I should say at the outset of this piece that I hesitated before writing at all about this subject. It’s one which evokes particularly strong responses understandably and on both sides of the debate. For most I’d imagine it’s also not something which can be viewed through a traditional left/right prism or of any collective political thought. It’s an issue of conscience and in many ways our own spiritual and moral guidance, not an area the vast majority of us in Scotland are particularly well equipped to discuss in my experience. It’s also for clarity an area where my views over the years have admittedly flipped 180 degrees. A process that’s developed somewhat naturally over time, through discussion and my own experiences. Not something it should be said in the context of this area that I view as a weakness and in fact quite the contrary.
That seemingly old fashioned idea of changing minds through discussion and debate rather than approaching issues having a fixed closed mind to others experiences and thoughts is still something I cling to despite societies increasingly fraught nature and the changing political and media landscape. Lastly and for utmost clarity I am not a religious person, but do come from a Catholic family and went through the Catholic education sector. With that context behind us, the issue in discussion is that of assisted death and my opposition to the proposals both here in Scotland and across the UK. With Kim Leadbeater’s bill now progressing through the Westminster Parliament committee stage at present and a similar bill being introduced to the Scottish Parliament by Liberal MSP Liam McArthur, it seemed this was a reasonable time to attempt to grapple with the issues at play here. Leadbeater’s Bill of course has passed the 1st stage and is now the subject of amendment through committees and the process underway here is largely what has prompted this piece.
A serious of amendments have come forward in recent weeks and have subsequently been rejected which cover a range of safeguarding issues vital to the safety and protection of the most vulnerable. Examples include amendments relating to those with eating disorders, the role of specialist palliative care consultants in the assisted death process, for those with depression and long term mental health issues, opt outs for hospices opposed to the plans and their relationship with public funding, assisted death discussions with terminally ill children and the fundamental relationship between a terminally ill persons autonomy and the wider societal and family pressures that may be impacting the decision. Many of these questions and debates rather than settle questions those of us who instinctively have concerns about the plans had, have grossly exacerbated them.
As an example, Stephen Kinnock MP in the committee debate argued against a proposal that each patient should have the opportunity to have discussed in detail their condition and prognosis with palliative care specialists in each case as not feasible as it would put too much pressure on what are already overstretched consultants. Simon Opher MP remarked that it was “very important” for the committee not to “get too hung up on anorexia” when discussing the amendments around safeguarding proposed by other MP’s and which were backed by the major eating disorder charities. Rachel Hopkins MP voted down an amendment legally requiring a doctor to ask the patient why they were seeking an assisted death on the grounds that this would apparently in her mind likely happen anyway and she then went on to argue that perhaps then even doctors shouldn’t ask this question as it “was none of your business”. Leadbeater herself when asked if she would be content with someone choosing assisted suicide to save their family money at the end of their life argued that it was “ultimately a question of autonomy” for the individual concerned.
This all of course comes on the back of the hastily cobbled together decision by proponents of the bill to drop the legal requirement for a High Court Judge sign off on any assisted death almost immediately after it passed its 1st reading instead replacing it with an expert panel who’s accountability it seems no-one can pin down. This dropping of the High Court judge has substantially weakened the protections upon which many MP’s with concerns around the legislation voted to allow the bill to proceed to committee stage in the first place. Where this does get overtly political is that this bill and the process by which it is being discussed, and the similar proposals here in Scotland to come forward later in the parliamentary term simply cannot be analysed or discussed with no thought, context nor awareness of our wider political, economic and societal developments, both at home and internationally.
On the international front, the continuing scourge of war and a newly found seeming impunity that exists for leaders who have undoubtedly committed acts of genocide and broken international law with indiscriminate slaughter, starvation and torture of civilian populations is cutting at the core of a once universal acceptance of the value of life and equal protections for individuals under international law irrespective of race, gender, ethnicity, religion or nationality. Over the past 2 years in particular we have seen a total disregard for these protections and the seeming normalisation of mass death, destruction and famine. On the domestic front, our collapsing public services including the Health and Care Services have decimated the social fabric which we once relied upon.
The recent Labour government attacks on our elderly, our disabled and those with long term mental health conditions have created an environment in which the most vulnerable justifiably feel under sustained attack and that their inability to contribute to the labour market somehow reduces their contribution to society and the value of their life itself. These attacks come in tandem with the very services they rely upon to survive being cut to the point of extinction – all to meet arbitrary, self imposed treasury fiscal rules. The state’s first responsibility should be to the maintenance of life and security for its citizens. Security at home with a dignified and valued existence that aims to maximise life’s potential irrespective of your circumstance. Security in the knowledge that the health profession oath to prolong, extend and enhance life applies to all of us and at all time irrespective of individual circumstances.
What Britain needs is not state assisted death but sustained investment through taxation of the wealthiest in society to deliver high quality healthcare providing high quality palliative care and a publicly owned social care system that is fit for our ageing population with our increasingly complex health problems. A welfare system that supports our most vulnerable and values their contribution to our society – not one that labels them as economically inactive and slashes support which keeps them alive. A society which understands and empathises with those suffering from long term chronic mental health conditions and which seeks to address the fundamental insecurity in society that is driving rates of anxiety and depression. A society which holds dear, protects and enhances the value of life and life itself.
