The Christian Institute warns Holyrood against ‘hugely damaging’ assisted suicide Bill.

• CI responds to Scottish Parliament’s Health Committee call for evidence on Liam McArthur MSP’s Assisted Dying Bill
• Proposals would put vulnerable people under pressure to die for fear of being a burden
• Doctor-patient relationship would be undermined
• Legalisation would see an inevitable widening of the law

The Christian Institute has told the Scottish Parliament’s Health Committee that any change to the law on assisted suicide would be “hugely damaging” to society.

In its response to the Committee’s call for evidence on Liam McArthur MSP’s Assisted Dying Bill, the Institute said the legislation would devalue the lives of vulnerable people, risked such people being coerced into ending their lives, and would also fundamentally change the relationship between doctors and their patients.

The Christian Institute’s Head of Policy and Research, David Greatorex, said:

“The Bill would usher in a major and hugely damaging change to Scottish society. It would mean that, for the first time, doctors could approve the intentional taking of life as an acceptable option for some.

“The Bill’s title is itself an attempt to obfuscate, confuse and sanitise its objectives. A survey in 2021 found that less than half of respondents knew what “assisted dying” meant. In reality, it is an assisted suicide Bill, designed to allow people to help others to kill themselves. Legalising assisted suicide would make a mockery of the State’s efforts to reduce suicide in Scotland through its Suicide Prevention Strategy – ‘Creating Hope Together’. This Bill does the very opposite of creating hope: it endorses surrendering to despair.

“The Bill’s supporters say it is about compassion. But true compassion for those who are deemed to be terminally ill means valuing their lives, giving them hope and supporting high-quality palliative care for all who need it.

“Making assisted suicide an option would inevitably put vulnerable people under pressure to consider that option. Making assisted suicide a ‘right’ will quickly turn it into a ‘duty’. The law’s current prohibition on helping others kill themselves is an important safeguard against coercion and pressure, and must be kept in place.”

The Bill would allow those aged 16 or over deemed to be ‘terminally ill’ and who have been resident in Scotland for at least twelve months to get help to kill themselves, but the Institute criticised these eligibility requirements.

‘Terminally ill’ is defined in the Bill as someone who has “an advanced and progressive disease, illness or condition from which they are unable to recover and that can reasonably be expected to cause their premature death”.

The Institute said this was a “very broad” definition, and could be interpreted to include heart disease and progressive neurological conditions. It also pointed out that in Oregon, assisted suicides have been approved for conditions such as anorexia, hernias, and arthritis, while in Belgium and the Netherlands, patients with eating disorders were considered eligible for euthanasia as their conditions were deemed ‘hopeless’ or ‘untreatable’.

Eligibility requirements can also be quickly watered down, as has been the case in Canada, where just five years after legalising euthanasia, legislators scrapped the requirement for a person to be terminally ill.

Liam McArthur’s Bill sets out other so-called safeguards, which include a “test of non-coercion” and a “period of reflection”. The Institute warned it will be impossible to guarantee the absence of coercion once assisted suicide becomes an option, and that many vulnerable people may choose it out of fear of being a burden on others. It also said the 14-day reflection period is “far too short, given the irreversible nature of the decision”.

Mr Greatorex continued:

“Allowing assisted suicide for certain categories of people inevitably sends the message that there are some lives not worth living. People who have terminal illnesses need a clear, firm law to protect them in their darkest moments. They certainly do not need the law to affirm their belief that their life is not worth living.

“The Bill contains no requirement for a person to be near the end of their life. A person with years to live could feel pressured into ending their life prematurely. It is simply not safe to legalise assisted suicide for anyone.

“It is impossible to guarantee the absence of coercion. The very fact of making assisted suicide legal means that it will always be an option that many people will feel they have to consider. The only way to guarantee the absence of coercion and duress is not to make it an option in the first place.

“Where assisted suicide is legal, concerns about being a burden become a matter of life and death.”

The Institute was also clear in its response that changing the law “risks undermining the doctor-patient relationship”.

This is supported by recent polling by Whitestone Insight for Living and Dying Well, which revealed that among those in favour of assisted suicide, more than half said they think introducing it would “fundamentally change the relationship between a doctor and patient”.

Mr Greatorex said:

“The doctor-patient relationship relies on trust and the assumption that a doctor will do no harm. Allowing doctors to assist their patients to take their own lives fundamentally changes their role. Many doctors are worried about this, especially those involved in caring for those approaching the end of their lives.

“Opposition to assisted suicide among doctors is highest for those who are most involved in end-of-life care. When the British Medical Association polled its members in 2020, the majority of those working in palliative care or geriatric medicine were opposed to a change in the law. And although overall half of respondents supported a change in the law, only 36 per cent said they would be willing to prescribe the drugs themselves.

“In 2022, the Association of Palliative Medicine asked its members in Scotland about their views on assisted suicide. Almost all said they would not prescribe lethal drugs, even if patients asked for them. Around nine in ten rejected the idea that safeguards would protect vulnerable people, and 43 per cent would resign if assisted suicide was introduced in their healthcare setting.

“This tells you the scale of true opposition to the proposals within the medical community. Very few will be comfortable participating in a procedure to intentionally end another person’s life, which flies in the face of the purpose of their profession.”

Mr Greatorex concluded:

“Once assisted suicide is legalised, the law inevitably gets wider and the number of cases increases year-on-year. In Canada, there is no longer a requirement for a person’s death to be ‘reasonably foreseeable’. Quebec is pushing ahead with allowing doctors to approve advance requests for euthanasia for those with dementia, and it has been suggested for disabled babies.

“Belgium already permits euthanasia for children, with no lower age limit, having initially only legalising it for adults, and it is also permitted for people with Alzheimer’s, depression, and older people with a combination of complaints.

“The situation is similar in the Netherlands, where ‘unbearable suffering’ is applied broadly. Hundreds of euthanasia cases have involved elderly people who were not seriously ill but had conditions associated with normal old age. Euthanasia for children is legal there too.

“Proponents of assisted suicide may claim the ‘slippery slope’ argument does not hold water, but evidence from abroad is clear that the law does not remain fixed after legalisation. Scotland must not legalise assisted suicide even under the narrowest of circumstances, because once the principle is conceded, activists will not rest until it is as wide as possible and almost anything goes. Once it is legal for some, where do you stop?”