First appeared in The Scotsman 12th February
◆ The vote on Liam Mcarthur’s Bill is a matter of conscience and Scotland must not look away, writes Emma Cooper
n the coming weeks, MSPS will cast one of the most profound votes since the inception of Scottish Parliament. Liam Mcarthur’s Assisted Dying for Terminally Ill Adults (Scotland) Bill is not about party politics, constitutional bargaining or political advantage. It is about conscience At its heart, this Bill asks a simple but human question. Should a mentally competent adult, who is terminally ill and suffering at the end of life, have the safeguarded option of assistance to die?
That is a question about whether each individual MSP believes that compassion, autonomy and protection can coexist within a carefully regulated legal framework.
The Bill has been scrutinised for more than four years. It builds on 30 years of international evidence and legislative experience. Scotland is not stepping into uncharted territory. Other international jurisdictions have debated, implemented and reviewed assisted dying laws. If the slippery slope that opponents speculate about was real, we would see clear statistical evidence of uncontrolled expansion. We do not.
The Bill before MSPS is tightly defined. Eligibility is limited to mentally competent adults who are terminally ill. Disability or long-term health conditions categorically do not qualify.
It contains the strongest safeguards against coercion found in any end-of-life legislation. Repeated voluntary requests. Independent medical assessments. Continuous confirmation of mental capacity. Specialist training for medical professionals to detect coercion. Mandatory referrals where appropriate. And a new criminal offence for anyone who coerces at any stage of the process.
This is not a removal of safeguards. It is the creation of safeguards. At present, end-of-life decisions take place daily in the NHS. Patients refuse treatment. Lifesustaining care is withdrawn. Doctors administer medication under the principle of “double effect”, where high drug doses are given for pain, but with a secondary effect of hastening death. Some patients voluntarily stop eating and drinking. None of these pathways are regulated, transparent or accountable.
The status quo is not neutral. It is ambiguous and inhumane at worst. Any assistance may constitute the common law offence of homicide, exposing loved ones and clinicians to the risk of prosecution and a mandatory life sentence. Dying people with sufficient financial means circumvent this by travelling to countries where assisted dying is lawful. Those without such means can be left to suffer here. That is not equality before the law. That is not compassion in 21st-century Scotland.
Opposition to assisted dying is entirely
Compassion and protection are not mutually exclusive. Autonomy and safeguarding can coexist
legitimate. Religious groups are entitled to their beliefs and to live by them. But belief cannot dictate the legal choices available to others. Conscientious objection for clinicians is also explicitly protected. The Bill simply allows those who would choose this option, within strict legal criteria, to do so.
Public support is clear and sustained. Recent polling found 81 per cent of Scots are in favour of assisted dying, backed in every constituency and across political affiliations. This is not a fringe campaign. It reflects a considered and compassionate majority view.
Yet as this vote approaches, underhand tactics are at play politically. We have seen claims framed in ways that conflate terminal illness with disability, despite the Bill’s clear eligibility criteria.
We have seen assertions about coercion that are not supported by international evidence. We have seen “slippery slope” arguments that rely on hypothetical future scenarios rather than empirical
Support for an assisted dying law in Scotland is strong
data. Robust debate is welcome. Misinformation is not.
There have been attempts to reframe this as a constitutional battleground, invoking Section 30 or Section 104 powers and implying institutional conflict. The legislative competence of the Bill has been carefully examined.
These are matters for legal process and parliamentary procedure, not political theatre. To reduce human suffering to a proxy constitutional fight risks diminishing the experiences of those dying now. Because this is reality. People in Scotland are dying today. Evidence from jurisdictions where assisted dying is lawful shows it is typically accessed only in the last two to three weeks. People are not choosing death years early. They are seeking assurance that, if suffering becomes unbearable, a peaceful and regulated option exists.
Assisted dying does not replace palliative care. It complements it.
Our charity, FATE, strongly supports improvements in palliative provision, but even the best palliative care cannot relieve all suffering. This Bill has a specific and distinct purpose. To provide a safeguarded, regulated choice when the limits of care have been reached.
For MSPS, this is a deeply personal vote. It is right that members reflect on their own moral framework, on evidence, and constituent’s voices who have witnessed difficult deaths. With an election approaching, this vote carries significant weight. Public support is overwhelming in every constituency across Scotland. MSPS’ positions are well known, closely scrutinised, and will be remembered at the ballot box.
This is not about compelling anyone to choose assisted dying. It is about whether the state should continue to deny choice to those who meet strict legal criteria and who, after careful reflection, request it.
Compassion and protection are not mutually exclusive. Autonomy and safeguarding can coexist. This is a matter of conscience.
And Scotland must decide whether it is prepared to look suffering in the eye and offer a regulated, humane choice at the end of life.
Emma Cooper is convenor of charity Friends at the End (FATE), which is campaigning to change the law to allow assisted dying in Scotland
