There was good news from Scotland last week when the Scottish parliament voted by 69 votes to 57 to reject a Bill to legalise assisted suicide. This was not expected when the Bill first reared its head and especially as Scottish politics is dominated by the Scottish National Party, which is roughly equivalent to the Social Democrats or Labour here.
The key was twelve MSPs changing their position since the first vote in May last year. Testimony from experts who look after sick and elderly people seemed to be a crucial factor.
In its final form, the Bill sought to make assisted suicide available to mentally competent adults resident in Scotland who have a terminal illness and who made a voluntary request verified by at least two doctors. The person would have had to administer the lethal substance themselves; direct euthanasia, involving a doctor administering the substance, was not permitted.
Over time, the debate moved from “should we consider it?” to “is this workable and safe enough to enact?” Some MSPs were not opposed in principle, but also not convinced that the proposed safeguard mechanisms were sufficiently robust or effective.
A recurring concern was not only the risk of explicit coercion, but the more subtle possibility that individuals might feel pressure because they are ill, dependent, costly to care for, or perceive themselves as a burden. The committee’s Stage 1 report had already warned that eligibility criteria might, over time, be challenged and widened.
Concerns were also raised about the protection of healthcare professionals [1].
The British Geriatrics Society [2], for example, wrote to MSPs ahead of the final vote, stating that the Bill did not contain adequate safeguards to protect older people and failed to sufficiently protect healthcare professionals who do not wish to participate.
Those MSPs who changed their position came from across the political spectrum (five Conservatives, four SNP, and three Labour), underlining that this was not a party-political issue.
The Scottish National Party did not impose a party whip, treating the vote as a matter of conscience. In the final division, SNP MSPs voted 37 in favour and 22 against, while the Health Secretary, Neil Gray, abstained.
The SNP leader and First Minister, John Swinney, voted against the Bill. He stated [3]: “I am concerned that it will fundamentally change the relationship between patients and doctors in a detrimental way. I am concerned that vulnerable individuals in our society, who may feel that they are a burden to their loved ones or to society, may opt to end their life prematurely. And lastly, I am concerned that the legislation will not protect us from the scope of this legislation being extended, and I think that would be regrettable.”
His predecessor, Humza Yousaf, who does not sit in the current Parliament, had also opposed assisted suicide during his time as First Minister.
Likewise, former First Minister Nicola Sturgeon expressed similar concerns. “The issue that most concerns me is a situation where somebody, even if it is a small number of people, feels an internal pressure to exercise a right to die. It becomes not a right to die, but a duty to die”, she said to Sky News [4].
This vote in Scotland comes just after a similar proposal has also encountered significant resistance in the British House of Lords [5].
In a society as secular and multicultural as the United Kingdom, such decisions suggest that concerns about safeguarding the vulnerable and preserving the integrity of medical care continue to carry weight across political and cultural divides. There is reason to hope that Irish politicians, too, will approach this issue with similar prudence, resisting pressure from lobby groups and upholding a commitment to the protection of human life and dignity.