"Assisted dying" legislation will be published at Holyrood on Thursday. In the coming months, MSPs will hear a range of views on a bill from LibDem MSP Liam McArthur that would allow terminally ill Scots to access lethal medication. Parliament and the public are divided on this issue, and it’s clear that people on both sides of the argument have strong views.

In the past, I was supportive of this kind of legislation. I understand the case being made by advocates, who highlight very difficult cases. As a liberal type, I thought: "Who am I to stand in the way of another person’s choice?" But after looking at evidence, reflecting on the societal context that this law would be introduced to, and seeing the effects of "assisted dying" in my home country of Canada, I changed my mind. I no longer believe that a law change would be beneficial. And I would plead with MSPs not to take this step in Scotland.

For "assisted dying" to work, we need to be sure that it would not be abused, and that vulnerable people would not face pressure to end their lives. I’m afraid there’s no way to prevent these outcomes, as the experience of other nations shows. "Safeguards" fail. Each jurisdiction has its own, alarming examples. This is because every system inevitably involves error. Mistakes happen. Abuses happen. Important details are missed. Anyone who claims Scotland won’t witness bad outcomes is either misleading the public or refusing to heed the evidence.

When it comes to "assisted dying", the stakes couldn’t be higher. We are talking about people ending their lives with the assistance of doctors. If there is any prospect at all of unjust deaths occurring, the state must say no - and there is every prospect of this happening. I think this concern was a major factor in parliamentarians rejecting a change in the law in the past. It’s still a huge - and, in my view, unanswerable - problem today.

I’d also stress that safeguards can be watered down or removed over time. In other nations, we have witnessed a gradual push for easier access to "assisted dying" by more groups of people. Once it becomes a healthcare right, denying people access becomes increasingly difficult because it means discriminating.

Why limit access to people who may only have a few months left to live? What about people with non-terminal conditions? Psychological conditions? Why not “mature minors”, given that children also become terminally ill? Campaigners will push for changes through the parliamentary process and through the courts. No assurance can be made today that expansion will not occur tomorrow. And I don’t think the public support permissive laws. Only saying no to any law change can avoid extension.

The Herald: Liam McArthur promoting his Assisted Dying BillLiam McArthur promoting his Assisted Dying Bill (Image: PA)

As a sociologist, I’m keenly aware of how "assisted dying" would play out in a society that is riven by inequality. This isn’t something that is talked about a great deal in relation to this issue, but I think it deserves close attention from MSPs during scrutiny of Mr McArthur’s Bill. We need to be clear that people’s decisions on "assisted dying" will be influenced by a wide range of factors, arising from their personal lives, and society more widely. There is great potential for injustice in this.

The way a terminally ill person experiencing healthcare inequality, poverty, addiction, homelessness, or loneliness approaches "assisted dying" will be wholly different to the way a person not facing these challenges approaches it. Ultimately, we would see disadvantaged people opting for "assisted deaths" because they feel that life isn’t worth living any more. Others in society would choose not to end their lives because they are well-off, supported, and valued enough to choose this path. The introduction of "assisted dying" will compound existing inequalities - and no amount of good will, or legislative drafting, would prevent this.

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I am also concerned that a law change will worsen negative value judgments about disabled people. Dr Miro Griffiths, a co-supporter of the Better Way campaign, speaks movingly about this issue. He has said: “When I’ve gone to hospital, usually because my respiratory is declining, the question often asked to my partner, or to a family member, or even my personal assistants, is ‘should we place a do not resuscitate notice on Miro’s notes?’

“Straight away the conversation is built upon the premise of ‘is this life worth saving?’ I know my life and the value placed on it is questioned. If you introduce a mechanism of assisted suicide you’re effectively saying ‘we’ll still debate whether your life is worth saving but we’re also always going to have this option on the table now where your life can be ended’. This is increasing the levels of anxiety felt by myself and also others in my community.”

This concern explains why no major disability group in Scotland, or the UK more widely, supports "assisted dying". And why many of the leading campaigners against this practice across the world are disabled people. We need to listen to the voices of disabled people, and I hope that people like Miro will be invited to give evidence when scrutiny begins.

Another powerful factor that informs my view on "assisted dying" is the way it has played out in my home nation of Canada. A family member was diagnosed with cancer last year. There was no sense of urgency when this happened. We had to fight to get any kind of treatment and, although my loved one wanted to fight, the treatment he needed was very expensive. Doctors effectively counselled him to accept death. There’s no doubt in my mind that things would have been different had he been diagnosed before Medical Aid in Dying (MAiD) was legalised.

For those who may, like myself, find themselves instinctively in favour of "assisted dying", I’d urge you to think again about the ramifications of this change. Especially with regard to people on the margins of society. I’m convinced there is a better way forward for Scotland.

Originally from Canada and a member of Nipissing First Nation, Dr Ashley Frawley is an author, lecturer in sociology, and spokeswoman for Better Way