Assisted dying and the law in Scotland: Both sides now

In the second instalment of our assisted dying series, we look at the subject from both for and against perspectives, writes Ellie Philpotts.

If you practise law, no matter how experienced you are, you’re likely to come across scenarios that permeate your solely professional view and speak to your personal emotions too. You don’t have to operate in crime to be affected by some of the cases you represent.

Assisted dying is a particularly emotive area. Campaigners from each perspective, the for and against camps, rarely shy away from presenting their views, usually informed by diverse factors. More and more of the profession, and public, also sit somewhere in the middle, seeing and respecting both sides of the coin.

In the first of our assisted dying series, we looked at the story so far. No doubt, as the debate continues to pick up pace despite a reject rejection from the Scottish Parliament, campaign efforts will continue to come to the fore.

At the heart of pleas of this magnitude are the people who would be directly affected by assisted dying becoming enshrined in law. These are mainly people with a terminal diagnosis who wish to end their lives in a protected environment that meets the listed characteristics. Of course, their families, friends, loved ones, healthcare professionals and potentially legal practitioners also come into this.

So in this instalment, The Journal hears from speakers with differing views on whether assisted dying should become Scotland’s reality.

In favour

Dignity in Dying is the most prominent charity campaigning for assisted dying. Its Scottish arm says: “Liam McArthur MSP’s Assisted Dying for Terminally Ill Adults (Scotland) Bill made unprecedented progress in the previous Parliament. Although ultimately it didn’t pass at Stage 3, there was clear consensus reached across the public and MSPs that the status quo is untenable and puts dying people and their loved ones in dangerous, cruel situations.

“In the absence of an assisted dying law, terminally ill people will continue to suffer and it’s clear the issue isn’t going away. The Bill remains unfinished business in the Scottish Parliament, likely to return in its next session.”

A survey from January to February this year also indicates backing across Scotland. From 5,000 adults, the charity states that every constituency supports law change. Specifically, 71% of respondents said they would support making it lawful for someone to seek assisted dying in Scotland, with 17% against but 78% of Scots “wanting the law to change”.

This was consistently high across those who plan to vote SNP (80%), Labour (69%), Green (77%), Liberal Democrat (73%), Reform (74%) and Conservative (64%).

Vehemently against

On the other hand, Care not Killing is an alliance of individuals and organisations including disability and human rights groups, healthcare providers and faith-based bodies. Established in England 20 years ago, its Scottish branch has won the support of Pam Duncan-Glancy, a disabled MSP.

There are fears assisted dying could put vulnerable and disabled Scots at risk of systemic coercion, and warnings that society should instead make life easier for disabled people, as Glasgow’s Duncan-Glancy told The Journal in 2024.

Care Not Killing recently led the campaign against the Holyrood Bill. Its chief executive, Dr Gordon Macdonald, elaborates to The Journal: “Assisted suicide and euthanasia place the most vulnerable people at risk of coercion or pressure to end their lives prematurely. We know from overseas jurisdictions that it’s impossible to have failsafe mechanisms preventing those who are depressed or suffering from other mental health conditions from accessing euthanasia and assisted suicide.

“For example, over 60 documented cases of ‘assisted dying’ have been reported where anorexia nervosa or other eating disorders are present. One study from Belgium revealed that multiple comorbidities of minor conditions are often the reason for euthanasia. In the Netherlands, cases of euthanasia for mental health reasons are increasing rapidly.

“The legalisation of these practices changes the role of doctors and other healthcare staff from healers to killers. It corrupts medicine and undermines Hippocratic ethics. Ending the life of vulnerable patients comes to be seen as a medical treatment or healthcare option. It rapidly becomes a go-to option in difficult cases where resource intensive treatment and care is unavailable or in short supply.”

Dr Macdonald, who is joined on the Board by other doctors, turns his attention to human rights: “Human rights, especially the right to life, are undermined. Article 2 of the European Convention on Human Rights has been repeatedly recognised as fundamental to the realisation of other rights and is subject to strictly limited derogation. Unfortunately, the European Court of Human Rights itself failed to properly construe the nature of Article 2 in its limited consideration of the legality of legalising euthanasia. In Mortier v Belgium, the court erroneously referred to the fact there was nothing in the travaux préparatories that could assist in the interpretation of Article 2 and cited this as support for applying a margin of appreciation.

“However, this finding overlooks the obvious fact that the absence occurred because its status as an absolute right was never questioned when the convention was drafted. Allowing the decriminalisation of euthanasia and assisted suicide inverts the plain and ordinary meaning of Article 2’s text and contravenes the principles of the Vienna Convention on the Law of Treaties.”

Better Way is another organisation opposing assisted dying legislation. In 2025 it urged supporters to write to their MSP, citing issues such as “social and internal pressure” and “mission creep in legislation”.

Spokesman Dr Miro Griffiths MBE says: “We believe assisted suicide is unethical and unsafe. There is no way to rule out abuses and mistakes, coercion and people facing pressure to end their lives – either because they feel like a burden, or because loneliness, poverty, inequality and other factors make them feel like there is no other choice for them. Assisting the suicides of such people should be unthinkable.

“The perfect storm of an ageing population and rising pressure on public services makes an assisted suicide law in Scotland particularly dangerous. McArthur’s Bill proposal noted the multi-million-dollar cost savings of ‘assisted dying’ in Canada. It was concerning to see this utilitarian thinking at the very beginning of the debate and it would inevitably have reared its head should the legislation have been approved.

“A better way forward for Scotland involves affirming and protecting every citizen and ensuring that those living with terminal illnesses have the support they need. [We need to work] towards a more accessible, inclusive, participatory society for disabled people, and bolstering efforts to prevent suicides and improve mental health support. We hope MSPs will continue to choose this path.”

Political spectrums

In 2025 Jeremy Balfour, a disabled MSP then representing Lothian, wrote to Clare Haughey MSP, of the Health, Social Care and Sport Committee, to say: “As someone living with a disability, I’m deeply concerned that this proposed legislation fails to address certain forms of coercion that could pressure individuals with disability to access assisted dying and would result in discrimination prohibited by the UN Convention on the Rights of Persons with Disabilities, which was ratified by the UK in 2009.”

The same year, Haughey also received a letter on assisted dying – now from three Scottish academic law experts. They expressed “concerns about the Assisted Dying for Terminally Ill Adults (Scotland)’s legislative competence” – “the question of whether the Bill deals only with matters that are within the legislative competence of the Scottish Parliament, or also with matters that are reserved to Westminster”.

The Journal will hear from one of these authors, Dr Mary Neal, in the next instalment of this series, where we look at what the future might hold in the legal sphere.

Finally, some groups aren’t fully against assisted dying, but do not support the Scottish Bill. Scotland’s Royal College of Psychiatrists moved to oppose it at Stage 3, with the removal of Section 18, which would have provided “statutory protections for clinicians who chose not to participate in assisted dying, ensuring that their decision would not affect their employment, regulatory standing or professional relationships”.

The college felt this removal could reduce Parliamentary scrutiny, but increase members’ uncertainty and low morale. Representatives expanded on four specific concerns in these areas with MSPs.

It is clear the assisted dying debate raises an array of questions for medics as well as lawyers – and that they have not all been answered yet.