Comment from Fiona Mackenzie, CEO of the Other Half, a think tank developing policy in women’s interests

This polling confirms that Scottish people are worried about the vulnerable being coerced into state death. That worry is heightened for older people and disabled people, who report the greatest concern of all the public. They may see the vulnerability and dependence of older age and disability.  We should listen to them.

We know that older adults, especially older women, are vulnerable to escalating abuse in older age, with 1 in 6 over 60s estimated to have experienced elder abuse in the last 12 months.  Over 60s are those most likely to be given assisted deaths elsewhere, yet this polling shows over 60s Scots’ fear over the risk to the vulnerable.  In new research we recommend the Scottish Government plans for 100 or more victims of domestic abuse to die each year through assisted deaths, presenting a staggering problem for all of us to face. This bill has no meaningful protection for those in domestically abusive relationships.

In our 2024 report on assisted death and women, we raised specific concern that homicidal men may exploit this new law, as they have on the lenient ‘mercy killings’. But we also know that domestic abuse is a risk factor for suicide, and some abusers already coercing women into suicide in the UK. The Scottish Government recognises the risk of suicide as an outcome of domestic abuse in its latest work on Domestic Homicide and Suicide Reviews. MSPs cannot ignore the real likelihood that this bill becomes a weapon of femicide.

on the Highlands and Islands results:

As someone from the Highlands, it does not surprise me that people there are most concerned about the risks to those vulnerable to being wrongly pushed into death by the state. In small communities you rely on each other and that means you will see all of human nature – the best and sometimes, the worse  – and ideas like ‘autonomy’ and ‘choice’ ring false when you know the reality of patchy or nonexistent services.

Comment from Isabelle Kerr, expert on violence against women and recently retired CEO of JK Rowling’s charity, Beira’s Place

“My biggest concern is that legislators, and many of those who support assisted dying, have a picture in their heads of people with a degenerative, probably terminal, disease that may take away their remaining ability to communicate and their dignity in the remaining months of their lives. People who are lucid, in control of their own decisions and facing no pressure from anyone. For a woman who has lived with, or is living with domestic abuse, there is no control, only the pressure to ensure that the abuser is appeased. Domestic abuse survivors who have lived with coercive and controlling behaviour from a partner will believe that she is the one making the decision to end her life, that it is best for everyone, and that her life is worthless as this is part of that pattern of behaviour common to many controlling and abusive men. Any medical personnel assessing applications for assisted dying would have to be highly skilled in the nuances of coercive and controlling behaviour and the ability of the abuser to groom and gaslight wider groups of people, including medical staff. This Bill may place domestic abuse survivors in even more danger from perpetrators who have contributed to their suffering, physical and psychological.”

Comment from Dr Anni Donaldson, Honorary research fellow at the University of Strathclyde and expert in domestic abuse. Note Dr Donaldson is also sending this as a letter to MSPs

I am professional in the field of violence against women and I have many concerns about the proposed legislation. 

The Bill has progressed to Stage One without the Health, Social Care and Sport Committee giving serious consideration in their final report to the risks created for terminally ill women living with domestic abuse. 

Domestic abuse is mainly perpetrated by men against women.  One in four adult women in Scotland are affected while rates for disabled women are double that. Domestic abuse-related homicides in Scotland are rising and the links between domestic abuse and women’s suicide are recognised by the Scottish Government. In this context, the absence of any consideration by those scrutinising the Assisted Dying Bill that the state may create a new form of violence against women is shocking.

Assisted dying is likely to offer a new, potentially lethal weapon to abusive men with a terminally ill partner.  The Bill relies on the consent, choice, free will and autonomy of the person wishing to end their life, all are absent in the daily lives of Scottish women living with domestic abuse.  The abuse will not stop when a woman receives a terminal illness diagnosis.   Regularly demeaned and told they are worthless and would be better off dead, their abusers’ words will weigh heavily on the minds of terminally ill women.  The existence of Assisted Dying legislation is more likely to increase women’s vulnerability, and compound the risks she faces from her abusive partner.   

The Domestic Abuse (Scotland) Act 2018 criminalised non-physical violence and abuse within intimate relationships and is a course of conduct offence. It is unclear how this legislation would interface with the new offence created under the Assisted Dying Bill for anyone coercing or pressurising a terminally ill adult into making a first or second declaration. Women victims live with the very real fear of the consequences of disclosure and are reluctant to disclose to professionals. This places an unrealistic expectation on medical professionals to identify coercion in the highly emotional and public context of an assisted dying process. Detection requires specialised domestic abuse-informed skills and knowledge, particularly in this context. Criminal prosecutions under either law are likely to take time and verdicts may come too late to protect the woman at the centre of the case who may already be dead.

I would ask that you consider the potentially lethal context the Bill may create for so many Scottish women.  No woman coping with a terminal illness and already living with fear, violence and intimidation should have to face the prospect of being coerced into an assisted death. Please think of them on Tuesday 13 may 2025 and vote against this proposed Bill.

New Research by the Other Half on the scale of state assisted death given to domestic abuse victims

We look at the potential number of domestic abuse victims given assisted deaths each year, and recommend the Scottish Government should plan for 100 recent victims of domestic abuse to be given assisted suicides each year, presenting profound moral, legal and societal questions for us all.

As we highlighted in our research on the Westminster bill [1400 victims, The Other Half], this assisted death toll will dwarf that from domestic homicides or from suicides after domestic abuse.

Based on 62,291 Scottish deaths in 2024 [National Records of Scotland], we estimate how many people may take up assisted death in the Holyrood bill in year 3 of operation, looking at models in Australia, the USA, and Canada. Note that no assisted dying regime has any meaningful safeguards against domestic abuse victims being coerced into state death.  Mandatory doctor training and checks for domestic abuse in Australian states (Victoria and W Australia) screen nobody out at all.

How many Scots will receive assisted deaths?

The Scottish bill Financial Memorandum assessed that assisted death in Oregon, USA or Victoria, Australia were the most likely model for uptake of assisted death in Scotland. But these states require a terminal diagnosis with prognoses 6 months or less (or 12 months in Australia for those with neurodegenerative conditions). Despite the title of the bill, the Scottish bill is more expansive and allows much closer to Canada where Medical Assistance in Dying now delivers 4.7% of all deaths since launching in 2016.

Further, these are the states with the slowest uptake of all assisted dying in the world. The Bill sponsor estimates that 50-100 people in year 3, and 400 people by year 20 will be given assisted deaths. We believe these estimates are too low given the Scottish bill design, but even so, more than 60 of those 400 people would be expected to have recently suffered domestic abuse (assuming domestic abuse prevalence as explained below).

How many Scots experience domestic abuse, specifically elder abuse?

Estimates on this poorly researched area vary, with the Scottish Crime and Justice Survey having the lowest estimate of the incidence, although this considers only abuse by partners. Domestic abuse by others can be common for older adults. We note that the Holyrood Justice Committee demanded better data on elder abuse in 2018. It does not appear that this has been progressed since. Estimates include:

15.6% in a 2017 global metanalysis of people aged 60+ had experienced elder abuse in the last 12 months. This is the most robust estimate although not Scotland specific – see 1400 victims for discussion

9% in 2018 polling by Action on Elder Abuse Scotland exploring elder abuse in the last 12 months

5-9% in 1993 Age Concern Scotland research

0.5% in the Scottish Crime Survey 2018-19 for those aged 60+ who had experienced partner abuse [only] in the last 12 months.

The Other Half estimates of potential impact on domestic abuse victims by the Scottish bill

% of all deaths through assisted dying in year 3

Number of Scottish assisted deaths each year

Number of Scottish domestic abuse victims given assisted deaths each year

Assisted Dying Model

Lower: Elder Abuse/Age Concern

Upper: Elder Abuse Meta-analysis

Victori

These figures use the Scottish Crime and Justice Survey figures for domestic abuse in adults under 60 – but allow for estimates of elder abuse in the over 60s.

For the purposes of planning, we recommend that the Scottish Government plan for 100 domestic abuse victims to die each year by assisted death.

Note that figures may an underestimate as:

·        They assume domestic abuse victims are no more likely than the general population to receive assisted death, despite increased suicidality in women suffering domestic abuse. STADA and Macmillan Cancer care say that domestic abuse can be escalated by a serious diagnosis and by disability (and so the potential for suicidality and coercion into suicide even further increased).  

We have also not adjusted for disability given lack of data: but people with disabilities may be 2-3 x more likely to experience abuse. Some disabilities like “terminal” multiple sclerosis qualify for dying in Australia, any terminal illness (like cancer) cause disabilities.

·        We have not adjusted upwards for mercy killers – proposed by the assisted dying campaigns to be resolved with lawful assisted dying, a claim we refute in Safeguarding Women in Assisted Dying and instead highlight that these are domestic homicides.