Euan McColm: Spectre of coercion and pressure on doctors has eroded my support for assisted dying

Can we be confident relatives won’t abuse the law or patients feel that they are simply a ‘burden’

Few things are as difficult to cope with as the serious illness of a loved one.

Feelings of powerlessness and guilt consume us as we witness their suffering. And – though we’d never admit as much – we selfishly think of our own vulnerability; the rapid physical deterioration of a once healthy parent or sibling reminds us that life is precious and short.

Perhaps – like me – you’ve had conversations over the years about how the passing of this relative or that friend was a kind of blessing. Better they’re at peace than in constant physical torment.

It’s that sentiment which, for a very long time, made me a supporter of legislation that would allow doctors to help terminally-ill people end their lives. Of course, life his precious but for some it can become agonising. Why shouldn’t those people be allowed to choose to die with dignity on their own terms?

This, it would appear, is an idea whose time has come. Recent polling carried out by Opinium Research for the campaign group Dignity in Dying, shows overwhelming public support for the proposal, with 78 per cent of Scottish respondent saying they supported making it legal for someone to seek assistance with dying in the UK.

Last week, the Liberal Democrat MSP for Orkney Islands, Liam McArthur, published the Assisted Dying for Terminally Ill Adults (Scotland) Bill. It is expected his proposal to allow Scots to seek help in ending their lives will be debated at Holyrood this coming Autumn, with the possibility that MSPs will vote on the matter next year.

And with such high public support for the idea, there’s every chance Scotland could be the first part of the UK to make assisted dying legal.

This is the third time MSPs have been invited to consider this sensitive issue. Back in 2010, the late Margo MacDonald’s End of Life Assistance Bill was rejected by her fellow MSPs by 85 to 16 votes. When MacDonald, who had been diagnosed with Parkinson’s Disease, died in 2014, the Scottish Green MSP Patrick Harvie took up the cause but he had no more success in changing the law on the matter and his Assisted Suicide Bill was rejected by 82 votes to 36.

First Minister Humza Yousaf, a practising Muslim, has already let it be known that he is likely to vote against the bill, which also faces opposition from the Church of Scotland, the Catholic Church. and the Scottish Association of Mosques.

But faith groups do not have the same influence they once did. Words of opposition from preachers will not, I think, play much of a part in the decision making of MSPs. The Scottish Government has already said ministers and SNP backbenchers will not be whipped to vote any particular way on the issue and I would expect other parties to recognise this a matter of conscience and for them to follow suit.

Just as it looks more likely than ever that MSPs will change the law in favour of allowing the terminally ill to seek assistance in ending their lives, I find my long-term support for the idea has gone. The more time I’ve spent thinking through the potential consequences of legalised euthanasia, the less appealing I find the idea.

While urging support for his bill, Liam McArthur says that, in order for someone to qualify for help with ending their life, their terminal illness would have to be both advanced and progressive and that medics would have to ensure there was “no coercion”.

This is asking an awful lot of doctors who, no matter how well they might know their patients, surely cannot be expected to fully investigate every aspect of an individual’s relationship with their relatives.

The risk of coercion is central to my growing unease about changing the law. I’m afraid there is an abundance of evidence that not all families treat older members as well as we might hope.

Can we say with full confidence that no relatives of terminally ill people would abuse the law? Are we sure some people will not be made to feel they are such a burden that they believe assisted dying is the best course for them?

I’m not at all confident we can simply dismiss such concerns.

Growing public support for legislative change is all well and good but I find myself thinking of the views of those who care for the terminally ill.

Dr Fiona MacCormick of the Association for Palliative Medicine says she’s concerned about the potential for inaccurate diagnosis and prognosis, undetected coercion, and fluctuating mental capacity in seriously-ill patients.

McArthur dismisses such concerns. “We’re talking,” he says, “about people with a terminal illness, and the fact they are going to die has already been established.”

At the risk of seeming flippant, the fact we’re all going to die has already been established.

As the years pass, we see increasing numbers of friends family members deal with serious illness and, yes, in some instances it might seem that a death as painless as possible is the kindest solution. But we also see people whose circumstances might once have seemed utterly hopeless but who defeated the odds to regain a decent quality of life in their final years.

I’m bound to say the current state of the NHS has played a significant role in changing my mind on this issue. The health service is woefully underfunded and and understaffed and I’m not at all confident it’s in a state where we could have full confidence in every decision to support assisted dying.

I’m afraid that, as the NHS struggles to provide necessary care to the seriously ill, I’m deeply uneasy about a law that would make it easier to simply end their lives.