The debate in the Scottish Parliament yesterday was passionate, with strong views presented on both sides, but the size of the victory against Margo MacDonald’s End of Life Assistance Bill was phenomenal really.

The arguments that carried the day were those relating to public safety – the need to provide protection for the most vulnerable in our community and make better palliative care more widely available. The autonomy argument was certainly brought out but it is recognised that in a free and democratic society we are not free to make choices that endanger the reasonable freedoms of others and it was the argument about balance of harm that really convinced the Scottish Parliament.

That position was shared not only by the people you would expect to have that view, like churches, faith groups and prolife groups, but it also came very strongly from the medical community, the British Medical Association and the disability rights movement in Scotland.

Just a couple of weeks ago, the commission established to examine the Bill brought out a report a recommending that the Bill be rejected, and out of the number of those sitting on the fence previously it seems they read the report and were convinced by the arguments in it - that this is not the right thing for Scotland.

Margo MacDonald, the Bill’s sponsor, has vowed to go on with this issue if she is re-elected and I am sure she will. But what I am not so sure about is how warmly it will be greeted by people who feel it’s been given a really good investigation this year. This Bill has been going on for two years and we had Jeremy Purvis’ Private Member’s Bill on assisted dying before that. The last 10 months or so has seen a process of scrutiny whereby written and oral evidence was submitted and the commission’s report drawn up. They’ve really heard from everybody with an interest and they’ve listened.
MSP after MSP spoke last night of the huge volume of mail they had received from concerned individuals opposing the Bill and among the 600-plus written submissions, 87% were opposed to the bill and only 6% in favour.

There is clearly a difference between public opinion that you get in a telephone poll asking the loaded question on the one hand and committed public opinion, which is what you get when you ask if people are concerned about this enough to write to their MPs asking them to do something. It’s easy to get the answer you want in an opinion poll just by asking the right question but if you ask what the real grassroots concern is, then people draw different conclusions and that’s what we are seeing here.

We know that most opinion polls in Britain will show that 70 to 80 per cent of people are in favour of changing the law to allow assisted suicide and euthanasia but whenever this has been looked at in depth within Parliament and the institutions you get people taking a very different view. This is now the third time in five years that such a proposal has been rejected. The House of Lords did an extensive inquiry back in 2005. Then there was the Joffe Bill in 2006 and another huge debate in the House of Lords last year over Lord Falconer’s amendment to the Coroners and Justice Bill. Both Joffe’s Bill and Falconer’s amendment were defeated by large majorities and this majority we saw yesterday was overwhelming.

When people really take the time to look at the issues coolly and objectively and hear the arguments they come to the conclusion that it’s going to introduce a lot more problems than it claims to solve. The real point of law is to protect vulnerable people, not to give liberties to what in reality is a small number of very determined individuals.

There is a huge job ahead in educating people about the issues and that has to be done in the churches let alone in society at large, because people’s opinions can be very easily swayed when they hear about a hard case that’s got a high public profile, without really having an opportunity to dig deep into the issues.

Another good example of this is capital punishment. The opinion polls will point towards support for capital punishment but whenever parliaments have looked at it, they have decided that the risk of innocent people being killed is too great. The issue of assisted dying is like that, where public opinion should not be the indicator. The reason we elect representatives is because we don’t believe everything should be decided by referendum, by people who are uninformed or who haven’t had the opportunity to look rigorously at the issues and evaluate them. There is a lot of education that needs to be done and that will be an ongoing task for us.

And it’s interesting because if you ask the terminally ill or disabled whether they think the law should be changed or whether they want assisted suicide for themselves, the vast majority don’t. People who are disabled or terminally ill tend to adapt to their condition and learn to appreciate the quality of life that they have much more than the worried well who see a dreadful case on television and feel ‘if that were to happen to me I would want to end it all’. When it does actually happen to them they draw very different conclusions.

When you ask doctors about this you find that around two-thirds of doctors are opposed to any change in the law. Hence the royal colleges and the British Medical Association remain opposed. But if you ask the doctors who work closest to the dying patient, those who work in palliative medicine, you find that it is 95% who are opposed and that is because they recognise the vulnerability of dying people and, secondly, they know what to do. They know what treatments are available.

So many specialists in palliative medicine have said to me that in a lifetime you might see 10-20,000 dying patients and you can count on the fingers of one hand those who have persistent, ongoing requests to have their lives ended. There are lots who in a moment of crisis might think they want to have it all ended but in terms of those with ongoing, persistent requests, the numbers are very small indeed.

So the question has to be: do we change the law for a very small number of determined and persistent people? That’s the key question and our answer has always been ‘no, you don’t’, because if you do then you will remove legal protection from a large number of vulnerable or potentially vulnerable people who are depressed, elderly or sick. It’s too great a risk to public safety and that’s why we oppose any change to the law. Many people are persuaded by the public safety argument and it is held very widely among doctors and particularly in the disability rights movement. This is an issue that many Christians feel strongly about but it’s not solely a faith issue.

At present, there’s no Bill or attempt to change the law currently in the Westminster Parliament. I’m sure there will be more in the future but the sheer margin of this defeat after such an exhaustive investigation over many months really does settle this issue in Scotland for a generation. It’s been thoroughly looked at, Margo MacDonald got the investigation she asked for, and after evaluating the evidence MSPs have voted this bill out.

What is particularly striking is that they felt it wasn’t even worth a second stage, in other words they felt it was flawed in principle and could not be amended to anything that would be safe or workable. That is a striking conclusion. I’m sure that activists who want to see the law change will continue to try in the various parliaments in Britain. But this is the third crushing defeat in the last five years on this issue and it gives a clear signal that people recognise the dangers in this kind of legislation. We should not be legalising assisted suicide or even voluntary euthanasia in Britain.



Dr Peter Saunders, a former general surgeon, is Director of Care Not Killing and Chief Executive of the Christian Medical Fellowship.