Assisted Suicide Bill report takes no formal position
The Assisted Suicide (Scotland) Bill should go to the full Parliament for a stage 1 vote without a formal recommendation from the committee examining it on whether to allow it to proceed, MSPs have decided.
In its stage 1 report on the bill published today, Holyrood's Health & Sport Committee records its belief that the bill contains "significant flaws" which "present major challenges as to whether the bill can be progressed". However, "Whilst the majority of the committee does not support the general principles of the bill, given that the issue of assisted suicide is a matter of conscience, the committee has chosen to make no formal recommendation to the Parliament on the bill."
The member's bill was initiated by the late independent member Margo MacDonald and taken on following her death by the Green Party's Patrick Harvie. It would allow individuals aged over 16, who have been diagnosed with an illness or progressive condition that is terminal or life-shortening and who have come to the conclusion that their quality of life is "unacceptable" and that there is no prospect of any improvement, to receive assistance in ending their own lives, following a three stage approval process.
Following lengthy evidence hearings on the bill, the committee's report contains a series of conclusions and comments on the different matters argued before it. It expressly "notes the good intentions of the member in charge of the bill and recognises the complexity of the various moral and ethical issues that consideration of this bill presents", along with the strength of feeling on both sides of the argument. It "recommends that the Parliament approach the stage 1 decision with due respect for this diversity of views".
Among its more specific points:
- The committee is not persuaded by the argument that the lack of certainty in the existing law on assisted suicide makes it desirable to legislate to permit assisted suicide; it considers that the law must continue to provide an effective deterrent against abuse, and to be responsive to the individual facts of particular cases.
- It acknowledges an ethical duty to respond with compassion to the suffering of others, and that there are ways of responding to suffering, such as palliative care, which do not raise the same concerns as are raised by assisted suicide.
- The committee is not persuaded that the principle of respect for personal autonomy on its own requires that assisted suicide be permitted in some circumstances.
- Experience from other jurisdictions, although informative, cannot be regarded as evidence either in favour of the Bill or against it, because each regime is different and each cultural context distinct.
- "It seems clear that in numerous respects, some of which go to the heart of the bill’s purpose, the language of the bill would introduce much uncertainty... such significant uncertainty must be unacceptable and would require to be addressed were Parliament to approve the bill at stage 1."
- The bill does not define the criteria for eligibility sufficiently clearly; it describes the role of the facilitator using ambiguous terminology; and it contains a savings clause which may make prosecution difficult in cases where it would be desirable.
- A requirement for mandatory psychiatric assessment would be desirable in relation to any request for assisted suicide by a person who was terminally ill, under the age of 25, and/or with a history of mental disorder. It is arguable that given the magnitude of the decision to commit suicide, assessment by a psychiatrist ought to be routine in all cases.
- If the bill were to be approved at stage 1, consideration would need to be given to measures aimed at minimising the risk of coercion; however the committee notes that the risk of coercion can never be eliminated completely.
- There would be difficulties in preserving individual medical practitioners’ rights of conscience.
- The role of the licensed facilitator would require to be clarified in a number of respects were the bill to be approved at stage 1, including what counts as permissible assistance, the means by which an assisted suicide may be accomplished under the bill, and whether the facilitator is obliged to be present at the time of the suicide/attempted suicide.
- Provision should be made for the creation of an independent supervisory body with responsibility for ingathering and checking of paperwork; collecting, analysing and publishing data on assisted suicide in Scotland; and overseeing and scrutinising the activities of licensed facilitators. This would be essential both to safeguard the public, and to protect facilitators themselves.
- Legislation to permit assisted suicide seems discordant with a wider policy of suicide prevention: it risks sending negative messages, and it could have a corrosive effect on the central suicide prevention message by “normalising” suicide and seeming to endorse it.
- The committee has concerns that specifying that the act of assistance must take place within 14 days of the second request being recorded may create pressure for a person to proceed with an act of suicide prematurely; and at the prospect of lethal doses of drugs being dispensed into the community in an uncontrolled manner.
Deputy convener Bob Doris commented:
“The committee has recognised throughout its work that the proposed legislation touches lives in a deeply personal way and we thank those individuals for sharing their personal experience.
“The committee’s intention was to inform the debate and not influence the outcome as that is a matter of conscience for the Parliament when they vote later this month.
“However, the committee agreed that the bill will need significant amendment should it progress through the parliamentary scrutiny process.”