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ss triple helix - Easter 2009,  End of life care in Scotland

End of life care in Scotland

Comprehensive palliative provision or physician assistance to die?

CMF has about 450 doctor and 100 student members in Scotland, and since devolution of health policy, they have had to face some different challenges. At the time of writing, two Members of the Scottish Parliament are reviewing results of their radically different consultations on end of life care.

Margo MacDonald MSP has Parkinson's disease and supports assisted dying. In December 2008 she sought views on her proposed End of Life Choices (Scotland) Bill. (1) CMF is now mainly opposing euthanasia through its membership of the Care Not Killing Alliance (2) which brings together disability and human rights organisations, healthcare and palliative care groups, and faith-based organisations to promote palliative care, prevent weakening or change of the law, and influence public opinion. Their robust response (3) criticises the consultation's lack of clarity (does it advocate euthanasia or physician assisted suicide or both?) and its lack of detail, particularly about 'safeguards'. CMF Scotland's submission (4) develops some specifically Christian arguments and amplifies medical and public policy concerns. MacDonald needs 18 MSP signatures to have any chance of her proposed Bill being debated in the Scottish Parliament.

Meanwhile, Roseanna Cunningham MSP has been consulting (5) on a proposal to make needs-based palliative care uniformly available across Scotland. She 'highlights the uneven access to palliative care in Scotland' and 'aims to place a statutory duty on health boards in Scotland to provide high-quality palliative care to those who need it'.

This edition of Triple Helix features (6) some of the conclusions of an innovative primary care research group in Edinburgh developing palliative care which is accessible for people with all life-threatening illnesses, is delivered in the community, and explores spiritual distress at the end of life. There are characteristic trajectories of physical decline at the end of life which also have a spiritual dimension, and this understanding allows spiritual support to be planned and delivered to patients and their carers to relieve distress and help in the search for meaning and purpose. CMF supports care, not killing.

References
  1. The proposed End of Life Choices (Scotland) Bill. Consultation document
  2. www.carenotkilling.org.uk
  3. www.carenotkilling.org.uk/?showh2
  4. www.cmf.org.uk/ethics/submissions/?idY
  5. The proposed Palliative Care (Scotland) Bill. Consultation document
  6. Murray S. Spiritual support in palliative care. Triple Helix 2009; Easter:8-10
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