Doctors express strong opposition to assisted suicide in Scottish consultation

A significant majority of doctors have expressed strong opposition to proposals to legalise assisted suicide in Scotland.

A total of 82% of doctors who responded to the Scottish Parliament Health, Social Care and Sport Committee’s detailed call for views, and who gave permission for their responses to be published, have said that they “strongly oppose” the proposals.

The responses came from 114 people who described themselves as doctors, including professors with medical degrees.  

Of the 114 respondents, 93 (81.6%) strongly opposed the Bill, 1 (0.9%) partially opposed, 2 (1.8%) remained neutral, and 4 (3.5%) expressed partial support. Only 14 (12.3%) stated that they fully supported the Bill.

Many submissions came from palliative care specialists and elderly care physicians—two groups that are overwhelmingly against the Bill.

Palliative care concerns

Some argued that passing the Bill would shift focus away from improving palliative care, which is already underfunded in Scotland, and some said that true compassion for those who are terminally ill means valuing their lives, giving them hope and supporting high-quality palliative care for all who need it.

There was a warning for government and parliamentarians that legalising assisted suicide would send a harmful message that ending lives is more acceptable than investing in supportive, life-affirming care. They also warned that society would start seeing people with chronic conditions as drains on resources, and healthcare workers would start to see patients as candidates for assisted suicide instead of people who need care.

Terrifying

One submission described the legalisation of assisted suicide as terrifying for older, disadvantaged, and vulnerable people, potentially creating a “killable class”.

There were concerns about ensuring that decisions to end life would be truly voluntary, without subtle coercion from family members or even healthcare staff. As one respondent remarked, “Doctors aren’t telepathic, and it isn’t possible for two assessments to reliably identify coercion. It won’t pick up internal or structural coercion created by a lack of services.”

Several respondents referenced the case of Dr Harold Shipman, warning that such legislation could make detecting malicious intent difficult and might attract the wrong individuals to the medical profession.

Slippery slope

Many submissions referenced the slippery slope observed in other countries like Canada and the Netherlands, where initial strict criteria for assisted dying were gradually broadened to include mental illness, disabilities, and, in some cases, non-terminal conditions. Doctors warned that despite the safeguards in place, such expansions could happen in Scotland as well. “The only reliable safeguard is to never permit assisted suicide and euthanasia,” said one doctor.

Several doctors highlighted that terminal diagnoses are not always accurate, and prognoses can be wrong. People may live much longer than expected, and in some cases, their conditions may even improve.

The Bill’s broad definition of “terminal illness,” which could include people with chronic but non-fatal conditions, also sparked concerns.

Damage to doctor-patient relationship

Many argued that legalising assisted dying would fundamentally change the role of doctors, from those who preserve life to someone who provides means to die, which contradicts the Hippocratic Oath and core medical ethics. This shift could irreparably damage the doctor-patient relationship, particularly for vulnerable people with advanced illnesses who need the support of their healthcare professionals the most.

One doctor pointed out that the British public has already seen a breakdown of trust between doctors and patients when the Liverpool Care Pathway was introduced, stating: “Many were extremely scared of being admitted to the NHS hospital…when they rolled out the Liverpool Care Pathway as the ‘Gold Standard of End of Life Care’. They were convinced they would not come out alive, and many NHS patients, who could not afford it, called for private care because they did not trust the NHS.”

Conscientious objection

Others mentioned the lack of provisions for conscientious objections, which could leave healthcare professionals feeling pressured to participate against their will. This, in turn, could result in moral distress, burnout and professionals leaving the medical field altogether. In their submissions, several doctors have already expressed their intention to leave medicine if the Assisted Dying Bill passes. This chimes with a 2022 survey of palliative care doctors in Scotland which found that 75% would not be willing to participate in any part of the assisted suicide process, and 43% would resign if their organisation offered assisted suicide.

The current law is the safeguard. It should not change.