IN Scotland, the implacable desire of those seeking to enable people to kill themselves more easily has endured for 13 years.

A colossal amount of time, energy and money has been devoted to this project, involving dozens of MSPs, their advisors, the per-diem lobbying sector and at least two national newspapers. It betokens a culture of death in which the debate around “Assisted Dying” is framed in the most callously simplistic manner.

Would that a similar quantum of effort and cash had been expended on improving end-of-life care for chronically ill people. But concepts such as funding better and more targeted palliative care have never been permitted to intrude on this debate. Nor has the notion that much of what we are told is “insufferable” pain can be made much more tolerable if our health care system prioritised it.

Instead, they’ve chosen the path of least resistance (and least cost). The prescription of quick and summary death has replaced a desire to make terminally or chronically ill patients as comfortable as possible. Thus, when patients and their families are at their most helpless they will enter a realm where the need for an accelerated death has far outstripped any desire to maintain a patient’s quality of life in their final days.

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The world-renowned care specialist Professor Leonie Herx put it much more precisely. “I’ve been practising palliative medicine for 16 years and I’ve yet to encounter someone whom I’ve been unable to help make comfortable at the end of their life,” she told me last week.

Yet, those who have been the most zealous in promoting Liam McArthur’s Assisted Dying Bill would rather not discuss the ways in which suffering can be eased, life prolonged and authentic dignity at the end of days maintained. A quick and perfunctory death is much cheaper.

Mr McArthur, the Lib Dem MSP for Orkney, wrote these words on his petition seeking support for his bill: “I believe dying people should have choice about how they die.” Here’s a better pledge: “I believe dying people are still people and should be given the best treatment the state can provide (and which they’ve already paid for).”

You could add that dying people also deserve the full facts about what’s really going on here. From Mr McArthur’s own analysis of the public consultation he ran in support of his bill, we can find several glaring gaps and omissions. It says that “people living with terminal illness have an increased likelihood of attempting to end their own life, and many do, often alone and in traumatic circumstances”.

Nowhere is there any suggestion of a suicide prevention campaign to inform terminally ill people of appropriate support networks. There is no stated desire to fund research into the mental health challenges that chronically ill people naturally encounter, or about how to control symptoms. Rather, it marches to a constant drumbeat: Suicide! Suicide! Suicide!

Let’s also follow the money on this one. Mr McArthur’s consultation outlined in seductive detail the financial rewards of legalising euthanasia for the public sector and for “business”. It cited the cash windfall accruing to the Canadian Government of their Medical Assistance in Dying legislation which amounted to anything between Can$35m and Can$140m. This isn’t Dignity in Dying, this is Liquidity in Dying.

The consultation said legislation would “particularly increase choice for those on lower incomes, given that the only current equivalent (travel to an organisation such as Dignitas in Switzerland) is expensive. Of course it’s expensive; Dignitas is a sort of death spa for the well-heeled.

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Care Not Killing, the main organisation opposed to state-assisted suicide, refutes this and points out that Mr McArthur’s bill “would do nothing to tackle the huge financial cost of living with a terminal illness”. It cites a report by the Marie Curie Hospice which found that “two thirds of households affected by terminal illness experience financial strain as a result and disadvantaged families can spend as much as 98% of their income on the added costs brought on by terminal illness”.

These people are already struggling to live, but rather than help them in their time of greatest need, Mr McArthur and his 38 Holyrood co-signatories can only offer them death as a way out. Perhaps the most sinister and chilling proposal in Mr McArthur’s consultation is the one suggesting that death certificates list underlying illnesses as “primary” causes of death on the basis that they are public documents. Yet if “assisted dying” is as ethical as its proponents claim, then why the need to hide it as the main cause of death?

The orchestrated propaganda aimed at cajoling public opinion towards implementation of this bill suggests that professional medical support has begun to swing behind it. Yet, the Royal College of Physicians doesn’t support it and nor does the British Geriatrics Society. The Royal College of General Practitioners and the World Medical Association are against it, as is the UK Association for Palliative Medicine, along with many other health bodies.

Professor Herx fears that what’s being proposed in Scotland may result in the profoundly chilling consequences that Canada is now seeing six years after it passed its own euthanasia bill.

In that time there have been more than 30,000 euthanised killings, including a 35% increase from 2019 to 2020. In Canada, euthanasia now accounts for 2.5% of all deaths. Yet during the slick and well-funded lobbying campaign advocating for the change in legislation, Canadians were told that euthanasia would be an extremely rare event with projected estimates amounting to a mere 100 or so deaths per year.

A grim legislative progression has been evident in the few other countries that have legalised euthanasia. One by one, all the original constraints and safeguards have been eroded to the extent that it has become the default solution for any form of human suffering.

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The implications of this for people with mental health issues or with complex patterns of physical disability are profoundly disturbing. Once you introduce a cost analysis as part of their care assessments, state-provided euthanasia becomes a beguiling option.

Professor Herx offered this to the Canadian Parliament recently: “Physicians who know that there are reasonable treatment options for their patients have a professional duty to instil hope and support resilience and not to stimulate a desire to die. My professional integrity as a physician compels me to offer recommendations to promote the health and well-being of my patients.”

And when you start making highly subjective value judgments on what constitutes a meaningful quality of life, you quickly go through the door marked “Department of Eugenics”.