Letter: Suicide morals

MARGO MacDonald’s Assisted Suicide (Scotland) Bill, which suggests the legalisation of physician-assisted suicide, closes for public consultation on 30 April.

We believe assisting in suicide is a fundamental contradiction in the role of a doctor. Legalisation of assisted suicide would involve not only a paradigm shift in medical practice but would threaten trust within the doctor- patient relationship. It would also have resource, training and recruitment implications.

Most patients take the view that a doctor is working in their best interests. How can we safely introduce a procedure which is designed deliberately to bring about the death of the patient, in which the assessing doctor is likely to be one of a small minority of doctors who sees assistance with suicide as an acceptable response to terminal illness?

Margo MacDonald proposes “pre-registration” to safeguard vulnerable people. But it would appear that a patient seeking to pre-register need not even be ill. Imagining how we might cope with serious illness is not the same thing as dealing with the situation if and when it arises.

The pre-registration scheme would play to “worried well” fears of serious illness and might put healthy patients on the first step of the road to assisted suicide. In any case what is to prevent those who “might be perceived to be vulnerable to coercion or pressure” opting for pre-registration?

These are questions which need to be considered with care but on which the consultative document is silent. They need to be thought through and exposed to the public before any steps are taken to present this legislation to the Scottish Parliament.

(Dr) David Jeffrey

University of Dundee Medical School

(Prof) Marie Fallon

St Columba’s Hospice Chair of Palliative Medicine

University of Edinburgh