The Assisted Dying for Terminally Ill Adults (Scotland) Bill is expected to be debated and voted on at stage 1 on Tuesday, 13 May. If it passes, it will progress to stage 2, where it can be amended. If it doesn’t pass, the bill won’t progress any further and won’t become law. Over several years we have been engaging on this issue and are urging MSPs to vote against it at stage 1. Many Christian leaders across Scotland have signed our joint letter to formally join us in our advocacy on the bill.

The Scottish Parliament’s Health, Social Care and Sport Committee has published its Stage 1 report on the bill, and they made no overall recommendation to MSPs on whether they should vote for the bill to progress to the next stage or vote against it. We think the evidence the committee has taken provides a strong case for why MSPs should vote against the bill, and in this article we summarise eight key reasons from it why we are urging MSPs to vote against the Assisted Dying for Terminally Ill Adults (Scotland) Bill at stage 1, as it cannot be amended for improvement.

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  1. The definition of terminally ill

The definition in the bill of terminal illness is:

“a person is terminally ill if they have an advanced and progressive disease, illness or condition from which they are unable to recover and that can reasonably be expected to cause their premature death.” (para 153)

We are very concerned about the potential wide eligibility under the bill’s definition of terminal illness, which does not include a prognostic timescale. The committee report states:

“the Committee also recognises that not including a life expectancy timescale within the definition of terminal illness means widening eligibility for assisted dying to include individuals who, although living with an illness or condition that is progressive and untreatable, may not be approaching death for a considerable period of time.” (para 167)

We believe that MSPs should not vote to progress a bill which holds this possibility. The next reason follows this one.

2. The risk of coercion

The bill would create a criminal offense of coercing or pressuring a terminally ill adult into making a decision on assisted dying. However, the report states in paragraph 384:

“Neither the Bill nor accompanying Policy Memorandum specify how a healthcare professional should undertake assessment of coercion.”

It is impossible to identify and stop all forms of coercion – especially internalised coercion. Nobody should ever feel that they are being a burden for receiving healthcare and treatment – they aren’t, and their life is every bit as valuable as anyone else’s. Not having assisted dying as an option therefore takes any possibility of internalised coercion off the table.

3. What has happened in other countries and states

The committee report states:

“The Committee notes evidence from other jurisdictions that there has been a general tendency towards the number of people requesting assisted dying increasing over time following legislation. Some have argued that such trends are a cause for concern while others take the view that such a trend should not, in and of itself, be considered concerning.” (para. 97)

We do think the trends are concerning, particularly with reference to Canada, Belgium and the Netherlands. Dr Mary Neal from the University of Strathclyde gave compelling evidence to the committee about prospective legal challenges to the bill which could lead to assisted dying being offered more widely than originally intended in the legislation.

4. The impact on disabled people

The committee wrote in the report:

“In oral evidence, representatives of disability organisations described their fears that the scope of the Bill would quickly be expanded to include those with disabilities within the eligibility criteria for assisted dying. On the back of this, these witnesses expressed concerns that assisted dying would then be presented to them as a viable alternative to support for living.” (para. 78)

What disabled people think about the bill should be reason alone for MSPs to vote against it. Two further direct quotes from the report:

“those witnesses representing disabled peoples’ organisations who gave oral evidence to the Committee were strongly of the view that the provisions in the Bill as introduced represented a direct threat to disabled people’s rights.” (para. 126)

“My view, as someone who is most interested in the implications that the Bill has for disabled people’s communities, is that the state has a role and a responsibility to protect disabled people, particularly because of systemic inequalities that are faced by disabled people’s communities across the country. The state therefore has a role in protecting all life associated with disabled people’s communities. I think that what you are proposing is incompatible not only with disability rights, but with the principle that the state is there to protect disabled people.” (Dr Miro Griffiths, para 129)

5. The exacerbation of inequalities for vulnerable groups

As outlined in our joint letter, our primary concern when considering this legislation as people of faith should be protecting the most vulnerable members of society. If the healthcare system is already rife with inequalities that disproportionately affect those who are elderly, have disabilities, are from minority ethnic backgrounds or are living in poverty, then this legislation significantly risks exacerbating them. From the report:

“The Committee notes the concerns raised by organisations representing disabled people and by others about what they perceive to be the risks to vulnerable groups posed by the Bill” (in relation to Article 2 of the European Convention on Human Rights, the right to life). (para 133)

6. The risks to those who suffer from domestic abuse

A very concerning letter sent to the committee from Dr Anni Donaldson (University of Strathclyde) and Isabelle Kerr (CEO, Beira’s Place) stated the following:

“In our view, [the Bill], completely ignores the risks his [Liam McArthur MSP] proposed legislation creates for women living with domestic abuse. The Bill relies on the consent, choice, free will and autonomy of the person wishing to end their life. For too many women living with domestic abuse in Scotland today, these principles are simply non-existent in their daily lives. It is unrealistic to assume that domestic abuse will cease when a woman receives a diagnosis of terminal illness… State sanctioned killing could provide a conducive context for a domestic abuse perpetrator’s ultimate act of control.” (Letter sent to committee on 12 March 2025)

7. The impact on palliative care

We have significant concerns for how a prospective law facilitating assisted dying would critically impact palliative care services which are already under-resourced by the state. From the report:

“The Committee heard concerns that current inadequacies in palliative care provision may lead people to consider assisted dying to be their best or only option. The Committee heard evidence of current shortcomings in services which some contributors argued needed to be addressed before the prospect of legalising assisted dying should be considered.

“Contributors on both sides of the debate called for greater resourcing of palliative care and shortcomings in availability of palliative care were highlighted repeatedly in evidence. For example, in her written submission, Rachel Kemp told the Committee: “…there are more MSPs than palliative care consultants in Scotland.”” (para 100101)

As outlined in our joint letter, the Association of Palliative medicine found that ​“95% of palliative care doctors would refuse to prescribe lethal medication to their patients if it was legal to do so and 40% would leave their jobs if assisted dying was introduced in their place of practice”.

8. Non-participation/conscientious objection

The committee heard evidence from BMA Scotland, Hospice UK and the Scottish Partnership for Palliative Care that they think non-participation or conscientious objection by medical professionals in assisted dying should be expanded to include anyone who wishes to not be involved (para 310, 311, 312). We agree with this, because we have significant concerns about any person of faith being involved in any part of the process against their conscience.

The implications of the gospel extend to all of life, including to the consideration of this potential legislation. There are many reasons why we believe that the outworkings of the gospel are incompatible with the introduction of an assisted dying law, but chiefly among them is love. Jesus came to earth in perfect love, perfect compassion and perfect care for us when at our best or at our worst, ill or not ill, more vulnerable or less vulnerable, to restore us to new life reconciled to God. Our response is to do all we can to bring life and hope to all those around us, and especially to those who are ill in their pain. Where MSPs don’t share our faith, we hope that we can share this worldview – and vote against the introduction of assisted dying in Scotland.