BY Alfie Robinson

The Dying for Terminally Ill Adults Bill, which was introduced on March 27th 2024, is at the first parliamentary stage of becoming an act in Scotland. The bill which was initially proposed by Lib-Dem Orkney MSP Liam McArthur, has been the centre of much controversy especially since a UK-wide bill was introduced to the current Labour Government towards the end of October 2024.

It will allow terminally ill adults (over 16s) in Scotland who meet certain criteria to lawfully request and be provided assistance by medical professionals to end their own life, with the use of approved substances.

Some of the key criteria are:

They must be a resident of Scotland for 12 months or more
They must be expected to die within six months
They must be deemed to have expressed a clear, settled and informed request while being mentally capable and free from pressure or coercion
They must be assessed by two separate doctors (one must have not treated patient) seven days apart and must be deemed eligible
They must make two separate declarations both witnessed and signed, about their wish to die
A High Court judge must hear at least one of the doctors and can question the patient or anyone else they feel necessary. There must then be a further 14 days between the hearing and judges decision

The bill has proven to be divisive with differing ideological, theological and moral perspectives at the heart of the rift. Given that the dissimilarities of opinion on the bill seem driven by these fundamental and personal differences, it is of paramount importance that the reality of families, medical professionals and patients who find themselves in circumstances where the individual may desire assisted death are explored.

By Digicomphoto/Science Photolibary via Gettyimages

Shona Robinson, a trained nurse practitioner with 40 plus years’ experience in both England and Scotland, said: “Assisted dying already takes place. In palliative care we already help people during end-of-life care by in some cases, administering higher doses of drugs for example morphine, which ultimately hastens the death process. If there are strict parameters, I am all for the bill. I understand it is a dangerous topic but morally I see nothing wrong with it. It’s not exactly like for like of course but if your neighbour had a sick dog, constantly in pain and struggling to move, wouldn’t you call the RSPCA?”

People with neurological degenerative diseases such as Huntington’s, Parkinson’s or MS towards the end of their life are often in significant pain or have limited functionality. Clearly comparing the value of human life to a pet dog isn’t appropriate however the example does a fair job depicting the real issue. Human rights.

Understandably people opposed to the bill worry about the dehumanisation of the patient as death shouldn’t be conflated with medical assistance. But what could be more humanising than unlike pets, giving the power to the individual over when, where and how they die.

Safeguarding has been a buzz word for those against the bill. Based on the rules outlined within the proposal, there are clear steps in place to ensure the safety of not only the patient, but the medical professionals too.

If anything, some suggest that there are too many barriers between the decision of the patient, and the lawful acceptance leading to action. Namely the Professor of End-of-Life Law and Regulation at Queensland University, Australia, (one of 10 countries worldwide who already have laws for assisted death in place) Ben White. After being asked his view on the Scottish Bill by the Health, Social Care and Sport Committee, he said: “I support the Bill not specifically requiring a designated expected timeframe until death.”

Assisted dying protest (Dan Kitwood via Gettyimages)

It’s telling that an expert on the subject in a country where the law has proven to be a successful and positive change believes we may even need to loosen the proverbial tightropes, when it comes to this question of safeguarding.

Bethany Collins, a young Scottish girl who has experienced firsthand how assisted death could have benefited loved ones, said: “When my grandad had a stroke, he went from being the fittest and most active man to someone who struggled to swallow on his own. Of course, for a while he was full of life still and was motivated to keep going but in time the frustration and aches and pain he felt from inactivity took over. It got to a point for at least a year I would say that he was begging us to end it and that was what he wanted. It ended up that on his last day he was struggling to get his breath and swallow saliva and the nurse said we can give him medication so rather than him dying over the course of hours it would be 45 minutes. We obviously took that and honestly, if we could have done it six months earlier, we 100% would have so I’m glad the bill is hopefully coming into place.”

Regardless of Wes Streeting, Health Secretary, denouncing the bill on various media outlets, when you put it into perspective, this is personal for people and families and patients face real consequences nursing terminally ill people. From a human rights perspective, the bill is as necessary as it is inevitable.

Could assisted Dying Bill be passed in Scotland?