The cases both for and against Scotland's Assisted Dying Bill
As MSPs prepare to vote on the Assisted Dying Bill, dementia expert Professor June Andrews and Liam McArthur MSP offer arguments from both sides of the debate
When they decide whether to advance legislation on “assisted dying”, MSPs will vote according to their conscience. But their opinions ought to be based on better knowledge about dying, the current law, and a careful scrutiny of what’s missing from this bill.
“Assisted dying” sounds compassionate, even humane. But the claim that there’s public support is built on dangerously simplistic questions, and this is about your conscience, right? Not populism.
If you ask, “should people be helped when they are dying?”, humane people say yes. But that’s not the same as endorsing this bill. The details, which are poorly understood, are where danger lies.
Words like euthanasia not used
In countries where similar laws exist, people have experienced prolonged, distressing deaths, retching for hours or regaining consciousness after ingestion of the fatal dose. This is not the peaceful drifting-off that the phrase “assisted dying” implies.
Worse still, those most likely to be offered this “choice” are more likely to be women, disabled or older people who have been made to feel a financial or emotional burden on their family or the under-funded health system. Mental health assessments are not a required safeguard. Families are not consulted.
Words like “suicide” and “euthanasia” are carefully avoided. Why? Because if we spoke plainly, we might think more clearly.
Legal right to refuse treatment
Instead, we are plied with stories of horrific deaths, ignoring the fact that these anecdotes, while shocking, don’t reflect the more common, everyday, end-of-life experiences about which we don’t hear.
The truth is, everyone in Scotland already has a legal right to refuse treatment and be made comfortable at the end. You can appoint someone you trust to advocate this for you, even if you lose consciousness. It’s legal already and it happens, every day, in good care settings across the country.
If this bill was being sold to us as an emergency measure, a stopgap until our broken health and care systems were fixed, it would be more transparent (though I’d still vote against it). But that’s not what’s being proposed. This is a permanent and radical shift, the beginning of a path we would one day bitterly regret.
Professor June Andrews OBE is an expert in caring for older frail people and people with dementia, who has worked in academia, the NHS, and government, and the author of Dementia: the One Stop Guide
On Tuesday, my Assisted Dying Bill will be voted on in the Scottish Parliament. I’m asking my fellow MSPs to look not just at the politics, but to listen to those that this bill is meant to serve: terminally ill Scots facing the end of their lives with far too little choice and control.
This is not an abstract debate. It’s about families who witness their loved ones endure unbearable pain. Throughout the four years that I have been working on my bill, these are the real stories, from real people in our communities, that have stayed with me.
Assisted dying isn’t a radical idea. It’s supported by decades of evidence and practice from around the world. Places like New Zealand and Australia have shown that it’s possible to offer this choice safely, with robust safeguards in place along the same lines I am proposing. In Scotland, we can learn from that experience and, where necessary, tweak it to suit our needs.
Strong safeguards
Under the current law, the only options for too many Scots are to travel abroad at great cost and distress, or to suffer in silence. My bill would offer a carefully regulated, medically supervised route for those with a terminal diagnosis and the mental capacity to end their lives on their terms.
The safeguards are strong. Two doctors must independently confirm a terminal illness and capacity, with referrals to specific experts if necessary. There must be clear consent, understanding of all the treatment options available and protections against coercion. No doctor will ever be forced to participate. This is about choice, not obligation.
This will be a free vote. That’s why I am appealing to each of my colleagues: listen to the public and those with a terminal illness who are demanding more choice. A majority of people in Scotland support change, because they recognise the current ban on assisted dying is failing too many.
Given the countries that have gone before us, this is not necessarily a revolutionary moment but it is a significant one. I hope MSPs will agree to allow parliament the chance to move to the next stage of considering amendments to my bill. In so doing, they can take an important step in standing up for choice, dignity, and compassion at the end of life.
Liam McArthur is Scottish Liberal Democrat MSP for Orkney
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