Monday, December 6, 2021

Scotland assisted suicide consultation (Guide)

Your responses are invited to a consultation document on assisted suicide for Scotland ahead of a 22 December deadline

"A proposal for a Bill to enable competent adults who are terminally ill to be provided at their request with assistance to end their life" has been lodged with the Scottish Parliament by Liam McArthur MSP, and a public consultation on the terms of the proposal is underway. A report based on the responses will then be compiled and published, and will inform the final bill.

The proposal envisages assisted suicide for persons:
  • Aged 16 or over (the age of majority in Scotland) 
  • Resident in Scotland for at least 12 months  
  • Deemed to be "terminally ill", which McArthur understands to mean "a registered medical practitioner has diagnosed them as having a progressive disease, which can reasonably be expected to cause their death."

The consultation document includes detail on what McArthur expects a bill to include by way of eligibility and procedure, as well as background to the proposals, and runs to some thirty pages. The more substantial your response to the consultation, the more effective it will be in pushing back against the proposals - especially if supported by your own personal experiences - but you're not required to answer all of the questions.

Respond to the consultation at: 

The essential questions

There are five mostly tick-box questions in the first section, "about you".

Regarding "your views on the proposal", your submission will be the stronger for every answer you give, but of the ten questions in the second section, the first is essential:

1. Which of the following best expresses your view of the proposed Bill?
We strongly recommend ticking Fully opposed

Please explain the reasons for your response.

We suggest making clear your objection to both the proposal and the principle. Principled objections can be summarised as noting that euthanasia and assisted suicide laws are:

Uncontrollable - once the principle is accepted into law, it is subject to abuse and extension as arbitrary lines are redrawn as seen in Oregon, Canada, Belgium and beyond.

Unethical - legalisation would make assisted suicide a treatment option to be offered alongside others, forcing the choice upon all eligible patients and making it a budgetary consideration when the great expense of end-of-life care is under review. To say in law that some suicides are to prevented, and others assisted, necessarily devalues people's lives.

Unnecessary - repeated studies have found that end of life suffering is often rooted in a lack of access to palliative care, including access to specialist palliative care, and also to constraints on living with dignity with proper financial and community support.

The detail
2. Do you think legislation is required, or are there are other ways in which the Bill's aims could be achieved more effectively? Please explain the reasons for your response.
We strongly recommend answering "no". You might point to the need to ensure equitable access to fully-funded palliative care and adequate financial support for dignity in living for those with terminal and chronic illnesses, and disabilities.
3. Which of the following best expresses your view of the proposed process for assisted dying as set out at section 3.1 (Step 1 - Declaration, Step 2 - Reflection period, Step 3 - Prescribing/delivering)?
We strongly recommend ticking Fully opposed
Please explain the reasons for your response, including if you think there should be any additional measures, or if any of the existing proposed measures should be removed. In particular, we are keen to hear views on Step 2 - Reflection period, and the length of time that is most appropriate.

You might point to the phenomenon of doctor-shopping in places like Oregon, where physicians who often have no prior knowledge of patients and who are predisposed to agree to assisted suicide sign an alarming number of requests and prescriptions.

4. Which of the following best expresses your views of the safeguards proposed in section 1.1 of the consultation document?
We strongly recommend ticking Fully opposed
Please explain the reasons for your response.

The proposal is being sold as a limited offering because it is based on a terminal diagnosis - "the choice to live has already been taken away", McArthur claims. You might point out that while life expectancy predictions are notoriously unreliable, the choice not to include a time-frame in the proposal's definition of "terminal" means including people who could live for many years.

5. Which of the following best expresses your view of a body being responsible for reporting and collecting data?
We strongly recommend ticking Fully opposed
Please explain the reasons for your response, including whether you think this should be a new or existing body (and if so, which body) and what data you think should be collected.
The proposal would require that deaths by assisted suicide be listed on death certificates as in fact caused by the underlying illness. You might say that any system of oversight which requires dishonesty from the outset cannot serve transparency or justice.
6. Please provide comment on how a conscientious objection (or other avenue to ensure voluntary participation by healthcare professionals) might best be facilitated.
The requirement that doctors with conscientious objections make effective referrals to colleagues open to assisted suicide requests is deeply concerning, requiring meaningful participation in the process despite claims to the contrary.
Financial implications

7. Taking into account all those likely to be affected (including public sector bodies, businesses and individuals etc), is the proposed Bill likely to lead to:
We strongly recommend ticking a significant reduction in costs
Please indicate where you would expect the impact identified to fall (including public sector bodies, businesses and individuals etc). You may also wish to suggest ways in which the aims of the Bill could be delivered more cost-effectively.
You might point to a report issued when Canada was in the process of widening its euthanasia law, calculating multi-million dollar savings if more people could take up euthanasia, and a paper from the University of Strathclyde suggesting that "the economic costs of denying assisted dying should not be ignored; they should not be the key driver of any legal change, but it would be irresponsible not to consider them." The cheaper option would cheapen human lives.

8. What overall impact is the proposed Bill likely to have on equality, taking account of the following protected characteristics (under the Equality Act 2010): age, disability, gender re-assignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation?
We strongly recommend ticking Negative

Please explain the reasons for your response. Where any negative impacts are identified, you may also wish to suggest ways in which these could be minimised or avoided.

You might note that barriers to euthanasia for children have been challenged in Canada and overturned in Belgium; and substantial concerns from within the disabled community that "if assisted suicide is legal, lives will be lost due to mistakes, abuse, lack of information, or a lack of better options; no current or proposed safeguards can change that."


9. In terms of assessing the proposed Bill's potential impact on sustainable development, you may wish to consider how it relates to the following principles:
living within environmental limits
ensuring a strong, healthy and just society
achieving a sustainable economy
promoting effective, participative systems of governance
ensuring policy is developed on the basis of strong scientific evidence.

With these principles in mind, do you consider that the Bill can be delivered sustainably?
We strongly recommend ticking No
Please explain the reasons for your response.
You might point to the proposal's attempt to justify legalising assisted suicide before ensuring equitable access to fully-funded palliative care, and adequate financial support for dignity in living. Such mis-prioritisation is an affront to a "healthy and just society."

10. Do you have any other additional comments or suggestions on the proposed Bill (which have not already been covered in any of your responses to earlier questions)?
If you have a pertinent personal perspective - especially experiences as patients, healthcare professionals and carers - this could be the moment to share something that showed up the threat of legalising assisted suicide or the difference made by accessing meaningful care and support.

Respond to the consultation at

You can read the full consultation document here here

Remember to respond before Wednesday 22 December.

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