Choice, autonomy, coercion in Scotland’s Assisted Dying for Terminally Ill Adults Bill 2024

Recent decades have seen an increased interest in end-of-life matters, with several jurisdictions introducing laws to permit assisted death, a form of end-of-life.1 As part of this growing movement, the Scottish Parliament is currently considering the Assisted Dying for Terminally Ill Adults (Scotland) Bill (“the Scottish Bill”).2 It comes against the backdrop of years of public3 and political activity4 in Scotland. A public consultation took place in 2021 based on a draft Bill.5 A final proposal was supported by 36 MSPs, thus granting Liam McArthur MSP the right to introduce it formally on 27 March 2024.
In this analysis piece, we comment on aspects of the Scottish Bill that we find most significant from a criminal and medical law perspective. We argue that the introduction of the Scottish Bill will clarify the criminal law in the area of assisted suicide, which is currently vague and unclear. The proposed legislation addresses the legal grey area that currently exists in Scotland and has left many who require assistance in suicide at risk of potential criminal charges. We also comment on how the Scottish Bill introduces a distinct offence of coercing someone to request assisted suicide, marking a significant departure from previous Scottish Bills and the latest Irish Bill.6 The Scottish Bill treats coercion as a distinctive wrong, further protecting autonomy.
On the medico-legal aspects, we note the Scottish Bill’s terminal illness definition as a basis for eligibility; we welcome the absence of a requirement for a prognosis but warn that it may still be subject to challenge. On the medical aspects, we also note the crucial role of healthcare professionals (“HCPs”) in the operation of the Bill and propose further actions in directly consulting with them via professional and membership organisations. We also note the importance of consulting with patients and others with lived experiences on the matter. We hope that this analysis, alongside the further review currently undertaken by the Health, Social Care and Sport Committee, will give MSPs the best start when the Bill returns to Parliament for Stage 1 and a vote. There are significant developments in UK Crown dependencies7 and Ireland,8 which will affect Scotland because of their geographical proximity. This fundamental “divergence in legislation” must be urgently addressed.9 The Scottish Bill is, therefore, timely.