Palliative Care Vs Assisted Dying: We All Lose In The End

Blog | David Pearce |

Yesterday the Assisted Suicide (Scotland) Bill was voted down by MSPs, despite the clear support for a change in the law among the people of Scotland and, indeed, the UK as a whole. But why?

Many MSPs spoke in the debate, with passionate speakers from both sides of the argument. But did those speaking against the principles of the Bill really understand the evidence? The Bill’s proposer Patrick Harvie, for one, indicated perhaps not:

The member suggests, as others have, that in passing the bill we would in some way undermine efforts to reduce suicide in the wider population. Is she able to point to any jurisdiction in which some form of assisted suicide has been put into law where there is evidence of an impact that undermines suicide prevention in the wider sense?

There’s no evidence to support the notion that choice at the end of life somehow undermines suicide prevention (perhaps there is no evidence because this is not true) but there is evidence of how assisted dying legislation can positively impact on palliative care.

Several MSPs must be unaware of this evidence because they spoke as if society must choose between improving palliative care OR legislating for assistance to die – the people of Scotland deserve the option of both. They could have both. As Patrick Harvie said, this Bill would have expanded choice, not limited it.

In Oregon, USA, dying people have been legally allowed assistance to die for 18 years and in that time palliative care has improved. When the law was reviewed, after 10 years of practice, not only had opponents’ fears and predicted terrible outcomes proved false, but care was also improving:

…the ODDA [Oregon Death with Dignity Act] served as a catalyst to improved end-of-life care among Oregon practitioners — including the increased use of hospice and palliative care

Instead of allowing the debate to continue where this evidence could be presented and debated in full, a majority of MSPs decided to reject the Bill out of hand. A full debate would have allowed all of those who thought the Bill could be improved to reach a consensus on what must be done, but instead we have seen MSPs decide that presenting a workable law was too difficult.

So when people re-read yesterday’s debate, much of which was excellent and well-conducted, they should take assertions that we should improve care before we enshrine choice for dying people into law with a pinch of salt. Instead, they should focus on the evidence that assisted dying and palliative care are not mutually exclusive – they’re complementary.

If elected representatives continue with a false dichotomy of palliative care Vs assisted dying one thing is certain – We will all lose out and those to suffer the most, sadly, will be dying people.

The evidence is clear the law must change.