Dr. Louise Campbell:

In my memory it is 14 years, but I am subject to correction on that. Ten years is mentioned for contraventions in the assisted dying Bill of 2020. I believe that people feeling their lives are devalued in jurisdictions in which provision is made legally for assisted dying is a very important concern but I also believe – this does not diminish the concern at all – that people who live in isolation and who are socially marginalised or excluded because of poverty, disability or chronic illness, or because they cannot access treatment, also feel their lives are devalued in very significant ways. We must try to have a balance. We must examine our duty as a society to minimise the sense of devaluation, regardless of the options we are talking about. I am very sorry if I came across as dismissive of a venerable philosophical tradition; however, I feel the doctrine of double effect is less useful in these discussions than a straightforward, nuanced, very careful examination of justifications on either side of a discussion about whether an intervention is legitimate.

We do not need a doctrine of double effect. If there is something useful about the doctrine of double effect, it is the distinction between a primary motivation or intention and a secondary intention. It is not a foreseeable versus an unforeseeable intention. I will hold my hands up, and I am sorry for holding members up, but I should not have been as dismissive about the acts and omission distinction as I was because clearly there is a moral and legal difference between withholding and, specifically, withdrawing medical treatment from somebody who is in the terminal phase of an illness on the one hand and administering a medication to somebody who may or may not be in the terminal phase of an illness on the other. Sometimes the debate focuses exclusively on the question of the agency of healthcare practitioners and their responsibility, legal and moral, in administering a medication to end a life when that actually distracts us from the particular circumstances and sometimes the desperation and suffering experienced from the person who is requesting it.