Assisted suicide law could impair trust

AS EDDIE Barnes reported last week, a debate on assisted suicide will take place in the Scottish Parliament later this month ("When pain becomes a matter of life and death", 3 January). This will encourage an open discussion of end of life choices in Scotland. However, the consensus within the British Medical Association (BMA) firmly remains that the law should not be changed to permit euthanasia or physician-assisted suicide.

If doctors are authorised, by law, to kill or help kill they are taking on an additional role that we believe is alien to the one of care giver and healer. The traditional doctor- patient relationship is founded on trust and this risks being impaired if the doctor's role encompasses any form of intentional killing.

Arguments for and against a change in law on assisted suicide are complex and challenging. As the debate continues, our focus must be on the provision of resources to ensure all patients, irrespective of diagnosis, have access to first-class palliative care to ensure terminal suffering is properly managed.

Dr Brian Keighley, chairman, Scottish Council of the BMA

THE title of Eddie Barnes' article on Margo MacDonald's personal battle with Parkinson's and her political campaign for an assisted suicide bill in the Scottish Parliament is somewhat misleading.

Crucially, MacDonald's bill is aimed primarily at allowing those who suffer from degenerative conditions to decide when their lives should end. In the past, religious groups have argued pain is a natural part of life and we should not try to escape it. However, it is the loss of capacity implicit within degenerative conditions, rather than the risk of pain, that MacDonald has argued to be so objectionable that she would rather end her life than continue to live.

Already the pro-life lobby have attempted to block parliamentary debate, but surely such an important issue merits discussion in our national legislature, at the very least. The pro-life argument is premised on human rights discourse but no right is absolute; and the right to life must, therefore, be reconciled with the right to personal autonomy. The concept of autonomy has become, after all, the lodestar of contemporary medical ethics and law.

MacDonald's argument is sound: individuals should be allowed to choose to die before their ability to choose becomes compromised to such an extent that they are no longer able to do so.

In short, she does not condone suicide, she contends that life should not be preserved at all costs. Her bill would not discriminate against the terminally ill but rather empower those who face the prospect of becoming incapacitated.

Deaths from degenerative conditions, as Barnes' article correctly asserts, account for only a small percentage of deaths in Scotland each year. Fears of widespread euthanasia are misconceived.

Of course, there are fears over the effectiveness of the legal framework to safeguard vulnerable people, but MacDonald's bill cannot be written off a priori simply because it touches on contentious issues.

Individuals should be allowed to choose and the law should enable them to do this.

David Mowbray, Aberdeen