Over the last few months, Scottish political life has been dominated by debates about the constitution, and gender recognition reform. As important as these issues are, there are other big issues facing MSPs. A new plan to introduce ‘assisted dying’ – assisted suicide – has been announced. A member’s bill will shortly be brought forward to allow people with a terminal or progressive condition to get lethal drugs and end their lives with the assistance of the state.
The implications of an assisted suicide law are seismic. It would radically change the medical profession’s relationship to patients, and significantly affect marginalised communities including disabled people, isolated elderly people, and people with mental health conditions. I understand the case being made for a law change, and I sympathise with aspects of it. But as a disabled person who spends his professional life focusing on disability policy, I will be arguing against the Scottish bill.
At a press conference this month, Nicola Sturgeon told journalists that her “views are not yet finalised” on the upcoming legislation. She added: “I think, like many people… I find it a very difficult issue”. I have a lot of respect for Ms Sturgeon, whose progressive politics align with my own. And it is encouraging to know she is approaching this issue with great care. I imagine other MSPs are in the same boat, their minds not being made up.
I recently wrote to the First Minister asking her to oppose ‘assisted dying’. I make the same call to every politician in the Scottish Parliament, for several reasons. In the past, MSPs strongly rejected assisted suicide due to uncertainty over safeguards. This crucial issue has not gone away since the last parliamentary debate. My fears about the efficacy of safeguards align with the US National Council on Disability, which states that where assisted suicide is legal:
“…some people’s lives, particularly those of people with disabilities, will be ended without their fully informed or free consent, through mistakes, abuse, insufficient knowledge, and the unjust lack of better options. No safeguards have ever been enacted or proposed that can prevent this outcome.”
Failings and abuses under ‘assisted dying’ laws are intrinsically linked to people who already face inequalities of various kinds: lonely elderly people; people with poor mental health; the disabled people’s community; people facing poverty; isolated communities. When the practice goes wrong – and it inevitably does, see the cases emerging in many countries – it is the most-marginalised who suffer. The current, compassionate approach to end-of-life care does not carry this threat.
The troubling expansion of ‘assisted dying’ laws overseas is another significant concern. This often arises from legal action designed to widen eligibility criteria. No matter how well-intended and narrow Scottish legislation is, guarantees about its future shape cannot be given. In Canada, we are seeing the rapid expansion of laws play out. Chilling reports have emerged of disabled people trying to access services and being encouraged, whilst doing so, to consider ‘Medical Aid in Dying’. Societal attitudes to disabled people have been negatively affected.
I would also emphasise the strong opposition to assisted suicide that exists among palliative care doctors, psychiatrists and others who have expert professional knowledge of its likely impact. It is notable that the people with expert knowledge about end-of-life issues are most opposed to change. With proposals of the kind shortly to be considered at Holyrood, there is no room for error or uncertainty. Yet, experts in medicine, disability, suicide prevention, law and policy, and other fields continue to warn that ‘assisted dying’ is unsafe, unpredictable, and unethical.
I hope that Nicola Sturgeon will lead from the top, and side with vulnerable and marginalised Scots in the upcoming debate on assisted suicide. And I hope that Scottish politicians in every party will again act wisely and say ‘no’ to the Pandora’s box of doctor-assisted deaths. I am confident that Scotland can find a better way forward in this area that sees people given the care and comfort they need, whilst upholding the safety, dignity, and equality of every person. That noble goal cannot be assured if the door to assisted suicide is opened.
Dr Miro Griffiths is a Research Fellow in Disability Studies; adviser to regional, national, and supranational bodies on disability policy; and spokesman for the Better Way campaign