Assisted Suicide is not safe: Dr Stephen Hutchison

I was going through my emails and I found this excellent article written by Dr Stephen Hutchison and published on June 20, 2013 in the The Herald newspaper in Scotland under the title: Agenda: Assisted Suicide. 

Hutchison, a physician who specializes in palliative care, was commenting on assisted suicide based on the expected assisted suicide bill by Scottish MSP Margo MacDonald. MacDonald's previous bill was overwhelmingly defeated in the Scottish parliament.

Agenda: Assisted Suicide.

Dr Stephen Hutchison, Herald - June 20, 2013

Hardly a week goes past without court cases about assisted suicide, or celebrities and politicians commending it.

The argument goes along these lines: "We are autonomous and assisted suicide is our right. Leaving people to die in agony or forcing them to go to Switzerland is terrible. Assisted suicide is safe and there is no slippery slope. Doctors here are doing it anyway, so let's make it legal. At the very least, let's have the debate."

Actually the debate has been pretty well had. Independent MSP Margo MacDonald's 2010 proposals were thoroughly considered in the public arena, among lay and professional groups and the media before being overwhelmingly defeated in the Scottish Parliament. Official reports show that 87% of public responses to her consultation were opposed, and nearly two-thirds were against her 2012 consultation. Casual public opinion is in favour, but considered opinion is against. On numerous occasions over the past few years assisted suicide has been debated in our parliaments and has been consistently rejected because it is unsafe. The duty of government is to protect its citizens.

Autonomy means to be self-governing, acting independently, regardless of others. But we are all interdependent, not autonomous. Autonomy is a myth. We have freedom to decide and act, but not without responsibility to others. The Parliamentary Committee examining Ms MacDonald's 2010 Bill came to the same conclusion. Being a burden to others is often cited as a reason for assisted suicide. But you can only be a burden because you have some form of relationship with others. You cannot have it both ways. It is irresponsible for politicians to peddle autonomy as the basis for any law, let alone something cataclysmic like this. Selfish individualism creates havoc.

I grow frustrated when I hear assertions that medical care of the terminally ill includes using such high doses of morphine to relieve pain that we hasten death. That is another myth. There is good recent evidence that UK doctors never practise assisted suicide. Even if they did, that would not be a sound basis for legalising it.

What about intolerable suffering? In our country you have access to the best palliative care in the world, according to an Economist Intelligence Unit report in 2010. It is usually fear of pain, not actual pain, that makes people think of assisted suicide. Where there is suffering we need to research and refine care to relieve it, not hasten death. If someone goes to Switzerland that is their choice. Nobody is forcing them, any more than if I move to that country because I prefer its tax laws.

Elder abuse is an increasing problem. The perpetrators are commonly friends or relatives of the victim. When you are facing an incurable illness, or the prospect of suffering, or the costs of care are eating into your family's inheritance, and you feel vulnerable and scared, just how little pressure would be needed to make you choose assisted suicide, particularly if you are elderly and frail or feel that you are a burden?

Assisted suicide is not safe. If it was why would proponents emphasise the need for safeguards?

There is evidence of risk to the vulnerable where assisted suicide is practised.

As for slippery slopes, how about the steady increase in people who die this way? How about progressive relaxation of diagnostic criteria? How about institutional disregard for initial restraints intended to promote safety? How about the killing of hundreds of patients every year without consent?

How about almost complete indifference towards psychiatric assessment designed to identify depression? These are happening where assisted suicide is practised. And how about the subtle anaesthetising of our own moral principles so that we think it is a good idea to kill people?

Keeping our law unchanged may be problematic for a tiny minority but it protects the majority. Superficially, assisted suicide may seem compelling. But we must not be fooled.

Dr Stephen Hutchison MD FRCP (Glasg) is a consultant physician in palliative medicine.