Assisted dying isn't what we need: it's assisted living

In the end she died, peacefully, in her own bed, as she had wanted. We miss her very much, but she died with dignity, care, and surrounded by love, and that is a blessing for which we will forever be grateful. I wish the same could be possible for everyone when their time comes.

I am sure that Liam McArthur feels similarly. The MSP for the Orkney Islands formally lodged his Assisted Dying for Terminally Ill Adults (Scotland) Bill on March 27. If passed, it would allow legal medically assisted dying for terminally ill people aged 16 or over.

Two doctors will have to be satisfied that a terminally ill person is capable of consent, along with two independent witnesses, and a period of reflection is required before the final steps can take place. Consent can be rescinded at any time. If those, and a number of other requirements, are met, adults who have been living in Scotland for at least 12 months may be given state assistance to end their lives.

McArthur insists that provisions in the bill are “robustly safeguarded” in order that assisted dying is administered in very specific circumstances. And yet, other than some paperwork requiring various signatures, there’s little detail in the bit about one specific area of concern that continues to cause alarm amongst disabled and chronically ill people.

While the draft legislation gives the slightest of nods towards protection from coercion into ending their lives prematurely, it is notably thin on detail about how it will do this. Close family relatives, such as partners, parents, or children are prohibited from witnessing a statement, with that alone being the sole provision designed to prevent them from, on paper at least, being involved in enabling a decision. The only other measure included in the bill is a requirement for a doctor to determine that an individual has taken a decision to end their lives without coercion. It’s hard to see how asking someone if they have been coerced will in itself protect vulnerable people against said coercion, given that coercion can be subtle, and in cases relating to long-term illness, disguised as concern.

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The appointment of doctors of the gatekeepers of that particular safeguard is particularly perplexing for many disabled people, amongst whom there is a wide distrust, and even fear, of the medical profession.

This hasn’t been helped by a report published by the Parliamentary Health Service Ombudsman last month that found evidence that do not resuscitate (DNR) orders were put on the medical notes of numerous patients through the course of the pandemic with neither the consent of the individuals themselves, nor their families. Most notably, DNRs were most often placed on the notes of elderly or disabled patients.

Fears over outright coercion is amplified by the fact that, while McArthur’s bill requires medical professionals to provide information about other options that are available, such as palliative care, social care already fails to meet the needs of so many disabled people.

It’s all well and good telling people that other options are available - except when they aren’t. It was as recently as December 2023 that UK Hospices issued a plea for help in the face of a £16 million funding deficit for the provision of end-of-life palliative care. The Scottish Government’s response that it “strives to support hospices wherever it can,” will ring hollow for every disabled or chronically sick person who has ever required government support to simply live from one day to the next.

Just last month the House of Commons Work and Pensions Select Committee published its latest report on Benefits in the UK, which found a significant shortfall between the levels of support provided and the cost of additional health and disability-related costs -another factor that isn’t guarded against in McArthur’s bill. An assisted dying bill, when we are shamefully failing to provide meaningful assisted living support feels like a sinister solution to a problem that politicians don’t want to talk honestly about.

UK Hospices has issued a plea for help in the face of a £16 million funding deficit (Image: Shutterstock)

I’ve watched as someone over years, withered and died, defeated by cancer, robbed of dignity, agency, choice, or peace. I get where Liam McArthur is coming from. But, addressing the issue on his website, he claims that Scotland is failing terminally ill people through its lack of provision for assisted suicide. It’s worth considering why our political representatives aren’t more invested in assisted living measures, providing fully funded compassionate and comprehensive care rather than the quick fix of an early expiration.

Annie was lucky that she was able to do things her way. The fact that she was only able to do so due to the unpaid care she received from other women in the family for almost two decades is telling. Without that love and support, she may have felt as though there was simply no alternative but a premature end to her life, that would have robbed her of precious time with her children, grandchildren, and great-grandchildren.

The fact that this might be the only option available to hundreds of Scots because our service providers can’t be bothered to deliver any alternative is bleak, and an appalling reflection on the way that we view the elderly, the sick, and the disabled. That we have seen the shifting of goalposts in other countries that are now extending state-aided suicide for those with mental illness should provide further cause for concern. It’s time our politicians put real effort into providing terminally ill Scots with meaningful care at all stages of life when it is needed and that truly enables end-of-life dignity.