Beware the unintended consequences of legalising assisted dying

I was an MSP when Holyrood voted against assisted dying last time around. My name doesn’t appear in the official report as casting a vote – not because of a principled abstention, but because it was too close to home. 

It was ten years ago this month when the Scottish Parliament voted against the Assisted Suicide (Scotland) Bill by 82 votes to 36. The bill had been introduced by Margo MacDonald, someone I admired immensely, and was continued by Patrick Harvie after her death in 2014. 

Margo had approached me earlier in the process while gathering support. I mumbled about looking at it very carefully. In truth, I was uncomfortable but hoped I could come to back it (Margo was a hard woman to refuse) if sufficient safeguards were in place. But that’s not why I couldn’t vote on 27 May 2015. At that exact time my father, Jim, was in the final stages of terminal cancer. Four weeks later, he was dead. 

I was given permission to miss some parliamentary sessions in order to help care for him, initially to take him to palliative radiotherapy that ultimately failed.

Those last weeks were a blur of emergency call-outs, hospital admissions and late-night crises. Like some older people, he was intolerant of morphine, which is a problem when you are in excruciating pain.

You might think this experience would make me more sympathetic to pro assisted dying arguments. Even the best palliative care with the best people can be difficult, at least in our experience.

But life, even as it ebbs, has a way of throwing up contradictions. One defining feature of the last days of my dad’s illness was the revolving door of A&E visits for aspiration pneumonia, triggered when his feeding tube was dislodged.

He would be treated with antibiotics and sent home, but things often looked precarious. On one occasion, as I was standing watch, the duty ward doctor – not much older than my daughter – told me they wouldn’t administer antibiotics if it happened again. 

She didn’t articulate why, exactly, but it was pretty clear what she meant. Drifting off in a haze of pneumonia was, following this unspoken logic, kinder than a distressing death in the days or weeks ahead. They would also have needed the bed.

I didn’t tell my father. The suggestion that he should go without a fight would have been incomprehensible to him. He had a strong faith and believed in life after death. Yet even in his pain and exhaustion, he appreciated every minute of this world – sitting quietly in the garden he could no longer tend, surveying the Clyde, a river where he built ships and sailed in them. 
Next month is his ten-year anniversary. Nothing stands still in life and certainly not in politics.

Last week parliament voted in favour of the general principles of the Assisted Dying for Terminally Ill Adults (Scotland) Bill, introduced by Liam McArthur MSP. The balance in favour was almost a flip of a decade ago. 

Free votes are meant to liberate MSPs to follow their conscience and listen to evidence. Some did that. Colin Smyth of Labour said he might change his yes to a no at stage three if the bill is not amended. 

Tory Sue Webber said she had initially been in favour but had changed her mind after listening to evidence. 

Others spoke from personal experience. Pam Duncan-Glancy opposed the bill, citing the dangers it posed to disabled people. 

George Adam referenced his wife Stacey, who has multiple sclerosis and wants control over her final days. 

But while last week’s debate generally showed parliament at its best, there’s a niggling feeling that a few MSPs indulged in a kind of “progressive” positioning which actually isn’t progressive at all. It’s about elevating individual choice above the collective good, and ignoring the unintended consequences well-intentioned laws can trigger. 

The title of McArthur’s bill suggests it is for those in the last stages of terminal illness. But the definition is broader, extending to conditions from which an individual is “unlikely to recover” and are “reasonably expected to cause premature death.” 

The health committee’s stage one report includes a chapter titled ‘The Slippery Slope’, citing evidence from countries like the Netherlands and Canada where assisted dying has been extended to those with depression and anorexia, or even when people fear “being a burden”. 

During the Covid pandemic, some disabled people had Do Not Resuscitate orders placed on their files without consultation. That is the context in which this debate is taking place.
I don’t remember whether I missed the 2015 vote because of a hospital emergency or because I just couldn’t face it. But last week, I would have shown up and voted no because of what I learned in those final days with my father. 

He was precisely the kind of patient the new bill is aimed at, a terminally ill adult in extreme pain at the very end of life. But he didn’t want to die and deserved that choice. I fear people like him might be denied it in future.