This month will be a significant one for the debate around assisted suicide in the UK, as politicians at both Holyrood and Westminster once more consider legislation. On 13 May, members of the Scottish Parliament will debate and vote on a bill from Liberal Democrat politician Liam McArthur to legalise the practice north of the border. The Westminster bill, proposed by Labour MP Kim Leadbeater, is scheduled for report stage three days later, following the publication of an impact assessment at the end of last week.

Now McArthur has suggested that he will raise the minimum age in the Scottish legislation from 16 to 18, citing the example of laws in Oregon and Australia. With the debate on his bill due first, a vote against assisted dying at Holyrood would galvanise opposition to a law change down south. Conversely, a vote to progress his bill would be seized on by proponents at Westminster, who have emerged from committee scrutiny somewhat bruised.

A report published last week on McArthur’s bill sheds some light on questions that will shape the Holyrood debate — and, by extension, discussions in Westminster. The document from the Scottish Parliament’s health committee, which has gathered evidence on the bill, makes no comment on its “general principles” but suggests areas which require further consideration. These include “issues around human rights, coercion, eligibility criteria, provision of assistance, self-administration and conscientious objection”.

Three statements in the report are particularly worthy of note. Firstly, it concedes that the definition of terminal illness in McArthur’s bill is broad enough to cover people who “may not be approaching death for a considerable period of time”. Unlike the Leadbeater bill, McArthur’s proposal includes no requirement for a life expectancy timescale. To be eligible, a patient need only have an “advanced”, “progressive” condition from which they are “unable to recover”, and which is “expected to cause their premature death”.

This controversial approach has drawn criticism from various groups, who note that people with  disabilities, dementia or anorexia could be eligible under this definition — a thought that will make many MSPs uncomfortable. Parallels may be drawn with permissive assisted dying regimes abroad, such as Canada’s Medical Assistance in Dying (MAiD) programme. It remains to be seen whether proponents of assisted suicide at Holyrood would be willing to amend the legislation to reduce its scope, but McArthur has been defensive of his definition to date, claiming that doctors would make appropriate judgements.

Secondly, the report acknowledges the potential for incremental expansion of assisted suicide legislation, citing a risk of McArthur’s bill being “subject to human rights or other court challenges” that “could result in eligibility for assisted dying being extended over time”. This gives credence to a central opposition argument that a “narrow” law is no guard against mission creep. This statement should also be noted at Westminster, where Leadbeater has promised a law which has the “strictest protections and safeguards of any legislation anywhere in the world”.

The health committee’s report also notes “particular complexities” with aspects of the bill that are beyond the legislative competence of the Scottish Parliament, including sections on the provision of lethal substances and conscientious objection. This adds an additional layer of complexity to the coming debate, and raises hard questions for proponents. One legal expert in Scotland has warned that conscience protections offered on the face of the legislation “might ultimately be meaningless”.

Much rides on the debate at Holyrood in two weeks’ time. As with the debate at Westminster last year, the onus will be on supporters of assisted dying to explain how serious problems associated with the practice can be overcome. The muddled definitions highlighted by last week’s report should provide cause for serious concern.

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