Hazel McHaffie

Margot MacDonald

The Assisted Dying Bill … yet again

Patience is the name of the game when it comes to legalising assisted dying, it seems. But this week there’s been a significant breakthrough.

Back in the noughties, when I was writing my novel, Right to Die, about a young man who contracts Motor Neurone Disease and contemplates ending his own life, I lived in daily dread that something would happen to steal my thunder, and the bottom would fall out of the marketing strategy, before it hit the bookshelves. That was 13 years ago! At that time, Lord Joel Joffe was expending his energy trying to get a bill drafted to ease the lot of those facing intolerable suffering at the end of their lives. I had the privilege of meeting him in London, at the House of Lords, to talk about our shared interests, and he very kindly endorsed my book. Sadly his bill didn’t get through, and he died disappointed by this.

In Scotland, MSP Margot MacDonald fought valiantly for an easement of terminal pain and suffering, her case the more powerful because she herself was suffering with Parkinson’s Disease. I listened to her too on a number of occasions, and was moved by the passion behind her case. She too died without seeing progress on this front.

These are but two of the many notable figures who have kept the issue alive, nibbling away at the edges of the arguments about the horror for some people who face a slow undignified and painful death, and who would welcome the security of knowing that, if things became intolerable, they had a way out that wouldn’t incur penalties for those left behind. Experience in other countries (the USA and Netherlands especially) shows that a large proportion of those who have an advanced directive authorising assisted death, never actually avail themselves of the service. It’s enough to know it’s there if needed.

Over the years, we’ve all heard and seen patients and families sharing their plight with the media, publicly throwing their dwindling energies and resources into fighting for compassion and understanding. We’ve listened to politicians, clergymen, philosophers, religious people, those with disabilities, putting their perspectives into the melting pot. For and against. Passionate, angry, distressed, vengeful, dogged. And gradually, over time, we’ve seen a softening of attitudes taking place.

As far as the general public are concerned, opinion has swung in favour of a change in the law; for some kind of easement of intolerable suffering. Politicians have gradually – almost imperceptibly – become less scared of picking up this hot potato.

But one group of people who’ve remained reluctant to back assisted dying has been the doctors. Small wonder: they’re the ones who will be on the frontline, actually taking those active steps to supply the fatal drugs, or even administer them, to help eligible patients end their lives, should this become legally permissible in this country. And, as we all know, doctors are in the business of caring not killing.

However, this week, the British Medical Association has dropped its opposition to assisted dying and adopted a neutral stance. Not in favour, please note. Neutral. And indeed, the vote hinged on a hairsbreadth! 49% of the representative body voted in favour of a move to a position of neutrality; 48% were opposed to such a move. They, in turn, were acting on behalf of their members: 40% of whom were in support of a change in the law to allow assisted dying; 33 opposed to it; 21% thought the union should be neutral on the subject. A position of neutrality gives scope for all ranges of opinion. It’s a major step.

And a timely one it seems. Because next month a new version of the Assisted Dying Bill is due to be put to the House of Lords for a second reading, this time promoted by Baroness Meacher – whom I have NOT met! It would seem to have a stronger chance of success this time because of the BMA shift. Time will tell, but I’ll be watching this space closely and thinking of all those who have paved the way but died disappointed.

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Assisted dying: whither next?

Wednesday afternoon

Here I am in a lecture theatre in Bristo Square. Outside the Fringe is in full giddy flight; inside faces are serious, the mood expectant. This is the debate organised by the Mason Institute for Medicine, Life Sciences and the Law, in conjunction with Sparkle and Dark Theatre Company, to which I was invited a while back, and I’m feeling devoutly thankful I’m on the listening side of the room with about 60 other folk, not in one of the hot seats on the other side of the table.

Right to DieAs regular visitors to this blog know, I wrote a book on this subject, called Right to Die. I even appeared at the Edinburgh International Book Festival to talk about it. But I still agonise over the issues. The arguments and counter-arguments are so complex and emotive, the issues so finely nuanced, and every time I listen to them I feel huge sympathy for each side. As preparation for today I’ve been reading relevant papers – eg Margot MacDonald’s draft Assisted Suicide (Scotland) Bill, and a position statement from The Scottish Council for Human Bioethics – and I don’t envy anyone having to hold all this stuff in their heads. I went crazy with a highlighter, and even so only just stayed abreast of the pros and cons.

So who are these folk who’re putting their heads above the parapet? Patrick Harvey, MSP, Professor Graeme Laurie (Professor of Medical Jurisprudence at the University of Edinburgh), Professor Calum McKellar (Scottish Council for Human Bioethics) and Lawrence Illsley (Sparkle and Dark Theatre Company). In the chair, broadcaster Sheena McDonald.

We hear the usual stuff: the present legal position; how Margot McDonald’s proposed new bill differs from the last one; the experience of assisted death in Oregon, Belgium and Switzerland; the pros and cons of assisting deaths. Words like dignity, respect, autonomy are used frequently, everyone wanting us to believe they respect dignity and autonomy totally.

The politician reminds us that parliament debates many moral issues, (sexual, reproductive etc), but how to help the dying – a condition we must all face – has taken the longest to resolve. Sobering thought. But the defeat of successive proposed bills has shown us how reluctant our friends in both Westminster and Holyrood are to grasp this nettle. Margot MacDonald has limited her new bill to those who are terminally ill, facing imminent death, in order to overcome some of the resistance. It’s no earthly use to folk like Tony Nicklinson and Diane Pretty, trapped in disintegrating bodies, facing appallingly protracted dying – and these are the ones I agonise over the most.

The poet/musician on the panel homes in on society’s reluctance to talk about death; the importance of thinking and talking about these issues while we’re conscious and sentient and able to articulate our choices. Good man.

The audience give Professor McKellar a rough passage (he’s opposed to assisting death). They really don’t like his insistence that all human life is equally valuable, society is about dependence and care of each other, and an assisted dying bill would mean that some lives were deemed less worthy than others. From all sides come protests – the cruelty of keeping people alive in appalling conditions; the right to choose either way; the iniquity of autonomy limited by the moral qualms of others; the limitations of hospital, hospice and palliative care; the wrongness of assuming other people’s reactions; the wrongness of imposing theoretical notions of respect onto others.

The house having shown a clear preference for some way out for those facing horrible undignified or painful deaths, the experts and experienced then pitch in with facts and details about the patchy nature of palliative care provision, the lack of hospice beds, the effect of just knowing there’s a way out, the position of minors. I’ve heard it all before, but I’m still glad I’m not on the panel – there’s a limit to the number of times you can simply agree with the challengers.

This whole debate was sparked off by Sparkle and Dark’s play, Killing Roger, which I reviewed on Monday, so it’s fitting to let Lawrence have the last word. The arts – plays, novels etc – allow conversations to happen. They stimulate and engage people. They inspire them to explore the issues that bit more, and encourage reasoned thinking, he says. I agree. This is precisely why I write novels on these issues; not to impose my ideas and opinions, but to encourage others to form their own.


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