Analysis: Opinion is still divided on the meaning of ‘death with dignity’

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THE tension between respecting patients’ wishes and protecting vulnerable groups lies at the heart of all assisted dying debates. The devil lies in the detail, and it is here that Margo MacDonald will face her biggest challenges.

MacDonald will face her biggest challenges.

Of the three major objections to the original bill, there are pros and cons surrounding any likely amendments.

For example, to follow the recommendations of the Commission on Assisted Dying – that the final act be by the patient’s own hand – would exclude some categories of patient who are completely immobilised and cannot act for themselves.

On the role of health professionals, Ms MacDonald now proposes “licensed facilitators” who will act as a “friend at the end” and who would be trained to assist and will be vetted for any personal interest in the patient’s death.

This would certainly send a clear message that assisted dying is not the proper role of the medical profession. It would, in turn, require many questions to be answered about who would be trained for such a role and what qualifications would be required. Whether it would engender the necessary trust from the public is entirely unknown.

The last point is likely to be the most difficult. What does Death with Dignity actually mean? Opinion is reasonably divided either way. For some, dignity is what we would choose for ourselves; for others, dignity is how we behave towards others and does not include any acts that hasten death. Dignity at the end is about care and compassion, not about killing.

Such deeply personal moral questions do not translate easily into cold hard words in an Act of Parliament. The battle for Ms MacDonald’s bill is none the easier for our understanding this.

• Graeme Laurie is professor of medical jurisprudence at the University of Edinburgh.