Lack of information on assisted suicide

EDDIE Barnes presented a balanced appraisal of aspects of both sides of the debate concerning Physician Assisted Suicide in your article "When pain becomes a matter of life and death," (Insight, January 3).

If any debate is to be of real value in our society, it is imperative that all sides are fully informed.

Margo MacDonald's consultation document, Proposed End of Life Choices (Scotland) Bill, refers to data from the Netherlands suggesting that, in 2005, assisted dying was involved in 2.8 per cent of deaths in that country, the legislation allowing this having been introduced in 2002. It is more useful to know that in the Netherlands and Belgium since 2002 and in Oregon, US, since 1987 there has been a yearly increase in the number of deaths through assisted dying of one kind or another. However these figures might be used, it is imperative that they are available in detail to those involved in the debate.

It is difficult to determine whether the introduction of Physician Assisted Suicide has had any effect on the development of palliative care in the Netherlands or Belgium.

If it transpires that the availability of Physician Assisted Suicide attenuates the evolution of palliative care, it may be that the expression of autonomy involved in such practice becomes self-defeating, as the choice of comprehensive and competent palliative care may no longer be available. This compromise of choice challenges the notion of social justice.

At the present time, our society has difficulty providing care for frail individuals of whatever age because of the paucity of both physical (not enough carers to go round in an ageing population) and fiscal (fewer taxpayers, fewer jobs, recession etc) support. Again, this might be used in either side of the debate, in that this could be seen as a driver towards the introduction of life- terminating practices, or as a threat to safety and freedom to decide how we should be treated at the end of our lives.

I fear that those who are responsible for the introduction of legislation in the Scottish Parliament will be increasingly influenced by the narrow argument from the perspective of respect for an individual's autonomy, unless these further aspects are explored in the debate.

The difficulty at present is that there is a public discussion about this which is poorly informed and emotive. At the end of the day, whether we have Physician Assisted Suicide and/or euthanasia will depend upon the democratic process. I believe we do not have the information yet to reach a decision that has such profound implications for our and our children's futures.

Dr Richard Lenton, Fellow of the Royal College of Physicians of Edinburgh, consultant physician, Forth Valley Acute Hospitals