Scotland’s looser rules on assisted dying could lead to ‘death tourism’, say senior politicians

Senior Scottish politicians fear there could be a risk of “death tourism” from terminally ill people travelling from other parts of the UK to end their lives in Scotland.

A cross-party group of MSPs, including the deputy first minister, Kate Forbes, said the looser controls on eligibility written into an assisted dying bill for Scotland could attract people unhappy with stricter rules planned for England and Wales.

The Scottish bill, which is expected to have its final vote in February, has no time limit on who can apply for assisted dying, although they must have lived in Scotland for at least a year and have “an advanced and progressive disease, illness or condition from which they cannot recover”.

The policies for England and Wales, which are being examined in the Lords, stipulate someone must be within six months of death. If Kim Leadbeater’s bill is passed it could take up to four years to be implemented, while Scotland’s measures may come into force several years earlier.

Concerns about so-called “death tourism” were raised by Dr Claudia Carr, an expert on medical ethics at the University of Hertfordshire’s law school. She said some terminally ill people could lead to Scotland having “a more positive climate for an assisted death and move accordingly”.

Edward Mountain, a Scottish Conservative MSP, who recently disclosed a bowel cancer diagnosis, said if Scotland’s bill became law there was a “real risk” that some terminally ill people could travel there rather than follow the stricter rules in England and Wales.

“There is always the chance that people will see Scotland, if this bill passed, which I hasten to say I hope it doesn’t, is an easier place to end your life than down south,” he said.

Michael Marra, a Scottish Labour frontbencher and another critic of the Holyrood bill, indicated that this was likely to be vigorously challenged when the bill reached its final vote, largely because attempts to tighten it up had been rejected by MSPs reviewing it.

He said these cross-border issues had been “hugely underexplored” by both parliaments and the UK and Scottish governments. “It’s a very complex issue, about how the two systems might interact,” Marra said.

Forbes, a member of the socially conservative Free Church of Scotland, said while speaking in a personal capacity that she worried the broader definitions and a lack of a time limit could lead some people to choose assisted dying unnecessarily.

“People with a potentially years to live might choose assisted dying for other factors unrelated to their terminal illness, because of poor mental health and so on,” she said.

Those concerns were downplayed by Liam McArthur, the Scottish Liberal Democrat MSP who has tabled the Holyrood bill. He said the financial, personal and medical challenges involved in changing country while terminally ill would be real and significant.

“In practice, it seems highly unlikely someone with a terminal illness will want to go through the upheaval of moving away from their home, family, friends and medical support at this point in their life,” he said. “Given that the progression of a terminal condition is rarely linear, making such a decision would be even more problematic.

“Ultimately, both my bill and the one going through the UK parliament build on best practice from around the world but there are distinct elements to the Scottish legal and health systems. It is right, therefore, that MSPs consider what approach is most appropriate here in Scotland.”