THE last time MSPs voted on assisted dying, in 2015, Scotland was a different place. The EU referendum was but a Tory manifesto pledge that few believed would be fulfilled, let alone result in Brexit.

A “cost of living crisis” was something that happened in foreign countries run by corrupt regimes. And, of course, the idea that a global pandemic would claim millions of lives was beyond most of our imaginations.

So it is in a different context that Liberal Democrat MSP Liam McArthur has introduced his Assisted Dying for Terminally Ill Adults (Scotland) Bill.

He hopes it will complete what he calls the “unfinished business” begun by Jeremy Purvis MSP, who first consulted on the issue in 2005; Margo MacDonald, who spent four years campaigning for the legalisation of assisted suicide; and Patrick Harvie, who took up the cause following MacDonald’s death in 2014.

In 2015, the Assisted Suicide (Scotland) Bill was defeated by 82 votes to 36 – a decisive result, but one that nonetheless represented more than a doubling in support compared to the 16 votes in favour of MacDonald’s End of Life Assistance (Scotland) Bill in 2010.

This time around the vote is likely to be much tighter. Indeed, 36 MSPs have already backed McArthur’s bill (twice the number needed for it to progress) and since government ministers are not allowed to sign members’ bills it is believed the overall level of support in a free vote will be higher.

Some may feel it is now inevitable that assisted suicide will become legal in Scotland – that it is now a matter of when, not if.

Much of the opposition is religious in nature, and in an increasingly secular society it feels wrong that such views should restrict the rights of non-believers to escape pain and suffering.

However, it would be wrong to characterise all objections in this way. There are those who support in theory the right to choose death, in certain circumstances, but have grave concerns about whether it can be safely legislated for in practice, without the risk that sick and disabled people will feel pressure to end their lives.

Some of those arguing it would be the first step on a slippery slope also have religious reservations, but not all.

It does not follow that McArthur’s carefully crafted bill should be opposed, but it would be a dereliction of duty not to look at evidence from other jurisdictions that have taken a similar first step.

Advocates of the bill may well wish they were having this debate in 2015 rather than 2023 (or 2024), especially given the trajectory of medical assistance in dying (known by the benign-sounding acronym Maid) in Canada. The feared slippery slope has proven to be a toboggan run towards a chillingly dystopian state of affairs.

It was not a campaigning parliamentarian but a landmark legal case that prompted the Canadian government to introduce Maid.

In February 2015, Carter vs Canada found that making it a crime to help a person end their life violated the Canadian Charter of Rights and Freedoms, and the nation’s supreme court gave the parliament a year to amend its laws, followed by a four-month extension.

On June 2016 a bill was passed legalising the assisted suicide of adults whose deaths were “reasonably foreseeable”. Quite the contrast in timescale between the nearly two decades for which Scottish parliamentarians have been mulling over the difficulties of legislating in this area.

In 2019 the Superior Court of Quebec ruled that restricting assisted suicide to those whose deaths were “reasonably foreseeable” was in itself a violation of the Canadian Charter of Rights and Freedoms, including its guarantee of “equal protection” under the law. The federal government prepared new legislation expanding access to Maid.

In March 2024 it is due to be expanded once again, to include people with severe mental illnesses who have exhausted all treatment options.

This highly controversial move was postponed amid serious questions about both the capacity of severely mentally ill people to consent and the ability of medics to assert that their conditions will not improve or become manageable.

Horror stories about Maid abound, such as claims disabled veterans were offered access to euthanasia while seeking support including housing adaptations.

The UN Human Rights Council’s special rapporteur on the rights of persons with disabilities has warned of “subtle pressure being brought to bear by, for example, lack of services or lack of community living options”.

There are real fears disabled people who could have a decent quality of life may choose assisted dying due to poverty and lack of state support.

The expansion of Canada’s laws has been brought about thanks to legal challenges by individual disabled people and it raises huge questions about individual rights and societal responsibilities.

MSPs must not shy away from addressing these in the process of legislating to ensure terminally ill Scots are empowered to make informed choices about their deaths.

Let this cautionary tale from Canada help to bolster the safeguards built into Scotland’s laws, not kill off yet another bill aimed at reducing human suffering.