This week, seven of the country’s most influential healthcare bodies united to express concerns about safeguards in Liam McArthur’s Assisted Dying Bill. Kevin McKenna isn’t surprised.

As they peer over Liam McArthur’s assisted dying precipice, it seems our health and care sector doesn’t like what it sees. Along with six other medical and healthcare organisations across the country, the Royal Pharmaceutical Society issued a joint statement of consensus this week expressing serious concern about changes being proposed to the Bill.

None of these membership bodies have signalled any position on the principle of assisted dying. The organisations include healthcare professionals some of whom will be asked to provide end of life care to their patients and must have the trust and confidence of them and their families that their ministry is entirely objective. What unites them are doubts about provisions relating to conscientious objection and the right not to participate.

They fear that recent interventions by the Scottish Government signal a move to remove such protections at Stage 3 of the Bill as they’re issues not covered by devolution. These issues would be addressed later, it seems, by a Section 104 Order which receives more limited scrutiny.

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In their letter to Mr McArthur and the relevant Holyrood committees, the organisations say: “The prospect of removing matters of such professional, ethical, and legal significance from parliamentary scrutiny at Stage 3, and deferring them to secondary legislation after the Bill has passed, raises important questions about transparency, accountability, and the robustness of the legislative process.

“These protections are central to the safe, ethical, and fair delivery of care, and to the confidence of our medical workforce who may be affected by the legislation.”

The Royal Pharmaceutical Society and its sister organisations were always destined to be placed under an intolerable moral dilemma with Mr McArthur’s bill. Nothing he and his supporters have said fully address wider societal concerns about coercion and issues around the mental health of patients receiving not just end of life care, but those experiencing pain and isolation as a result of serious illness. Doctors and others intimately involved in their patients’ wellbeing are much more attuned to the human behaviours of loved ones in critical situations. They can sense before the rest of us when an individual may be encountering undue pressure to agree to their lives being ended by artificial means.

In Canada, the passing of similar legislation has led directly to a pitiless terrain where the sick and emotionally vulnerable are being railroaded into decisions that have been made for them by individuals motivated either by personal greed or by local health bodies being forced to make cuts in their healthcare spending.

In 2023, Professor Leonie Herx, the globally-renowned palliative care expert, described the nihilistic and dystopian outcomes from assisted suicide legislation. Predictably, poor people or those experiencing short-term or long-term vulnerability were more at risk than affluent people with subjective decisions about the value of human life motivated almost entirely by cost considerations.

'Professor Leonie Herx, the globally-renowned palliative care expert, described the nihilistic and dystopian outcomes from assisted suicide legislation' (Image: Agency)

In an interview with The Herald, Prof Herx pointed out that legislation in her native Canada had advanced at “breakneck speed” beyond many of the so-called safeguards. These included the proviso that assisted death would only occur in exceptional circumstances and for physical suffering that couldn’t be controlled, even though investment in palliative care at the end of life can relieve such suffering.

In Scotland and throughout the UK, almost every disabled rights organisation had expressed opposition to what they regarded as horrific outcomes and consequences for those with mental and physical challenges. Professor Herx cited the case of a physician who’d been the main organiser of euthanasia provision at a hospital in Calgary. He was now a passionate opponent of euthanasia because he’d been appalled at how it was being used to target the weak and the vulnerable. It had been extended to children deemed capable of consent and those who had made “advanced requests”.

In Scotland and the UK, such concerns have been brushed aside under the catch-all “we’ll put provisions in the legislation to ensure no-one is unduly coerced into suicide”. Yet as the co-signatories of the Royal Pharmaceutical Society’s letter show, in Scotland any concerns around this are regarded as being of a secondary nature.

It’s not difficult to understand why Britain’s entire disabled rights sector is troubled by Mr McArthur’s Bill and the expected passing of Kim Leadbeater’s Terminally Ill Adults (End of Life) bill at Westminster. Implicit at their core is the concept of the value of human life according to a cost index and subjective perceptions of usefulness. The fact that babies with Down’s Syndrome can be aborted up until birth tells you that these tiny human beings are not considered worthy of being called fully human.

None of what’s being proposed in Scotland and England even considers the concept of palliative care for those suffering near the end of their lives. Professor Herx, who has advised authorities throughout the world about what can be achieved by proper investment in palliative care, says that no-one needs to suffer intolerable pain at the end of their lives.

In Scotland, the political establishment’s callousness around the care of the sick and the vulnerable is already evident. During the SNP’s watch outrage at the obscenity of drugs-related deaths has eased to resigned acceptance. The Scottish Government and its media sycophants think that by turning addicts into zombies by handing them unlimited Class A drugs in a safe consumption room is morally acceptable. I can’t think of anything more callous and savage.

Rather than see them as fully human and thus deserving of the chance of recovering through rehab facilities they condemn these poor people to a twilight existence in which, inevitably, they’ll eventually die prematurely and thus relieve the state of burden of caring properly for them. To then locate these houses of death in disadvantaged areas miles from the where the political and media elites live adds another level of contempt.

So, why would you trust such a class of amoral opportunists when they tell you they’ll provide safeguards so that the poor and those lacking advocates aren’t targeted by bad actors exploiting assisted dying? They already regard Scotland’s most vulnerable people as below contempt. So what chance do the sick and the dying have?

Kevin McKenna is Scotland's Feature Writer of the Year

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