Terminal illness is defined remarkably broadly as:'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'.
This will likely include advanced heart, respiratory, liver, and renal disease, progressive neurological conditions, and advanced cancer. There is no time limit (such as six months) nor any stipulation that there should be the presence of physical or psychological suffering. Two NHS doctors will be involved in the assessment and advisory process, but the patient will self-administer the medication.
There will be a two-week reflection process to allow the patient to change their mind. But we know this is not long enough to get a psychology assessment on the NHS nor even to assess response to an antidepressant. This reflection period can even be reduced to 48 hours if thought necessary.
The Bill also requires that death certificates list the underlying illness as the cause of death rather than the ingestion of a lethal substance.
The Association of Palliative Medicine conducted an opinion poll of its members in Scotland in 2022 and found that 95 per cent would not prescribe these lethal drugs, even if patients asked for them.[3] Forty per cent would leave their jobs if it was introduced in their clinical setting. They know that patients may not have a real choice if they don't get access to the right care.
Previous Bills were defeated in the Scottish Parliament in 2010 and 2015, but many are considering this Bill much more likely to pass, with many MSPs already stating their support for it. However, there was a mixed response in the press at the launch, with the Bill coming under much more criticism than might have been expected. Some commentators, such as Euan McColm in the Scotsman, expressed concern for those who might feel a pressure to die and the unintended consequences on those who are most vulnerable - ie those with mild learning disabilities and autism, those who are homeless, or those with early dementia.[4]
The next step is the appointment of a Committee to review the Bill. This will take written and oral evidence before a vote in the Chamber. If the Bill passes at this first stage, it proceeds to a second stage where it will be reviewed clause by clause and amendments will be taken. A second vote will be held at that stage - if in favour, the Bill will become law.
If you live in Scotland, write to your MSP and MP to express your concerns. Many are still undecided. North or south of the border, please join Our Duty of Care (ODOC)[5] to oppose the Bill with other concerned health professionals. Please email info@ourdutyofcare.org.uk for further information.
Your voice matters - we all need the right care at the right time in the right place, not medicalised killing.
