Baroness Fraser of Craigmaddie is a Conservative Peer and CEO of Cerebral Palsy Scotland.
As we await publication of Kim Leadbeater’s Assisted Dying Bill, the debates on both sides are hotting up.
These debates are about life and death and few topics could be more controversial. It should be expected that those involved would take the time to understand the issues and that the debates would be conducted with respect for the range of views and many questions arising across the board.
Sadly, Charles Amos’s article on ConservativeHome: Prohibiting assisted dying is torture, published November 7th, did none of this.
Fundamental to our society’s principles is respect for the individual worth and dignity of everyone. Mr. Amos managed to be offensive towards the disabled, (like sitting on a bamboo plant) the elderly, (those being pressurised into choosing death don’t matter) and to women, (agreeing to have sex with a man in exchange for a lift home). If this were the example MPs follow at the end of the month, then it would be a shocking betrayal of those who put their trust in legislators to consider such issues with care, with knowledge and understanding and with respect for those who are not able to advocate for themselves.
Parliament has debated assisted dying many times in living memory and at least two select committees have examined the issue in detail.
The current blanket ban on assistance with suicide has been challenged, unsuccessfully, through the courts on several occasions. In the Scottish Parliament, Liam McArthur MSP also has tabled a Private Member’s Bill, which has recently been publicly consulted upon. Over 20,000 responses were received, illustrating a fairly even split with 10,120 strongly opposed to the legislation, while 10,380 fully supported it. This suggests that, despite what Mr. Amos and others producing media sound bites tell us, the issues are complicated, and the public has many more questions to which they are demanding answers, once they are asked about the details of assisted dying procedures.
Draft legislation and subsequent debates in parliament must provide better answers to these difficult questions before endorsing such a radical legal shift in our approach to care.
Terms such as “suffering” or “terminal” do not have clear boundaries and cannot be assessed with certainty.
The discussion of “dignity” and “independence” can be problematic for some disabled people, many who require aids, adaptation and support from paid and unpaid carers to enable them to live with their condition. Bladder and bowel issues are very common, along with problems with movement, eating and drinking and communication.
Supporters of assisted dying agree that any legislation must include explicit safeguards to make clear that a life where someone needs support with daily activities must not be viewed as inherently less valuable or dignified than a life without these, but it is unclear at present what such safeguards would be.
Doctors themselves tell you that prognosis is an inexact process and that they are very poor at predicting when people will die. Patients often have more than one condition and are served by numerous medical teams and consultants. The difficulties in access to GPs has been well covered and most people don’t have a long term relationship with their GP any more.
Which doctors then will be asked to certify a patient would be eligible for assisted dying? Should they have known the patient and their family circumstances for a period time? Should they be required to be specialist in the condition of the patient to understand the likely prognosis and common side effects? Where would these processes fit within the capacity of a stretched and over-burdened NHS and what would be the implications for the doctor/patient relationship?
A decision to sanction assisted dying in any form should logically go hand-in-hand with defining the acceptable method(s). The drugs used to end life are yet to be properly scientifically scrutinised.
It is staggering to find that evaluations of the adverse effects and efficacy of lethal drugs do not exist and monitoring in jurisdictions where assisted dying is permitted is poor or non-existent. The drugs used do not necessarily provide the Hollywood death imagined. Often death is caused by asphyxia when the drug cocktails are injected. They often contain a paralysing agent. There appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re-awakening from coma (up to 4%), constituting failure of unconsciousness. These raise concerns that some deaths may be inhumane, and also what should an attending clinician do in such situations, intervene or leave alone?
I hope all parliamentarians in any jurisdiction that is due to debate assisted dying will look beyond the sound bites, the easy characterisation of polls and the extremely hard cases brought by both sides of the debate to illustrate their views.
Hard cases inevitably make bad laws and it is the duty of every parliamentarian to examine the difficult questions in the substance of this issue before deciding whether to lift the current legal prohibition of taking life intentionally through assisted dying. I recommend all parliamentarians should read the recently published book, “The Reality of Assisted Dying: Understanding the Issues”, published by the Open University Press, a series of essays from a variety of contributors, both for and against, which unpacks the legal, ethical and practical issues, would be a far better read than Mr. Amos’s trite and offensive article.
Baroness Fraser of Craigmaddie is a Conservative Peer and CEO of Cerebral Palsy Scotland.
As we await publication of Kim Leadbeater’s Assisted Dying Bill, the debates on both sides are hotting up.
These debates are about life and death and few topics could be more controversial. It should be expected that those involved would take the time to understand the issues and that the debates would be conducted with respect for the range of views and many questions arising across the board.
Sadly, Charles Amos’s article on ConservativeHome: Prohibiting assisted dying is torture, published November 7th, did none of this.
Fundamental to our society’s principles is respect for the individual worth and dignity of everyone. Mr. Amos managed to be offensive towards the disabled, (like sitting on a bamboo plant) the elderly, (those being pressurised into choosing death don’t matter) and to women, (agreeing to have sex with a man in exchange for a lift home). If this were the example MPs follow at the end of the month, then it would be a shocking betrayal of those who put their trust in legislators to consider such issues with care, with knowledge and understanding and with respect for those who are not able to advocate for themselves.
Parliament has debated assisted dying many times in living memory and at least two select committees have examined the issue in detail.
The current blanket ban on assistance with suicide has been challenged, unsuccessfully, through the courts on several occasions. In the Scottish Parliament, Liam McArthur MSP also has tabled a Private Member’s Bill, which has recently been publicly consulted upon. Over 20,000 responses were received, illustrating a fairly even split with 10,120 strongly opposed to the legislation, while 10,380 fully supported it. This suggests that, despite what Mr. Amos and others producing media sound bites tell us, the issues are complicated, and the public has many more questions to which they are demanding answers, once they are asked about the details of assisted dying procedures.
Draft legislation and subsequent debates in parliament must provide better answers to these difficult questions before endorsing such a radical legal shift in our approach to care.
Terms such as “suffering” or “terminal” do not have clear boundaries and cannot be assessed with certainty.
The discussion of “dignity” and “independence” can be problematic for some disabled people, many who require aids, adaptation and support from paid and unpaid carers to enable them to live with their condition. Bladder and bowel issues are very common, along with problems with movement, eating and drinking and communication.
Supporters of assisted dying agree that any legislation must include explicit safeguards to make clear that a life where someone needs support with daily activities must not be viewed as inherently less valuable or dignified than a life without these, but it is unclear at present what such safeguards would be.
Doctors themselves tell you that prognosis is an inexact process and that they are very poor at predicting when people will die. Patients often have more than one condition and are served by numerous medical teams and consultants. The difficulties in access to GPs has been well covered and most people don’t have a long term relationship with their GP any more.
Which doctors then will be asked to certify a patient would be eligible for assisted dying? Should they have known the patient and their family circumstances for a period time? Should they be required to be specialist in the condition of the patient to understand the likely prognosis and common side effects? Where would these processes fit within the capacity of a stretched and over-burdened NHS and what would be the implications for the doctor/patient relationship?
A decision to sanction assisted dying in any form should logically go hand-in-hand with defining the acceptable method(s). The drugs used to end life are yet to be properly scientifically scrutinised.
It is staggering to find that evaluations of the adverse effects and efficacy of lethal drugs do not exist and monitoring in jurisdictions where assisted dying is permitted is poor or non-existent. The drugs used do not necessarily provide the Hollywood death imagined. Often death is caused by asphyxia when the drug cocktails are injected. They often contain a paralysing agent. There appears to be a relatively high incidence of vomiting (up to 10%), prolongation of death (up to 7 days), and re-awakening from coma (up to 4%), constituting failure of unconsciousness. These raise concerns that some deaths may be inhumane, and also what should an attending clinician do in such situations, intervene or leave alone?
I hope all parliamentarians in any jurisdiction that is due to debate assisted dying will look beyond the sound bites, the easy characterisation of polls and the extremely hard cases brought by both sides of the debate to illustrate their views.
Hard cases inevitably make bad laws and it is the duty of every parliamentarian to examine the difficult questions in the substance of this issue before deciding whether to lift the current legal prohibition of taking life intentionally through assisted dying. I recommend all parliamentarians should read the recently published book, “The Reality of Assisted Dying: Understanding the Issues”, published by the Open University Press, a series of essays from a variety of contributors, both for and against, which unpacks the legal, ethical and practical issues, would be a far better read than Mr. Amos’s trite and offensive article.