On 17th March, a Bill to legalise assisted dying in Scotland was rejected at its final parliamentary stage by 69 votes to 57, with one abstention and two members not voting.
Twelve MSPs changed their position since the first vote in May last year, many of them influenced by evidence from palliative care specialists, who argued that good end-of-life care reduces the demand for assisted dying.
In its final form, the Bill limited assisted dying to mentally competent adults resident in Scotland with a terminal illness, who made a voluntary and informed request free from coercion, verified by at least two doctors. The person would have had to administer the life-ending medication themselves; direct euthanasia, involving a doctor administering the substance, was not permitted.
Over time, the debate shifted from the abstract question—“should this be considered?”—to a more practical one: “is this workable and safe enough to enact?” Some MSPs who supported the principle were ultimately not convinced that the proposed safeguards 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 highlighted safeguards as an area requiring strengthening, and warned that eligibility criteria might, over time, be challenged and widened.
Concerns were also raised about the protection and role clarity of healthcare professionals. The British Geriatrics Society, 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: “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, had also opposed assisted dying during his time as First Minister. Likewise, former First Minister Nicola Sturgeon expressed similar concerns, warning that what is presented as a “right to die” could, for some, become “a duty to die”.
“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.
This outcome in Scotland comes at a time when similar proposals in England and Wales have also struggled to secure parliamentary approval, encountering significant resistance, particularly in the British House of Lords. 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 policymakers, too, will approach the issue with similar prudence, resisting pressure from lobby groups and upholding a commitment to the protection of human life and dignity.
