If MSPs pass Assisted Dying Bill, I fear the cost to us all will be too high

Endless such leaps have allowed us to tinker with our fates, whether undergoing life-saving treatments to prolong life, fertility treatments to create it; or undertaking non-essential but desired cosmetic surgeries and procedures.

Some may raise an eyebrow at my grouping these things together – evidently life-prolonging or life-saving operations can be viewed as a universal good. But all new advances in medicine walk a tightrope between the individual’s wishes versus social norms, medical possibility versus medical ethics; with all including the possibility of disappointment, things not working, or having unintended consequences.

In our current era, non-essential but life-enhancing treatments are usually argued for in terms of ‘autonomy’ and ‘choice.’

But tomorrow, MSPs will make a decision far greater than any of these, which flips the question, while using the same appeal to both: whether a person - able to make the decision autonomously - has the right to choose the manner and time of their own death.

Within the inevitably emotional debate, and bickering over legislative minutiae, it can often be lost how monumental – and society-changing - a decision this would be.

Death can be frightening to contemplate. A majority – while not necessarily receiving a terminal diagnosis – will face decline and/ or serious illness before our inevitable end. For those with degenerative conditions this can be especially frightening. Should it pass tomorrow, The Assisted Dying for Terminally Ill Adults (Scotland) Bill would limit assisted death to those who are terminally ill. It’s not difficult to foresee, however, that the definition of ‘terminal’ may change, which is just one problem with the Bill as it stands.

The proposed legislation has been fraught with controversy, including despair at the limited time for adequate Stage 3 discussions. Last week, MSPs debated hundreds of amendments in marathon sessions, including rare sittings extending late into evenings - and on Friday - to complete the process.

On Friday, the Royal College of Psychiatrists was the latest medical organisation to state its opposition, saying it “poses an unacceptable risk to the public and the psychiatric workforce”.

Additionally, religious objections have been raised, most notably from the Bishops’ Conference of Scotland. Alarmed by MSPs failure to pass amendments ensuring organisations can conscientiously object, they point out this means Catholic care homes, for example, would be “forced to decide between acting contrary to their foundational values or closing.”

Like most, I’ve witnessed loved ones suffer in their final days. Most painful was that of my paternal grandmother, Isabel Lindsay. Though she didn’t officially have a ‘terminal’ diagnosis, she lived for years knowing her incurable, degenerative lung condition would likely, eventually, end her life.

In 2017, she was rushed to hospital for the final time, over a fortnight before she died. When she did, she was surrounded by her family.

Each was deeply affected by that experience. I believe my grandmother – as was her character, after a lifetime of putting everyone else first, including a late husband who gave her little choice in that – felt some guilt at circumstances completely outwith her control.

Which is but one reason I’m opposed not only to what I perceive to be a flawed bill; but to the principle of medically-assisted dying of any kind.

Once it is an option, I am unconvinced coercion can ever be fully ruled out. This includes self-coercion, brought about by being made to feel as if ‘being a burden’ is something one must always avoid. But burdens can be borne; they should be by a caring society. Idealistic, perhaps. But a principle worth defending.

In Canada, their Medical Assistance In Dying (MAID) legislation has seen precisely the ‘slippery slope’ critics of all assisted-death legislation forewarn of. Within a few years, MAID has been expanded to those without a terminal diagnosis, including those with depression and other manageable conditions.

Subsequently, the social discussion has rapidly moved far beyond the question of whether the state should help those suffering at the end of life. Instead, the question has become, “should we assist someone to die if they find life intolerable?” That is a fundamental reframing. Also: no.

I worry, too, about the assumptions inherent in the slogans of campaign groups like Dignity in Dying. My grandmother suffered, certainly, as all of us might. But being reliant on others, whether loved ones or palliative care professionals, isn’t ‘undignified.’ This framing is wrong.

Other placard messages from the influential lobby group include: “So my family remembers my strength, not my suffering.” “So I can be remembered as I lived, not as I died.” I do not wish to sound harsh, nor to diminish such deeply-held worries. But neither of those is in an individual’s control.

When I think of my grandmother, I remember her laugh, her advice, her company. I picture us on those long walks around Lanark Loch. Her yellow dress. Her dancing with my brother.

That day with the blackberry pies. I remember the pleasures she took from her quiet life. It is only secondary to remember that small hospital room. Its sadness – but also its love. That my grandmother may have thought herself a burden that final fortnight is something I’ll never know. But it’s something both family – and the palliative care nurses of Wishaw hospital - did our best to dispel.

I empathise with those living with terminal illness. But I fear if this Bill is passed, the cost to us all will be too high. I too hope my last experience of my fellow humans won’t be to feel burdensome. A society where people feel that way is one to avoid, not ensure.