LIKE Dr Alastair Rigg (Letters, GP), I am semi-retired as a GP, last seeing a patient in August – and also with faith. Last week, I spent time with a Dutch friend whose doctor husband had euthanasia in 2016, the same year my elderly doctor father died here bemoaning the lack of assisted death or euthanasia.

The practicalities are important to consider, especially in response to public support for assisted dying. As such, the statistics are worth getting right, because significant time and care are indeed required from the GP – and pharmacist as well.

In Holland in 2017, after 15 years of legalised euthanasia, there were 6,600 such deaths. For Scotland, that translates to just over 2,000 deaths per year. There are 4,900 GPs at work in Scotland, not all full-time.

If then around half of GPs in Scotland are prepared to participate within new laws and guidelines, they could expect to engage and assess just one or two patients, carers and families per year after some years of a change being effected.

My father died at 91 with rectal cancer but of heart and circulatory failure, weak, hugely weary and in pain from a peripheral neuropathy. He would have gladly stepped forward when in practice to assist a patient shorten their suffering when in such straits. My friend Siemens was just 69 but had a planned and safe death, with family around, some weeks before metastatic bowel cancer took its toll of pain, bowel difficulty and weight loss.

For me, the case is made on medical, compassionate and workload terms. I hope and think my colleagues will agree soon.

Dr Philip Gaskell,

Woodlands Lodge,

Buchanan Castle Estate, Drymen.

NONE of us asked to be born and most of the time none of us asks to die. The best one can hope for is to pass away while asleep but sometimes to go quickly is what we want and need, it may be the humane, compassionate solution but unless one can afford to visit Dignitas it won’t happen. Dr Alastair Rigg Letters, April 17) mentions the Hippocratic Oath; I do not wish to denigrate the care provided by the medical fraternity but when it comes to palliative care it’s often the hypocritical oath.

Having witnessed enough end-of-life scenarios, including that of my own father, the medical approach can appear to be to preserve existence, not to preserve meaningful life; not to be seen to be expediting a death which in the short term is inevitable. Just enough medication is given to relieve pain and distress in the patient in a futile attempt to eke a few more days or hours out of a human body which may have stopped interacting with attending family members some time past. The same medication given in a larger dose would ensure the spirit or whatever in the dying individual would slip painlessly and comfortably into whatever happens next.

To leave this world slipping in and out of consciousness returning to a waking state in distress must be a horrendous death and that is what the prevention of assisted dying condemns many to experience. If the patient is medicated to the extent this does not happen then what is the point in opposing it?

When I go, if I must, I want a handful of tablets and two bottles of Cava. It’s a shame to think some kind soul would risk going to jail just for handing them to me.

David J Crawford,

85 Whittingehame Court, 1300 Great Western Road, Glasgow.

Read more: Letters: The practical issues that need to be addressed if assisted dying is allowed

DR Alastair Rigg’s letter on the practicalities of assisted dying makes several good points.

For example, it is undeniable that in jurisdictions where such compassionate assistance is legally available, a few individuals decide not to consume the prescribed medication, despite being issued with it. However, it would only be fair to add that, during their final illness, great comfort is to be found in having this available, should their suffering become intolerable. It is also correct that the need for good palliative care to be made universally accessible is important. Nonetheless, I hope he will agree that even the best available palliative care is, on occasion, unable to assuage all distress. Happily, there is good evidence that palliative care and assisted dying can comfortably coexist.

Unfortunately, the letter also puts forward some puzzling ideas. The suggestion that "well-off people will pay privately for it and the poor will suffer longer and have even fewer GPs available to care for them” would appear not to be supported by any evidence, while speculation that there would be a need for crowd funding to allow appropriate care to be given in such circumstances is frankly absurd.

There is a need for balance and restraint in the debate surrounding this contentious matter. We should acknowledge that assisted dying can be appropriate for a few individuals even if that runs contrary to our personal beliefs. Showing tolerance towards the measured conduct of others, of which we do not approve, is the hallmark of a civilised people. A society that allows its members to take control over all aspects of their lives, including its end, truly will have come of age.

Dr Bob Scott (retired GP),

Creitendam Lodge, Balmaha Road, Drymen.

I WOULD like to offer my support from a patient's perspective for Dr Rigg's opposition to any introduction of assisted dying.

To begin with, the addition of such a responsibility would dramatically alter the relationship between a patient and his/her doctor.

Patients presently expect their doctors to aim at ameliorating whatever condition afflicts them. Where no amelioration can occur, there is an expectation of pain control and palliative care.

What would worry a patient, were assisted dying to be part of a medic's repertoire, would be that there could be a tendency on the part of the attendant physician to intimate that an untreatable and terminal condition might be best addressed by consideration of assisted dying.

This brings us to the current culture of disposability, already with us materially and in birth terminations. Assisted dying would conform with that predisposition of our current culture. Who knows how far down that road we would could then go?

Robotic technology is going to become more sophisticated, rendering many more humans surplus to requirements. Are we become no more than a functional and utilitarian society where loss of purpose will lead to loss of life?

We do have to be careful what we wish for and the unforeseen consequences which will inevitably follow in the wake of such an introduction.

Denis Bruce,

5 Rannoch Gardens, Bishopbriggs.