DURING the last couple of weeks, there has been something of a crescendo of voices calling for a change in the law on assisted suicide and euthanasia.

The people making these calls push a utopian image of assisted suicide and euthanasia systems around the world. They claim the systems work, that safeguards are respected and that the lives of vulnerable are not put at risk – none of which are true.

Proposals to change the current blanket ban on assisted suicide and euthanasia have been considered three times by the Scottish Parliament. Every time, MSPs have rejected introducing a law that would deliberately discriminate against disabled people, the terminally ill and those with chronic conditions.

This is what we see in the small number of countries that have legalised the killing of the sick and disabled people – safeguards eroded away, while eligibility for access to lethal drugs increases.

This worrying trend was confirmed in a major US study from the National Council on Disability in 2019, which found the laws in the handful of US states that had gone down this route, were ineffective and oversight of abuse and mistakes was absent. The findings mirror official government reports that show that year after year, a majority of those ending their lives by assisted suicide in Oregon and Washington states, the models often put forward by pro-killing campaigners, cite the fear of becoming a burden as a reason for their decision.

READ MORE: Scotland must legalise assisted dying, and not repeat the mistakes of 2015

Or take Canada, where in 2016 a law was introduced to allow terminally ill people to request assisted suicide and euthanasia. Then in September 2019, the Quebec Superior Court struck down the requirement that a person be terminally ill before they qualify for euthanasia.

This followed the case of a healthy 61-year-old man who was euthanised in the province of British Columbia. Alan Nichols, a former school caretaker, was not terminally ill but had struggled with depression. His life was ended by lethal injection in July 2019. In the Netherlands and Belgium, laws introduced for terminally ill mentally competent adults have been extended to those with chronic conditions, disabilities, mental health problems and even to children.

There is the alarming case of Marinou Arends, who euthanised a 74-year-old dementia patient under her care. Ms Arends, in a recent TV interview, confirmed she asked her patient three times if she wanted to die and that each time the lady replied saying no, but Ms Ardends decided to press ahead with killing the woman.

A review of the case criticised Ms Arends for a lack of care and for putting a sleeping medicine in the woman’s coffee without her knowledge. It reported that when the patient opened her eyes and saw what was happening, the distressed woman had pulled away from the lethal infusion, but her son-in-law restrained her by pushing her back down.

And then there is the elephant in the room – MONEY. Earlier this year a report written by two Scottish academics, Counting the Cost, published in the Journal of Clinical Ethics highlighted that legalising assisted suicide and euthanasia would save the NHS money and increase organs available for transplant. This is not even contested by those seeking to change the law. Indeed, the Canadian parliament voted in favour of expanding assisted dying in the country less than a week after press reports claiming the euthanasia law had saved around $150 million per year.

READ MORE: SNP activist to appeal for assisted dying support

Of course, saving money through hastening the death of costly patients is nothing new. In 2008, Barbara Wagner, a 64-year-old grandmother and resident of Oregon, received the crushing news that her cancer had returned. Barbara, who had been a healthcare worker, and who lived on a low income, received word from her health insurance company that it would not pay $4000 a month for the drug that could save her life from lung cancer. But the Oregon Health Plan would cover the cost of the drugs she would need for an assisted suicide – about $50.

Or there was the case Randy Stroup, a 53-year-old Oregon man with terminal prostate cancer.

He was denied the drug mitoxantrone, because although it could ease his pain and extend his life by six months, it was not a cure. Like Barbara, he was offered help to kill himself.

Is this really what we want the health care system of Scotland to look like? Yes, there is a problem in this country, with significant gaps in palliative care. One report published by Marie Curie in 2015 estimated that 10,600 people a year in Scotland do not receive adequate palliative care. So the real debate is not how to kill a tiny but vocal group of ideologues, but rather how we care for everyone in our community and provide proper and well-resourced palliative care for all.

Dr Gordon Macdonald is the CEO of Care Not Killing