It’s a clever tactic to deploy, to suggest not just moral superiority for the cause, but also a sense of inevitability. If all the world is moving in one direction, who with sense would stand against an unstoppable tide? We see this in play right now in relation to the gender reform issue, where proponents of self-identification claim that Scotland is simply adopting ‘international best practice’. Unfortunately for them, there is no sign that the public agree.
I am old enough to remember when those who advocated that the UK join the euro back in the 1990s and 2000s used the same ‘right side of history’ argument. Here, again, the political elite were out of step with what the voters wanted. It tells its own story that today even the most pro-European of our political parties, the SNP, are cool on euro membership. History has delivered a different verdict.
And so it is with the current debate on legalising assisted suicide, or ‘assisted dying’ as its supporters now call it. Liam McArthur MSP is bringing forward a Members’ Bill that will open the door to medically assisted dying in Scotland. This is an incredibly well-meant Bill from a highly respected MSP. It is framed in the most compassionate and caring language that I firmly believe is intended to help those who are suffering from terminal illness.
But in considering how we approach this legislation, we need to look at the experience of other countries which have gone down this route. Last week in Holyrood, Dr Leonie Herx met with MSPs to share her experience as a palliative care doctor in Canada where similar legislation on assisted dying was introduced six years ago. She explained how legislation and medical practice had evolved over the years to a place that no parliamentarian could have imagined, and to a place where members of the public who supported the legislation are now horrified at how easily medical assistance in dying is available.
Given that we are expecting similar legislation to be lodged in the Scottish Parliament over the next couple of months, it is important for us to listen to what has happened in Canada, and understand how they have got from a very well-meaning Bill to same-day euthanasia on demand.
In Canada today, an 18-year-old with anorexia can walk into a hospital in the morning, refuse treatment or psychiatric support, ask to be euthanised by a doctor, and may be killed that afternoon. Without her family being told or mental health support being given.
This is a terrifying prospect for anyone, and there is no way that parliamentarians when they passed the legislation ever thought this was going to happen, but it has. Through the courts and medical practice, the carefully crafted law has evolved into a standard treatment option for the most vulnerable in society.
‘Maid’ (Medical assistance in dying), as it is called in Canada, and assisted dying in other European countries, is now offered as a treatment by doctors. At a person’s lowest point, when they find out they have a terminal illness, they are offered assisted dying as a treatment option.
We don’t yet know the full detail of what is going to be in the Bill in Scotland but we expect it to say that a person with capacity who has a diagnosis of terminal illness and who requests doctor-assisted dying should be prescribed lethal drugs to allow them to take their own life. We will have the ridiculous situation where at one end of a hospital, people who have been admitted due to attempted suicide are being treated in A&E, while a couple of doors down a doctor is giving someone the drugs to help them take their own life.
It is the speed of change in Canada that we need to be most conscious of. Six years ago, the parliament there passed a very similar Bill to the one proposed here, with lots of safeguards, reflection periods, two doctors having to agree, etc. Now Maid has been made available to those with disabilities, non-terminal illnesses such as arthritis, people who refuse life-saving treatment, and it is now moving towards those with mental health illnesses. This has all happened through court cases and changes in medical practice; the legislation has only briefly come back to parliament.
As MSPs, we have to therefore consider not just the Bill that we will have before us but what happens next, where this legislation will go once it has left the parliamentary chamber. We all have stories about relatives who suffered at the end of their lives, but do we really want to live in a society where those who are disabled or mentally ill could be helped to die by their doctors?
In a recent survey, over 70 per cent of doctors who deal with these issues every day said that they were against the move to introduce assisted dying, and almost half said that they would leave the profession if this was brought in. Our NHS is there to help and care for our sick and vulnerable, not to offer suicide on demand.
I was struck most by these words of Dr Herx when she spoke to doctors this week: “Risks to the vulnerable are very real and seen internationally. We have to ask what type of society do we want to live in, one that cares for the vulnerable or one that suggests that they are better off dead.”
On that basis, claims from this Bill’s supporters that they are ‘on the right side of history’ will ring increasingly hollow. As with so many other issues where there is an attempt to railroad us into swallowing radical reform, we need to pause and consider carefully all the unintended consequences.
Murdo Fraser is a Scottish Conservative MSP for Mid-Scotland and Fife