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Exploring perspectives of Scottish medical students on the proposed 'Assisted Dying for Terminally Ill Adults (Scotland)' Bill.

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Title: Exploring perspectives of Scottish medical students on the proposed 'Assisted Dying for Terminally Ill Adults (Scotland)' Bill.
Authors: Geddes D; Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom. d.w.geddes@sms.ed.ac.uk., Knox J; Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom., Obree D; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom., Harden J; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
Source: BMC medical ethics [BMC Med Ethics] 2025 Dec 11; Vol. 26 (1), pp. 173. Date of Electronic Publication: 2025 Dec 11.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: BioMed Central Country of Publication: England NLM ID: 101088680 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6939 (Electronic) Linking ISSN: 14726939 NLM ISO Abbreviation: BMC Med Ethics Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2000-
MeSH Terms: Suicide, Assisted*/legislation & jurisprudence , Suicide, Assisted*/ethics , Students, Medical*/psychology , Attitude of Health Personnel* , Terminally Ill*, Humans ; Scotland ; Female ; Male ; Surveys and Questionnaires ; Adult ; Young Adult ; Legislation, Medical
Abstract: Background: The debate over legalising assisted dying is complex and multifaceted, eliciting strong and diverse opinions from all involved parties. Recently, the Scottish Parliament held an initial vote on the issue, opting to progress with proposed legislation. Hearing the perspectives of medical students, as future clinicians, is crucial when considering new medico-legal developments in assisted dying in Scotland. This study aimed to explore and examine medical students' views on assisted dying in Scotland and the specific provisions of the proposed Scottish legislation.
Methods: An online survey was distributed to students at the Scottish medical schools between October 2023 and January 2024. Participants were invited to respond to closed, quantitative questions, designed to assess specific attitudes towards the proposed legislation, followed by optional free-text fields for participants to provide qualitative explanations for their answers. These free-text responses were subsequently subjected to thematic analysis.
Results: A total of 295 students responded to the survey. The majority of respondents were in favour of the legalisation of assisted dying in Scotland (72.4%); however, only 48.5% of respondents thought that assisted dying should be introduced into Scottish legislation as proposed in the current bill. Additionally, 23.4% of respondents indicated they would conscientiously object to participation in the process. A significant number of respondents (n = 135) expressed concerns that the proposed safeguards were inappropriate or insufficient. Autonomy was the most cited medical ethics principle underpinning opinions, followed closely by non-maleficence.
Conclusions: The majority of respondents were in support of assisted dying, but a smaller proportion felt the current proposed bill should be implemented, due to different interpretations of the suitability of proposed safeguards. A significant portion of respondents' perspectives were based on information from their previous training and experience within healthcare. Other perspectives mirrored wider public opinion on end-of-life care and assisted dying principles. While a majority of respondents favour legalising assisted dying in Scotland, significant concerns remain regarding the specific provisions of the proposed bill, highlighting the complex and ethically charged nature of this issue. Key stakeholders and policymakers should actively involve medical students, as future medical practitioners, in the assisted dying discussion to help guide legislation and research.
(© 2025. The Author(s).)
Competing Interests: Declarations. Ethics approval and consent to participate: The study was reviewed and fully approved by the University of Edinburgh Medical Education Research Ethics Committee (Ref 2023/22). The research was conducted in compliance with the Helsinki Declaration Informed consent to participate was obtained from all participants prior to undertaking the study. Consent for publication: Not applicable. Competing interests: DG has previously received financial support from the Scottish Council on Human Bioethics for organising medical ethics events related to assisted dying.
References: J Adv Nurs. 2004 Sep;47(6):583-91. (PMID: 15324424)
JAMA Netw Open. 2025 Apr 1;8(4):e256849. (PMID: 40266622)
Eur J Gen Pract. 2019 Jan;25(1):44-48. (PMID: 30381970)
J R Soc Med. 2018 Nov;111(11):407-413. (PMID: 30427291)
Am J Bioeth. 2023 Sep;23(9):18-20. (PMID: 37647471)
BMJ Support Palliat Care. 2020 Sep;10(3):259-261. (PMID: 32430403)
J Med Ethics. 2024 Dec 23;50(12):841-845. (PMID: 38320847)
Hist Philos Life Sci. 2023 Jan 17;45(1):2. (PMID: 36648559)
Health Soc Work. 2019 Aug 2;44(3):185-192. (PMID: 30796809)
Healthcare (Basel). 2023 Jul 26;11(15):. (PMID: 37570368)
BMJ Support Palliat Care. 2023 Sep;13(3):305-308. (PMID: 35835544)
Health Policy. 2024 Nov;149:105172. (PMID: 39342784)
Med Law Rev. 2019 May 1;27(2):242-266. (PMID: 29982735)
Am J Hosp Palliat Care. 2008 Apr-May;25(2):112-20. (PMID: 18198363)
BMJ Open. 2020 Jul 8;10(7):e036054. (PMID: 32641328)
Palliat Med. 2019 Oct;33(9):1212-1220. (PMID: 31280666)
Int J Nurs Stud. 2022 Oct;134:104286. (PMID: 35777169)
N Z Med J. 2021 Dec 17;134(1547):114-120. (PMID: 35728115)
J Med Ethics. 2007 Oct;33(10):591-7. (PMID: 17906058)
SAGE Open Med. 2021 Mar 12;9:20503121211000918. (PMID: 33786182)
Acad Med. 1998 Apr;73(4):403-7. (PMID: 9580717)
Int J Environ Res Public Health. 2021 Nov 24;18(23):. (PMID: 34886053)
Ann Palliat Med. 2021 Mar;10(3):3540-3553. (PMID: 32921084)
Curr Oncol. 2012 Jun;19(3):143-54. (PMID: 22670093)
Linacre Q. 2013 May;80(2):99-102. (PMID: 24846597)
Ann Med Surg (Lond). 2022 Feb 11;75:103380. (PMID: 35242326)
Contributed Indexing: Keywords: Bioethics; Ethics, Medical; Legislation, Medical; Legislative Ethics; Palliative Care; Personal Autonomy; Right to Die; Students, Medical; Suicide, Assisted; Terminal Care
Entry Date(s): Date Created: 20251211 Date Completed: 20251211 Latest Revision: 20260626
Update Code: 20260627
PubMed Central ID: PMC12699872
DOI: 10.1186/s12910-025-01322-1
PMID: 41382154
Database: MEDLINE
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  Data: Exploring perspectives of Scottish medical students on the proposed 'Assisted Dying for Terminally Ill Adults (Scotland)' Bill.
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  Data: <searchLink fieldCode="AU" term="%22Geddes+D%22">Geddes D</searchLink>; Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom. d.w.geddes@sms.ed.ac.uk.<br /><searchLink fieldCode="AU" term="%22Knox+J%22">Knox J</searchLink>; Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom.<br /><searchLink fieldCode="AU" term="%22Obree+D%22">Obree D</searchLink>; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.<br /><searchLink fieldCode="AU" term="%22Harden+J%22">Harden J</searchLink>; Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
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  Data: <searchLink fieldCode="JN" term="%22101088680%22">BMC medical ethics</searchLink> [BMC Med Ethics] 2025 Dec 11; Vol. 26 (1), pp. 173. <i>Date of Electronic Publication: </i>2025 Dec 11.
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  Data: <searchLink fieldCode="MM" term="%22Suicide%2C+Assisted%22">Suicide, Assisted*</searchLink>/<searchLink fieldCode="MM" term="%22Suicide%2C+Assisted+legislation+%26+jurisprudence%22">legislation & jurisprudence</searchLink> <br /><searchLink fieldCode="MM" term="%22Suicide%2C+Assisted%22">Suicide, Assisted*</searchLink>/<searchLink fieldCode="MM" term="%22Suicide%2C+Assisted+ethics%22">ethics</searchLink> <br /><searchLink fieldCode="MM" term="%22Students%2C+Medical%22">Students, Medical*</searchLink>/<searchLink fieldCode="MM" term="%22Students%2C+Medical+psychology%22">psychology</searchLink> <br /><searchLink fieldCode="MM" term="%22Attitude+of+Health+Personnel%22">Attitude of Health Personnel*</searchLink> <br /><searchLink fieldCode="MM" term="%22Terminally+Ill%22">Terminally Ill*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Scotland%22">Scotland</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Male%22">Male</searchLink> ; <searchLink fieldCode="MH" term="%22Surveys+and+Questionnaires%22">Surveys and Questionnaires</searchLink> ; <searchLink fieldCode="MH" term="%22Adult%22">Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Young+Adult%22">Young Adult</searchLink> ; <searchLink fieldCode="MH" term="%22Legislation%2C+Medical%22">Legislation, Medical</searchLink>
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  Data: Background: The debate over legalising assisted dying is complex and multifaceted, eliciting strong and diverse opinions from all involved parties. Recently, the Scottish Parliament held an initial vote on the issue, opting to progress with proposed legislation. Hearing the perspectives of medical students, as future clinicians, is crucial when considering new medico-legal developments in assisted dying in Scotland. This study aimed to explore and examine medical students' views on assisted dying in Scotland and the specific provisions of the proposed Scottish legislation.<br />Methods: An online survey was distributed to students at the Scottish medical schools between October 2023 and January 2024. Participants were invited to respond to closed, quantitative questions, designed to assess specific attitudes towards the proposed legislation, followed by optional free-text fields for participants to provide qualitative explanations for their answers. These free-text responses were subsequently subjected to thematic analysis.<br />Results: A total of 295 students responded to the survey. The majority of respondents were in favour of the legalisation of assisted dying in Scotland (72.4%); however, only 48.5% of respondents thought that assisted dying should be introduced into Scottish legislation as proposed in the current bill. Additionally, 23.4% of respondents indicated they would conscientiously object to participation in the process. A significant number of respondents (n = 135) expressed concerns that the proposed safeguards were inappropriate or insufficient. Autonomy was the most cited medical ethics principle underpinning opinions, followed closely by non-maleficence.<br />Conclusions: The majority of respondents were in support of assisted dying, but a smaller proportion felt the current proposed bill should be implemented, due to different interpretations of the suitability of proposed safeguards. A significant portion of respondents' perspectives were based on information from their previous training and experience within healthcare. Other perspectives mirrored wider public opinion on end-of-life care and assisted dying principles. While a majority of respondents favour legalising assisted dying in Scotland, significant concerns remain regarding the specific provisions of the proposed bill, highlighting the complex and ethically charged nature of this issue. Key stakeholders and policymakers should actively involve medical students, as future medical practitioners, in the assisted dying discussion to help guide legislation and research.<br /> (© 2025. The Author(s).)
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  Data: Declarations. Ethics approval and consent to participate: The study was reviewed and fully approved by the University of Edinburgh Medical Education Research Ethics Committee (Ref 2023/22). The research was conducted in compliance with the Helsinki Declaration Informed consent to participate was obtained from all participants prior to undertaking the study. Consent for publication: Not applicable. Competing interests: DG has previously received financial support from the Scottish Council on Human Bioethics for organising medical ethics events related to assisted dying.
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  Data: J Adv Nurs. 2004 Sep;47(6):583-91. (PMID: <searchLink fieldCode="PM" term="%2215324424%22">15324424)</searchLink><br />JAMA Netw Open. 2025 Apr 1;8(4):e256849. (PMID: <searchLink fieldCode="PM" term="%2240266622%22">40266622)</searchLink><br />Eur J Gen Pract. 2019 Jan;25(1):44-48. (PMID: <searchLink fieldCode="PM" term="%2230381970%22">30381970)</searchLink><br />J R Soc Med. 2018 Nov;111(11):407-413. (PMID: <searchLink fieldCode="PM" term="%2230427291%22">30427291)</searchLink><br />Am J Bioeth. 2023 Sep;23(9):18-20. (PMID: <searchLink fieldCode="PM" term="%2237647471%22">37647471)</searchLink><br />BMJ Support Palliat Care. 2020 Sep;10(3):259-261. (PMID: <searchLink fieldCode="PM" term="%2232430403%22">32430403)</searchLink><br />J Med Ethics. 2024 Dec 23;50(12):841-845. (PMID: <searchLink fieldCode="PM" term="%2238320847%22">38320847)</searchLink><br />Hist Philos Life Sci. 2023 Jan 17;45(1):2. (PMID: <searchLink fieldCode="PM" term="%2236648559%22">36648559)</searchLink><br />Health Soc Work. 2019 Aug 2;44(3):185-192. (PMID: <searchLink fieldCode="PM" term="%2230796809%22">30796809)</searchLink><br />Healthcare (Basel). 2023 Jul 26;11(15):. (PMID: <searchLink fieldCode="PM" term="%2237570368%22">37570368)</searchLink><br />BMJ Support Palliat Care. 2023 Sep;13(3):305-308. (PMID: <searchLink fieldCode="PM" term="%2235835544%22">35835544)</searchLink><br />Health Policy. 2024 Nov;149:105172. (PMID: <searchLink fieldCode="PM" term="%2239342784%22">39342784)</searchLink><br />Med Law Rev. 2019 May 1;27(2):242-266. (PMID: <searchLink fieldCode="PM" term="%2229982735%22">29982735)</searchLink><br />Am J Hosp Palliat Care. 2008 Apr-May;25(2):112-20. (PMID: <searchLink fieldCode="PM" term="%2218198363%22">18198363)</searchLink><br />BMJ Open. 2020 Jul 8;10(7):e036054. (PMID: <searchLink fieldCode="PM" term="%2232641328%22">32641328)</searchLink><br />Palliat Med. 2019 Oct;33(9):1212-1220. (PMID: <searchLink fieldCode="PM" term="%2231280666%22">31280666)</searchLink><br />Int J Nurs Stud. 2022 Oct;134:104286. (PMID: <searchLink fieldCode="PM" term="%2235777169%22">35777169)</searchLink><br />N Z Med J. 2021 Dec 17;134(1547):114-120. (PMID: <searchLink fieldCode="PM" term="%2235728115%22">35728115)</searchLink><br />J Med Ethics. 2007 Oct;33(10):591-7. (PMID: <searchLink fieldCode="PM" term="%2217906058%22">17906058)</searchLink><br />SAGE Open Med. 2021 Mar 12;9:20503121211000918. (PMID: <searchLink fieldCode="PM" term="%2233786182%22">33786182)</searchLink><br />Acad Med. 1998 Apr;73(4):403-7. (PMID: <searchLink fieldCode="PM" term="%229580717%22">9580717)</searchLink><br />Int J Environ Res Public Health. 2021 Nov 24;18(23):. (PMID: <searchLink fieldCode="PM" term="%2234886053%22">34886053)</searchLink><br />Ann Palliat Med. 2021 Mar;10(3):3540-3553. (PMID: <searchLink fieldCode="PM" term="%2232921084%22">32921084)</searchLink><br />Curr Oncol. 2012 Jun;19(3):143-54. (PMID: <searchLink fieldCode="PM" term="%2222670093%22">22670093)</searchLink><br />Linacre Q. 2013 May;80(2):99-102. (PMID: <searchLink fieldCode="PM" term="%2224846597%22">24846597)</searchLink><br />Ann Med Surg (Lond). 2022 Feb 11;75:103380. (PMID: <searchLink fieldCode="PM" term="%2235242326%22">35242326)</searchLink>
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