The Proposed End of Life Choices (Scotland) Bill. An Interview with Margo MacDonald, MSP
by Francesco Sani 21st April 2010 F. S.: The first question I want to ask you is with regard to your bill [on End of Life Choices]: there have been a few precedents to the bill, and the last one was last year with Lord Falconer; in view of that, and of Lord Joffe’s attempts before, I was wondering what hopes you had for the bill to go through. M. MacD.: Well, I have higher hopes than I would have had this time last year, because there is so much opinion poll evidence now, and I can prove just how much public interest and how much public support there is. Quite a number of organisations such as the BMA [British Medical Association] have said no we do not approve, but they have never debated my bill, and my bill is not a carte blanche legalisation of assisted suicide, it is very specific in that it names two groups of people: terminally ill people or people with a progressive degenerative condition for whom life has become intolerable as they approach what could be a really awful end-of-life experience, people with MS [multiple sclerosis] perhaps – people with a rapidly deteriorating variety of MS – or other neurological conditions, Parkinson’s or Huntington’s, people with conditions like that who know that there is a very good chance there will have a bad end, that similarly won’t be able to be cared for in the way in which they would wish and in the way which gives them dignity and some sense of control over their own life at the very end; so, that is one group, and the other group is people who are terminally ill and know that there is no way back and just want to miss the last part of it. F. S.: One of my questions would be quite specific: there have been a lot of debates about safeguards, and one of Joffe’s attempts to get his bill through was quashed on the basis of safeguards and he was very upset about that because he said I have given as many safeguards as in Oregon and it is been proven that that would be sufficient to have all the steps, and you have obviously provided those as well. M. MacD.: Oh I have, I have been guided by the Dutch laws and their ways of operating this policy, and I have gone further than that, I have been tighter, more prescriptive than the Dutch have. F. S.: Do you think that this bill could pass this time round? M. MacD.: Yes, it depends entirely on the weight of public opinion: if the weight of public opinion makes itself known to MSPs… and I am convinced that the bill could pass: now, the reason I say COULD is that we will be into the run up to our elections for the Scottish Parliament and every party always becomes more conservative when that happens, they are just scared to move outside their known comfort zones, but I know from the support that I am getting very often from members of organisations who are supposed to be opposed to the bill, church people in particular, tell me privately – and this is ministers and priests as well (I won’t tell names) – that they believe that people are just people, there is a strong Christian faith [where] they believe that God is present at the very end if the person requesting help does so for that reason and that reason only, [i.e.] that life is intolerable and they have no fear of death and the person assisting them is doing so as an act of charity. What lots of religious people who do not clearly express it like that have said to me is: you are doing the right thing, carry on, I do not care what the hierarchy [issues are]. If people power asserts itself then it CAN get through, but I have refused to use this as a normal political campaign as I do not believe it is, it is of a different quality altogether (…) it is a question always of individual determination, each person decides whether or not their own personal moral code, ethical codes, guidelines with which they all live their life and their religion (…) can sit easily inside their beliefs. That has meant that I have not gone about this in a brash way at all, I decided to give people room to think about it. F. S.: There has been a public consultation by Kier Starmer and about 5,000 people replied: there have been a lot of responses basically outlining that the weight of a case should be on the part of the person assisting the suicide. M. MacD.: The person assisting from my point of view must be a medical professional, because I think that if you say friends and/or family, that can become quite burdensome on these people, it can also mean splits and dissention amongst family members because brothers and sisters who may have been asked by their parents to help may disagree, and this is not theory I actually had families tell me this, write to me about this, and so on. That was one reason for it going to the medical professional; the other reason was that if anything goes wrong, a medical professional knows what to do, the professional knows if someone is serious in their request for help to end their life, the best drugs, the quantity of drugs and how to use them. The medical professional is also in a much better position together with the other people who may care for a person requesting help to die, such as nursing staff from a GP’s practice, or perhaps from a hospital, social work staff may well be part of the support team: a medical professional pulling together all of the people who may have a core knowledge of the patience can come to the decisions about the patient’s capacity, about the patient’s seriousness, whether or not there is an element of a bit more depression than usual in the patient, which could be treated; that is why I asked for a medical professional. F. S.: Do you think that the politics at the moment are out of step with public opinion? M. MacD.: Public opinion is for it; political opinion as represented by the average party member is possibly privately supportive but politically a bit scared. F. S.: There have been similarities in some of the cases, and recently we had the two cases, quite different in a way, the Gilderdale and the Inglis [cases]... M. MacD.: Oh, no, VERY different: in one it was very easy to prove that the person concerned, the daughter who had ME, that she had requested it and her wish was quite plain, and her parents had stalled, had given her time to think again, and eventually had agreed, the mother, whereas with the other lad, he did not have capacity, we do not know what he thought, and no one doubted that his mother acted out of love and charity for her son, but that decision is not hers to take under English law or under Scots law, and it would not be her decision to take under the new law that I propose for Scotland. F. S.: And in the case of someone who is incapacitated, like Tony Bland in 1993, who cannot make that decision? M. MacD.: Well, in that situation just now, present laws cover that, and that is a next of kin or family, and that is a quite different situation from the one I am describing; the one I am describing depends on the person concerned falling into these two categories: having full capacity, [and] it is been demonstrable that they have not been coerced into asking for this, that no one associated with the process has anything to gain from their death. It also allows the person requesting assistance to change their mind as often as they like, and it allows the people that they might ask for assistance to opt out on ethical grounds. F. S.: Baroness Warnock was unfortunately quoted when she said that Alzheimer’s sufferers in the later stages of the disease would [be better off being helped to die]. M. MacD.: My bill specifically excludes people with the various forms of dementia or Alzheimer’s because they do not have capacity, and I have found it impossible to find a way of drawing up a law that is equitable, that could be used with people with Alzheimer’s and so on, because when people have Alzheimer’s or dementia, as far as I know, they are not suffering, their feeling [is quite] different from someone with rapidly deteriorating MS whose brain is still functioning one hundred percent. F. S.: When did your interest in the subject start? M. MacD.: Well, I did not take a very conscious [interest in] assisted suicide until I heard a debate in the Scottish Parliament in which a statement was made by some MSP which I knew to be incorrect, from my own experience, and I thought, well, if I am sitting here and I know this to be incorrect I wonder how this feels for someone who is not able to correct it, who has just got to lie there and listen to it, and so I corrected the statement. People then took a great interest in the thing, I became more interested in it, got to know more people and just I couldn’t walk away from it. F. S.: The law has changed in other parts of the world, do you think that if Scotland set a precedent in the UK, maybe England and Wales will follow? M. MacD.: That is not what I am trying to do; I think that it is quite possible, that our lead in Scotland will be followed up in England and Wales, perhaps Northern Ireland also, perhaps not quite yet in Northern Ireland; certainly in England and Wales I think people will be influenced by our debate in Scotland, and depending on our outcome I think that inside the English jurisdiction there will be some sort of persuasiveness as to the Scots legislation being a better way to do things, because right now England is in a mess, as regards coping with this, because the DPP seems to be a very humane and very decent person who has tried his very best to come up with a better situation than there was previously when Diane Pretty was going to Europe and so on, to try and make sure that anyone associated with helping her would not be accused of a criminal act; now the DPP was left holding the berry because the politicians were cowardly, it is something that must be (…) legal, that must be equitable, there is no way around it, politicians have got to decide whether to keep the law as it is or change it, and there is overwhelming evidence that they have to change the law, because you have the DPP saying that he will not pursue people who have (…) broken the law, but that is a question for people living in England and for the English parliament. We will do what we can in Scotland to make sure that we have something more satisfactory inside our jurisdiction, and if anybody wants to tap into it for information or help then they will be given it gladly. F. S.: How long do you think the scrutiny of the bill will take? M. MacD.: The first reading of the bill has got to be finished for the 24th of November this year.