McArthur Bill Leaflet

A Better Story

There’s a brighter path for Scotland than assisted suicide

FOR SCOTLAND

Assisted dying is a deeply emotional issue and discussions about the end of life are complex. At CARE for Scotland, we believe that regardless of one’s stance on assisted death, the challenges of legislating for it safely are insurmountable. Evidence for this is seen in places where such laws already exist. Below are seven poignant stories of lives that could have ended prematurely if assisted suicide were legal, alongside several practical concerns showing that safeguards fail, no matter how well drafted.

Heidi Loughlin1 In 2015, Heidi was diagnosed with breast cancer while pregnant and given 12 months to live. She even postponed cancer treatment in order to give birth, further threatening her condition. Her end was looking bleak. And yet, defying doctors’ predictions, to this day Heidi continues to live a meaningful life as a motivational speaker, author, and insurance advisor. She proves that even in dire circumstances, life’s potential surprises can’t be discounted.

Concern: Doctors get it wrong Doctors, while skilled, are not infallible.

Prognoses can be wrong, as seen in numerous cases where patients outlive terminal diagnoses by many years. Increasing the burden of prognosis by legalising assisted death risks lives being ended prematurely based on inaccurate predictions, and even triggering a desire to die prematurely that may not have otherwise existed. Legislation cannot solve this.

Alison Davies2 Alison, born in 1955, was living with spina bifida, arthritis, hydrocephalus and other conditions, and endured unbearable pain with the deterioration of her spine. She had a “settled wish to die” by the age of 30, following several failed attempts to take her own life, which lasted for over a decade. Her story is not one of a remarkable recovery. Rather, after visiting a project for disabled children in India in 1995, Alison said to her carer “You know, I think I want to live”. She came to recognise the beauty and value of her life and declared in her later years, “I would have missed the best years of my life had euthanasia been legal.” She died peacefully in 2013 at the age of 58.

Concern: Mental health & unsafe decisionmaking Under the Mental Health (Care and Treatment) (Scotland) Act (2003), poor mental health does not negate decisionmaking capacity. This means terminally ill individuals battling depression or anxiety or any other mental health disorder could legally request assisted death, even if their judgment is being impacted by their current mental wellbeing. Protecting such individuals from harm is impossible within existing legal frameworks, and will always be a threat as poor mental health can very often hide beneath the surface, out of sight.

Alison Davies pictured with friends in India.

Christine Gauthier3 Canadian army veteran and former Paralympian, Christine Gauthier, made an inquiry about getting disabled equipment to make her home more accessible. When the Veterans Affairs staff member heard Christine’s distress after the delays of getting this equipment installed, the staff member noted to Christine that she had a right to assisted dying instead. In Canada, assisted suicide is now the fifth-leading cause of death in the country4 and has expanded its initial laws to now include nonterminal illnesses and disabilities; and eligibility based on mental illness only will be introduced in 2027.

Concern: Today terminal illness, tomorrow anorexia?

No parliament can bind its successors, meaning initial safeguards can be weakened or removed over time. Whilst the McArthur Bill states it is intended for those with terminal illness, there is no reason to believe that future parliaments won’t expand the scope of those considered eligible, either because this is considered desirable or because of court cases. Safeguards are never immutable. This is a problem that cannot be legislated away, and this is the same reason why we see a ‘slippery slope’ elsewhere.

Roger Foley5 Roger Foley led an active and public-service-led life before his spinocerebellar ataxia sadly rendered him hospital-bound and dependent on full-time care. Rather than feeling heard, valued, and encouraged, Rodger says he has “faced neglect, verbal abuse, and denial of essential care.” He adds: “I’ve been told my care needs are too much work, and my life has been devalued. Worse still, I have been approached and told by healthcare staff to consider opting for Medical Aid in Dying (MAiD). Instead of offering compassionate support to alleviate my suffering, it is suggested to me that I should end my life.

I find this deeply hurtful.” He goes on to warn “I fear that the solicitation, coercion, and pressure I’ve faced to undergo an assisted death in Canada would be seen under a Scottish law”.

Concern: Undetectable pressure It can be difficult for healthcare professionals to identify coercion. The McArthur Bill includes jail time for those guilty of this crime. However, coercion is rarely overt and can take the form of subtle pressures and nudges from family, society, or even healthcare providers to influence vulnerable individuals. These undetectable influences make it impossible to guarantee informed consent every time, leaving room for abuse. There is simply no full-proof legislative method for detecting and preventing coercion.

Colin Campbell6 Thursday 15 June 2017 was the day that Colin was due to die.

Colin was diagnosed with multiple sclerosis (MS) in 1995. Living alone in a second floor flat and losing mobility, he began to feel like a prisoner in his own home, and slowly lost contact with his friends. In 2017, he planned to end his life at Dignitas. Everything changed, however, after meeting Rona. Rona also has MS and saw how Colin simply wasn’t getting the help and support he needed to live a full and independent life. She helped him secure better living conditions, disability equipment such as a scooter, and further care support. Colin, enjoying his new-found resources, rediscovered hope, and reflected, “It’s great to be alive”. As Rona put it, “He didn’t need to die; he needed support.”

Concern: Social Care systems fail Assisted dying laws focus on eligibility, not motivation. Patients eligible for assisted death may seek it due to financial pressures, fear, depression, lack of support, or any number of reasons other than unrelievable suffering. While laws require the person to consent to their death, there is no need to understand the person’s motivation. As the above case demonstrates, one’s wish to die could be the result of something as simple as lacking a mobility scooter.

Michelle Moffatt7 Michelle Moffatt, a nurse from Dumbarton, sadly became paralysed whilst at work. Becoming wheelchair-bound, Michelle found herself deep in depression and began to look into a visit to Dignitas.

Michelle reflects, “I felt like I couldn’t be a proper wife to my husband, or a real mum and believed I was a burden to everyone.”

One day, she got a call from her GP, who pointed her to the supportgroup charity Spinal Injuries Scotland, which she began to attend.

Amazed by the lives of those in the support group, and how much joy they found, Michelle said “All of a sudden, my mindset shifted...

I was still depressed and in a bad way, but I realised that ending my life wasn’t the solution. I didn’t know how I’d be okay, but I was determined to find a way to get there.”

Concern: Feeling a burden Amidst difficult times, one’s own voice can quickly become a distorted influence. This can take the form of a distorted sense of duty to one’s community, inheritance to one’s family, impact on health services, and much more. In Oregon, approximately half of patients cite “feeling like a burden” as a reason for requesting assisted death.8 Emotional and financial pressures amplify guilt, pushing patients toward choices they might otherwise reject. These internal struggles cannot be removed by legislation, making selfcoercion an inescapable risk.

Kurt Huschle9 In 2017, Kurt Huschle was suffering from bile-duct cancer at the age of 58 and opted for assisted suicide in his home state of Colorado. He and his wife were told that the process should take 2-4 hours, and that he would slip away peacefully into death.

What unfolded, however, was an 8-hour long horror ordeal where Kurt slipped in and out of consciousness, coughing and spluttering, all whilst his wife stood by his bed, unsure of whether he was dead or alive. He was declared dead at the end of this 8-hour trial, after which his wife, Susan, reflected that this was not the peaceful farewell they had wanted.

Concern: Russian Roulette Stories like Kurt’s are concerningly common.

Unfortunately, no amount of legislation can avoid problems with the assisted death procedure. Data in Oregon suggests a complication rate of 7.7%.10 Traumatic deaths are a sad side-effect of ‘assisted dying’ legislation, but an unavoidable one. Whilst some may write this off as a necessary consequence of any medical procedure, it is worth remembering that an assisted death is never a necessary procedure in the first place.

Concluding thoughts As we noted at the start, these issues are complex.

It is important, however, to acknowledge that assisted dying laws do not simply get rid of existing concerns around end-of-life situations.

Rather, they swap out existing problems for new ones, as highlighted in the stories above.

Given that the matter at stake here is life itself, we believe that it is far more responsible to err on the side of caution, seeking to resolve existing concerns with enhanced end of life care and treatment, not to make dying an easier option, with all of its subsequent problems.

References 1

BBC. (2022). “Heidi Loughlin defies medics to survive 7 years with terminal cancer”. BBC. Available at: https://www.bbc.co.uk/news/uk-englandsomerset-61442803 and (2023) ‘I’m still here’ - mum Heidi Loughlin still defying medics years after being given months to live | ITV News West Country

2

Harte, C. (2024). “Alison Davis – the most compelling advocate for and against ‘assisted dying’”. Parliament News. Available at: https:// parliamentnews.co.uk/alison-davis-the-most-compelling-advocate-for-andagainst-assisted-dying

3

Edginton, S. (2023). “Canadian Paralympian: I asked for a disability ramp – and was offered euthanasia”. The Telegraph. Available at: https://www. telegraph.co.uk/world-news/2023/09/02/canada-paralympian-christinegauthier-stairlift-euthanasia/ and Former paralympian tells MPs veterans department offered her assisted death | CBC News (2022)

4

CARDUS. (2024). From Exceptional to Routine, The Rise of Euthanasia in Canada. Available at: https://www.cardus.ca/research/health/reports/fromexceptional-to-routine/

5

Foley, R. (2024). “My life is at risk under Canada’s assisted dying law. Don’t follow it, Scotland”. The Herald. Available at: https://www.heraldscotland. com/politics/viewpoint/24944512.life-risk-canadas-assisted-dying-lawdont-follow/

6

Rose, B. (2017). “What’s it like to wake up the day after you planned to die?”

BBC. Available at: https://www.bbc.co.uk/news/disability-40042731

7

Jones, J. (2023). “Lucky to be alive. I was left paralysed after performing everyday task at work – I felt so alone”. Scottish Sun. Available at: https:// www.thescottishsun.co.uk/health/10342168/michelle-moffatt-paralysednurse-pen-spine/

8

Jones, A. (2023). “Twenty five years of the ‘Oregon model’ of assisted suicide: the data are not reassuring”. Journal of Medical Ethics. Available at: Twenty five years of the ‘Oregon model’ of assisted suicide: the data are not reassuring - Journal of Medical Ethics blog spcare-2023-004292_Oregon_reports_Regnard_Worthington_Finlay_ MAIN_Text_25Jul23.docx

9

Right to Life. (2021). “Parliamentary group uncovers assisted suicide horror stories and lack of regulation”. Right to Life. Available at: https://righttolife. org.uk/news/parliamentary-group-uncovers-assisted-suicide-horrorstories-and-lack-of-regulation

10

Oregon Health Authority. (2023). “Oregon Death with Dignity Act 2023 Data Summary”. (p14). Available at: https://www.oregon.gov/ oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/ DEATHWITHDIGNITYACT/Documents/year26.pdf

CAREORGUK

CARE.ORG.UK

CARE (Christian Action Research & Education) | Chief Executive Ross Hendry | Co-Founder Rev Lyndon Bowring | 77 Renfrew Street, Glasgow, G2 3BZ | 07583294787 | stuart.weir@care.org.uk CARE is a company limited by guarantee registered in England and Wales at 53 Romney Street, London, SW1P 3RF Company No: 3481417 Charity No: 1066963 | Scottish Charity No: SC038911