Proposals to make assisted dying legal in Scotland have passed their first hurdle.
Despite major legal and practical concerns, a majority of MSPs on Tuesday backed the general principles of legislation allowing people with terminal illnesses to ask a doctor for help to end their life.
The Bill, proposed by Liberal Democrat MSP Liam McArthur, was passed by 70 votes to 56 following nearly five hours of debate at Holyrood.
But the vote immediately sparked warnings about the threat of another costly legal battle if the legislation is challenged in the courts.
A wide range of concerns were raised about aspects of the Bill, including the risk of a ‘slippery slope’ where legal challenges force it to be extended, and the dangers of ‘coercion’, where vulnerable people may feel forced to end their life because they think they are a burden on their family or the State.
Last night’s vote also came despite direct warnings about the ‘practical and legal concerns’ about the proposals, including that the Bill may not be within the legal competence of the Scottish Parliament.
Mr McArthur hailed the result as a ‘landmark moment for Scotland’ and said it will provide a ‘compassionate choice for the small number of terminally ill Scots who need it’.
But Dr Gordon Macdonald, chief executive of Care Not Killing, said: ‘This could result in Holyrood becoming embroiled in yet another expensive court case as and when any future legislation is challenged through the courts.
‘There is massive opposition to the Bill and our campaign will now be stepped up as we prepare for what lies ahead.’
Labour MSP Pam Duncan-Glancy, Holyrood’s first permanent wheelchair using MSP, said: ‘I’m heartbroken. I genuinely hoped that colleagues would see the risks associated with the Bill and understand the message it could send across Scotland to disabled people.
‘But what I did hear was considerable trepidation in some colleagues and many colleagues saying that they would they need to see the Bill amended at Stage Two for it to retain their support. I am convinced that they will not be able to find the amendments that will put in the safeguards that are necessary, and I think my colleagues will see that.’
MSPs backed the legislation despite First Minister John Swinney and Deputy First Minister Kate Forbes both voting against it.
Among those supporting the legislation in the free vote – where MSPs did not need to follow the party whip – were six of Mr Swinney’s Cabinet ministers: Shona Robison, Fiona Hyslop, Jenny Gilruth, Mairi McAllan, Angus Robertson and Shirley-Anne Somerville.
Scottish Labour leader Anas Sarwar voted against, while Scottish Conservative leader Russell Findlay supported the proposals.
Many MSPs agreed to support the legislation in the first stage vote but will now see if amendments address the range of concerns before deciding whether to back the Bill becoming law in the final stage three vote.
Introducing yesterday’s debate, Mr McArthur told MSPs: ‘I know how much this Bill matters to those dying Scots and their families who are desperate to see the law change to allow more choice, compassion and dignity at the end of life.
‘And it’s their voices, their needs, their interests, that must be at the centre of this debate, at the heart of our considerations and at the forefront of our minds as we come to vote later on this evening.’
During Tuesday’s debate, many MSPs told deeply personal stories about their decisions.
Ms Duncan-Glancy said: ‘We are not simply voting on a principle of choice, but on a hugely consequential piece of legislation that, yes, could put disabled people at material risk.
‘Worryingly it is also legislation that could serve to legitimise the view that a life like ours, one of dependence and often of pain, is not worth living.’
She said that the proposal ‘brings the real risk that in moments when we are ground down, we would not only believe we are better off dead, but the state could help make that happen’.
She added: ‘It is inconceivable to suggest that the introduction of assisted suicide is about choice at the end, when so many people do not have choice throughout life.
‘It is impossible to accept that there could ever be certainty that someone has not been pressured into ending their life prematurely. The Bill is the start of a slippery slope.’
Tory Jeremy Balfour, who is also disabled, told MSPs: ‘I could imagine, in a few years time, having some terminal illness and feeling the burden that could be put on my wife and my children because of the care that they give me day-in day-out.
‘I have spoken to other disabled people who have felt and feel the same.
‘We as MSPs are bound to vote on behalf of the best interests of our constituents.
‘I would beg you, I would urge you to consider the most vulnerable in your constituency or in your region and say no to pray and dice with the sanctity of their lives.’
George Adam, MSP for Paisley, also spoke emotionally about his wife Stacey’s health conditions, including secondary progressive multiple sclerosis, osteoporosis, asthma, and high blood pressure, and acknowledged that the ‘road ahead could get harder’.
He said: ‘We hope that time never comes, but if it does, if the suffering becomes unbearable, Stacey should have that right to choose how her life ends, with dignity, with compassion.
‘This bill gives Stacey peace of mind, because the truth is I don’t know if I would be strong enough to let go. The thought of life without her is unbearable.
‘I don’t want to make that decision, I want Stacey to be able to decide. That’s what this Bill is about.
‘For Stacey, for me, for thousands of other families, it is about having that choice, peaceful and dignified end. This isn’t about ending life early, it is about making sure when death is near people have a choice that is safe, legal and compassionate.’
Highlands and Islands MSP Edward Mountain, who fought off bowel cancer following his 2021 diagnosis with intensive radiotherapy, chemotherapy and surgery, said: ‘I stand to speak in this debate with sadness; sadness because it is all about the ending of life.
‘During life there will never ever be a bigger to make than the decision to either take a life or to sanction the ending of life.
‘As a young soldier my view was death happened to other people. But age and cancer have made me realise that death was inevitably coming closer and I was forced to contemplate carefully how my life might end – not a comfortable or easy experience and this bill brings all that into sharp focus.’
He said he will ‘always seek life’ and said those with terminal illnesses can access good palliative care which puts them into control.
He added: ‘This parliament in my mind has a duty to make it easier to choose life, rather than making it easier to die, which is what this bill will do.’
SNP MSP Marie McNair, who previously worked in hospices, warned that passing the bill would “send a message” that some lives are valued above others and ‘fundamentally change the relationship between patients and clinicians’
She also raised concerns that the legislation ‘opens a door we may not be able to close’ and that eligibility will be extended in the future, and added: ‘We cannot, with any great certainty, guarantee that safeguards would be kept in place and that leads us down the very dangerous path of living in a society that devalues the lives of the most vulnerable.’
Following yesterday’s vote, the Bill will now be scrutinised by the health and sport committee and MSPs and the Scottish Government will propose a long list of amendments before the final stage three vote to decide if it becomes law.