Alcohol addiction is also of great concern. The number of people in Scotland whose death was caused by alcohol is thought to have risen to a 14-year high, with at least 1,276 alcohol-related deaths in 2022. This tragic situation is compounded by our beleaguered healthcare infrastructure. Scots simply cannot get the support they need to escape the terror of addiction, stay free and find the tools they need to rebuild their lives.
It is so important that people who are experiencing difficulties are shown compassion and offered a genuine escape route. This is what my charity, FAVOR UK, is trying to achieve through our work and policies such as the Right to Recovery Bill, which will be debated in the coming months at Holyrood.
I am now acutely aware of trends in wider society that threaten the safety and dignity of the people I care for. The situation on the ground when it comes to rehabilitation is dire. There are no beds to meet demand and the NHS is utterly unprepared to deal with other problems. A mental health tsunami, exacerbated by the pandemic, is currently sweeping through our services.
Against this unsettling backdrop, MPs in the Scottish Parliament are considering the next controversial piece of legislation at Holyrood: an “assisted dying bill”. This bill, which is currently in the first phase of consideration by the Health, Social Care and Sport Committee, would allow people to access drugs that they can take to end their lives. It is the third attempt we have seen at such a law in Scotland.
I believe that this Bill poses a serious threat to the vulnerable people I advocate for every day. And I am sorry to say that concerns about these people have not really been the subject of this debate so far. I would ask Scottish MPs to take them into account when considering the arguments of the various stakeholders.
I note that the bill itself does not include any provision limiting access to assisted dying if a person is addicted to drugs or alcohol. In fact, its authors seem to want the opposite result.
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The explanatory notes published with the Bill state that terminally ill people should not have access to assisted dying if they have a mental disorder, but add: “A person does not suffer from a mental disorder solely because of … alcohol and/or drug dependence or use, (and) behaviour which causes or is likely to cause harassment, alarm or distress to any other person, or because of acting as no prudent person would act. This means, in particular, that a terminally ill adult should not be regarded as lacking capacity on the basis that their decision appears to be imprudent.”
The meaning is clear: a person should not be denied an assisted death because of their addiction to drugs or alcohol. This is astonishing. Every professional, family member and friend of a person suffering from an addiction will tell you that their judgment is severely impaired. It would be a dark irony if vulnerable people who have spent years trying to escape drug addiction were deemed fit to die by ingesting lethal drugs because the state does not consider them vulnerable enough to be protected. To me, this is the opposite of compassion.
It is also worrying that the doctors’ assessments outlined in the Bill do not require consideration of the wider circumstances of individuals. It is obvious that a person who is deemed eligible for assisted suicide under the Bill’s broad definition of terminal illness will be influenced by a number of factors, including their experience with drugs and alcohol, perhaps stretching back years.
A person who lacks a strong support network and who has repeatedly relapsed may feel that they have no prospects for happiness in the months or years ahead and opt for assisted dying. This situation is more likely in a context where support for drug and alcohol addiction is inadequate. Nothing in the Bill as it stands would prevent such a tragic death. Nor would it prevent a death influenced by poverty, extreme loneliness or other factors.
The bill’s sponsors talk of “safeguards” but there are simply no safeguards, whether it is doctors’ assessment of your health, your capacity or your exposure to coercion. Errors and abuses inevitably occur. A failing NHS makes them more likely.
We must also take into account the international evidence. For example, a friend in Canada knew a person who opted for “medical aid in dying” not because of his physical condition, but because he had relapsed after 20 years of sobriety and could not find the support he needed to get sober. People will face this kind of dilemma if “assisted dying” is legal in Scotland. It is dangerous to open the door to it in a context of such serious inequality.
Several countries have gone much further with their “assisted dying” laws to allow people with non-terminal illnesses, disabilities and mental health problems to die. This is also a risk and there is no guarantee that Scotland will not follow suit in the coming years.
In my view, “assisted dying” would open the door to new and terrifying injustices against the people I care for and other groups in society. It is not safe and cannot be made safe. We need to find other ways to help people who are struggling at the end of their lives. I believe we can do that.
Annemarie Ward is Chief Executive of Faces and Voices of Recovery (FAVOR UK)
