Assisted suicide law 'needs tougher safeguards'
A law allowing assisted suicide in Scotland needs tougher safeguards to protect doctors and patients, medical experts have warned.
Doctors who specialise in palliative care have been giving evidence to MSPs on Holyrood's health committee.
Questions were also raised about how the backbench bill would affect people aged 16 to 25.
Supporters said the plan had widespread public backing, but critics have argued a change in the law would be unethical.
The Scottish government does not support a change in the law.
The Assisted Suicide Bill would give people whose lives have become intolerable through a progressive degenerative condition or terminal illness the right to seek the help of a doctor to help end their lives.
The legislation, which has begun its passage through parliament, says the final act must be carried out by the person seeking to end their own life.
Baroness Finlay of Llandaff, Palliative Care Lead Clinician for Wales and Crossbench Peer, said the bill did not include adequate safeguards for patients.
She said the issue of coercion was a danger, and also argued that doctors should not be involved in the decision-making process, which she said should be left to the courts.
"If you want to look at how to improve this bill, I think you should not make the doctor be the person who sits in judgement over whether or not they are suffering enough to be eligible for assisted suicide," she said.
"What you do is you maintain that doctor's duty of care to do everything they can to improve that person's quality of life and to carry on providing care."
Assisted suicide - the legal position
It is not illegal to attempt suicide in Scotland, but helping someone take their own life could lead to prosecution.
In England and Wales, the Suicide Act 1961 makes it an offence to encourage or assist a suicide or a suicide attempt, which is almost identical to the situation in Northern Ireland.
The Director of Public Prosecutions has to approve any assisted suicide court action in England, Wales and Northern Ireland.
In 2010, Keir Starmer, then the DPP, issued guidance that made it clear that family or friends who travelled with a loved one to the Swiss suicide group Dignitas would not risk prosecution.
The guidelines were the result of a case brought by Debbie Purdy, a terminally ill woman, who in 2009 won a legal ruling requiring the DPP to set out whether her husband would be committing an offence if he accompanied her to Dignitas to end her life.
Scotland's prosecution service, the Crown Office, has issued no such guidance.
Assisted suicide is legal in Luxembourg, the Netherlands and Belgium as well as Switzerland.
Dr David Jeffery, from the University of Edinburgh, warned the bill did not give enough legal protection to doctors and would make it difficult for them to discuss depression and suicide with patients.
He said: "Doctors, by their oath, stay on the side of no - they can't kill patients.
"We're confident in that and that enables us, in all sorts of ways, not just these difficult conversations, it enables us to feel confident using large doses of drugs where they are necessary to combat pain.
"We feel confident in that we are protected by the law."
The Committee also heard evidence from Dr Pat Carragher from the Children's Hospice Association Scotland, who said he had "profound concerns" about how the bill could affect young people and possibly give parents the power to end their child's life.
He said the Adults with Incapacity Act allowed parents to apply for legal attorney.
"I'm not sure the bill gives me any reassurance that parents couldn't take that one stage further and decide that what was in the best interests of their child would be assisted suicide," he said.
The Assisted Suicide Bill, which contains a series of safeguards which aim to prevent abuse of the legislation, was brought forward by the late independent MSP Margo MacDonald, who died last year after a long battle with Parkinson's disease.
It is now being championed by Green MSP Patrick Harvie, who said there was "substantial public support" for the principle behind the legislation.
He said: "I believe this bill represents the continuation of a long term trend toward respect for the right of people to make choices about their own lives, in an informed and supported way, and to decide what kind of assistance they need."
Assisted Suicide Bill - key measures
- Only those who are terminally ill or who are suffering from deteriorating progressive conditions which make life intolerable can seek assisted suicide
- An "early warning" aspect, whereby anyone over the age of 16 can inform their GP of their support in principle for assisted suicide
- The indication can be noted in the person's medical records, but must be stated at least seven days before they can formally request help to end their life
- Any requests to GPs must be backed up by a second professional opinion, and followed by a 14-day "cooling off" period
- The process is then repeated again with a second request, after which one of the doctors concerned supplies a licensed facilitator with a prescription to enable assisted suicide to take place
- The facilitator, or "friend at the end", has no relationship with the patient and is given the task of collecting the prescription and agreeing the process of assisted suicide
- If the prescription is not used within 14 days, it must be returned to the chemist
But those opposed to legal assisted suicide, including the campaign group Care Not Killing, have described it as "unnecessary, unethical and uncontrollable".
A spokesperson for the organisation, said: "We do not want the state-sanctioned killing of old, ill and disabled people of all impairment.
"We want support for people to live - not to die."
The health committee, which will also hear from faith groups and campaigners on both sides of the debate, will spend the next few months taking evidence before reporting to parliament in the spring.
MSPs will then get the opportunity to pass or reject the bill.
In 2010, a similar piece of legislation was defeated by 85 votes to 16, with two abstentions, by MSPs who were allowed a free vote on the proposals, rather than on party lines.