A lifelong resident of a remote Scottish village, George Mackay had hoped to spend his final days in the place of his birth, surrounded by familiar landscapes and communities.

However, this proved to be unfeasible due to circumstances beyond his control.

The closure of the Melness care home in 2023 marked the end of nearly five decades of providing palliative care to local residents, including those living in the vicinity of Tongue Bay, an area now traversed by the North Coast 500 tourist route.

In the year that followed, George received a terminal cancer diagnosis, significantly impacting his quality of life and care requirements.

As George's health continued to decline, he was forced to relocate to a hospital in Wick, a journey of over 90 minutes by car, in order to receive the necessary medical attention.

George's residence in Melness was conveniently located near the Caladh Sona care home.

According to Margaret, George's sister, the care home's continued operation might have allowed him to receive care there until his passing on January 2025, at the age of 72.

George had a diverse background, having served in the army and lived in Canada, and he was survived by four siblings and two children.

Margaret noted that the proximity of the care home would have enabled frequent family visits, saying, "Family members could have been with him constantly, and he would have been familiar with the staff and surroundings."

However, George's preference was to spend his final days in the comfort of his own Melness home, surrounded by loved ones, a wish that ultimately could not be fulfilled.

His departure from home was a necessity, albeit an unfortunate one, leaving a sense of sadness in its wake.

Margaret notes that her perspective on assisted dying legislation, which is set to face a final vote at Holyrood in the near future, has been influenced by George's experience.

The upcoming decision by MSPs remains highly uncertain, with the surrounding debate having been intensely contentious.

In this isolated community, the conversation surrounding assisted death takes on a pragmatic tone.

A key consideration is whether the legalization of assisted dying would lead to increased uptake in areas where palliative care services are limited.

Concerns have been raised that individuals in similar circumstances to Margaret's brother may feel pressured to opt for a medically assisted death due to the potential of facing a distant death from their loved ones.

Margaret expressed her concerns, stating that the limited options available could have influenced her brother's decision, had he been aware of them, and potentially led him to choose a medically assisted death.

In contrast to George's experience, Steph Bruntlett is currently receiving care at the Highland Hospice, located approximately two-and-a-half hours south of Melness, in Inverness.

At the age of 66, Steph Bruntlett is battling a rare form of liver cancer.

As a resident of Tornagrain, Steph has access to continuous care, available around the clock, and conveniently located just a short drive from her home.

Her husband Les, who provides diligent care at home, also benefits from this arrangement, as it offers him a much-needed break from his caregiving responsibilities.

The care she is receiving has made a significant positive impact on both her and her husband, who express their gratitude for the support.

The care extends beyond just administering medication; it involves taking the time to engage in conversation and provide emotional support.

Having access to reliable and consistent support is a crucial aspect of the services provided, offering reassurance that help is available when needed.

Steph has been a vocal advocate for assisted dying, having personally considered this option in the past.

After contacting Dignitas for information and materials, the individual ultimately found it was too late to pursue this option, as they are no longer able to travel.

While receiving high-quality palliative care, the person has lost control over the circumstances of their death and must now accept the progression of their condition.

Karen Watson, a 62-year-old from Inverness, is another patient who attends the hospice, participating in a discussion group for women and receiving massage therapy.

Karen Watson's battle with breast cancer began 29 years ago, and the disease has since spread throughout her body.

Throughout her 29-year journey with cancer, Karen Watson's beliefs have provided her with support and comfort.

Palliative care and chemotherapy are currently sustaining her life, with treatment expected to continue until the end of her life.

Despite being told on multiple occasions that her condition was terminal and she would not survive the night, she has persevered, attributing her resilience to her spiritual beliefs and divine intervention.

Having witnessed the quality of care provided to others, she expresses a preference for receiving end-of-life care at a hospice.

She states that assisted dying is not an option for her, citing her strong religious convictions as the reason.

While holding her own views on the matter, she maintains a non-judgmental stance towards those who may hold differing perspectives.

She notes that a lack of access to facilities like hospices can lead to feelings of isolation for those in need of support.

The organization behind Highland Hospice has taken a neutral stance on the assisted dying bill, refraining from taking a position on the issue.

According to Chief Executive Kenny Steele, the decision on the matter is one for society as a whole, but the charity's focus is on providing support for individuals to receive the care they prefer.

A particular concern is that individuals in rural Highland areas may opt for assisted death due to the limited availability of local care options, forcing them to choose between their community and the care they require, which can be as far as 100 miles away from their loved ones.

Such a scenario would be regrettable, and regardless of one's stance on assisted dying, it is essential to prioritize respecting individuals' choices as they approach the end of life.

According to estimates by Marie Curie, a charity that supports end-of-life care, the demand for palliative care services in Scotland is projected to increase by nearly 20% by 2050, resulting in an additional 11,000 people requiring care annually compared to 2025.

The Scottish government has allocated £6.5m for hospice funding in the upcoming year, as part of its efforts to support palliative care services.

However, Hospice UK has expressed concerns that this funding is insufficient to alleviate the significant pressure on palliative care, particularly in rural areas of Scotland where access to hospice services is limited due to distance.

Kenny Steele acknowledges that the Scottish government's additional funding will help hospices maintain their existing services, but emphasizes that a substantial expansion of palliative care is necessary to meet the growing demand.

To address this need, Steele's organization is seeking to expand its Hospice at Home program, which provides urgent care to individuals in their own homes, aiming to reduce unnecessary hospital admissions and improve patient outcomes.

According to the Scottish government, the Highlands have been facing persistent social care issues, prompting collaboration with local stakeholders to consider establishing a taskforce aimed at devising long-term solutions.

The government claims to have allocated a historic high of nearly £15.7bn to local authorities, underscoring its commitment to crafting a health and social care system that delivers timely and appropriate care to those in need.

Scottish ministers argue that certain UK government policies have exacerbated the challenges by restricting the recruitment of international care workers and imposing higher National Insurance contributions on employers.

NHS Highland is currently developing plans for a new care facility and GP surgery in Sutherland, which would bolster the area's healthcare capacity and better serve the local community.

A spokesperson for NHS Highland noted that its care at home service has implemented several enhancements over the past year, marking a positive step forward for the organization.

NHS Highland has noted significant difficulties in hiring adult social care staff, with remote and rural areas being particularly affected by recruitment challenges.

To address staffing shortages, the organization has implemented expedited recruitment initiatives to facilitate quicker appointments.

In the coastal town of Tongue, near Melness, residents are awaiting the construction of a new care facility to replace Caladh Sona.

Andrea Madden, formerly in charge of NHS care at home services in the area, now dedicates her time to North Coast Connections, a community-based outreach initiative.

According to Madden, the region has experienced a decline in essential services, resulting in a shortage of social care options.

Prior to discussing assisted dying, it is essential to ensure that assisted living is adequately established in the community, according to her statement.

Individuals have the right to hold their own beliefs, but any decision regarding end-of-life care should be made with all available options accessible, which is currently not the case.

The community lacks sufficient care and support systems, making it difficult for people to feel secure and confident in their ability to pass away in their place of birth.