Scotland's Assisted Dying Bill must not be another addition to Holyrood’s list of botched legislation – Paul Wilson

Given it is a matter of life and death, politicians must take extreme care when considering a proposed law to allow assisted dying

As debate rages over the enforcement from Monday of the Hate Crime Act, MSPs must now wrestle with another contentious piece of legislation that is bound to polarise opinion. The conspicuous volume of duff Bills at Holyrood in recent years might instil little confidence in the ability of parliamentarians to grapple with what is literally a matter of life and death.

Yet that is precisely what will be required of them following the publication of Liberal Democrat MSP Liam McArthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill. This will be the third time Holyrood has voted on legalised assisted dying, with previous bids – led first by independent MSP Margo McDonald and then by Patrick Harvie of the Scottish Greens – overwhelmingly rejected.

It is not hard to understand and sympathise with the purpose of this proposed legislation. Of course, everyone wants to do everything possible to avert a painful and prolonged death for themselves and for their loved ones. Perhaps, in days gone by, doctors could – with the understood consent of patients and their families – effectively administer ‘mercy killings’ of those in agony and near death through the use of large amounts of painkillers. Such medication might even have shown up as a contributory factor on death certificates, without health professionals needing fear repercussions.

Prue Leith meets Liberal Democrat MSP Liam McArthur at an event in support of his proposed Assisted Dying for Terminally Ill Adults Bill (Picture: Jeff J Mitchell/Getty Images)

Get our weekly opinion newsletter for expert analysis from The Scotsman’s team of columnists

But although such scenarios may have unfolded in the past, it seems unlikely they would today. This is despite an ageing population and medical advances meaning that more of us than ever could live to face a painful, prolonged death, and more of us than ever living in fear of dying without dignity.

Pressure on vulnerable people

Maybe it is this same fear that has helped drive the issue up the political agenda, with Prime Minister Rishi Sunak and Labour leader Sir Keir Starmer both pledging to allow a debate on assisted suicide at Westminster after the next general election. It is the same fear, perhaps, that has already led to legalisation or moves towards legalisation of assisted dying in other countries.

But critics warn those countries that have taken this step have set foot at the top of a grim and potentially very slippery slope. Dr Gordon Macdonald, chief executive of Care Not Killing, which is campaigning against McArthur’s Bill, has said changing the law “would place the vulnerable under pressure, and possible coercion, to request death for fear of being a financial, emotional, time or care burden”. “Evidence from the Netherlands, Belgium and Canada shows what starts for people who are terminally ill extends to the chronically ill, from adults to children, from ‘mentally competent’ to those lacking capacity,” he added.

The dangers of this macabre mission creep are perhaps most apparent in Canada. Medical Assistance In Dying (MAID) was legalised there in 2016, and in 2021 the country’s parliament removed the law’s previous requirement that natural death must be imminently foreseeable for a person to be eligible.

Assisted dying is now no longer restricted to those who have only months to live, but is extended to non-terminal conditions. Why not extend it further to include disabled people, or those with psychological conditions too, or terminally ill minors deemed mature enough to make such a decision?

How safe are the safeguards?

Earlier this week, a judge in Calgary ruled a 27-year-old woman with autism can seek a medically assisted death and lifted an injunction stopping her from ending her life. The judge’s decision has been stayed for 30 days so that lawyers for the woman’s father can decide whether to file an appeal. Assisted suicide is now said to be Canada’s fifth-highest recorded cause of death.

McArthur’s Bill will have safeguards built into it, but can we guarantee how safe these really are or how long they will last? MSPs will have to seek ways of ensuring an assisted dying law would not be abused and that the most vulnerable people in society would not be made to feel pressured into ending their lives.

But inevitably, people’s decisions on ending their own lives will be influenced by inequality. The disadvantaged – those with the least access to emotional and financial support, perhaps those who have already fallen victim to poverty, homelessness or addiction – would surely be more likely to die a state-sponsored death.

These people will more readily ask themselves whether their life is worth living. Meanwhile, some healthcare providers, perhaps under pressure to free up beds, might start asking whether certain lives are worth saving and sustaining. What safeguards could be put in place to prevent mistakes from happening? One powerful argument against capital punishment is that it is impossible to guarantee mistakes won’t happen. A similar argument surely applies here.

Yousaf and Sarwar not persuaded

Proponents of assisted dying believe momentum is with them. McArthur said at the weekend that he believes “the political mood has changed”. Prominent celebrities including Dame Esther Rantzen and Dame Prue Leith have lent their support to the Dignity in Dying campaign. MSPs are expected to be given a free vote on McArthur’s Bill and the result could be tight.

First Minister Humza Yousaf has spoken of his opposition, saying in September last year: “My view has always been to be open minded to the discussion, but I have not been persuaded and I feel even less persuaded after a recent discussion with the Glasgow Disability Alliance.” Earlier this week, Scottish Labour leader Anas Sarwar said he was “not currently minded” to support the Bill.

But, whatever the result, we must expose these proposals to more thorough and intelligent scrutiny than that to which we have come to expect from our bungling lawmakers. This is the same parliament that has presented us with such dog’s dinners as the Offensive Behaviour at Football Act, the named person system of child protection, and botched reforms of trans rights.

Above all, MSPs must strive for the respectfulness and sensitivity that seems absent from our current political discourse.