Chamber
Plenary, 09 Dec 1999
09 Dec 1999 · S1 · Plenary
Item of business
Adults with Incapacity (Scotland) Bill: Stage 1
Although we all agree with its aims, the proposed legislation throws up the ethical question of euthanasia. Despite the minister's assurances, there are parts of the bill that could allow unscrupulous individuals to apply some form of back-door euthanasia. I ask the minister to clarify the priorities in the bill. Part 1 lists the number of conditions that must be taken into account, but it does not say whether, for example, medical evidence should override previous wishes. The conditions are listed (a) to (d), rather than ranked in order of priority. Some classification of priority would be helpful.
The bill tries to balance a medical opinion with the opinion of a carer who may be ill informed. In 99 per cent of cases, the decision will be made jointly by carers and medical staff in the best interest of the adult with incapacity, but we must make plans for the exceptions. For example, a carer who is set to benefit financially may decide to override a doctor's decision, and there is no onus on that carer to seek informed medical advice. I note Jim Wallace's announcement that there will be an independent body to monitor people who have such a financial interest. His changes to section 47 have satisfied me that there will now be an onus on carers who may be the financial beneficiaries of the people for whom they care, and that medical advice will play a more prominent role in the carer's decision.
The Hippocratic oath binds doctors to a duty of care. The legislation lifts some of that responsibility from the doctor, but it does not transfer it to the carer. I am concerned that, coupled with the limited liability described in section 73, which the minister has now amended, that reduction in the duty of care could allow power without responsibility.
I am aware that this is stage 1 of the bill, so I have concerned myself only with protecting the aims of the legislation, on which we all agree, from the worst-case scenarios. However, the size of my mailbag confirms my view that there is genuine concern about back-door euthanasia. Although I am confident that the Executive does not intend to allow that, I urge it to take those concerns seriously. Better clarification of the priorities and a tightening up of the liability provisions would go a long way to ease those concerns.
The bill tries to balance a medical opinion with the opinion of a carer who may be ill informed. In 99 per cent of cases, the decision will be made jointly by carers and medical staff in the best interest of the adult with incapacity, but we must make plans for the exceptions. For example, a carer who is set to benefit financially may decide to override a doctor's decision, and there is no onus on that carer to seek informed medical advice. I note Jim Wallace's announcement that there will be an independent body to monitor people who have such a financial interest. His changes to section 47 have satisfied me that there will now be an onus on carers who may be the financial beneficiaries of the people for whom they care, and that medical advice will play a more prominent role in the carer's decision.
The Hippocratic oath binds doctors to a duty of care. The legislation lifts some of that responsibility from the doctor, but it does not transfer it to the carer. I am concerned that, coupled with the limited liability described in section 73, which the minister has now amended, that reduction in the duty of care could allow power without responsibility.
I am aware that this is stage 1 of the bill, so I have concerned myself only with protecting the aims of the legislation, on which we all agree, from the worst-case scenarios. However, the size of my mailbag confirms my view that there is genuine concern about back-door euthanasia. Although I am confident that the Executive does not intend to allow that, I urge it to take those concerns seriously. Better clarification of the priorities and a tightening up of the liability provisions would go a long way to ease those concerns.
In the same item of business
The Deputy Presiding Officer (Mr George Reid):
SNP
We move to the next item of business, a debate on motion S1M-213, in the name of Mr Jim Wallace, which seeks the Parliament's agreement to the general princi...
The Deputy First Minister and Minister for Justice (Mr Jim Wallace):
LD
I am pleased to move this motion to approve the general principles of the Adults with Incapacity (Scotland) Bill. The bill is a major piece of law reform. It...
Mrs Margaret Ewing (Moray) (SNP):
SNP
Part of the problem that I have with the bill is the inclusion of people in discussions of how to decide to give power of attorney, for example. What does th...
Mr Wallace:
LD
Individual cases—it is important to stress that cases are considered individually—will differ according to the individual's incapacity and the particular cir...
Malcolm Chisholm (Edinburgh North and Leith) (Lab):
Lab
I welcome the change to section 44 and the deletion of the reference to nutrition and hydration by artificial means as a medical treatment. However, as that ...
Mr Wallace:
LD
Malcolm Chisholm is talking about situations in which there is a conflict of opinion between the doctor and the guardian on a proposed course of action. We h...
Roseanna Cunningham (Perth) (SNP):
SNP
It is only right that, as convener of the Justice and Home Affairs Committee, I take a few minutes in the chamber to comment on the committee's experience of...
The Deputy Presiding Officer:
SNP
Please close.
Roseanna Cunningham:
SNP
A great deal of concern has also been expressed about the definition of "medical treatment" in the bill. In large part, that is linked to the definition of "...
The Deputy Presiding Officer:
SNP
Will you close now, please?
Roseanna Cunningham:
SNP
The clock shows that I have 50 seconds left, Presiding Officer.
The Deputy Presiding Officer:
SNP
You are two minutes over.
Roseanna Cunningham:
SNP
We should recognise that many organisations feel that, whether it intends to or not, the bill will introduce euthanasia by the back door. Much of the evidenc...
Ben Wallace (North-East Scotland) (Con):
Con
I speak as the reporting member of the Health and Community Care Committee and as the deputy health spokesman for the Conservative party. When I welcome the ...
Mr Jim Wallace:
LD
I am happy to give the member that assurance.
Ben Wallace:
Con
Although we all agree with its aims, the proposed legislation throws up the ethical question of euthanasia. Despite the minister's assurances, there are part...
The Deputy Presiding Officer:
SNP
I call Nora Radcliffe.
Nora Radcliffe (Gordon) (LD):
LD
I did not expect to be called.
The Deputy Presiding Officer:
SNP
You are on the list to speak for the Liberal Democrats. Do you want to speak? If not, I can open the general debate.
Nora Radcliffe:
LD
I have not prepared a speech, but I will make some remarks, wearing my equal opportunities hat. I welcome, in particular, the bill's emphasis on the rights o...
The Deputy Presiding Officer:
SNP
Contrary to expectation, we can probably fit in two general speeches before lunch. I call Richard Simpson, to be followed by Kay Ullrich.
Dr Richard Simpson (Ochil) (Lab):
Lab
The bill is to be welcomed—that is clear—but there are some problems with it. I am not sure whether the bill will last as long as the Curators Act 1585, whic...
Kay Ullrich (West of Scotland) (SNP):
SNP
As Roseanna Cunningham said, we made a commitment in our manifesto for the Scottish Parliament to support an incapable adults bill, with the proviso that the...
The Presiding Officer (Sir David Steel):
NPA
I am sorry, but the chair is in some slight confusion. The debate will be resumed this afternoon.I advise members who have indicated a wish to speak that I h...