On March 28th I wrote to the Herald, as follows:
Dear Sir,
Reading the text of the Assisted Dying for Terminally Ill Adults (Scotland) Bill, published today (March 28), I am struck by 3 things.
First is the fact that the delivery of this proposed service is utterly dependent upon the participation of medical practitioners. If my ex-colleagues decline to take part, the bill will collapse.
Secondly, there is no provision for an unsuccessful attempt. Remember, there is not a medication in the world, or poison for that matter, that does not have a failure rate. Under these circumstances it would be rational for the attending healthcare practitioner to administer a coup de grâce, in some form, but that would be illegal. With this new set of circumstances, the initial directive of the patient (or rather, client), would be null and void, and the healthcare practitioner would be obliged to provide the client, perhaps in a coma, with palliative care.
Lastly, Paragraph 17, Death certification, states “The terminal illness involved is to be recorded as the disease or condition directly leading to their death (rather than the approved substance provided to them).”
In other words, the medical practitioner is being instructed to tell a lie.
Food for thought.
Yours sincerely…
I was published the following day, more or less verbatim. Well, not quite. The first sentence was removed and replaced by a banner headline:
There are three major flaws in the provisions of the Assisted Dying Bill.
One thing any seasoned writer to the newspapers knows is that he has no control over the headline covering his piece. I would not have composed that headline, because it implies that if the three major flaws could be ironed out, the bill would be flawless. But I have an idea that it would not matter how carefully you crafted this bill, how lengthy it might be in an attempt to anticipate every contingency that might arise in every situation, there would always be a gap, through which somebody might fall. M’lud might baulk at this, but I think this particular interpretation and elucidation of ethics and morality is beyond the compass of the Law.
I’ve said it before: when you write to the papers, the day following publication you must look out for rejoinders and ripostes, be they bouquets or brickbats. There was certainly a sizeable correspondence about the issue, but I was neither endorsed, nor instructed to wake up and smell the coffee. Perhaps the points I was making were considered slightly obscure.
But the focus of my letter was not really an expression in principle of opposition to, or, for that matter, support of Liberal Democrat SMP Liam McArthur’s bill. Rather it was an expression of irritation at the implication that the cooperation of the medical profession could be taken for granted. I’m not sure how much consultation has taken place. I do know that some of the august medical colleges, and associated bodies, have moved from a position of opposition, to one of neutrality. I remember having a discussion with a very senior representative of the Royal College of General Practitioners about the efficacy, or otherwise, of online consulting. He thought that post-pandemic, the ratio of virtual to face-to-face consulting might settle down at about fifty-fifty, half and half. And he raised a finger and said, “Finger in the air.” I presume he was alluding to the way the wind was blowing. In other words, whatever the prevailing trend, the RCGP would fit in.
We see something similar now, with the shift from opposition to “neutrality” with respect to assisted dying. Polls suggest members of the public are, in the majority, in favour of assisted dying, with safeguards. Finger in the air. So whatever our political masters decide, we will play along.
But surely the medical profession should debate this issue and come up with a point of view, and a policy, albeit one that medical practitioners may as individuals wish to eschew on grounds of conscience. The idea of abstaining, standing on the side-lines awaiting the political vote, and then accepting the result with a shrug, is abhorrent.
I still can’t get over Paragraph 17. I think I scoffed out loud when I read it. Here it is in full:
17 Death certification
- This section applies where a terminally ill adult has been lawfully provided with assistance to end their own life and has died as a result.
- For the purposes of section 24 (certificate of cause of death) of the Registration of Births, Deaths and Marriages (Scotland) Act 1965, the terminal illness involved is to be recorded as the disease or condition directly leading to their death (rather than the approved substance provided to them by virtue of section 15).
Muddled thinking is often characterised by woolly modes of expression. Sometimes in common parlance we use “their” to mean “his or her”. In a legal document it sounds almost inarticulate. Perhaps the law-makers are concerned that people who profess to be non-binary may slip through the loop. But in any case, how can the politicians take it upon themselves to make, from afar, a pathophysiological diagnosis? How dare they?
jamescalumcampbell 