People need to be able to trust doctors, not fear them

NOBODY wants to see anyone suffer at the end of their life. Having worked as a doctor in hospitals, hospices and the community, I know the good palliative care can do, but that many do not get access to that care.

We need to listen to those families who have been distressed by the death of their loved one and those who are anxious and in pain. But how do we respond as a nation? Do we allow patients to end their lives with medical help because we have failed to provide the end of life care they need? This Bill proposes new legal powers to permit NHS doctors to administer lethal medication, but that is a fundamental change from a doctor’s essential role of saving lives. It is crossing the Rubicon.

Currently the law prohibits the intentional taking of life by an individual or by the state. Why is that? Because of the incredibly high value and worth that society places on all human life, without exception.

The primary danger of assisted suicide is that individual lives are devalued by society because they are ill, disabled, confused or that their contribution to society is perceived to be minimal.

The secondary danger is that terminally ill and disabled individuals may begin to devalue themselves because of the burden that they perceive they are to society. In a cruel twist, a Bill designed to empower may have the effect of eroding the autonomy of the most vulnerable.

Those of us who work with the terminally ill do understand that there is suffering at the end of life but this should drive us as a society not towards enabling assisted dying, but instead well-funded, accessible, highquality palliative care for all.

There are presently huge gaps in palliative care provision and access to highquality care is sadly inadequate. It is worth noting that there are just 126 palliative care specialists working across Scotland right now – that is fewer than the 129 MSPs who will ultimately decide whether the Assisted Dying Bill becomes law.

Palliative care will involve a team of doctors, nurses, social workers, physiotherapists and many others to provide care for physical symptoms, but also psychological, social and spiritual care too. As their condition deteriorates, a patient can be transferred to a hospice or specialist palliative care unit.

But the point remains: it is committed to neither hastening nor prolonging death but simply to helping people live well for the time they have left.

This should be an issue for the whole of society: it has been portrayed as applying to only a small number of seriously ill patients, but a quarter of those admitted to Scottish hospitals are in the last year of life. Those treating them want to do the very best they can to alleviate their suffering – it is the reason they go to work.

A recent survey of palliative medicine professionals reported that 95 per cent would refuse to prescribe these lethal drugs, even if patients ask for them, while two-fifths say they would leave their job if assisted dying provision was introduced in their workplace.

IDON’T doubt Liam McArthur is driven by compassion to help a small number of people who have difficult and distressing deaths and I’m grateful that he’s putting palliative care and the dying on our front pages, because there are people who don’t get the care that they need.

They will be in pain at weekends and overnight and they shouldn’t be. But because they are not getting the true care they should receive, assisted dying cannot be a true choice.

This legislation is not what is needed for an NHS on its knees. Before we look at new laws, we need to look at how to get them the proper palliative care they need rather than force doctors to become complicit in ending their life. People need to be able to trust their doctor, not fear them.

We need to have this debate in Scotland, but what people need is the right care at the right time in the right place – not medicalised killing.