Margo MacDonald MSP last week launched her new assisted suicide bill in Scotland - a day after the launch of the Euthanasia Prevention Coalition Europe (EPCE) in Brussels. The Scottish government has said it does not support a change in the law and the British Medical Association (BMA) has in response reiterated its opposition to assisted suicide.

In 2010 MSP Margo MacDonald's very similar End of Life Assistance Bill was defeated by 85 votes to 16, in a free vote at the Scottish Parliament.

This should have settled the debate in Scotland for a generation.

Yet, Ms MacDonald now proposes her Assisted Suicide (Scotland) Bill, under which people as young as 16 would be able to tell their GP about their desire for assisted suicide.

Despite the fact that 65 per cent of responses to the consultation process were opposed to the Bill the MSP plans to take her Bill forward, essentially on a system based on that operating in Oregon, USA.

There, the annual number of assisted suicides has risen by 450 per cent since legalisation in 1997. One in six of those are depressed, less than one in 20 receive psychiatric assessments. Some patients have been denied medical care and offered assisted suicide as a cheaper alternative.

Care Not Killing, which is spearheading opposition to the proposed Bill, is an alliance of individuals and more than 40 organisations which brings together disability and human rights groups, healthcare providers, and faith-based bodies and believes that assisted suicide is unneccessary, unethical and uncontrollable.

Dr Peter Saunders said:

"MSPs rejected Ms MacDonald's last attempt to legalise physician-assisted suicide and euthanasia in Scotland by an overwhelming majority of 85-16 recognizing that such a move would seriously endanger public safety. Instead, they sent a ringing endorsement to making the very best palliative care widely available and accessible.

"The right to die can so easily become the duty to die and vulnerable people who are sick, elderly or disabled will inevitably feel pressure, whether real or imagined, to end their lives so as not to be a burden on others. The stories of incremental extension presently coming out of Belgium and the Netherlands give a stark warning about the dangers of going down this road.

"Ms MacDonald's new proposals are effectively her old ones dished up again. I expect the Scottish Parliament to give them short shrift."

Care Not Killing Scotland committee member John Deighan said: "Compassion must urge us towards giving proper support and care for the sick and suffering.

"Killing can never be the right answer in a civilised society. History teaches us the importance of protecting every human life. We must ensure the frail, disabled and sick are not put at risk for the sake of a small minority determined to end their lives."

Dr Gordon Macdonald, Convenor of Care Not Killing Scotland said:

"Margo MacDonald's Bill is unnecessary, unethical and dangerous. Experience from Oregon, Belgium and the Netherlands shows that there can be no safe system for legalising assisted suicide or euthanasia.

Margo seems to think that by resurrecting her proposal she will be able to convince people to support it this time. However, the arguments remain the same and dangers of practice elsewhere are well known. Margo should move on to another issue and accept the settled will of Parliament. It is not a priority for the Scottish people and the Scottish Parliament has made its view clear. Her personal interest in this matter should not be allowed to dictate to the rest of Scotland."

Dr Stephen Hutchison MD FRCP (Glasg), a Consultant Physician in Palliative Medicine at the Highland Hospice said:

"As a practising palliative care consultant, I am working hard every day to provide the highest standard of care for my patients. Having seen assisted suicide so rigorously debated in the public and parliamentary arenas, and so resoundingly rejected by our parliament on the grounds of public safety, the launch of this new Bill once again undermines my work, and the confidence which my patients can have in those who are looking after them at this most fragile and vulnerable stage of their lives.

"Once again Margo MacDonald is revealing how little she really knows about the clinical care of people who are seriously ill. Killing people has always been wrong, and it remains wrong. We can do much better than that in a properly caring society.

"The legalisation of assisted dying/assisted suicide has been debated widely in public and parliamentary arenas on numerous occasions over several years. It has always been rejected by parliaments on the grounds of public safety, and this criterion remains absolutely unchanged.

"The legalisation of assisted suicide would be dangerous and unnecessary. We have the best palliative care in the world here in the UK. The law as it stands is safe, and gives assurance to the public, and particularly to those who are experiencing the vulnerability of serious illness, that those looking after them will not do anything to prejudice their lives."

The Scottish Council on Human Bioethics (SCHB) is also opposed to the proposal. Formed in 1997, SCHB is an independent, non-partisan, non-religious council composed of physicians, lawyers, ethicists and other professionals from disciplines associated with medical ethics.

The SCHB recognises that crossing the boundary between acknowledging that death is inevitable and taking active steps to bring about death, changes fundamentally the role of the physician, changes the doctor-patient relationship and changes the role of medicine in society.

Dr Calum MacKellar, Director of Research of the SCHB said the concept of a "life unworthy of life … should never be accepted in a civilised society" and added:

"Assisted suicide is unnecessary since physical suffering can now be adequately alleviated in all but the rarest cases by appropriate palliative care. And even in the very exceptional cases where physical suffering does not fully respond to treatment there is the possibility of using artificial transient or (very occasionally) total permanent sedation in patients to keep them asleep in order to address physical and/or mental distress."

The SCHB emphasises that vulnerable people need to know that society is committed first and foremost to their well-being, even if this does involve expenditure of time, effort and money.

Dr MacKellar added: "These proposals are asking the people of Scotland to agree that there are lives that should be ended. That there is such a thing as a 'life unworthy of life' which is a concept that should never be accepted in a civilised society."

The SCHB is also of the opinion that the government should encourage society, comprising an ageing population, to accept that elderly or disabled people may become dependent on others without losing any of their inherent dignity.

Dr MacKellar concluded: "The SCHB agrees that the concept of autonomy is extremely important in medical ethics and law but that there are times when inherent human dignity must take priority over autonomy for a descent civilised society to exist."

Care Not Killing emphasises the following points

• Any change in the law to allow assisted suicide would place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others. This would especially affect people who are disabled, elderly, sick or depressed.
• The pressure people will feel to end their lives if assisted suicide or euthanasia is legalised will be greatly accentuated at this time of economic recession with families and health budgets under pressure. Elder abuse and neglect by families, carers and institutions is real and dangerous and this is why strong laws are necessary.
• If assisted suicide or euthanasia is legalised any 'safeguards' against abuse, such as limiting it to certain categories of people, are unlikely to work. Instead, once any so-called 'right-to-die' is established we will see incremental extension with pressure being applied to expand the categories of people who qualify for it.
• The vast majority of UK doctors are opposed to legalising euthanasia along with the British Medical Association, the Royal College of Physicians, the Royal College of General Practitioners, the Association for Palliative Medicine and the British Geriatric Society.
• Major disability rights groups in Britain (including SCOPE, UKDPC and Not Dead Yet UK) oppose any change in the law believing it will lead to increased prejudice towards them and increased pressure on them to end their lives.