Legislation on assisted dying is currently progressing through the Scottish Parliament.

The RCN has a neutral position on whether the law on assisted dying should be changed, reflecting our members' differing views on the issue. We also have a responsibility to do all we can to ensure the Bill, which currently has a key role for registered nurses, has the necessary safeguards to protect nurses and the nursing profession.

We are working to protect both nurses who may wish to participate in assisting a death under the framework established by the bill, and those who may not wish to participate. 

Our position is that the Bill, as currently drafted, does not sufficiently protect nursing staff.

As well as protecting our individual members, we are also aware that, if the Bill passes, it must result in a high-quality service which does not have a negative resourcing impact on existing, and often struggling, nursing services.

We are working with MSPs across the political parties to influence changes, known as amendments, to the Bill.

A different Bill is currently being considered at Westminster. For more information on what is happening across the UK visit our UK-wide resource. 

Liam McArthur MSP introduced the Assisted Dying for Terminally Ill Adults (Scotland) Bill in March 2024 as a Members Bill. If passed by MSPs, the Bill will allow eligible, terminally ill adults in Scotland to request assistance by health professionals to end their own life.

We set out our concerns about the lack of safeguards for nursing in our Stage 1 evidence to the Health, Social Care and Sport Committee.

MSPs voted in favour of the general principle of the bill (Stage 1) in May. Stage 2 of the process allows MSPs to propose changes to the bill. The Health, Sport and Social Care Committee members will review and vote on amendments in November.

An amended version of the bill will be published following this process and considered at Stage 3. MSPs can propose further amendments at this point ahead of a final debate and vote in the Parliament. If MSPs vote in favour of the bill it will become law but it will not come into force immediately.

The current bill allows for a registered nurses to take on the role of authorised health professional (AuHP) and provide an eligible individual with a substance to end their own life.  When acting as an AuHP, the bill requires a registered nurse to undertake a final assessment of the individual’s capacity and be satisfied that they have not been coerced.

In the England and Wales assisted dying bill only a doctor may make the final assessments and provide assistance to end life.

The bill says little on how an assisted dying service would actually be delivered. 

Last year we asked members about their views on key areas of the Bill.

Participation for healthcare professionals:

• The Bill should make clear that an opt-in model will be established.
• There should be a general right to refuse to participate in activities related to assisted dying.
• Provision of assisted dying cannot simply be added to existing teams. We want to see the establishment of a specialist workforce that has opted in to provide this dedicated service, as well as the development of distinct patient pathways.
• Protection from discrimination and harassment is required.

Final assessment and provision of approved substance:

• The Bill should be amended to provide that a doctor must undertake the final assessments on capacity and coercion.
• Nurses must not provide assistance to die while working alone.

Training, qualifications and experience:

• The Bill should include a clause on the qualifications and experience needed and acknowledge that specialist training must be provided.

For more on our positions read our parliamentary briefing.

The RCN remains neutral on whether the law on assisted dying should be changed, reflecting the diverse views of our members. However, as currently drafted, RCN Scotland does not believe that the Bill provides the necessary safeguards to protect nurses and the nursing profession.

In May 2025 MSPs agreed to the general principles of the Bill and it passed Stage 1 of the legislative process. It is currently at Stage 2, where MSPs may propose changes to the Bill. The Health, Social Care and Sport Committee will debate and consider these amendments, starting on 4 November 2025. Only MSPs on this committee may vote on amendments at Stage 2.

If amendments are agreed to at Stage 2, an amended version of the Bill is published. This version is considered at Stage 3, where a final debate and vote will place. Further amendments may be proposed ahead of Stage 3 debate. If MSPs vote in favour of the Bill it will become law. 

If supported by MSPs at Stage 3, implementation timings are uncertain, and it could take years before assisted dying services are delivered in Scotland. 

As currently drafted, the Bill could apply to all registered nurses across health and social care settings.

We believe that assisted dying services should be provided by the NHS only, to ensure the service is delivered by a specialist NHS workforce who have chosen to opt-in and received in-depth training. 

Section 15 of the Bill allows registered nurses to perform the role of authorised health professional (AuHPs), meaning they could be responsible for providing eligible individuals with a substance to end their life. In practice, registered nurses across various health and care settings may be expected to take on this role. 

As it stands, the Bill requires registered nurses acting as AuHPs to assess the individual’s capacity and ensure they are not being coerced. We believe the Bill must be amended to require that a doctor conducts the final assessments of capacity and coercion. This is to ensure the protection of nurses participating in assisted dying, where assessments of this nature may go beyond their scope of practice. 

Furthermore, we are concerned that the Bill permits nurses to carry out the role of AuHP while working alone. Although it allows for another health professional to be present, it is not mandatory. We believe the Bill must require at least two health professionals to be present at time of the assisted death.

The role of nurses in assisted dying differs across countries with the equivalent legislation. International evidence demonstrates that, over time, nurses have become increasingly involved in assisted dying services. Research on the role of registered nurses found that nurses are more likely to participate in assisted dying than medical practitioners. 

We do not consider the current conscientious objection clause to offer sufficient protection to registered nurses who do not want to participate in assisted dying. We are calling for the Bill to establish an ‘opt-in’ model, where only registered nurses who actively choose to participate are expected to do so. 

We broadly welcome proposed Stage 2 amendments to replace conscientious objection with a ‘no duty’ clause, whereby individuals are under no duty to directly participate in provisions authorised by Act. However, we have raised concerns about the meaning of ‘directly participate’ and are seeking reassurance about the implications of this. We also maintain that an opt-in system is essential for the protection of the nursing workforce.

The Scottish Bill allows registered nurses to act as AuHPs, meaning they can provide the substance to end a person’s life and carry out final assessments of capacity and coercion. In contrast, the Bill being considered in the Westminster parliament for England and Wales restricts this role to doctors only - either the coordinating doctor or another doctor they authorise. Under the Bill being considered for England and Wales, only a doctor may provide assistance and conduct the final assessments.

The Bill offers little detail on how assisted dying would be implemented, though accompanying documents suggest it may be delivered by a patient’s GP or specialist doctor as part of routine care. RCN Scotland does not support this approach. We believe assisted dying should be provided by a dedicated, specialist workforce that has opted in and received appropriate training, supported by clear patient pathways. 

The Bill does not currently provide statutory protection from discrimination for registered nurses based on their decision to either participate or not participate in assisted dying. We welcome the Health, Social Care and Sport Committee’s call to consider a ‘no detriment’ clause during stage 2 of the Bill’s debate. 

We believe the Bill should be amended to provide statutory protection from discrimination for registered nurses, so it is unlawful to discriminate based on individual decisions to either participate or not participate in assisted dying. This provision may provide reassurance for staff who work in rural areas.

The Bill currently does not specify the level of experience or qualifications required for registered nurses to adopt the role of AuHP. Stage 2 amendments have been submitted that would allow Scottish Ministers to determine the level of qualification and experience a registered nurse performing the role of AuHP must have. 

RCN Scotland believes the Bill must allow for specialist and mandatory training to be provided to those taking part in assisted dying, to ensure nurses are fully prepared and protected. 

The current Bill does not mandate training for healthcare professionals who choose to participate in assisted dying. We believe specialist training must be provided for registered nurses who choose to be involved. Our position is that the best way to ensure an effective service and safeguarded workforce is for staff to be required to complete training as part of an opt-in model.

The Bill currently does not outline specific wellbeing supports for registered nurses and other health professionals who wish to participate in assisted dying. We believe wellbeing support measures should be provided for all staff involved, including access to emotional and psychological support, as well as the development of clinical and peer networks.

We welcome the Health, Social Care and Sport Committee’s recommendation that amendments should be made to ensure legal clarity and protections for health practitioners when discussing assisted dying with patients. RCN Scotland believes the provision of clear guidance is essential to protect professionals from legal risk if they choose to participate.

We recognise that many members have serious concerns about access to palliative care across Scotland. RCN Scotland believes that, regardless of whether the Bill becomes law, there must be urgent and sustained investment in palliative and end-of-life care. We will be supporting amendments to the Bill that seek to strengthen and improve the provision of palliative and end-of-life care.

The Bill does not currently consider the impact that assisted dying may have on current nursing services. We believe that if the Bill passes, a high-quality service must be established that does not have a negative resourcing impact on existing, and often strained nursing services.

RCN Scotland is engaging members through online briefings, surveys and events to gather views and share updates on the Bill’s progress through the Scottish parliament.

Even though RCN Scotland remains neutral on the matter of assisted dying, we are working to ensure that the Bill contains necessary safeguards to protect nurses and nursing practice, whether they choose to take part in assisted dying services or not. We will continue to work with stakeholders on common priorities in preparing the details of amendment proposals. We engaged directly with MSPs to lay amendments ahead of Stage 2 and briefed the Health, Social Care and Sport Committee in advance of their Stage 2 considerations. Our priorities can be found in this briefing.

If you’d like to contribute your perspective on assisted dying, you can contact the RCN Scotland policy team directly by email.