Why Scotland's assisted dying bill would make death an acceptable substitute for care

This may seem like a contradiction. I have long argued that government should not interfere unnecessarily in private lives. I believe adults should be free to make their own choices. But autonomy does not exist in a vacuum. It relies on context – on conditions that allow us to make decisions free of pressure, coercion, or despair. And that is precisely where this Bill falls short.

In theory, the Bill offers a compassionate choice. In practice, it risks creating a quiet, subtle pressure on the most vulnerable members of our society, particularly older people, those living with chronic illness, people with disabilities, and those who are isolated. The message they may hear, however unintended, is this: your suffering is inconvenient, your care is costly, your life, perhaps, is no longer worth living.

Elderly anxious not to trouble others

Let us be honest about the pressures older people already face. Across Scotland, social care is stretched thin. Families are under strain. Costs are rising. Many older individuals tell us they feel like a burden, not because their families say so, but because the system around them whispers it in a hundred small ways.

Now introduce assisted dying into that equation. Even with safeguards, the psychological shift is profound. What begins as a right can, over time, become a perceived duty. For someone who is frail, dependent, and anxious not to trouble others, the “option” of assisted death may appear less like freedom and more like an escape from guilt.

Imagine a woman in her 80s, recently widowed, with limited mobility. Her care costs are mounting. Her family visits her when they can, but their own lives are full. She feels like a weight. Because she suffers from a progressive and untreatable illness, though not necessarily close to death, she will fall under the Bill’s broad definition of "terminally ill”.

The Health, Social Care and Sport Committee at Holyrood has noted that the absence of a specific life expectancy opens the door to eligibility for those who may live for many more years. In this scenario, how freely is her choice made?

This is not hypothetical. The committee acknowledged that, without a defined timeframe, the Bill expands eligibility well beyond those imminently dying. It also recognised that clinical judgment alone may determine who qualifies.

That’s a heavy burden on doctors, and a risk. A risk that the law will be interpreted more loosely over time. A risk that definitions will be legally challenged, expanding access even further, as the committee has warned.

Warnings from Canada and Netherlands

We are also reminded of the concern around “doctor shopping” – when someone who is refused access seeks out another practitioner for a different answer. The committee suggested that this loophole could pressure doctors to interpret the law more liberally. If we proceed with this Bill, these are not minor flaws. They are warning signs.

We are told that other countries have introduced assisted dying safely. But in many, boundaries have shifted. In Canada, assisted death began with narrow limits. It is not now required that death be reasonably foreseeable. By 2027, mental illness, as the sole reason, will render someone eligible.

In the Netherlands, it extends to cases involving dementia and depression. The ‘slippery slope’ is real. The changes, once introduced, are hard to contain.

Supporters promise robust safeguards. But laws evolve. Exceptions expand. Interpretations vary. The Health, Social Care and Sport Committee specifically cautioned that the Bill may face human rights-based legal challenges. Once the principle is established – that some lives are no longer worth preserving – it becomes difficult to draw a firm line. That is not fear-mongering. It is prudent foresight.

I do not believe that suffering should be romanticised. Nor do I underestimate the anguish that terminal illness can bring. But our response to suffering should not be to end life – it should be to improve the care and support we offer.

Death not a compassionate answer to despair

Palliative care in Scotland has improved over the years, but it remains underfunded and uneven. The committee rightly highlighted the need to invest in it further and expressed hope that this debate would lead to greater attention and resources in this area. That’s where our energy should go.

In truth, the most compassionate societies do not offer death as an answer to despair. They show people, especially the vulnerable, that their lives matter. That their worth is not tied to their independence, or productivity, or cost. That dignity comes from care, not control.

We do not get there through assisted dying. We get there through better hospice care, stronger support for carers, and a national commitment to fight loneliness. No one should feel they have to die just to stop being a burden.

Legalising assisted dying would create a subtle but permanent cultural shift. What is permitted becomes what is expected. For the elderly, the ill, or those without strong support systems, that expectation could be dangerous.

Assisted dying changes the moral landscape in ways we cannot fully predict. It is irreversible. And at a time when so many feel vulnerable and undervalued, it sends the wrong message about who we are and what kind of society we want to be.

We shouldn’t risk it. Don’t risk legal drift. Don’t risk unintended pressure on the vulnerable. Don’t risk making death an acceptable substitute for care.

Instead, let us build a Scotland where every life is treated as precious – however frail, however dependent, however near its end. That is the truly compassionate path. And that is the choice we should make.

Murdo Fraser is a Scottish Conservative MSP for Mid-Scotland and Fife