The Scottish Parliament’s Heath, Social Care and Sport Committee held its first oral evidence session on Liam McArthur’s Bill this morning, focusing on “the implementation of Assisted Dying in other jurisdictions”. Despite the apparently broad title of this session, the Committee chose to invite three witnesses from Australia, one of whom didn’t attend. Australian states only recently introduced the practice and have accrued limited data on its implementation. Other jurisdictions would offer more robust data and expert testimonies. We might ask why this particular jurisdiction gets so much attention.
The identity of the witnesses called to give evidence should also be examined more closely. It bears pointing out that two of the witnesses called to give evidence to Committee MSPs – Ben White and Katherine Waller – are colleagues of an assisted dying activist who worked in Liam McArthur’s office until recently. Ben White is a longtime campaigner for assisted suicide, and the architect of Australian policies. We’d question whether this line up, for a session on global evidence on a hugely contested practice, allows for truly balanced, rigorous scrutiny.
Notwithstanding the narrow and partisan make-up of today’s session, there was discussion that merits attention. Julian Gardner AM, Chairperson of the Voluntary Assisted Dying Review Board in Victoria, was pressed on medical complications that occur in ‘assisted deaths’ and unable to give firm answers. He suggested that data on this issue is probably recorded but gave no indication of where and how. And he attempted to play down reports of people vomiting and taking several hours to die. He argued that because people who take lethal medication do die eventually, the process is effective. He also described a patient being “a bit distressed” as they’re helped to take lethal drugs by family members as a “hiccup”.
Ben White, who has spent his career advocating for assisted suicide, confirmed the concerns of UK critics about the practice’s impact on medical professionals. He noted that an assisted suicide law cannot be wholly reliant on patients ‘self-administering’ lethal drugs, as some patients will be unable to do this. Australian legislation allows doctors to facilitate drugs being taken intravenously – mandating a higher level of participation in ‘assisted dying’ than many would be comfortable with. Euthanasia is a logical next step.
White also noted differing approaches to conscientious objection, illustrating that it is a thorny area. He confirmed that in Australia, there’s often a “minimum requirement” for doctors to share information about assisted suicide with their patients – even if they object to doing this. And he said that navigating institutional opposition to assisted suicide – such as by hospices with a religious designation – has been a challenge. In the UK, oversight of medical regulations is not devolved, meaning McArthur’s Bill cannot guarantee conscience protections for Scottish doctors.
On eligibility for assisted suicide, White backed the removal of an “arbitrary time limit” of six or twelve months of remaining life. He praised Liam McArthur’s approach to terminal illness, which is defined very broadly in his Bill as an “advanced”, “progressive condition” a person can’t recover from that’s expected to cause their “premature death”. Gardner said that there has been “pressure to expand the nature of terminal” in Australia, including to people with dementia as people with this condition “lose capacity”. A supporter of our campaign has previously raised concerns that people with dementia will be at risk under McArthur’s Bill.
Asked about safeguarding, Gardner described the process in Australia as “very bureaucratic”, involving “a large number of safeguards”. And White descried the fact that there was “so much consideration of safeguards” during political scrutiny of the issue in Australia that “there wasn’t proper debate”, saying that the model can end up being “unwieldy”. The emphasis seemed to be that rules have made access overly restrictive. A review of Victoria’s law is now ongoing, and campaigners are calling for access to be widened and streamlined.
Gardner questioned whether a residency requirement in the Scottish Bill – that would require anyone accessing assisted suicide to have lived in Scotland for 12 months – is workable. He said that people often want to move near to family when they are dying, and suggested an “exemption” will be required for Scots who live in other parts of the UK who want to move back to Scotland and die by assisted suicide. This again highlights the constitutional difficulties involved with Liam McArthur’s legislation, which leaves substantive issues such as the cross-border implications of a law change unresolved. Many critics are alarmed by this.
An additional Committee session next Monday will consider evidence from witnesses in Canada, including proponents and supporters of ‘assisted dying’. The second week of scrutiny will focus on the legal, human rights and equalities considerations, and mental health considerations, including safeguards, assessing capacity and psychological support. We will be following committee scrutiny closely and would urge MSPs to take a much wider ranger of evidence and opinion into account as they form a position on Liam McArthur’s Bill.