Humanist Society is a passionate supporter of assisted dying, which brings choice, compassion and autonomy at the end of life. Liam McArthur MSP’s Assisted Dying Bill will begin its passage through Scottish parliament very soon. This could make assisted dying legal in Scotland by 2025. But the debate around this emotive topic is badly affected by misinformation. We sat down with Dr. Amanda Ward, a researcher on the assisted dying bill, to talk through some of the commonest misconceptions.*
Can you introduce yourself and tell us about your role in relation to the assisted dying bill?
I’ve been involved in assisted dying law reform for approximately 12 years now. Initially it was an academic exercise, as I was doing a Masters and PhD on the issue. Then I started advising MSPs in charge of the proposals as Research and Legal Advisor.
How will the assisted dying procedure work in practice?
A terminally ill person would raise it with their care team. If the healthcare practitioners (HCPs) involved agreed to support the person through the process, a multitude of assessments and safeguarding measures would follow. These include, but are not limited to, two independent assessments by separate doctors on the nature and effects of the terminal illness, capacity assessments, coercion screening, and an exploration of all other health and social care measures that could support the patient.
If the person was eligible and wished to proceed, mandatory waiting and reflection periods would have to be completed. Then, they would have the substance delivered to them on an agreed date at an agreed time. They would then self-administer this whilst accompanied by a HCP.
There is decades’ worth of data showing that when the initial parameters are tightly drawn, as Liam’s proposal is, there is no extension over time to broaden eligibility.Dr. Amanda Ward, Research and Legal Advisor, Assisted Dying for Terminally Ill Adults (Scotland) Bill
What would you say to those who fear the law will be expanded once in place?
As with all other areas of healthcare, there are many models for assisted dying worldwide. After two decades since the first attempt to legalise assisted dying in Scotland, we have learned what the right fit for our country is. Liam McArthur’s proposal is modelled on legislation that has been operating in Australia and US states for many years.
There is decades’ worth of data showing that when the initial parameters are tightly drawn, as Liam’s proposal is, there is no extension over time to broaden eligibility. Additionally, a five year review of the law would be undertaken if passed. That would allow a thorough exploration as to how it is working in practice.
A plethora of national and international peer-reviewed studies shows that disabled people’s lives are not devalued because of the introduction of this choice for terminally ill people.Dr. Amanda Ward, Research and Legal Advisor, Assisted Dying for Terminally Ill Adults (Scotland) Bill
Doesn’t this bill put disabled people at risk or devalue their lives?
Disabled people have the same rights under the proposal as any other terminally ill person. That is key: any terminally ill disabled person wanting the choice of an assisted death must satisfy the legal thresholds in place for eligibility. Liam McArthur has been explicit that no person, other than those who are terminally ill, can access assisted dying.
Thus, having a disability alone would not meet the legal threshold for eligibility. A plethora of national and international peer-reviewed studies from places where assisted dying has been legalised shows that disabled people’s lives are not devalued because of the introduction of this choice for terminally ill people.
“The recent House of Commons inquiry into assisted dying concluded that palliative care alone cannot relieve all suffering and that it would be ‘arrogant’ to suggest so. The report also showed that palliative care provision had improved after assisted dying was legalised.”
Dr. Amanda Ward
Isn’t there a risk that offering assisted dying will mean less focus on palliative care?
Where assisted dying is already legal, the vast majority of patients are receiving palliative and other end of life care and continue to do so until the day of their assisted death.
The recent House of Commons inquiry into assisted dying concluded that palliative care alone cannot relieve all suffering and that it would be ‘arrogant’ to suggest so. The report also showed that palliative care provision had improved after assisted dying was legalised.
I would urge people to take a look at the responses to Liam McArthur’s consultation. There you’ll find thousands of testimonies of grave pain and relentless suffering experienced at the end of life, despite excellent care.
I now live in Queensland, Australia. Here, like in other jurisdictions, assisted dying is run by a former clinical palliative care team. Often, once HCPs have witnessed one assisted death, they realise that it is a peaceful, straightforward process. Many state that it is the most rewarding work they’ve ever done.
Everyone involved wants to see improvements to palliative care and supports the wider efforts being made to do that. Assisted dying and palliative care work in tandem and are not mutually exclusive.
First appeared in Humanist Society Scotland website March 2024
