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I completely understand the motives of those who have introduced the Bill. Anyone who has watched a loved one die in terrible suffering will entirely understand why they have introduced their proposals, and no one should impugn their motives. I have to say, however, that it is all too easy to open a Pandora’s box, with utterly unintended consequences that may be very different from the primary intentions of those promoting the Bill.
I want to make a few comments based on my experience as a doctor. Doctors can come under enormous pressure from relatives and from their own emotions to hasten the death of a patient whom they believe to be suffering too much. I worked in Glasgow Royal Infirmary during the early days of the marrow transplant programme. We had to give patients huge doses of sometimes very crude treatments, and when I was sitting with a young patient, there was very often a strong temptation to end their suffering. Some of them went on to survive, which is a lesson to doctors not to make judgments too hastily. I believe that anything that increases such pressures on doctors opens up an ethical trap that we do not want.
We already have laws relating to the concept of double effect. If a patient is suffering, we can give them medication whose primary aim is to alleviate their suffering, even though its effect will be to shorten their life. That is very different ethically and morally from giving a patient something that is primarily designed to kill them.
We need to understand that assisted dying can have an effect on the medical profession. Studies from the Netherlands and the United States on doctors who have performed or assisted at assisted suicides have shown that the medical professionals concerned had
“high levels of emotional discomfort, distress and feelings of overwhelming burden”.
There is also a fundamental change in the doctors’ relationship with patients. The No. 1 rule is “Do no harm”. If a patient arrives unconscious or in a coma, their family needs to know—as the patient themselves would want to know—that the doctor will do them no harm and will not come under any pressure to do so for one reason or another. I fully understand that the Bill does not cover that, but it does fundamentally change the relationship between doctors and patients, and that change cannot be undone once it has been made. We are talking about overturning 2,000 years of the Hippocratic oath.
Lyn Brown made an absolutely wonderful and emotionally charged speech. It set out very clearly the risks for another group of patients that doctors deal with—the vulnerable. In his moving article at the weekend, the Archbishop of Canterbury spoke about the Age UK research and stated:
“It is impossible to ensure that they and other vulnerable people would not be placed under pressure to end their lives prematurely in ways that proposed safeguards cannot hope to detect.”
It was noted earlier that people feeling that they are a burden when making a decision to end their lives prematurely is only one factor, but that is one reason too many. The answer is not to make it easier to kill people; we need societal change to prevent people from feeling a burden in their elderly years.
Finally—I am aware of the time—there has been an argument about whether the Bill would make it easier for euthanasia to be introduced in this country. Doctors in the Netherlands who have experience of assisted suicide recognise that failures will occur from time to time. Those failures make up around 7% to 16% of cases, and include failure to induce coma, or patients who come out of coma before the process is finished. The Royal Dutch Medical Association recommends that a doctor be present when assisted suicide is performed in the manner proposed in this Bill, precisely so that euthanasia can be performed, if necessary, if the process fails. In practice it is impossible to differentiate between assisted dying and euthanasia. If we have one, because of the failures of process we will inevitably get the other. I do not believe that that is an improvement to our society. However well-meaning the proponents of this Bill may be, they will open a Pandora’s box that will fundamentally change who we are, how we are as a society, and how we relate to the medical profession. I believe that none of that will be to the benefit of future generations.