The bill seeking to legalise assisted dying for terminally ill adults in Scotland, brought by MSP Liam MacArthur, is due to be published tomorrow.

As a general practitioner in a rural community, now retired, I have helped many patients over the decades through their last days of life. My colleagues and I have tried in every case to use the very best palliative care for these people and their families. It is a fact that suffering is often present at the beginning. But I have never come across a case where physical pain is not controllable, though psychological and spiritual suffering can be more difficult. However, with close support of loved ones, very good as well as targeted analgesia, careful palliative sedation (if required), and loving care from nurses and doctors, I have seen those with even the most difficult terminal illnesses die peacefully usually in their own homes.

However, the proposed dill will enable frightened patients to ask their doctors to end their lives prematurely, assuming that, to do otherwise, would be painful and terrifying. My experience over many years has shown me that such fears about the last days are real but, with good care and communication, these can be effectively addressed.

I recently attended a bioethics conference in Madrid where a professor from the Netherlands gave an update on how assisted dying and euthanasia are practiced in this country, including for children. At the end of the talk, I challenged the speaker about the euthanasia of infants under one year of age (which had not been mentioned). In response, the speaker admitted that this also happens, and not just for terminal illnesses but for infants with disabilities such as spina bifida, who might live a fulfilled and happy life.

Moreover, there is now good research indicating that the rate of suicide in countries which have legalised assisted suicide, such as in The Netherlands, increases compared to similar countries who have not taken this route. The genie comes out of the bottle and suicide becomes somehow acceptable. Therefore, it is possible to question why suicide should be normalised in a country, such as Scotland, where suicides are already far too frequent?

A very real danger also exists for those who feel they are a burden to family and carers being assisted to end their lives. Any talk of safeguards against this scenario seems very weak to those of us who know how vulnerable people are when faced with terminal illness. In Oregon, USA, research on those choosing assisted suicide indicates that over 50% of people who provided information on their end-of-life decisions state “being a burden on family and friends/caregivers as their main concern”. A high proportion also indicate that financial pressures were a significant reason to end their lives early.

Let us, as a country, fund more excellent palliative care and refuse to go down this defeatist and ultimately cruel route.

Dr Antony Latham is a retired GP and Chair of the Scottish Council on Human Bioethics

Agenda is a column for outside contributors. Contact: