Scots debate on end-of-life care

End-of-Life (EoL) care issues and the ethical questions they raise are making the headlines around the globe. In Scotland, on 5 December 2010, the Palliative Care Bill(1) was withdrawn from Parliament. MSP Paterson, who introduced the bill, hoped to eliminate variations in EoL care due to postcode lottery and type of illness.

At the same time, MSPs rejected Macdonald’s End-of-Life Assistance Bill(1) which would have given patients the right to choose when to die. Physician-assisted suicide is the practice of providing a competent patient with a prescription for medication for patient use with the primary intention of ending his or her own life.

Opponents of the Macdonald’s Bill(2) expressed concern that the introduction of physician-assisted suicide could slow down funding and research in the area of P. C.

« Society needs to know that you can’t have both physician-assisted suicide and palliative care. In reality, you can only have one or the other, » an MSP said.(3)

In a report on the P. C. Bill, it was considered that « establishing a definition of palliative care in statute which is simple and unambiguous is challenging… »(4)

A NHS Board manager argued that legislation would help to break down barriers between local government and healthcare professionals. « Some of the barriers have been down to confusion about roles and who sets the agenda. Why is a manager setting an agenda for a clinician ? Such tensions always exist in the constructs that we have created for service delivery. »(4),(5)