Ethics of suicide

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In response to Bob Scott’’s criticism that I have confused suicide with homicide (Letters, 19 February), I would point out that, since attempting to commit suicide is not a criminal offence in Scotland, any prosecution for assisting in a suicide would probably be brought under the law on culpable homicide or some other law (SPICe briefing, 2 November 2010).

It seems to me that supplying a prescription for a lethal dose with instructions on how to take it contributes significantly to the death of the person who commits suicide. This has not yet been tested in the courts and so the legal position is not clear.

What is clear is that this would be a historic departure from the ethical standards of the medical profession since the time of Hippocrates. With regard to the position of the General Medical Council (GMC), I agree that it takes no position on any proposed change in the law. Its current guidance for doctors reflects the current law and so does not allow assisted suicide.

The main purpose of the GMC is “to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine.” In my view, if assisted suicide were legalised and the GMC guidance changed, patients would be put at risk, thus compromising the aims of the GMC.

Experience in Switzerland and Oregon has shown that assisted suicide is liable to be extended to categories of patient not originally specified in the law.

I did not insinuate that Parliament has a choice between palliative care and assisted suicide. As I have already pointed out in these columns, this new bill is no improvement on its predecessor. If it were to become law, financial pressures could well be brought to bear on the vulnerable, as assisted suicide would be a cheaper option than palliative care.

I am disappointed that Parliament has to take up its valuable time by considering this Bill so soon after it had decisively rejected the End of Life Assistance Bill at stage 1. I agree with Mr Scott that “the issues surrounding end of life care are complex, interrelated and nuanced”. Because of his stress on individual autonomy, I do not think he considers adequately the effects this bill would have on the medical profession and on society, especially the most weak and vulnerable.

(Rev Dr) Donald M MacDonald

Edinburgh

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