals and organisations responding to the initial consultation on the issue rejecting a change in the law and the previous bill being defeated in Holyrood by a massive 85-16 in 2010.

In some ways I am pleased that the right to die or euthanasia is still a contentious subject in which to debate, and subsequently is not made law.

Not wishing to be cynical, but when it comes to making money killing is no object, but if it was made law that the right to die or euthanasia was allowed, I would be very suspicious of ‘ Private Care Homes ‘ using this as an opportunity to, lets say, get rid of less profitable patients who take up resources and beds that could otherwise be used by ‘ richer patients ‘.

As said ‘ When it comes to making money, killing is no object………as people of this mindset (making money) generally have no conscience when it comes to what methods they use to make a profit (typical trait of capitalism).

Surely demanding the “human right” of being able to request a doctor to end our lives is introducing a “duty to kill” into the role of our medical profession which impacts on their autonomy and rights as human beings… There is no really autonomous right, as all our actions and rights impact the lives of other people.

Also, does it not say a lot about a society how that society treats it’s most vulnerable members? Often vulnerable, sick and terminally I’ll people feel like they are a burden on society, and to legalise assisted dying would introduce a pressure, either real or perceived, for those who are in that position to have their lives ended through euthanasia.

It seems that a minority in our country think there are only two options ahead when diagnosed with a terminal illness. Either suffer a horrible prolonged death, or euthanasia. Their is in fact a third way, which is high quality palliative care, which has in our modern age progressed beyond that of previous generations to relieve pain, provide comfort and treat people with the dignity and honour they deserve.

Compare the UK with Holland (where euthanasia is legal) and we see a stark contrast. The Netherlands have a much smaller hospice movement, and invest comparably far less in quality palliative care for their elderly and vulnerable people. This has coincided with the introduction of euthanasia.

In the UK rather than legalising the assisted suicide of our most vulnerable, we have a large hospice movement which cares for these precious lives with dignity and respect. Medical advances have meant that even the most debilitated patients such as those with motor-neurone disease can have symptoms managed and reduced making latter life dignified and far more comfortable than would have been in times past.

Admittedly people who have been in accidents who have suffered paralysis may have many years to life with their condition, but it has been proven time and again that life for these people is valuable, meaningful and full of opportunity.

Instead of legalising the killing of our elderly and most vulnerable, surely we should maintain our approach of providing and investing in quality palliative care, which gives dignity, shows respect and proves that we view our parents, grandparents, and others as precious human beings, not mere animals who can be “put down”.

Matthew Laurenson
Irvine Place
Aberdeen

“Surely demanding the “human right” of being able to request a doctor to end our lives is introducing a “duty to kill” into the role of our medical profession which impacts on their autonomy and rights as human beings… There is no really autonomous right, as all our actions and rights impact the lives of other people.”

@ Matthew Laurenson. There’s a significant element of missing the point, and arguing against claims that have never been made being introduced here.

The “human right” to which I referred is not that of being allowed to demand a doctor end a life, but that of freedom of choice and self-determination of the individual, in this case, the right to do with their life exactly as they see fit, how they see fit, when they see fit. In fact I would argue that involving a doctor in any right to end life process is rather unwise on the grounds of conflict of interest.

Any impact an individual choosing to end their life can have on anyone else is on an emotional level only, and no one individual has responsibility for any other individual’s emotions either in life, or death, unless they choose to take responsibility for them. To suggest, as you seem to be, that an individual should not consider suicide in any circumstances, at least partially on the grounds of the effect doing so may have on other people, is, quite frankly IMHO highly disrespectful to the individual concerned, and if an “expectation” of those other people, is a highly selfish act on their part.

You may well be right that introducing assisted suicide would increase pressure, perceived or real, on the terminally ill etc to at least address the possibility of choosing it, but how is that in some way “worse” than the status quo?

If someone commits suicide right now, the assumption is automatically made by society they were mentally ill. If someone decides to commit suicide and it can be proven that someone else knew that was their intent, and failed to summons “assistance”, even if the person concerned had left long standing clear instructions that assistance must not be summonsed in any circumstances, and threats of the consequences should their instruction be ignored and they recovered. That other person can be charged with a criminal offence.

If someone is diagnosed with a life threatening condition it is automatically assumed by all medical professionals that they will unquestionably accept every treatment deemed viable, and continue to accept that treatment(s) for as long as flesh and organs remain “alive”, regardless how far advanced their condition becomes, and how much they deteriorate from being a functional human being. To the point that anyone declining treatment is strongly urged to consult with a psychiatrist, and for anyone relying on State Benefits (as a number in such a state of health are likely to be), runs a very real risk of having them reduced or stopped as a result of making and standing by a decision to refuse a recommended treatment. What was that you were saying about introducing “pressure”? From where I’m sitting the current regime is doing everything in its power to pressurise everybody as strongly as they possibloy can to endure to the bitter end of what medical science can do to keep flesh and organs alive, regardless whether they really want to endure any of that at all, or make a reasoned rational decision at some point during the advance of their condition that enough is enough.

The point I am trying to make is, every individual should be allowed the choice of handling what is a very difficult situation as best as it suits them, they are the victim, and if there can ever be one time in anyone’s life that its “all about them”, then surely their own death qualifies head and shoulders above all other. Yes, unfortunately some people will have the misfortune, despite the best efforts of the best possible care, to suffer a horrible prolonged death, but if it is their choice that they’d rather endure that rather than not be around at all, then they should be allowed it. As you say, there is now a standard of medical and nursing care that can in many cases allow the patient a relatively comfortable and peaceful decline and passing, and if that is what the person concerned can be happy with, then they too should be allowed it.

However, what is woefully missing is the ability for an individual, who does not want to risk a horrible prolonged death, and regardless how excellent the medical and nursing care was to accompany it, would consider the process of declining and “lying around waiting to die” their own personal living hell, the ability to make a quick exit, should they for whatever reason be too incapacitated to undertake the act alone. Why should they be denied what they want, when everybody else is getting what they want?

Nobody should be made to feel that they are “too much trouble” or that their life has no worth, but by the same token nobody should be forced to continue to live when they know beyond a shadow of a doubt that their own life has become worthless to them, and that situation can only deteriorate, and the latter scenario is what is happening right now.

The “State’s” place is not to dictate what I choose to do with my own life, or when, that is my exclusive choice. Their job, as I said previously is to legislate and provide safeguards against anyone feeling coerced or pressurised in to making any one choice, but to also protect the right of those who choose to terminate themselves how and when they see fit, and any other person they engage to assist them in the act, so that they too can have their final wishes met equally as well as those who make other choices do.

Some of us, even when staring our own mortality straight in the face can still assess the available evidence objectively and make a judgement call on which battles are worth fighting, and which are already lost. Death, although never welcome, when facing an already lost battle, becomes a thankful exit. All folk are asking for, is the right to choose it, without being considered insane, browbeaten and financially penalised in to changing their mind, and left to get on with it in peace, while anyone they may choose to assist them achieve it, is protected from potentially serious criminal charges as a result.

@ Matthew Laurenson. To slightly paraphrase a line from a song of the not too distant past, “Everybody is doing it, so why the hell should we?”

Simply copying what others do has all the components of a recipe for disaster, and if taken to its logical conclusion would mean the human race would all still be living in caves taking potshots at passing wildlife with rock tipped spears, hoping to get lucky before starvation set in. Certainly when considering introducing any new statute we should examine very carefully the system(s) in place by those who already have a comparable statute, to identify and replicate the good ideas therein which are suitable for creating what we want to achieve, but also to identify the less than ideal components of their system(s) so that we can either improve upon them or create something different which we believe is better for our own.

I still maintain doctors should be kept well clear of performing assisted suicides, Pierrepoint, to the best of my knowledge had neither medical training nor qualifications, yet managed to quite successfully dispatch several hundred individuals. All he had was effective equipment, and the knowledge and skills to use it properly, anyone performing an assisted suicide has no need to have anything more than that either.

To be honest, I find your choice or phrases “…care for his mind”, and “….given the right treatment” quite worrying, as they would appear to echo the widespread societal attitude that anyone who would contemplate suicide in any circumstances “must be wrong in the head”. A view which has scant if any supporting scientific medical evidence, and is arguably only maintained and driven by the predominant religious creeds of the country, and nothing else. I find such a view abhorrent, as it permits both judgement and discrimination against an individual by another or others, without they having any right to do so.

I share your concerns about assisted suicide for individuals where the SOLE reason for they wishing to go through with such, is an already diagnosed mental condition. Firstly on the grounds that I do not feel I am adequately informed on the subject of mental conditions to have an opinion either way, and secondly that mental conditions open up a whole other debate on what is and isn’t valid evidence of assessing such conditions, and the altogether far more complicated debate of others acting in any capacity on behalf of such sufferers. I’m not saying that those with a mental condition shouldn’t be permitted assisted suicides, I am saying that the way ahead needs far more work and debate than the case for those without mental conditions, and I would not consider supporting assisted suicide solely for mental conditions until and unless that work is done and that debate held.

In your own example of Matt King you state that by his own admission, for the first five years after becoming paralysed he “wanted to die”, but after “medical care for his mind” he got past that wish and took his life in a different direction. If it took five years to achieve this “positive” transition, I’m afraid it comes off sounding more like being browbeaten in to submission, brainwashed, or being “comfortably numb” on “happy pills” for so long he didn’t know who or what he was, than simply a case of “changing his mind”. If so, how can society and humanity justify ethically and morally using such tactics to achieve the text book’s “desired outcome”, and the five years of denial and the inevitable stress if not mental torture accompanying it to achieve that end.

The introduction of crystal ball gazing in to the debate achieves nothing. *If*, to use your example, Stephen Hawking had chosen suicide, society and human kind would have been denied a great thinker. That effectively says that regardless of an individual’s personal suffering, either physically or mentally, if their contribution to the advancement of society should become great enough in the future, it was reasonable and justifiable to force them to endure whatever personal pain was involved for them in preventing them from dying when they wanted to at an earlier time, and even if their future contribution wasn’t it was still okay to condone their suffering just in case they had became the next genius. You may not have a problem with that scenario, but I do on the grounds of the selfishness of society to expect any such thing from any individual. Furthermore, to take your apparent stance to its logical conclusion, shouldn’t we then as a society be absolutely pacifist, and ban any and all abortions and contraception, in case the next genius is erased in some petty military skirmish, or denied life right from the start.

As a society we make it very easy to prevent the creation of a life, and to snuff one out in the very early stages, and even accept its “okay” to send forth young people to be killed at our leader’s whim so long as its “for the greater good”. Yet, when it comes to allowing the aged and crippled who crave release to attain it, society fights with every thing its got to prevent it at all costs. To me, there is something seriously wrong with that equation – either have one standard for all human life, or have none, making it so easy to erase it from the start, yet make it so difficult to obtain release at the end is a scenario which defies all logic and reason.

A fallacy which frequently crops up with those opposed to legalised assisted suicide, and is present in your posts, is that much of the opposition to the proposal treats it as if what is on the table is in fact a motion to make assisted suicide available on demand. To my understanding no such thing is being proposed, rather what is on the table is the right of a person who either has a condition, or has declined in health to the point they cannot perform their own suicide, to be allowed assistance from a third party to do so. Put another way, it is empowering and removing discrimination against the severely ill and disabled, by providing them with a facility through which they can take their own life, if that is what they choose, which is exactly what every one of their healthy or physically able counterparts have available to them each and every moment of their lives. Why should someone unable to use of their arms because of their disability be denied the right to end their own life, when someone else denied the use of their legs by their illness or disability still retains it? That is effectively what this is all about.

Medical and nursing care should be of the highest standard, and every individual should be encouraged to make the very best of whatever their life situation is, that all goes without saying, and where that works for folk I have no problem with it. However your goal of having a care system where nobody ever chooses suicide or assisted suicide can and will only ever exist in one place, your own personal Utopia.

What constitutes “quality of life” is unique to every individual, and regardless how good a care system is in place, there are always going to be some who will choose suicide over entering it, or proceeding beyond a certain point in it. As once their own personal benchmarks of what is vital to make their life worth anything are crossed, they have reached their own personal check out point, and any attempts to persuade them to proceed further will be received as patronising and resisted by whatever little ability they still have left to do so with.

As things stand, anybody who wishes to gain the maximum time they still have left before “x” of their illness/disability overcomes them, but do not wish to continue beyond that point, is faced with two choices. Either they perform their own demise at an earlier point than they really wish to do so, so as to fully ensure they avoid going beyond the point they which to go, and thus denying themselves however long they did have between the two points. Or they take the risk of relying on being aware when they are close to their own check out point, and still be able to do what they need to do not to pass it. Undoubtedly, a final decline being what is, by its nature will be largely unpredictable, especially to the layperson, and as a result some will not be able to succeed and end up having to endure whatever medical staff have been trained to believe is the “right” way forward until they, and not the patient decide “all hope is lost”, and the patient has no choice but endure that process regardless of how much they want to terminate it immediately, as they no longer have any way out.

All that’s being asked for is that people who have no interest in being kept alive beyond a certain point of decline, where that decline has rendered them incapable of performing their own demise, a viable way out. Folk that are happy to cling to life to the last possible moment medical science can obtain for them are catered to, folk who have no interest in enduring every treatment going and wish to just let nature take its course, as you already note, are catered to. So why are those who having been diagnosed with a terminal condition, and are already feeling it dragging them close to the point where their life is worthless to them being heavily discriminated against? Nobody is asking for anyone to “kill” anyone if they don’t want to, only that where someone makes a private arrangement with a willing person to assist them with suicide at a pre-agreed stage of their decline, that both their right to do so is recognised, and that the person assisting them is immune from persecution and prosecution after the fact. That is all.

There is no dignity in being pumped full of morphine for weeks, sometimes months, waiting for the Grim Reaper aka morphine overdose to take you.

Death is part of life and the sooner we accept that, the better, instead of expecting people to be cured of all and sundry.

Nobody has the right to tell another person that they cannot die by their own choosing at a time and place which suits them with the aid of another; that’s the crux of the matter.

@ Matthew Laurenson. I could spend another quite lengthy period composing another long response providing counter arguments to all of the points you raise. However I am going to cut straight to the chase instead, and pose to you a purely hypothetical situation. I invite you to offer your perspective on it, as within the given scenario lies the bottom line of this issue.

Let us suppose then, that in the very near future both you and I are diagnosed with terminal conditions, your’s let us suppose is an inoperable and untreatable malignant tumor, which although predicted to be fatal, you are expected to retain your physical mobility and consciousness reasonably intact until at least death is imminent. I, on the other hand, although also diagnosed with an inoperable and untreatable malignant tumor, I am expected to become largely or fully paralysed and/or slip in to a deep coma virtually imminently, but it is probable despite doing either of those, that with “the right treatment” my death need not be inevitable for anything up to several months in to the future.

Now, I am not going to presume how you would choose to plan your own treatment in your hypothetical scenario, as you have already noted, you could either put yourself in the hands of medical professionals and the health etc care services of your choice, and be guided by them to wherever they and you agreed was the “best way forward” for you. Or, you could choose to simply accept pain management assistance and let nature take its course.

Whichever of those you choose, or even if you choose something else, makes absolutely no difference to me whatsoever. As far as I’m concerned its your life, and death, and you have the absolute right to do with both exactly as you see fit, it is none of my concern and absolutely none of my business whatsoever.

However, as regards my own treatment in my hypothetical scenario, I have no interest in “putting myself in the hands” of medical professionals and health care services, whoever they may be. I have no interest in stottering around zombiefied tanked to the gunwales on “pain relieving” chemical drugs. I want, when the pain reaches the point I can no longer function, and/or I become paralysed, and/or I become comatose, someone somewhere to pull the plug. I don’t much care who they are, or what method they use, as long as they do it and do it successfully, one way or the other.

I want recognition in statute that it is accepted I have the right to organise my own demise as above, or any other way I might choose, whenever I choose. I also want it removed from statute that anyone associated with me, who may become aware of what I am doing when it is is process, is immune from facing criminal charges for “not summonsing medical assistance”. I also want anyone I come to whatever agreement I choose to have with them to assist me in my demise, to be fully protected in statute from any action taken against them as a result of their actions during the act.

I am curious as to why you oppose my wishes so strongly. I don’t know you, as far as I know you don’t know me. It is highly unlikely that were I to have my wishes granted that you would ever know it had happened, and even less likely that the event, if it occured would have the slightest effect on you in any way.

Why does what I, a complete stranger, choose to do to myself and my life come to be a concern of yours, and quite frankly, how in hell does it come to be any of your business in any way whatsoever?

Yes, I may have been a little bit abrupt, and did not take into consideration other unforeseen circumstances which may dictate the ending of your life.

However, my point being is that no matter what the circumstances may be to the demise of your life, it will and does affect other people regardless to their connection to you, whether this is relatives or people outwith this circle.

The crux of the matter is, as far as I can see, should the rights of the individual take precedence over societies obligation to sustain life as best it can under all circumstances?

Yes Suzy, as you have said ‘ It is your life ‘ but where is the balance between your actions or choice (not taking into consideration unforeseen circumstances) to end your life to this of you as an individual being a positive contributor to the society you live within?

Ultimately, society or people within your life will have no control if you decide to end your life by what you have described in terms of suicide.

What role, if any, should society take in assisting you to end your life?

Just because you can commit suicide, does this exclude societies responsibility to help or try to prevent you taking such action in the first place?

Where is the balance between your rights as an individual to this of loved one and/or societies rights to try and prevent you from taking your life?