Putting off the inevitable?

Written by: Colin Young, Senior Policy and Outcomes Officer, the ALLIANCE

Published: 14/03/2014

Different perspectives toward assisted suicide will influence our reaction towards the new Bill writes Colin Young.

Death is an emotive subject. The traditionally Scottish attitude of ‘keeping it aw’ in’ often restricts its discussion. Yet Margo McDonald’s Assisted Suicide Bill, introduced in November 2013, causes us to reflect upon our feelings about dying and suicide, and to crucially ask, should people who deem their lives ‘intolerable’ be allowed assistance to die? With it being suggested that “unnecessary harm is caused because people in Scotland are not open about death, dying and bereavement”[1], this Viewpoint discusses the dilemmas of our feelings toward assisted suicide.

We can all agree that dying is an inevitability that is out of our hands. Perhaps more emotive then, suicide, with debate surrounding its legality, morality and the act of ‘committing’ it, provokes us to consider death as a rational and reasoned action for which the individual is responsible. Therefore it would seem that not being in control over one’s own death legitimises the case for dying.

However, for disabled people and those with long term conditions, this inevitability has at times been commandeered by societies that have rejected disabled people’s place within it. Paradoxically, recent cases have caught the nation’s passion for or against assisting disabled people to die. But while disabled activists have raised concerns about the message it sends to disabled people – that ending life is an accepted response to deteriorating impairment – debate has focussed on the outcome of the assistant. Media, legislators and the judiciary have centred their argument on whether the act of assisting should be considered as illegal, rather than on why assisted suicide should be an option at all. The power imbalance that disadvantages disabled people in their daily lives, through exclusion and discrimination, pertains also to their ultimate question.

The Assisted Suicide Bill proposes a strict process to determine eligibility for support to end life, and the poignant question to be asked is whether disabled people should have control over their death. With the pendulum swinging towards disabled people having choice and control over their lives, it is logical to suggest the same right and responsibility should be afforded in dying. ‘Assisted Suicide’ suggests an equalities issue – if a person can take their own life, shouldn’t someone who can’t be enabled to do so? However, this is not a fair comparison. Research suggests the main causes of suicidal thoughts are social factors[2] – traumatic events, substance misuse or loss of an important aspect of life. Whereas the reason advocated for requiring assistance to commit suicide is medical; the deterioration of one’s physiological condition. In effect, choice to die with assistance is being equated to whether one’s impairment is making life intolerable.

This suggests death is an option, and choosing it is an informed choice. Yet the only assessment being made is the continuation of an intolerable life. Exploring other options to living requires support and funding to ensure better options are available, but at least it is a choice of equals. Choosing to die then, becomes not about the intolerability of living but the inevitability of death.

The choices most people search for are the company and setting in which they die, not when. Making sure these choices are available – being at home rather than hospital, being in least amount of pain, or supported to remain alongside loved ones for as long as possible – should be paramount regardless of when the time comes to die.

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