Witnessing a painful, protracted, death is a common reason for supporting assisted suicide: a term I use rather than "assisted dying", which many people understand as including palliative care. So, my heart goes out to Liam McArthur MSP, whose stated motivation in proposing his bill to legalise assisted suicide in Scotland was that "dying people are facing traumatic deaths that harm both them and those they leave behind".

However, as both a doctor and ethicist who witnessed the mismanaged dying process of my own father in hospital before he was moved to a hospice, I am concerned about many of the elements in the proposed legislation on assisted suicide.

The bill seeks to legalise the prescribing of lethal drugs for self-administration by adults having a progressive disease, illness, or condition from which they are unable to recover, and can reasonably be expected to cause their death. This reflects the terminology used in Canada, which decided upon death being “reasonably foreseeable” in the setting of a “grievous and irremediable medical condition”.

But as a legally defining criterion, this is incredibly vague. The whole of life could be called a terminal condition since death is not just reasonably foreseeable but an absolute certainty for everyone at some point. Having no specified time period for which to qualify as eligible for assisted suicide means some people will have their lives shortened by possibly decades. My father enjoyed life for well over a decade after being given a "terminal" prognosis. In Oregon, where assisted suicide has been legal since 1997, the lethal dose is sometimes not taken for years after being accessed.

The Scottish bill also indicates that doctors should be able to prescribe the lethal dose as soon as they are fully registered healthcare professionals. Mr McArthur oddly recommends swathes of new training and support for those implementing the proposed assisted suicide service and yet, at the same time, maintains that the workforce "is likely to be small" as the numbers using it in Scotland will be low.

Whilst numbers are always initially low in other countries where assisted suicide has been legalised, they inevitably increase and in the case of Canada have done so very rapidly. Over 5% of all deaths in Quebec are now from assisted suicide or euthanasia. The latest figures for the US state of Oregon show a 21% increase in deaths from assisted suicide in 2023 from the previous year.

The proposed assisted suicide bill seems to assume that the procedure will not adversely affect those living with chronic illness or disability. However, it ignores widespread global concern about what is happening in Canada where the homeless as well as the disabled are offered assisted suicide, rather than basic care.

Moreover, the proposed bill seeks to introduce assisted suicide in Scotland for a limited group of people. But its lack of clarity on what constitutes ‘terminal illness’ and its disregard of the adverse consequences clearly seen in Canada and other countries, make it a cocktail of misleading and dangerous provisions.

Dr Trevor Stammers FRCGP is a former GP and Associate Professor of Bioethics and a Member of the Scottish Council on Human Bioethics

Agenda is a column for outside contributors. Contact: agenda@theherald.co.uk