From coercion to conscience: Medics warn MSPs of assisted suicide Bill’s risk to the vulnerable

Almost 200 medics have written to MSPs about “serious risks” in Liam McArthur’s assisted suicide Bill that need to be addressed.

The 188 leading doctors and nurses signed a letter highlighting six key areas of concern: coercion, ability to change one’s mind, safeguards for mental illness, undermining conscientious objections, unmet social needs, and lack of other alternatives such as palliative care.

The Assisted Dying for Terminally Ill Adults (Scotland) Bill, which would allow those deemed to be terminally ill to get help from a medic to kill themselves, passed Stage 1 by 70 votes to 56. Some MSPs have withdrawn their support due to safeguarding concerns. Only five more need to follow suit for it to fall at a vote later this month.

Not theoretical

One of the signatories, Dr Jonathan Blackwell, said: “We care for people at their most vulnerable. In our professional judgement, the Bill as it stands does not contain sufficiently robust safeguards to protect patients from coercion, untreated mental illness, or unmet social and palliative care needs.

“This is not a theoretical debate for us – it concerns the safety of real patients. Before Parliament proceeds further, we believe these issues must be addressed.”

The gastroenterologist at NHS Lothian added: “While the signatories hold different views on the principle of assisted dying, they have united to warn against the legislation’s unintended consequence.”

Treatable pain

Professor June Andrews, a psychiatric nurse who specialises in dementia care, stated: “We do not all share the same personal view about assisted dying in principle. But we share serious concern about how this Bill would work in practice.

“As the Bill is written, there’s no requirement for an expert multi-disciplinary assessment of our patient’s full medical, psychological and social needs.”

She explained: “Without that safeguard, requests for assisted death will, in some cases, arise from treatable depression, treatable pain, disability-related problems, loneliness, and gaps in care. That’s not a fully informed and settled choice.”

Further opposition

Last week, seven healthcare organisations came together to warn the Scottish Government of their “significant collective concern” around the Bill, despite being neutral on the principle of it.

The signatories were the Association for Palliative Medicine (Scotland), Medical and Dental Defence Union of Scotland, Royal College of General Practitioners Scotland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Psychiatrists in Scotland, Royal College of Surgeons of Edinburgh and the Royal Pharmaceutical Society.

Their letter stated the need for “clear, robust statutory protections when legislation may require involvement in ethically sensitive practices”, criticising the legislation for leaving key safeguards to be added or decided on later.