Surely it makes sense that if someone is suffering pain during a terminal illness and wishes to die, clinical or nursing staff should be empowered to bring that life to an end?

After all, we put down family pets if they are suffering and there is no betterment for them, don’t we?

We respect people’s right to choose in many other areas of life, so shouldn’t we honour that same right when a human being elects to leave this earthly life?

These questions are swirling around in the wintry Scottish darkness right now, and it’s right that they should be. Brave independent MSP Margo MacDonald is to be commended for sparking off a national debate on the issue of legalised assisted suicide, with her End of Life Assistance Bill.

Her proposals would allow anyone aged over 16 to request help to die, so long as they have been diagnosed as terminally ill or permanently physically incapacitated and find life intolerable.

She has made some qualifications: the patient must have been registered with a GP in Scotland for at least 18 months, two formal requests must be made and approved by the doctor, and they must have a meeting with a psychiatrist.

People with dementia would be excluded if they were not in full control of their faculties.

So is that all right then? If only life – and death – were so easy. But they are not.

I can see the force of the argument that the procedures Margo is asking for should be in place, on compassionate grounds.

No-one likes to see anyone suffer; and I would refute the insistence of some of the opponents of the proposed legislation that modern drugs can guarantee a pain-free death.

This is simply not so. Having been around a few death beds in my time, though, I have reservations.

I suppose I’ll be categorised as being part of the “religious lobby”. (For some people, that ranks alongside suffering from dementia. If only religion and dementia were so simple.)

I sympathise with the qualms of so many doctors, and would agree with Dr Brian Keighley, chairman of the BMA in Scotland, who said: “The traditional doctor-patient relationship is founded on trust and this risks being impaired if the doctor’s role encompasses any form of intentional killing.”

The last time I checked, the BMA was not made up of religious nutters.

Conscientious doctors are well aware that the clinical decision to increase the morphine dose in order to relieve pain may have the effect of hastening death. That, though, is morally different from the straightforward intention of killing the patient.

I like Arthur Hugh Clough’s “Thou shalt not kill but need’st not strive, officiously, to keep alive.” This is precisely where the issue of trust is so important.

In a state of vulnerability, the patient needs to be sure that the person in a white coat advancing with syringe in hand is not seeking to kill him or her.

People suffering from serious illness may feel under subtle pressure from family, or even from the NHS, to move nearer to the exit.

Where we do need investment is in the area of palliative care. Hospices, with their track record of caring for the total person in extremis, have much to teach general hospitals.

I have no confidence that the “safeguards” in Ms MacDonald’s bill would actually be observed. The truth of the matter is that doctors and psychiatrists are too busy to implement them.

When the abortion act was passed in 1967, various safeguards were put into place to prevent abuse. The reality is that we have moved to a place which is close to abortion on demand.

The womb and near the tomb are two of the most vulnerable places for human beings to be.

For all the good intentions, utilitarian ethics may take us to a society which, in the name of compassion, becomes a waste land of the spirit.