Church of Scotland moderator fears assisted dying could be seen as way to save money

‘Change in assisted dying law would mean society viewed lives of people on margins as less valuable’

Legalisation of assisted dying could be seen as "an opportunity for cost-saving" in the health service, the Moderator of the Church of Scotland’s General Assembly has warned.

The Rt Rev Dr Iain Greenshields said the Kirk had repeatedly opposed any change in the current law and was “very concerned” it could regarded as a way to save money amid current pressures on the NHS. He also said that if assisted dying was legalised society’s view of older and disabled people could become “more utilitarian” and their lives would seen as less valuable.

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Liberal Democrat MSP Liam McArthur is expected to introduce a Members' Bill on assisted dying later this year. It would allow mentally competent adults who are terminally ill to end their lives. Two doctors would need to confirm a person was terminally ill and mentally competent, and there is a suggested reflection period of 14 days. It is the third attempt to legalise assisted dying in Scotland.

Moderator Rt Rev Iain Greenshields

Writing in The Scotsman, Dr Greenshields said: "The Church cares about people – which is why we feel strongly that it would be wrong to introduce legalised assisted suicide in Scotland. Our opposition is based on our Christian faith and includes concerns around the principle of assisted dying, around the application of the law in practice, the perception value of human lives, and also the effect this change is likely to have on the provision of care, especially palliative care. The current societal prohibition on killing is clear; to move away from this would not be a simple modification of the law, but would represent a significant shift from which there would be no return.”

He said in countries where assisted dying was allowed, the framing and maintaining of safeguards had been “fraught with difficulties, and frequently subject to removal or relaxation of restrictions to eligibility”. “In Canada, the law from 2016 was amended in 2021 to remove the requirement for an individual to have a terminal illness, and there is currently debate to extend eligibility even further. Similar patterns can be noted in the Netherlands. The law passed in 2002 has contributed to a normalisation of physician-assisted dying and has inevitably led to an expansion of its practice.”

And he continued: “We are concerned that, should assisted dying be legalised, the way our society views older people and those with disabilities will, over time, become more utilitarian. The lives of those on the margins of society will inevitably come to be seen as less valuable or even burdensome. Is this really the kind of society we aspire to?”

Dr Greenshields suggested that allowing assisted dying could have a negative effect on palliative care". And he went on: "Given the pressure on healthcare resources, we are also very concerned that assisted dying could be seen as providing an opportunity for cost-saving. An analysis from Canada, referred to in the consultation document for the legislation shortly to be considered by the Scottish Parliament, states that a 2017 cost analysis of assisted dying concluded that 'medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million [£20.8m] and $138.8m [£83.3m]'."

Kirk Moderator the Rt Rev Dr Iain Greenshields has reasserted the Church of Scotland's opposition to assisted dying. Picture: Lisa Ferguson.

Mr McArthur said: "My only motivation in bringing forward proposals for a new assisted dying law is to give dying people who are suffering unbearably the peace of mind that they do not need to suffer against their will. In bringing forward legislative proposals, MSPs are required to produce robust financial information that detail the costs of setting up a new system, but also provide evidence of potential savings. However, this is not the reason why I am bringing forward this legislation. This bill is solely about ensuring dignity and choice for those at the end. The evidence shows that where the right to an assisted death exists, palliative care spending goes up, not down - this is because there is a greater focus on end-of-life care and treatment. My bill proposals include that two doctors would outline alternative treatment and care options to someone seeking an assisted death. I want to see strong investment in palliative care in Scotland, alongside a change in the law on assisted dying."

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