Scots doctors write protest letter to Times on assisted dying Bill

1273168808 86 Scots doctors write protest letter to Times on assisted dying Bill In their letter, the medical professionals say that the Bill as proposed would legalise both euthanasia and assisted suicide for terminally ill patients and those with a chronic condition or disability who find life “intolerable”.

They add: “It also applies to anyone over the age of 16. This sends a message to all disabled people and terminally ill patients that somehow because they are dependent on others they are of less value to our society and so may feel that they ought to choose to bring forward the time of their death.”

The Bill, they add, is also unnecessary since it does not recognise the realities of end-of-life care which is concerned with the control of pain and other distressing symptoms and addresses the emotional and social concerns of patients and their families.

“The safeguards in the Bill fail to acknowledge uncertainties in clinical practice. For example, patients often change their minds about wanting to end their lives once they receive palliative care and their fears concerning suffering are addressed.

“In contrast the proposed Bill may put pressure on some vulnerable people to make a choice they do not wish to make. In addition, there are difficulties in assessing the mental capacity of some patients and not all doctors are aware of the possibilities of palliative care.”

The specialists argue that not enough is known about the long-term effects of legislation in this area “to justify threatening the well being of hundreds of thousands of people for the sake of a very small number who feel a need to control the timing of their death”.

Ms MacDonald told The Times that she could not understand why the authors of the letter had said that her Bill proposed the legalisation of both euthanasia and assisted suicide. She added: “They must know the distinction between the two. Therefore, I think we must be wary of their other comments on the Bill. The explanatory notes accompanying the Bill make it abundantly clear that the proposals rest on patient autonomy, and that no other person would legally be able to end another person’s life.”

Ms MacDonald said it was also “disingenuous” to follow this comment on the Bill with an opinion that it sent a message to all disabled people … that they are of less value to our society

“The Bill and its motivation rests on respect for the ability of those with a progressive, irreversible condition and/or terminal illness to decide whether or not their lives have become intolerable and whether or not they would prefer to seek assistance to end their own lives.

“Any other person suggesting this course of action would be committing an offence. This is a completely different scenario from that which has been the norm for some time now.”

Ms MacDonald disputed the claim that not enough was known about the long-term effects of legislation: “There is ample information and corroborative evidence from jurisdictions in which assisted suicide is legal for conclusions to be drawn as to how such legislation would work in Scotland.”

THE LETTER

Dear Sir,

As healthcare professionals involved with the care of patients at the end of their lives we wish to raise our objection to the End of Life Assistance (Scotland) Bill. The Bill proposes legalising both euthanasia and assisted suicide for terminally ill patients and those with a chronic condition or disability who find life “intolerable”. It also applies to anyone over the age of 16. This sends a message to all disabled people and terminally ill patients that somehow because they are dependent on others they are of less value to our society and so may feel that they ought to choose to bring forward the time of their death.

The Bill is also unnecessary since it does not recognise the realities of end of life care which is concerned with the control of pain and other distressing symptoms and addresses the emotional and social concerns of patients and their families. The safeguards in the Bill fail to acknowledge uncertainties in clinical practice. For example, patients often change their minds about wanting to end their lives once they receive palliative care and their fears concerning suffering are addressed. In contrast the proposed Bill may put pressure on some vulnerable people to make a choice they do not wish to make. In addition, there are difficulties in assessing the mental capacity of some patients and not all doctors are aware of the possibilities of palliative care.

We do not know enough about the long term effects of legislation in this area to justify threatening the well being of hundreds of thousands of people for the sake of a very small number who feel a need to control the timing of their death. The special committee of the Scottish Parliament considering the Bill have asked for written comment by the 12th May 2010. We hope that your readers will show their commitment to the highest standards of palliative care by sharing their objections to this Bill.

Dr David Jeffrey, Academic Mentor, University of Dundee Ninewells Hospital & Medical School, Dundee

Professor Marie Fallon St Columba’s Chair of Palliative Medicine,University of Edinburgh, Western General Hospital

Dr Sheila McGettrick Medical Director, The Prince & Princess of Wales Hospice

Dr Stephen Hutchison Consultant in Palliative Medicine, Highland Hospice, Inverness

Dr Jeremy Keen Consultant in Palliative Medicine, Highland Hospice, Inverness

Professor Scott Murray St Columba’s Hospice Chair of Primary Palliative Care, University of Edinburgh

Dr Pamela Levack Consultant in Palliative Medicine, Ninewells Hospital, Dundee

Dr J. Martin Leiper Consultant in Palliative Medicine, Roxburghe House, Dundee

Dr Deans Buchanan Specialist Registrar in Palliative Medicine, Roxburghe House,Dundee

Dr Claire Douglas Specialist Registrar in Palliative Medicine, Roxburghe House,Dundee

Dr T.F. Benton Medical Director, St Columba’s Hospice, Edinburgh

Dr Duncan Brown Consultant in Palliative Medicine, St Columba’s Hospice, Edinburgh