On the evening of 17 March 2026, MSPs voted 69 to 57 against legalising assisted dying in Scotland. Both campaigns and the penultimate debate were emotionally charged. This is the third time Holyrood has rejected a bill on medically assisted death, with MSPs granted a free vote to respect their individual opinions.
There is a gaping disconnect between moral arguments for and logistical arguments against assisted dying. Simply on a matter of principle, I support increasing individual autonomy and choice in healthcare, particularly informed by my own experience as a disabled woman. However, this view begins to crack in the face of bureaucratic implementation.
What would an assisted death actually look like in Scotland?
Firstly, where does the funding come from? Across the UK, palliative care and disability support are shockingly underfunded. The debate around dignity for those wishing to end their lives has been amplified in this conversation, but less has been said about the dignity of those struggling to access end-of-life care and support during terminal illnesses. Assisted dying feels like an ‘easy fix’ — a way of addressing the failures of social care in the UK without having to acknowledge the deep-rooted structural issues within the system itself.
It is difficult to justify the funding needed to operationalise this bill; millions of pounds would have to be reallocated from other areas of healthcare to set it up in Scotland, let alone maintain it. More funding and political attention are needed for palliative care and disability support, not less. If the state starts to provide assisted death without addressing preexisting pressures within social care, then this reinforces the status quo that certain individuals are a burden to society.
Arguments for this bill also emphasised unequal access to services like Dignitas, as a luxury only available to those who can afford to fly to Switzerland. Theoretically, providing assisted death through the NHS democratises this problem. But Scotland “has the worst health inequalities in western and central Europe,” according to Public Health Scotland. The Scottish Human Rights Commission published a report in 2024 outlining key barriers to accessing health and social care in the most remote areas of Scotland. Assisted dying would just become another ‘postcode lottery’ that is hindered in practice by external pressures like public transport reliability, GP availability, and access to mental health services.
Even disregarding the economics and logistics of implementing assisted dying in Scotland, the debate tests the principle of conscientious objection. The British Medical Association has emphasised the need for physician autonomy alongside patient autonomy, recommending an ‘opt-in’ model for doctors with the right to decline to participate in any stage of the process. The trade union also rejects the integration of assisted dying into existing care systems and recommends establishing a separate referral service instead.
Fundamentally, Scotland is not ready for assisted dying. Individuals who use palliative care services, who are living with disabilities and terminal conditions, who work in the NHS and social care, are concerned about the precedent this legislation would set. I would love to imagine a future in which Scotland provides assisted dying as part of an adequately funded and truly socially equitable welfare state. But there are too many pre-existing issues in Scotland’s health and social care system that must be dealt with first.
Photo by César Badilla Miranda on Unsplash
Related
Scotland Is Not Ready For Assisted Dying. Yet.
On the evening of 17 March 2026, MSPs voted 69 to 57 against legalising assisted dying in Scotland. Both campaigns and the penultimate debate were emotionally charged. This is the third time Holyrood has rejected a bill on medically assisted death, with MSPs granted a free vote to respect their individual opinions.
There is a gaping disconnect between moral arguments for and logistical arguments against assisted dying. Simply on a matter of principle, I support increasing individual autonomy and choice in healthcare, particularly informed by my own experience as a disabled woman. However, this view begins to crack in the face of bureaucratic implementation.
What would an assisted death actually look like in Scotland?
Firstly, where does the funding come from? Across the UK, palliative care and disability support are shockingly underfunded. The debate around dignity for those wishing to end their lives has been amplified in this conversation, but less has been said about the dignity of those struggling to access end-of-life care and support during terminal illnesses. Assisted dying feels like an ‘easy fix’ — a way of addressing the failures of social care in the UK without having to acknowledge the deep-rooted structural issues within the system itself.
It is difficult to justify the funding needed to operationalise this bill; millions of pounds would have to be reallocated from other areas of healthcare to set it up in Scotland, let alone maintain it. More funding and political attention are needed for palliative care and disability support, not less. If the state starts to provide assisted death without addressing preexisting pressures within social care, then this reinforces the status quo that certain individuals are a burden to society.
Arguments for this bill also emphasised unequal access to services like Dignitas, as a luxury only available to those who can afford to fly to Switzerland. Theoretically, providing assisted death through the NHS democratises this problem. But Scotland “has the worst health inequalities in western and central Europe,” according to Public Health Scotland. The Scottish Human Rights Commission published a report in 2024 outlining key barriers to accessing health and social care in the most remote areas of Scotland. Assisted dying would just become another ‘postcode lottery’ that is hindered in practice by external pressures like public transport reliability, GP availability, and access to mental health services.
Even disregarding the economics and logistics of implementing assisted dying in Scotland, the debate tests the principle of conscientious objection. The British Medical Association has emphasised the need for physician autonomy alongside patient autonomy, recommending an ‘opt-in’ model for doctors with the right to decline to participate in any stage of the process. The trade union also rejects the integration of assisted dying into existing care systems and recommends establishing a separate referral service instead.
Fundamentally, Scotland is not ready for assisted dying. Individuals who use palliative care services, who are living with disabilities and terminal conditions, who work in the NHS and social care, are concerned about the precedent this legislation would set. I would love to imagine a future in which Scotland provides assisted dying as part of an adequately funded and truly socially equitable welfare state. But there are too many pre-existing issues in Scotland’s health and social care system that must be dealt with first.
Photo by César Badilla Miranda on Unsplash
Share this:
Like this:
Related