TERMINALLY ill patients in remote areas of Scotland who are seeking to end their lives could be assessed by doctors over videolink, a consultation on assisted dying has suggested.

Liberal Democrat MSP Liam McArthur wants to introduce new legislation in Holyrood which would permit assisted dying for adults who are both terminally ill and mentally competent.

But the plans – the third attempt to pass such a law in Scotland – have sparked strong opposition from campaigners and some medical professionals.

A consultation on the proposed Assisted Dying for Terminally Ill Adults (Scotland) Bill suggests a range of safeguards, including requiring two doctors to confirm a person is terminally ill and mentally competent. 

The person would also have to sign a written declaration of their request, which would be witnessed and signed by both doctors.

However, the consultation notes that "assisted dying may in practice be harder to obtain for people living in small and remote communities, including island communities – particularly as travelling is likely to be particularly difficult for people with a terminal illness".

It continues: "The process requires the direct involvement of a number of other people to carry out certain functions, for example the two independent doctor assessments at stage one.

"It may be harder for a person living in a small and remote community to identify individuals who are able to attend at the relevant time and place.

"It may also be more difficult for someone living in such a location to gain access to an alternative doctor if the only local doctor declines to assist on grounds of conscience. 

"The member [Mr McArthur] acknowledges these difficulties and is keen to hear views on how this can be mitigated."

A footnote in the consultation document adds: "Research from permissive jurisdictions shows that assessments can be undertaken via videolink with the doctor and the patient in exceptional circumstances.

"Indeed, this has become more common practice for healthcare more generally since the Covid-19 pandemic forced us all into new ways of working."

Dr Gordon Macdonald, chief executive of Care Not Killing, which highlighted the footnote, said the reference to a videolink consultation "beggars belief".

He added: "How can a medic make a decision on the state of mind of an individual on a remote internet connection without being in the physical presence of that person to try and make a measured judgement?"

He said many healthcare experts are "vehemently opposed to the Bill and are already expressing their views".

He added: “Legalising assisted suicide would put immeasurable pressure on vulnerable people including those with disabilities to end their lives prematurely, for fear of being a financial, emotional or care burden on others."

Mr McArthur said there is "strong public support for a change in the law to end the current blanket ban on assisted dying".

HeraldScotland: Liam McArthur MSPLiam McArthur MSP

He said: "My proposals aim to deliver that change and give dying people who are suffering unbearably, more choice at the end of their life and the peace of mind that they do not need to suffer against their will.    

"My proposals would require two doctors to outline alternative treatment and care options to someone seeking an assisted death. 

"I also believe this needs to go hand in hand with significant further investment in palliative care, to both improve and widen access to such care. 

"That is a case I will be vigorously making as the proposed bill goes through Parliament.

"However, it is increasingly clear that some terminally ill people find themselves beyond the reach of palliative care and wish to have the choice to die a dignified and compassionate death. 

"No amount of scaremongering by some opponents of reform can change the fact that the status quo offers no real options, precious few safeguards and all too often only dreadful decisions. 

"People in Scotland deserve better.” 

On the prospect of online consultations, he said:  "The proposals outlined in the bill consultation take into account the very real challenges of delivering aspects of healthcare in rural and remote communities. 

"It is a very genuine consultation that seeks input on how to navigate these issues and provides information about how other jurisdictions operate in exceptional circumstances. 

"There are ongoing wider conversations about how remote consultations might best be utilised in healthcare to reduce inequalities and barriers to access for individuals. We must ensure dying people are not left behind."

The consultation, which is open until December 22, says more than 200 million people currently live in jurisdictions which have legalised some form of assisted dying.