Is Scotland ready to legislate in favour of a right to die? The Firm heard the poignant and powerful argument made by MSP and stoic Parkinson’s sufferer Margo MacDonald, and asks if  solicitors can help make the final journey dignified.

“There is but one truly philosophical problem, and that is suicide. I see many people die because they judge that life is not worth living. I see others paradoxically getting killed for the ideas or illusions that give them a reason for living. What is called a reason for living is also an excellent reason for dying.”
Albert Camus, The Myth of Sisyphus

When facing a crisis, dealing with a problem or otherwise generally struggling, it is an easy consolation to remind ourselves that worse things happen at sea, and that whatever it is that temporarily consumes us, it isn’t a matter of life and death. Except occasionally it is, and if it isn’t, inevitably one day it will be.  When that time comes, it may also be a comfort to believe we will face it with swiftly and with dignity. The creeping reality in the era of longevity is that the final journey can be protracted, messy and far from pretty.  For those dealing with the anxiety and distress of a degenerative condition, preventing this eventuality is presently a criminal offence.  

The great John Diamond despised bellicose metaphors, and resisted the default setting of every journalist who described those affected by cancer -as he was- as ‘brave’ souls who ‘battled’ with the condition, descriptions which implied strength and virtue in those who survived, and weakness in those who died.  Cowards get cancer too, he said.  However, in Margo MacDonald’s case, the bravery label is entirely warranted and achingly appropriate.   

Her public campaign to lobby for the right to die is very much a personal race against time. Parkinsons disease is nibbling away at her physically, although it has yet to take a bite out of her joie de vivre.  When we meet at the Parliament, her progress is slow. She walks with canes, but enjoys a lunchtime glass of pink champagne.  Notable politicians greet her warmly, laugh and share an effusive joke.  In due course, she needs to channel their ostensible support into tangible action and new, significant law. Law that does more than tweak the tax system or balance budgets, but applies the lessons of philosophical jurisprudence.  She needs them to let her die on her own terms.  

“I see this as being the interface between private morality and public policy, which is the most difficult interface of all when you are policy making,” she says.

“You have to allow everyone to make up their own mind.  At this point in the morality interface, everyone will abide by the law in their own way.”

MSP Jeremy Purvis has picked up the baton and taken the first steps to presenting legislation for Parliament. MacDonald has thought carefully about the practicalities that would need to be addressed to decriminalise what she considers to be merciful, empathetic treatment of people at the end of their journey.

“Once I had started thinking about this, the whole notion was not simply about the rights of the person nearing the end of their life, and for whatever reason wants to shorten the very last period. It is every bit as much about the doctor or nursing professional who is involved.  I know that for generations, centuries, ever since they have been able to, doctors have expedited a swifter end to life than nature would have allowed.  Often because they not only felt that person was suffering needlessly, but the relatives had asked them to cut short their suffering,”

“For a lot of other people, it might not have been pain.  It might be the loss of dignity, loss of control, the loss of feeling they are a separate personality. So I am talking about clarifying the role of the doctor. Mens Rea comes into these things. They used to give a heavier dose of opiates than may have been required, that would likely shorten a life.”   

In this litigious generation, formal protection is likely to be a practical necessity, and what MacDonald and Purvis have initiated is not without precedent.  Assisted suicide is lawful in the Netherlands, and Australia introduced the world’s first voluntary euthanasia law, the Rights of the Terminally Ill Act of the Northern Territory, in 1997 which legally permitted four deaths before the experiment was reversed. There the issue remains politically live. Given our universal mortality, and the increasing prevalence of degenerative illness among an ageing population, MacDonald believes that the taboo needs to be confronted practically, and its realities faced with workable, ethical solutions.  She is appealing for the direct input of the legal profession, who are likely to need to be involved in drawing up a code to facilitate any assisted suicide decision.

“You have to act according to the wishes of the patient, nobody else, as they do in the Netherlands,” she says.

“The doctor is covered by having known that patient for a considerable period of time and -the theory is- having built up a relationship, not just a knowledge of the patient’s attitude and state of mind.  That is what I would like to see here.”

“I think a lot of people imagine assisted suicide is OK in the hands of family and close friends.  I am not sure. I think we may have to try this and, for the first step  -which might prove to be the only step- do it in conjunction with lawyers and medical professionals. People are concerned.  I would like the safe guard of having the professionals properly protected from accusations of criminality, if they follow what is to be the code.”

“There are difficult cases; people change their minds and go in and out of periods of lucidity.  Should this involve a lawyer when the person is quite capable of taking a rational decision that would provide some sort of safeguard for the doctor or any member of the family, to confirm the wish was expressed?”

MacDonald says the public are way ahead of the politicians, who are “being cowardly and conservative as usual”, and has hundreds of letters and emails from the public asking her to progress enabling legislation.

“I don’t want to short change them or let them down. I feel very responsible,” she says.

“I am committed professionally. I believe we have a public duty to address the examination, investigation and consultation of this subject area. With this one, with all the sensitivities involved, we should first of all have a consultation, which I am going to ask the government to do. It shouldn’t be easy to get something as radical as this through. They should examine it minutely and be very, very aware of public opinion.” 

Her famous fighting spirit and social conscience burn brightly today, but are dimming visibly. Like Dickens’ Sydney Carton, she is stepping up to the tumbrels in our stead, but inevitably you and I must follow.  Whether we do it with dignity is, at the moment, a choice we don’t get to make. Surely we can do better.