DOCTORS from across Scotland have announced their support for the legalisation of assisted suicide.

In a letter to The Herald 11 senior clinicians, including psychiatrists, surgeons and a neurology expert, said they were backing the Bill proposed by MSP Margo MacDonald in the Scottish Parliament.

The doctors say they believe the Bill, which allows trained facilitators to provide patients with a lethal prescription after a three-stage scrutiny process, contains sufficient safeguards to protect vulnerable people from any kind of coercion.

Dr Gillian MacDougall, a practising ear, nose and throat surgeon who helped organise the letter, said more doctors would have signed it but had been concerned about possible repercussions.

She said: "It is really hard in the medical profession to stand up and say you support this as a practising doctor. I think there is a fear of being labelled Dr Death and fear of any political repercussions. I know, for example, there are GPs out there who support [it] but they do not feel able to put their name to a present publication because of possible backlash from partners and the community."

She stressed that under the proposed Bill patients have to initiate any discussion about assisted suicide - such a move could not be proposed by a doctor.

She said: "Patients have nothing to fear from their doctor supporting this Bill. The Bill is very clear that it all has to come from the patient."

Dr MacDougall, who works for NHS Lothian, said she had never been asked by a patient for help to die, but on occasions people had expressed regret about waking in the morning because they had wanted to die during the night.

She said: "I am not a head and neck cancer specialist, but I have witnessed a lot of sufferers dying over the years and it is a particularly difficult condition to palliate. Some suffer from pain, but the main issues are that they cannot swallow and they cannot breathe. The majority of patients I have seen would not want or need to use the Bill. It is a tiny minority of people who would want to use it, but I do think the choice should be there."

In the letter the doctors say: "The measures in this Bill will complement the excellent palliative care already on offer in Scotland, not undermine it. We believe the safeguards designed to protect the vulnerable are comprehensive and rigorous, with doctors being the best professionals to assess for any concerns regarding coercion. We are also reassured a doctor cannot be compelled to participate in the process, should they not wish to do so."

Professor Charles Warlow, who has retired as Professor of Medical Neurology at Edinburgh University with an international reputation for his work, is also among the signatories.

He said: "I have felt for many years very strongly that people who are in a hopeless and helpless condition usually, but not always, nearing the end of their lives, should have the option."

He added that the best of palliative care did not work for everyone. "I think it is part of one's doctoring responsibility to help someone at the end of life. I know many people do that with the double effect of morphine. It is all secretive and it should not be," he added.

However, a spokesman for Care Not Killing, the umbrella organisation spearheading opposition to the proposed Bill, said the Royal College of General Practitioners, British Medical Association, Royal College of Physicians, Association for Palliative Medicine, British Geriatric Society and World Medical Association all opposed a change in the law.

He added: "It is clear that the majority considered opinion of doctors is strongly against assisted suicide."

Meanwhile, England's Care Minister Norman Lamb yesterday backed moves to legalise assisted dying with "proper safeguards".