MSPs reject Assisted Suicide Bill – read two compelling speeches from Lib Dems McArthur and McInnes

I was sad that Holyrood rejected the Assisted Suicide Bill yesterday, but I was heartened by the fact that support for such a measure is growing and I think the debate will continue.

It was also good to see that it was conducted in such a respectful and sensitive fashion.

I thought you might like to see the two speeches our MSPs made, one on each side of the argument from Alison McInnes and Liam McArthur. Both were brilliant, thoughtful and liberal. If I had been persuadable, Alison’s speech might have done it.

Alison McInnes:

I come to this debate as a liberal and as a humanist. As a liberal, I seek always to balance the fundamental values of liberty, equality and community. As a humanist, I try to resolve ethical issues through reason, reflection and empathy rather than by petitioning a higher being, although of course I respect others who live their lives according to religious scriptures.

As other members have done, I have had many representations on the matter. Indeed, many constituents on both sides of the argument have shared with me deeply personal stories about the value of life and about their family members’ experience at the end of life, and I thank them for that.

I think that everyone is agreed that compassion, the dignity of the individual and the alleviation of pain and suffering should be at the forefront of our consideration, but there is profound disagreement over whether legislating for assisted suicide is a safe way forward. Some have argued that the bill will allow a small number of people—difficult cases—to be helped at the end of their life, but the bill is cast very widely and includes life-shortening illnesses. Those people argue that the bill will bring certainty and clarity to the law, yet there is a lack of definition of key terms such as “assistance” and of the role of facilitators. Some people say that there are robust protections against abuse and coercion, while many others warn that the safeguards are “totally illusory”.

The significant flaws in the bill and the major challenges to progressing it are set out clearly in the stage 1 report. The questions and caveats in the report illustrate graphically just how dangerous it is to try and make the state the gatekeeper of who can die at a time of their own choosing and who cannot.

Today, we need to decide whether we agree with the principle of assisted dying. Do decisions about the timing and manner of death sit exclusively with the individual? Is the value of a person’s life no more than the value that they ascribe to it? Is it equivalent only to a possession that can be given away, or, as many of us—both of faith and of no faith—believe, is the intrinsic value of life more profound than that? Are some rights so profoundly ours, as the liberal philosopher Locke argued, that we cannot give them up even with consent? If the right to life is paramount, is it not the case that we inevitably weaken the prohibition against killing if we countenance state-assisted suicide in some circumstances?

I do not accept that there is a right to die. Patrick Harvie has acknowledged that autonomy is not absolute—we are not entitled to exercise freedom that undermines or endangers the freedom of others. There is a reciprocal principle that operates; we need to have choice with responsibility. In his evidence, Dr Stephen Hutchison of the Highland Hospice argued that the issue cannot only be about what an individual chooses and demands but that

“it has to be balanced with careful scrutiny of the implications for the rest of society and, in particular, for the vast numbers of frail, vulnerable and frightened people whom we look after.”—[Official Report, Health and Sport Committee, 27 January 2015; c 5.]

For me, that is where the bill founders. It utterly fails to address the very real risk that, in vulnerable people’s minds, the right to die will become a duty to die. If we value the principles of equality and community as well as that of autonomy, it seems to me that the state must not sanction assisted suicide.

Many of those who are lobbying for change have argued that allowing assisted suicide will not harm those who find it morally wrong. They have argued that it is a case of each to their own and that assisted suicide will be just one more option, but changes in the law bring about changes in the way we understand ourselves and our place in the world. In elevating the status of individual autonomy, we reduce the status of those who are dependent. Allowing assisted suicide would, over time, change the way we view and treat the elderly, the disabled and the infirm.

Inclusion Scotland has argued persuasively that much of the support for the bill is driven by a profound fear of becoming disabled, of ageing and of becoming ill. I agree with that and with the organisation’s conclusion that, rather than saying that we should make it easier for people with that profound fear to end their lives, we need to challenge those negative attitudes and have good public policy that ensures that everyone has the best possible quality of life.

Greater importance needs to be placed on prioritising wide access to good palliative care. Dame Cicely Saunders, who was the founder of the modern hospice movement, said:

“You matter because you are you. You matter to the last moment of your life and we will do all we can to help you die peacefully, but also to live until you die.”

We should be doing everything possible to make that the reality for everyone at the end of their life.

It is precisely because there is an inalienable right to life for everyone, equally, that the so-called right to die for some cannot be countenanced. I will not support the bill this evening.

Liam McArthur

Shortly after first being elected in 2007, I sat in the chamber listening to a members’ business debate that was led by my former colleague Jeremy Purvis. He was the sponsor of an earlier bill that was aimed at achieving many of the same objectives as the one that we are considering this afternoon. I had no intention that evening of speaking or making an intervention; I just wanted to listen. I remember coming away genuinely proud, as I am today. I believe that this is how our Parliament should be.

The exchanges then were unencumbered by false consensus or by political rancour, in the main. Those participating did themselves and the Parliament great credit by arguing their case passionately, with sincerity and conviction, even where those convictions had evolved over the years.

That bill fell, but the late Margo MacDonald then took up the cudgels. Without any disrespect to Jeremy Purvis or, indeed, Patrick Harvie, even now Margo remains posthumously synonymous with the issue and these proposals.

A charismatic advocate for change, Margo nevertheless took care to nurture cross-party support. Patrick Harvie continued that approach, and I thank and pay tribute to him. I also thank and pay tribute to the my life, my death, my choice campaign and others for all that they have done to progress the bill since Margo’s untimely death. I thank, too, the Parliament’s committees for their diligence and, in particular, the Health and Sport Committee for producing the lead committee’s report, which seeks to reflect the divergent views of its members while identifying areas of legitimate concern.

Although it is an improvement on its predecessors, the bill is certainly not perfect, as Patrick Harvie acknowledged. There are those who feel that it goes too far and others who believe that it does not go far enough. My constituents, whose generally measured and thoughtful input I have greatly valued, fall into both camps and pretty much all places in between. I am grateful to the many groups and organisations that have contacted me. I respect the positions that they have taken, but I am acutely aware that, within and between different faith and disability groups, as well as across the medical and legal professions, individuals hold individual views for and against change.

As members are aware, I am supportive of the general principles of the bill. That support does not stem from direct personal experience of a loved one left suffering unduly at the end of their life, although I have close friends for whom that ordeal was very real and unbearably painful to witness. Over the years, I have come to the conclusion that the status quo is no longer tenable, that change is necessary and that finding ways of allowing individuals dignity in death, as in life, is now essential. Growing numbers of people in Scotland have reached that conclusion, often, I suspect, based on their direct experience of what has happened to a family member or good friend.

Of course, majority public support is not in and of itself reason enough to change the law in such a complex, sensitive and profoundly emotive area. However, it must give us confidence that we should have this debate, that there is an appetite for a move away from the status quo and that, hopefully, there will be patience as we explore a solution that can command the broadest possible support and confidence.

The crux of the bill for me and for many of those I speak to on both sides of the debate is the issue of safeguards. The three-stage process, with cooling-off periods between each, the need for uninvolved witnesses, the requirement for two independent doctors and four separate consultations, the presence of a facilitator and the compulsory reporting of cases to the police set a very high standard of protection.

I understand why people express specific concerns about those who suffer from poor mental health, but general practitioners are accustomed to diagnosing and treating depression and assessing mental capacity. Any suggestion that an individual is suffering from a mental illness will bar them from entering the assisted suicide process. In doubtful cases, a GP can refer a patient to other doctors, including a psychiatrist, for an opinion. I believe that those safeguards will ensure that the vulnerable are protected, but would welcome proposals about what might reasonably be done in addition.

I do not accept the argument that the bill represents a slippery slope. It will allow individuals—only those who are terminally ill, I would argue—to seek assistance in bringing their life to its conclusion, while giving legal protection to those who provide such assistance.

I also struggle to see why support for the bill might imply a lack of commitment to palliative care. Such care will still be the preference for the vast majority, and Marie Curie was right to point out that, at present, at least 11,000 people are missing out on that care every year. That must be addressed, regardless of the bill.

The right to life is not the same as a duty to live. The bill is about providing dignity, respect and choice at the end of life. I hope that Parliament will agree this evening to allow the bill to proceed to the next stage. If it cannot be satisfactorily amended at stage 2, there will still be an opportunity to vote it down at stage 3. I believe that we owe it to those who are looking to Parliament to reflect the public’s desire for change at least to allow that debate and those detailed deliberations to take place.

* Caron Lindsay is Editor of Liberal Democrat Voice and blogs at Caron's Musings

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16 Comments

  • Helen Tedcastle 28th May '15 - 12:33pm

    For me, Alison McInnes MSP has it about right. She offers a coherent argument from a Liberal Democrat perspective and from her position as a secular-humanist, why assisted suicide is not a good option in our society.

    Firstly, she says, ‘ I do not accept that there is a right to die. ‘ Autonomy is not absolute. We are not entitled to exercise our freedom such that it puts in real danger the freedoms of others.

    Secondly, she argues that with this Bill (indeed in my view, any legislation on assisted-suicide/ Euthanasia) there is ,

    ‘…the very real risk that, in vulnerable people’s minds, the right to die will become a duty to die. If we value the principles of equality and community as well as that of autonomy, it seems to me that the state must not sanction assisted suicide.’

    Well said Alison McInnes MSP. Thankfully your fellow MSPs listened to you and threw out the Bill.

  • Jonathan Pile 28th May '15 - 12:34pm

    I’m glad that there was pause for thought here, and feel it is a non-party political matter and a very real moral dilemma for us all.

  • We may only have 5 MSPs in Holyrood, but wow their quality trumps quantity .
    I believe that legislation like this must (and will) become law in the not too distant future, and I am very proud of Liam’s contribution – and of those made by Jeremy Purvis in the past, and indeed the article by Norman Lamb yesterday. But I respect Alison’s views too, and admire her for her excellent speech.

  • Toby Keynes 28th May '15 - 4:02pm

    I’m encouraged that all 5 of our LibDem MSPs took part, and the majority were in support of the bill. Jim Hume, Liam McArthur and Tavish Scott voted for; Alison McInnes and Willie Rennie voted against.

    The two Greens also came out in support. By contrast, and dispiritingly, the SNP, Labour and Tories all voted heavily against.

    Overall, the Bill was rejected by 82 votes to 36.

    We’ve made major progress on assisted dying over recent years, and public opinion has moved dramatically to the point where the great majority of the Scottish population (and the UK population as a whole) support the principles of the Bill, but it’s clear that this is not yet reflected in Holyrood.

    It will come.

  • Douglas McLellan 28th May '15 - 7:40pm

    I was very disappointed by the votes against from the people who didnt claim a religious excuse. Those who worried about the effects of the bill on vulnerable people have a devastating critique of the people of Scotland. We want our old and/or ill relatives dead to get their assets. That is a shocking belief to have in the people of Scotland.

    I am particularly worried about the disabled lobby. On *every* other topic they want the social model of disability to empower them to make decisions about their lives but on this topic they revert to the medical model and demand that their doctors are there for protection and making decisions about their lives. Hypocritical much?

    The argument that society will change is the same that those against same sex marriage put forward and its disappointing that equality is only seen in terms of a label, rather than personal choices. For a Lib Dem to deny a person an equal opportunity is a very poor show.

    If the proposed legislation needed amending that was the way forward – vote for the principle and amend to meet concerns. As things stand the court systems is full of cowards who say its a choice for politicians and politicians who are cowards for foisting their views on other people.

  • Helen Tedcastle 28th May '15 - 8:03pm

    Toby Keynes

    ‘ It will come.’ Why should it? It is not a human right, although this is claimed by the pro-assisted-suicide lobby.

    It lost the vote heavily for very good liberal and progressive reasons – assisted-suicide/euthanasia, fails to balance self-regarding and other regarding freedoms. Politicians have to balance all factors – the individual’s wish to die and the effect of sanctioning a doctor by law to provide lethal drugs to a patient.

    There will never be enough safeguards to ensure that people do not interpret the ‘right’ to die as the duty to die.

    The vote No was decisive, courageous given the media’s continual hyping of this issue and it is a progressive vote for the balance of liberty, equality and community.

  • Douglas McLellan 28th May '15 - 8:28pm

    Helen Tedcastle

    You are wrong about the safeguards unless you have such a poor view of the humanity of Scottish/British people. Why does the system work in Oregon for example? Are the people of Oregon better humans than us? I dont think so.

    And why embed the privilege of going to Switzerland to those who can afford it and are able to make the journey? Is every person going to Dignitas doing so out of duty? No they are not. Can you point to one who is doing it for any reason other than a desire to make a personal choice that is denied to them here in the UK?

  • Helen Tedcastle 28th May '15 - 8:49pm

    Douglas McLellan
    ‘ You are wrong about the safeguards unless you have such a poor view of the humanity of Scottish/British people’

    Elder Abuse in the UK is real in the UK as is poor care experienced by disabled adults as witnessed a few years ago at Winterbourne View care home. So a dose of realism is needed as well as the hope that on balance, people will behave well towards their fellow human being.

    If we allowed an Oregon-style system of assisted suicide we would have to be prepared for around 1,2000 deaths per annum in relation to the size of out population. Around 200 people per year go to Dignitas. That is a tiny number of very determined, strong-minded individuals.

    Why should the law which protects particularly the vulnerable groups be changed to help a strong and very determined minority?

  • Kevin McNamara 29th May '15 - 12:42am

    Helen, do you have any compelling arguments that the rest of those 12k people are vulnerable, and not just unable to access assisted dying? Your argument relies on the fact that we want to apparently sacrifice 11.8k vulnerable people, to suit the strong wishes of 200 people. Have you proof of this assertion?

    I’m not surprised you’re on the wrong side of this issue, given your stance on same-sex marriage. I guess your argument then would have been that if Brits want it that bad, surely there are other places that provide it?

  • Mavarine Du-Marie 29th May '15 - 7:18am

    I’ve always sat on the fence on this issue due to concerns of coercion and the quality of life. However, I will also say that when God assists a death through the Reaper, or when Mankind assists a death through his own affairs of suicide (or now perhaps a Bill being proposed) because of suffering. There are always going to be that part that says it was unfair, and questions raised as to why? Dignity as being the aim in the 21st century as opposed to having lived a Good life to have a Good Death which was the aim in the Renaissance period. Can this be achieving with/out suffering, for what suffering does not bring out the humanity in us? Take suffering away and we become what? Dehumanized perhaps. Either way their is going to be some discomfort in this debate as to either reality that Mankind faces for our liberal views, but for sure, we have to keep listening to each other.

  • Stephen Hesketh 29th May '15 - 8:05am

    As a Liberal I believe this is such a fundamental matter of individual conscience, self determination and individual human rights that we should permit and enable assisted dying in the UK for those who wish it.

    Perhaps we might consider an opt-in system … counter signed by a GP and Solicitor?

    Those who do not wish to have the option open to themselves need do nothing.

  • Douglas McLellan 29th May '15 - 11:55am

    Helen Tedcastle

    I think that linking what was instituional abuse to the personal choice of individuals is an interesting approach. Elder abuse is a small (but one that needs addressed) problem. In fact, that is one of the reasons why the proposed legislation stated there needed to be two chances for the person involved to speak to a Dr in private about the reasons behind their desire for assited suicide.

    I think in future the campaigns for this should be about equality front and centre.

  • Helen Tedcastle 29th May '15 - 3:30pm

    Kevin McNamara
    Oregon, the sparsely populated rural state with assisted-suicide provision, so lauded by Lord Falconer as a model for a post-industrial, densely populated society like the UK to follow, showed the following increases in deaths in this manner:

    In 1998 there were 24 prescriptions written and 16 assisted suicide deaths. By 2012 these numbers had risen to 116 and 85 respectively. This is a 380% increase in prescriptions and a 430% increase in assisted suicide deaths in 15 years. The number of assisted suicide deaths in Washington State, increased by at least 43% in 2013.

    How would this translate to the UK? There were 56.6 million people in England and Wales in 2012 but only 3.9 million in Oregon. So 85 assisted suicide deaths in a year in Oregon would equate to 1,232 in England and Wales (14 times that of Oregon).

    So the relatively tiny number of around 200 very determined individuals – some terminally ill, others at the start of an incurable illness or other reason (Dignitas rarely turns people away) – would increase in number should such as system ever be implemented here.

    Is the death of one vulnerable person, a victim either of depression or prolonged psychological abuse, a price worth paying for the ‘freedom’ for determined others to implement their own wishes for themselves in your view?

  • Helen Tedcastle 29th May '15 - 3:44pm

    Douglas McLellan

    Elder Abuse is not actually a small issue. It is a major issue. At least two cases a month are reported in the press alone. Action on Elder Abuse reports around 500, 000 cases per annum with the main victims being females over 70 years of age.

    Furthermore, the main causes of abuse are psychological bullying and financial bullying. This is the reality. See this link: http://www.elderabuse.org.uk/index.html

    In the light of this major problem, is it really wise to be campaigning for loosening the protections for vulnerable groups like the elderly, so that a few others can have their so-called ‘right’ to die?

    As a Liberal I would have thought it is necessary to weigh carefully individual and personal freedom with the freedom of others to be protected fully from possible psychological coercion to end life prematurely.

  • There will be coercion, there will be demands that people choose death, there will be doctors advising death, and I don’t think elder abuse is a small problem either. Abuse of the disabled and of younger terminally ill people also happens. It is not a vote winner, it is hard to prove, so I suppose some people think that makes it a “small problem”.

    I wonder what that looks like to the people who are currently experiencing such abuses? Like if they wanted to die, the Lib Dems are right behind that, backing their “right” (not just to die, they have that, this is get a doctor to help them), oh, but if what they prefer is to live their lives as they are, safe from harm, and not harrassed by people who are uncomfortable sharing the planet with them, then that is such a petty little issue that the Lib Dems are maybe going to consider after they have finnished legalising doctor directed killing?

  • Sorry, I meant to add “which will put those very people at greater risk of harm, since in the eyes of some of the medical proffession and many of the public, it will be seen as a duty to die.”

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