MSPs will vote later today on whether to legalise assisted dying for terminally ill adults in Scotland.
Hundreds of amendments have been debated during multiple marathon sessions as the proposed legislation has made its way through the Scottish parliament.
If passed, the Assisted Dying for Terminally Ill Adults (Scotland) Bill would allow those aged 18 or older with decision-making capacity and six months or less to live to seek medical help to end their life.
The final vote is expected to take place at about 10pm.
Scottish Liberal Democrat Liam McArthur, who put forward the bill, will meet with supporters outside Holyrood this morning.
He said MSPs had the chance to deliver “a robust and well safeguarded law that would give terminally ill Scots with mental capacity the choice of an assisted death if they wanted one”.
Mr McArthur said the bill has the “overwhelming support of a significant majority of Scots regardless of religious affiliation, political party or disability status”.
“MSPs have added detailed amendments on coercion, prognosis, and protection of vulnerable groups,” he added, “and there are cast iron protections for healthcare professionals ready to go.”
How did we get here?
A total of 175 amendments to the bill were accepted in the past week alone.
MSPs sought changes to ensure it does not contain elements outwith Holyrood’s powers.
Other amendments focused on patient safeguards, including protecting people from coercion and ensuring alternative treatment management options are discussed.
If passed, two doctors would both have to confirm a person is terminally ill and be “reasonably expected” to die within six months to be eligible for an assisted death.
The patient must also have the mental capacity to make such a request – and be able to understand, decide, communicate, comprehend and remember their decision.
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Some changes to the bill prompted backlash – with the Royal College of Psychiatrists in Scotland (RCPsychiS) and Royal Pharmaceutical Society in Scotland withdrawing support.
RCPsychiS said it “remains neutral” on the principle of assisted dying but claimed the removal of a key section of the planned legislation had “significantly weakened safeguards for psychiatrists and other healthcare professionals”.
Section 18 previously provided statutory protections for clinicians who choose not to participate in assisted dying, ensuring their decision would not affect their employment, regulatory standing or professional relationships.
With employment rights reserved to Westminster, there were fears that if the section had remained in the bill, it would have been outside Holyrood’s competence.
However, a deal has been agreed with the UK government that should enable the rights to be protected if the bill passes.
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Opponents brand bill ‘dangerous’
Others – including crossbench peer Baroness Tanni Grey-Thompson; Tressa Burke, chief executive of Glasgow Disability Alliance; and Heather Fisken, chief executive of Inclusion Scotland – have also voiced their concerns about the bill for vulnerable disabled people.
Mike Smith, spokesperson for Not Dead Yet UK, said “coercion comes in many forms, whether it’s intentional or more subtle”.
Mr Smith, former disability commissioner at the Equality and Human Rights Commission, branded the bill “dangerous”.
Dr Gordon Macdonald, chief executive of campaign group Care Not Killing, added: “Vulnerable people who are sick, elderly or disabled can so easily feel pressure, whether real or imagined, to end their lives so as not to be a burden on others.
“Parliament’s first responsibility is to protect its most vulnerable citizens from exploitation and abuse by those who may have a financial or emotional interest in their deaths.”
Deputy First Minister Kate Forbes also urged MSPs to consider their views as she revealed she would be voting against the bill.
Ms Forbes said: “Doctors, psychiatrists, pharmacists, and palliative care specialists – the people who would be tasked with implementing this – are asking us not to do it.
“These are the people on the frontline of compassion in Scotland, the people who have dedicated their lives and careers to helping people in life and in death. They think this bill is unsafe.”
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‘Dying people should not have to suffer’
However, in his final pitch to MSP colleagues ahead of the free vote, Mr McArthur said it is now the “toughest and most comprehensively safeguarded assisted dying bill in the world”.
He added: “If you believe that dying people should not have to suffer against their will, and you have heard, like I have, of the many instances where they have been simply failed by the lack of compassion and safety in our current law, you now have to back this bill.
“It is time to look terminally ill Scots in the eye and make this change.”
This is the third time MSPs have considered legislation on assisted dying, with two previous attempts having failed at their first vote.
Last month, Jersey voted to legalise assisted dying for terminally ill adults.
It came almost a year after the Tynwald in the Isle of Man became the first parliament in the British Isles to agree a framework for assisted dying.
However, the process of getting that framework on the statute book is yet to be finalised.
Meanwhile at Westminster, the Terminally Ill Adults (End of Life) Bill for England and Wales is progressing slowly through the House of Lords and is at risk of failing due to a lack of parliamentary time.
