Chamber and committees

Health, Social Care and Sport Committee [Draft] Business until 12:46

Meeting date: Tuesday, November 18, 2025

Attendance
Assisted Dying for Terminally Ill Adults (Scotland) Bill
Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 2

Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 2

The Convener

Agenda item 2 is day 3 of stage 2 proceedings on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. I begin by formally welcoming to the committee Liam McArthur, who is the member in charge of the bill, and a number of other members who have lodged amendments to the bill. Depending on the progress that we make at this morning’s meeting, the committee might continue stage 2 proceedings from 6 pm this evening.

As members will be aware, the debate on the group of amendments on assessments of the terminally ill adult was commenced but not concluded on day 2 of stage 2 proceedings. The debate on this group will continue where it left off, with Jeremy Balfour, Stuart McMillan and Paul Sweeney still to speak to the amendments in the group, and Pam Duncan-Glancy to wind up. I call Jeremy Balfour to speak to amendment 157 and other amendments in the group.

Jeremy Balfour

I am sure that the committee will be glad to hear that my amendments in this group are the last ones that I will be speaking to, so members will not hear my voice again.

Amendment 157 follows on from other amendments in the group that have been debated already. It seeks to strengthen the assessment process for anyone who is requesting assisted dying. Amendment 157 would mean that, before approval of that request, the person must be seen by a psychiatrist and a social worker. The doctor leading the process would then take into account what both of those professionals say before making a final decision.

The amendment is about making sure that the decision to die is made freely and with full understanding of what it means. Such situations are deeply complex and emotional, as we all acknowledge. People might be facing pain, fear, isolation or pressure, and those factors can affect how they think and feel. A psychiatrist can help to identify whether someone’s judgment is being clouded by depression, anxiety or another treatable condition. A social worker can help to uncover whether a person is feeling lonely, unsupported or under pressure, and perhaps feeling that they are a burden to others.

Bringing in those perspectives does not delay or deny a choice; it protects the choice and makes it more safeguarded. The amendment gives the public reassurance that the process will be careful and humane. It ensures that every request is looked at from all sides, so that any decision that is made truly reflects the individual’s own free and informed will.

Amendment 159 addresses another issue that is essential when it comes to life and death. Doctors need to know exactly what the law expects of them. If wording in the legislation is unclear, it can lead to hesitation, mistakes or uneven interpretation, and ultimately that could lead to lots of legal cases happening in Scotland. Amendment 159 removes any doubt about the responsibility of medical practitioners and makes that responsibility clear and unambiguous. We owe it to the professionals and the lawmakers that no doctor should ever have to guess what Parliament meant or have to see whether they can interpret it themselves. A clear law is safe law for everyone involved.

Amendment 160 would remove the phrase “in either case” from section 7. On the face of it, that might sound like a very small change, but I believe that it is an important one. The current wording could be read to suggest that doctors have different responsibilities in different circumstances. I do not think that that is what Mr McArthur has intended. The duties of medical practitioners to check that someone has capacity, is acting voluntarily and meets eligibility criteria should apply equally in every case. By removing those words, we would make the law clear and more consistent, ensuring that there is no room for confusion or uneven treatment between different cases, whether that is due to geography or the type of condition. If amendment 160 were accepted, the bill would be stronger, simpler and faster. It would help doctors to follow the law with confidence and it would give reassurance to the public that the same high standards would apply to every person in every case, whoever they are, wherever they live and whatever their condition.

The Convener

I call Bob Doris to speak to Stuart McMillan’s amendment 232 and other amendments in the group.

Bob Doris (Glasgow Maryhill and Springburn) (SNP)

I will restrict myself to speaking to Stuart McMillan’s amendments—he cannot be here this morning and sends his apologies.

I begin with amendment 117A, which amends one of my amendments in the group. The bill will require a registered medical practitioner to confirm that a person meets the criteria of terminal illness. That provision is essential, but it is not enough. Trust, transparency and accountability are fundamental in healthcare. We cannot legislate for assisted dying without protecting those principles. Mr McMillan is concerned that, without safeguards, a patient who is dissatisfied with one practitioner’s refusal could simply seek another who is willing to provide the statement. Not only would that scenario undermine the integrity of the assisted dying process; it could erode public trust in the health service itself.

A system that would allow repeated solicitation for an irreversible act of life-ending intervention would be unsound. Amendment 117A would introduce a practical safeguard, which is that any refusal by a registered medical practitioner to provide a statement under section 8 would need to be

“recorded in the patient’s medical records”

along with the reasons for that refusal. Furthermore, the amendment would prevent further assessment for the same request for a period of six months.

Stuart McMillan acknowledged Mr McArthur’s comments last week in relation to this issue, which suggested that a six-month time period would be “arbitrary”. However, that could be suggested about any timescale and age that is available throughout the bill. Mr McMillan’s point is that, wherever you draw the line, it will be an arbitrary decision. Mr McMillan thinks that the six months is a reasonable timescale because it would reduce the risk of repeated requests and doctor shopping while preserving existing provisions for referral to a specialist where there is doubt about the patient’s terminal illness or capacity.

Amendment 117A is not about limiting patient choice; it is about ensuring that choice is exercised responsibly, ethically and with integrity. It would ensure that the medical profession can act confidently, knowing that professional judgment is respected and that the process cannot be manipulated.

In the same group, Mr McMillan also lodged amendment 232. Mr McMillan comments that the bill, as currently drafted, would not require a person who seeks assisted death to consult a specialist in their condition to determine whether they truly meet the criteria of terminal illness. That is a significant gap. Prognosis is not an exact science; it varies by individual, treatment and circumstance. Without specialist input, there is a risk that someone with many years of life ahead could be permitted to proceed down an irreversible path. That is why it is essential that every assessment be informed by the most accurate expert knowledge that is available.

Amendment 232 addresses that risk. It would require that, in all assessments under section 6, the medical practitioner must consult a specialist in the person’s terminal condition and take their opinion into account. Mr McMillan notes Liam McArthur’s comments last week indicating that he thought that the amendment mirrored section 7(2). However, Stuart McMillan contests that comment. That is because the important word is “may”, which is not a guarantee that a registered medical professional and the relevant specialist would be involved. Amendment 232 would put that beyond doubt and ensure that decisions are based on the expertise of those who understand the specific trajectory and prognosis of the illness in question.

With that remark, I conclude Mr McMillan’s comments on his two amendments in the group.

Paul Sweeney (Glasgow) (Lab)

I will speak to amendments 239, 240 and 241. If passed, those amendments would ensure that the bill works in practice. That means ensuring that doctors feel that they can participate safely and confidently without undue risk of criticism. At present, the bill places a heavy burden on doctors to make all the key judgments about eligibility. The concern of the Medical and Dental Defence Union of Scotland is that that could create a significant legal risk that would deter clinicians from participating at all.

My amendments would create a multidisciplinary panel to act as the final assessor of a patient once the statements from both the co-ordinating and independent doctors have been submitted. That panel would review all evidence, confirm that the person met the criteria, and issue a certificate of eligibility if satisfied that that was appropriate. The intention of my amendments is not to obstruct the bill but to ensure that decisions are consistent and transparent. In effect, the panel would offer a final level of assurance for both patients and clinicians, confirming that all the necessary conditions have been met before assisted dying can proceed.

The Convener

I call Pam Duncan-Glancy to wind up and press or withdraw amendment 229.

Pam Duncan-Glancy

I will press amendment 229. We have had much debate on the group, including from last week, so I will be brief in my remarks, but I will remind us of some of the discussion that we had last week, which is important.

Checks and balances in legislation, particularly in matters of life and death, are crucial. Members have asked whether the referrals in my amendments, which come at the end point, are too late, perhaps suggesting that there is an issue with the drafting. However, the fact is that referrals do not readily happen. Referrals to social work or to disabled people’s organisations, to help disabled people or terminally ill people understand what it could be like to have to live a life in which they have a loss of function of some description, do not happen all that readily.

That is why it is important that, in this legislation if in no other—it should be in other legislation, too, but we have one piece of legislation before us today—referrals must be in place. I seek to add them to the bill because, as a last resort, surely, in considering life and death, the Parliament must contend that such provisions are crucial, even if we cannot provide them before that.

Many disabled people talk about how disabled people’s organisations changed their lives and helped them to see that life was indeed worth living. I note some of the comments that were made last week, particularly by my colleague Liam McArthur, saying that that is subjective. That is true, but so is the level of tolerance that people have for loss, and so is the desire to live or die. People who are seeking to end their lives must have access to that emancipatory support. Without it, life may appear, for some, to be intolerable.

Right now, the organisations that provide such support are on their knees and there have been questions about capacity, but there is no requirement to meet requirements on social care or housing—nor, indeed, to prevent poverty. Liam McArthur was right, last week, to raise questions about local authorities’ ability to meet the requirements of article 19 of the UNCRPD. Indeed, I am sure that they readily fall short, due to the lack of resources that they get. My amendments are an 11th-hour attempt to force action on the human rights of disabled people, which, surely, the Parliament must ensure that we put in place, to make it easier to live if—should the bill progress to stage 3 and pass—we legislate to help people to die.

Furthermore, I suggest that, in the absence of solid mitigation against such intolerable circumstances, fears that are proffered—for example, that people will not declare money concerns or the feeling of being a burden, so that they may be supported to die—would be better addressed by ensuring that the amendments are made, so that it is easier to live, rather than rejecting them, as has been the case so far.

These are reasoned amendments. They would protect the human rights of disabled people and people with terminal illnesses, and I encourage the committee to support them.

I press amendment 229.

The Convener

The question is, that amendment 229 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 229 disagreed to.

Amendment 87 moved—[Bob Doris].

The Convener

The question is, that amendment 87 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 87 disagreed to.

09:30

The Convener

Amendment 88, in the name of Bob Doris, has already been debated with amendment 229. I remind members that, if amendment 88 is agreed to, I cannot call amendments 50, 89 and 12 because of pre-emption.

Amendment 88 moved—[Bob Doris].

The Convener

The question is, that amendment 88 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

FitzPatrick, Joe (Dundee City West) (SNP)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

Harper, Emma (South Scotland) (SNP)

Abstentions

Harvie, Patrick (Glasgow) (Green)

The Convener

The result of the division is: For 6, Against 1, Abstentions 1.

Amendment 88 agreed to.

Amendment 67 moved—[Liam McArthur]—and agreed to.

Amendment 230 moved—[Paul Sweeney]—and agreed to.

Amendment 68 moved—[Jackie Baillie].

The Convener

The question is, that amendment 68 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Mochan, Carol (South Scotland) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 68 disagreed to.

Amendments 154 and 155 not moved.

Section 6, as amended, agreed to.

Section 7—Assessment under section 6: further provision

Amendment 69 moved—[Liam McArthur]—and agreed to.

Amendment 90 moved—[Bob Doris]—and agreed to.

Amendment 231 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 231 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 231 disagreed to.

Amendment 91 moved—[Bob Doris].

The Convener

The question is, that amendment 91 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 91 disagreed to.

Amendment 29 moved—[Liam McArthur]—and agreed to.

Amendment 156 moved—[Brian Whittle].

The Convener

The question is, that amendment 156 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 156 disagreed to.

Amendment 157 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 157 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

The Convener

The result of the division is: For 0, Against 8, Abstentions 0.

Amendment 157 disagreed to.

Amendment 92 moved—[Bob Doris].

The Convener

The question is, that amendment 92 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

Haughey, Clare (Rutherglen) (SNP)

Abstentions

Harvie, Patrick (Glasgow) (Green)

The Convener

The result of the division is: For 6, Against 1, Abstentions 1.

Amendment 92 agreed to.

Amendment 93 moved—[Jackie Baillie]—and agreed to.

Amendment 158 moved—[Sue Webber].

The Convener

The question is, that amendment 158 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 158 disagreed to.

Amendment 94 moved—[Bob Doris].

The Convener

The question is, that amendment 94 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 94 disagreed to.

Amendment 232 moved—[Bob Doris].

The Convener

The question is, that amendment 232 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 1, Against 7, Abstentions 0.

Amendment 232 disagreed to.

Amendment 233 not moved.

Amendments 95 and 96 moved—[Bob Doris]—and agreed to.

Amendment 97 not moved.

09:45

The Convener

Amendment 159 is in the name of Jeremy Balfour. I remind members that, if amendment 159 is agreed to, amendments 98 and 74 will be pre-empted.

Pam Duncan-Glancy

I have been instructed to move the amendment.

Amendment 159 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 159 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 1, Against 7, Abstentions 0.

Amendment 159 disagreed to.

Amendment 98 moved—[Bob Doris]—and agreed to.

Amendment 74 moved—[Jackie Baillie].

The Convener

The question is, that amendment 74 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 2, Against 5, Abstentions 1.

Amendment 74 disagreed to.

Amendment 99 moved—[Bob Doris]—and agreed to.

The Convener

Amendment 160 is in the name of Jeremy Balfour.

Pam Duncan-Glancy

Again, I have been asked to move the amendment.

Amendment 160 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 160 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

The Convener

The result of the division is: For 0, Against 8, Abstentions 0.

Amendment 160 disagreed to.

Amendment 13 not moved.

Amendment 51 moved—[Jackie Baillie].

The Convener

The question is, that amendment 51 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 51 disagreed to.

Amendment 100 moved—[Bob Doris].

The Convener

The question is, that amendment 100 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 100 disagreed to.

Amendment 101 moved—[Bob Doris].

The Convener

The question is, that amendment 101 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 101 disagreed to.

Amendments 102 and 103 not moved.

Amendment 234 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 234 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 234 disagreed to.

Amendment 235 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 235 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 235 disagreed to.

Section 7, as amended, agreed to.

After section 7

Amendment 75 moved—[Jackie Baillie].

The Convener

The question is, that amendment 75 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 75 disagreed to.

Amendment 161 moved—[Brian Whittle].

The Convener

The question is, that amendment 161 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 161 disagreed to.

Amendment 236 not moved.

Section 8—Medical practitioners’ statements

Amendment 104 not moved.

Amendment 237 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 237 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 237 disagreed to.

Amendment 105 moved—[Bob Doris].

The Convener

The question is, that amendment 105 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 105 disagreed to.

10:00

Amendment 238 moved—[Pam Duncan-Glancy].

The Convener

The question is, that amendment 238 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 238 disagreed to.

Amendment 162 moved—[Brian Whittle].

The Convener

The question is, that amendment 162 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 162 disagreed to.

Amendment 5 not moved.

Amendment 106 moved—[Bob Doris].

The Convener

The question is, that amendment 106 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 106 disagreed to.

Section 8 agreed to.

Schedule 2—Medical practitioners’ assessments: form of statements

Amendments 107, 163, 108, 30, 6, 109 and 110 not moved.

Amendment 111 moved—[Bob Doris].

The Convener

The question is, that amendment 111 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Harvie, Patrick (Glasgow) (Green)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 111 disagreed to.

The Convener

Amendment 7, in the name of Daniel Johnson, is grouped with amendments 8 and 9.

Daniel Johnson (Edinburgh Southern) (Lab)

Although I very much appreciate having a group entirely to myself, I think that, in some ways, these amendments should be considered with the amendments in the previous group.

To my mind, there are two hugely important elements to the bill. The first is the judgment that will be made by medical practitioners as to whether an individual meets the criteria set out in the bill: that they are terminally ill and unable to recover. In those circumstances, they would meet the criteria for assisted dying.

The other really important element is that individuals will have to fully consider all the options that are available to them. To that end, the 14-day period is doing an awful lot of work, and I am not sure whether it provides a sufficient safeguard. It is an arbitrary time period. It is neither short enough, if death is imminent, nor is it long enough to provide a genuine period of reflection if an individual’s death is not imminent and they are planning ahead of time.

I will not move the amendments, which are probing. I wanted to draw to the committee’s attention the fact that the 14-day period is doing an awful lot of work. There need to be more safeguards to ensure that the individual makes a clear decision. Facing the end of life is clearly going to be difficult and, as human beings, we often find it difficult to make fully rational judgments.

I note that the committee has rejected a large number of amendments that seek the provision of additional information. This is an area that needs to be considered at stage 3 to ensure that people have full information, can reflect and can make a careful and considered decision.

I will not move the amendments at this time.

The Convener

Mr Johnson, for us to have a debate on the group, you have to move the lead amendment.

Daniel Johnson

Forgive me, convener. I move amendment 7.

Liam McArthur

We cannot give you a grouping all to yourself if you are not going to play ball, Mr Johnson.

I thank Daniel Johnson for lodging the amendments and for speaking to them and explaining their rationale, which I entirely understand. I accept that there would be a degree of arbitrariness with any timeframe that we set for the period of reflection.

On Mr Johnson’s point about people whose prognosis is that death might be more imminent, there is a provision in the bill that will allow anybody who is assessed as being likely to die within 14 days to have a reflection period of 48 hours, which is not much but should allow sufficient time for at least some reflection. That will also allow the process, with all the safeguards, to run its course.

I believe that the period of 14 days strikes the right balance between ensuring that a terminally ill adult has time to reflect on their decision at the end of life and ensuring that they are not subject to prolonged suffering, having taken that decision. In the stage 1 evidence that the committee received, including from the voluntary assisted dying review board in Victoria, Australia, it was noted that many who seek assisted death may not live for 14 days after having signed the declaration.

I note that amendments 7 and 8 are consequential on amendment 9. I understand the rationale for Daniel Johnson lodging the amendments. He is almost certainly correct that we will return to the issue at stage 3, but it will be difficult for the committee or Parliament to come up with a timeframe that is any less arbitrary. We can draw confidence from what we see in other jurisdictions, which is that, by and large, 14 days seems to be an appropriate timeframe to set.

I again thank Daniel Johnson for lodging the amendments. I will leave my remarks there.

The Convener

I call Daniel Johnson to wind up the debate.

Daniel Johnson

I have nothing further to add.

Amendment 7, by agreement, withdrawn.

Amendment 112 not moved.

The Convener

I remind members that, if amendment 113 is agreed to, I cannot call amendment 114.

Amendments 113 and 114 not moved.

Amendment 115 moved—[Bob Doris].

The Convener

The question is, that amendment 115 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 115 disagreed to.

Amendment 8 not moved.

Schedule 2 agreed to.

After section 8

Amendment 116 moved—[Bob Doris].

The Convener

The question is, that amendment 116 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 116 disagreed to.

10:15

Amendment 117 moved—[Bob Doris].

The Convener

I call amendment 117A, in the name of Bob Doris—sorry, the amendment is in the name of Stuart McMillan, but it will be moved by Bob Doris.

Bob Doris

I can confirm that I am not Stuart McMillan, but I will nevertheless move the amendment on his behalf.

Amendment 117A moved—[Bob Doris].

The Convener

The question is, that amendment 117A be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)

Against

Abstentions

Whittle, Brian (South Scotland) (Con)

The Convener

The result of the division is: For 1, Against 6, Abstentions 1.

Amendment 117A disagreed to.

The Convener

Bob Doris, do you wish to press or withdraw amendment 117?

Bob Doris

I press amendment 117, convener.

The Convener

The question is, that amendment 117 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 117 disagreed to.

Amendment 239 moved—[Paul Sweeney].

The Convener

The question is, that amendment 239 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)

Against

The Convener

The result of the division is: For 1, Against 7, Abstentions 0.

Amendment 239 disagreed to.

Amendment 240 moved—[Paul Sweeney].

The Convener

The question is, that amendment 240 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 240 disagreed to.

Section 9—Period for reflection

Amendment 9 not moved.

Section 9 agreed to.

Section 10—Request for assistance: second declaration

Amendment 241 moved—[Paul Sweeney].

The Convener

The question is, that amendment 241 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)

Against

The Convener

The result of the division is: For 1, Against 7, Abstentions 0.

Amendment 241 disagreed to.

Amendment 164 moved—[Brian Whittle].

The Convener

The question is, that amendment 164 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 164 disagreed to.

Amendments 165 to 167 not moved.

Section 10 agreed to.

Schedule 3—Form of second declaration

Amendment 118 not moved.

The Convener

I remind members that amendments 3 and 168 are direct alternatives. The text of whichever amendment is the last to be agreed to is what will appear in the bill.

Amendment 3 moved—[Brian Whittle].

The Convener

The question is, that amendment 3 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Abstentions

FitzPatrick, Joe (Dundee City West) (SNP)

The Convener

The result of the division is: For 7, Against 0, Abstentions 1.

Amendment 3 agreed to.

The Convener

I call amendment 168, in the name of Claire Baker. I have had no indication that anyone else will move her amendments. Are you moving her amendments, Ms Duncan-Glancy?

Pam Duncan-Glancy

Claire Baker has asked me to say, “Not moved”, if that is helpful.

The Convener

That is very helpful.

Amendments 168 and 119 not moved.

The Convener

Are you moving or not moving the amendments in the name of Rhoda Grant, Ms Duncan-Glancy?

Pam Duncan-Glancy

I have not been given instructions.

The Convener

Amendment 31 is in the name of Rhoda Grant. The clerks have informed me that Ms Grant has said that she does not intend to move that amendment.

Amendments 31 and 120 not moved.

Schedule 3, as amended, agreed to.

The Convener

At this point, I suspend the meeting for 10 minutes for a brief comfort break.

10:25 Meeting suspended.

10:39 On resuming—

Section 11—Cancellation of declarations

The Convener

Amendment 121, in the name of Bob Doris, has already been debated with amendment 229. I invite Bob Doris to move or not move amendment 121.

Bob Doris

I would not like to say that I was caught out there, convener. Could you please give me the number of that amendment again? If you give it to me slowly, I will read the correct bit of my notes.

The Convener

I called your amendment 121, Mr Doris. Do you wish to move it or not move it?

Bob Doris

As keen as I am, I will not move amendment 121.

Amendment 121 not moved.

Amendment 169 moved—[Brian Whittle].

The Convener

The question is, that amendment 169 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 169 disagreed to.

Section 11 agreed to.

Section 12—Signing by proxy

The Convener

Amendment 32, in the name of Liam McArthur, has already been debated with amendment 149. I remind members that, if amendment 32 is agreed to, I cannot call amendment 170.

Amendment 32 moved—[Liam McArthur]—and agreed to.

Section 12, as amended, agreed to.

Schedule 5 agreed to.

After section 12

Amendment 171 not moved.

Section 13—Recording of declarations and statements

Amendment 172 moved—[Brian Whittle].

The Convener

The question is, that amendment 172 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 172 disagreed to.

Amendments 122 and 123 not moved.

Section 13 agreed to.

Section 14 agreed to.

After section 14

The Convener

Amendment 242, in the name of Ross Greer, is grouped with amendments 243, 274, 279 and 283.

I call Patrick Harvie to move amendment 242 and to speak to all the amendments in the group on Ross Greer’s behalf.

Patrick Harvie

I thank the convener for her flexibility in allowing me to speak on behalf of Ross Greer, who has lost his voice. It is very tempting to abuse the privilege. However, to be clear, I will simply read the statement that Ross has given me, so references in the first person should be taken as referring to him.

As I mentioned at stage 1, I have two primary concerns about the bill. The first is in regard to the proposal for a dispersed rather than a specialist service. My amendments on training, in a later group, are intended to address that concern.

This group of amendments is intended to address, in part, my other concern, which is about the risk of coercion of and undue influence on someone considering making the choice to end their own life.

To summarise my amendments in the group: amendment 242 would create a right to access independent advocacy for those who were considering making a request for assistance under the act; amendment 243 would require the provider of independent advocacy services to comply with minimum standards that would be set by ministers in regulations; amendment 274 sets out that those regulations should be subject to the affirmative procedure; amendment 279 sets out that provisions on the right to advocacy and advocacy service standards would commence on the day after royal assent; and amendment 283 sets out that substantive provisions on assisted dying services could not commence before the minimum advocacy standards were set.

10:45

The key amendment is 242, which would create for those who engage with the assisted dying system the right to high-quality, independent and rights-focused advocacy. A neutral third party would be able to support a person through what is a potentially complex system and put their interests first.

That right mirrors other statutory provisions for independent advocacy—for example, in the Social Security (Scotland) Act 2018. As is the case with the 2018 act, which I drew on for drafting purposes, advocacy would be optional and would be intended for those who would benefit from an advocate’s support to ensure that they could make their choice with all the relevant information available to them and with the safeguard of someone whose only role in the process would be to represent their interests and help them navigate the system.

I envisage that the advocate would not already be known to the person and that they would otherwise not be involved in the person’s care. They would be able to advocate for a person from the point at which that person first contemplated assisted dying until the point of their death, should that be the choice that they ultimately make. Among other services, the advocate would support the person in navigating the system, ensure that the person’s rights were respected, and act as a safeguard against coercion or other forms of undue influence.

The intention of amendment 242 is to embed a patient’s rights throughout their interaction with the assisted dying process. In particular, in recognition of the potential increased risk to a patient’s rights from a dispersed rather than a centralised service delivery model, the advocate is intended to protect against potential infringements of those rights and to identify and intervene in cases of potential coercion, pressure or undue influence.

I thank Dr Sandra Lucas and Dr Rhona Winnington from the school of health and life sciences at the University of the West of Scotland for their support with these amendments. Their briefing helped to shape my thinking ahead of the stage 1 debate, and the amendments stem from that briefing and my subsequent discussions with them. They both have invaluable experience of assisted dying systems in Australia and New Zealand.

My advocacy amendments reflect the voluntary assisted dying statewide care navigator service system that is operated in Victoria, Australia. Research, including the Ben White report in the Medical Journal of Australia, which was a qualitative study of the Victoria scheme, has called the advocate—the navigator—the “jewel in the crown” of that scheme, facilitating crucial discussions with compassion and giving people the confidence and knowledge to assert their rights. If the Parliament passes the bill, I want people in Scotland who will access or will consider accessing the system to have that same confidence and knowledge of their rights.

Other jurisdictions that have adopted assisted dying have included navigator or advocacy schemes, such as the Queensland voluntary assisted dying support service. The Victoria model is staffed by trained allied health professionals, but the Queensland scheme is open to social workers, psychologists and lawyers as well. I can see the advantage of the role’s being fulfilled either by medical professionals or by those with a degree of separation from the health service entirely; my amendments therefore do not specify either way. It could reasonably be up to ministers to set that out via regulations, although I would be happy to look at revisions ahead of stage 3 to clarify some details about the advocacy scheme, if colleagues felt that further detail was required in the bill.

I am grateful to various stakeholders for supporting the amendments. The Equality and Human Rights Commission’s briefing for stage 2 supports including a statutory right to access independent advocacy, and I am aware that the British Medical Association has welcomed debate on the issue of advocacy at stage 2.

I clarify that the intention is that everyone who was contemplating or undergoing assisted dying would be entitled to advocacy akin to the care navigator in other jurisdictions. Amendment 242’s proposed subsection (3)(b) is intended to capture that anyone who would benefit from advocacy would be entitled to it.

The intention is not to replace the role of assessing doctors in spotting coercion. The advocates would complement that, providing an additional safeguard. That goes to the heart of my concern about putting on to the doctor, under a dispersed model, the burden of spotting something as complex and contestable as coercion. To me, that feels too much like risking a single point of failure in the system. Part of the training that I envisage for the mandatory service standards would be in identifying coercion and spotting warning signs of undue influence.

I am nearly finished, convener. On interaction between advocacy and a potential information service, my intention is for advocates to take on the role similar to that of the Victoria and Queensland navigators, who are more than just a source of information and signposting; they are a source of fuller support and safeguarding, particularly emotional support for patients and, importantly, their families.

I would be happy to work with the British Medical Association and other interested stakeholders and members ahead of stage 3 to add further details if they believe that that is necessary. I certainly do not oppose provisions for an information service as proposed by others, but I do not think that that would be enough. If we are providing independent advocacy for those accessing social security, for care-experienced young people and others, we should provide it for those who are considering making a decision as significant as this.

I move amendment 242.

Liam McArthur

I thank Patrick Harvie for setting out the rationale for the amendments and wish Ross Greer a speedy recovery—he is lined up to speak in a few debates this week.

It is fair to say that I fully support folk being available to help people to understand and navigate the process. That is why section 23 of the bill allows ministers to make guidance on matters relevant to the bill. It is also why I have lodged an amendment to strengthen that provision by requiring ministers to provide or ensure the provision of information about the process in an accessible and understandable format, for the benefit of terminally ill adults, certainly, and of medical, social care and social work professionals, as well as the wider public.

I am also aware that structures exist to ensure patient safety and supported decision-making. Health boards in Scotland must observe equal opportunity requirements. Although not strictly advocacy, the patient advice and support service provides support to patients, while the GMC provides guidance to doctors on supporting patients in their decision making.

Under my bill, proxy arrangements can be made to support a person in accessing assisted dying services and the Patient Safety Commissioner will also have a role to play. However, through my engagement with third sector organisations, I am aware that many stand ready to provide assistance, advice and support through a navigation service. That would be my hope. As Patrick Harvie rightly said, we have seen that in other jurisdictions that have assisted dying legislation in place. As with some other amendments, the Scottish Government might be best placed to comment on how the provision would fit with existing structures, policies and services.

Ross Greer’s amendment 283 would provide for the Scottish ministers to commence the substantive parts of the bill by regulation. That reflects that ministers are responsible for ensuring that all aspects of the assisted dying service are workable and that they tie in with all other aspects of health and public service delivery in an integrated and safe way. The Scottish ministers will have the necessary oversight, and I expect them to commence the various substantive parts of the act only when all relevant health, social care, social work and other services are appropriately prepared and all necessary measures are in place to enable assistance to be requested and provided. Singling out in statute particular steps that must happen before the act can be commenced risks undermining the process and further delaying the availability of assistance to those who need it.

I note that the Scottish Government has highlighted that it is unclear from the amendments whether the conditions will have to be met by the individual advocate or the service provider, and how the service would be funded or monitored. That said, I am sympathetic to what Ross Greer is seeking to achieve through his amendments in this group. I will be happy to speak with him once his voice returns and, ahead of stage 3, to see what more the bill can provide to address the concerns that he rightly raises.

At this stage, however, I urge him, through Patrick Harvie, not to press the amendments, but I am pleased that the committee has at least had an opportunity to engage with the issue, which reflects what we see in other jurisdictions. There is a balance to be found as to whether we put the provisions in statute or allow the process to develop organically, as has been the experience in many of those jurisdictions.

Patrick Harvie

I thank Liam McArthur for his broadly constructive and positive comments. I am aware that Ross Greer is keen to press amendment 242, so I will do that. I note that, if the committee is not minded to support amendment 242, there is an intention to work constructively before stage 3. For the time being, I will press amendment 242.

Amendment 242 agreed to.

Amendment 243 moved—[Patrick Harvie]—and agreed to.

Section 15—Provision of assistance

The Convener

Amendment 173, in the name of Brian Whittle, is grouped with amendments 175, 76, 77, 176, 244, 78, 10, 79, 177 to 180, 33, 181 to 184, 245, 185, 125, 187, 126, 188, 127, 275, 136 and 137. I point out that, if amendment 180 is agreed to, I cannot call amendment 33 due to pre-emption.

Brian Whittle

Amendments 178 and 180 seek to deal with concerns, in the event that something does not go to plan, about the liability of medical professionals who are not in the room and are not immediately aware of any adverse reaction, should it occur. In essence, the amendments would ensure that the medical professional providing the substance must remain in the same room as the patient.

I turn to amendments 185, 177, 173 and 175. It has been my approach, as a committee member, to take a neutral stance on the ethical and moral issues surrounding assisted dying and to focus instead on ensuring that the legislation is as good as it can be. In line with that, I have evaluated the approaches that were put to me by organisations looking for someone to lodge amendments on their behalf in order to identify where I believe such amendments would improve the legislation.

There are clearly gaps for the pharmacy profession, which I hope we can address—if not at stage 2, then at stage 3. The concern is that the bill is not clear on the role of pharmacists in the process of assisted dying with respect to their scope of practice. That could also risk devaluing the skills of the pharmacist. Amendment 185 seeks to make provision for registered pharmacists to undertake the role of the authorised health professional, clarifying the role of the pharmacist in the process and allowing them the clear option to use the conscientious objection clause.

Amendment 177 seeks to limit the role of the pharmacist within their scope of practice but does not expect them to make decisions on the competency of the individual.

Amendment 173 seeks to clarify that a pharmacist should supply the substance to the registered medical practitioner or authorised healthcare professional and would also allow the option to use the conscientious objection clause.

Amendment 175 seeks to limit the role of the pharmacist within their scope of practice when acting as an authorised health professional to providing a terminally ill adult with the approved substance and to removing it from the premises at which it was provided.

I move amendment 173.

Marie McNair (Clydebank and Milngavie) (SNP)

I appreciate getting the opportunity to speak early on in the group, convener, which will enable me to get back to the Equalities, Human Rights and Civil Justice Committee.

My amendment 244 goes to the heart of the wider debate about assisted dying. Those who are in favour of the bill have consistently said that it is about allowing someone to end their own life and not about another person ending it for them. However, the bill as drafted does not clearly rule out that possibility. There is no clear prohibition on another person administering the life-ending substance on behalf of the patient, and that omission matters. If another person can administer the substance, we are not talking about assisted dying but about euthanasia. That is a very different act in moral and legal terms. If the Parliament allows that ambiguity to remain, we risk crossing a boundary that even many supporters of assisted dying do not wish to cross.

My amendment would bring clarity. It would strengthen section 15 to make it explicit that the substance must be self-administered by the terminally ill adult, and that no one else may do so on their behalf. It would preserve the distinction between assisted dying and euthanasia—a distinction that supporters of the bill believe is fundamental. It would ensure that assisted dying remains in law and in practice an act of personal agency, rather than the taking of life by another. Proponents of assisted dying say that they oppose euthanasia. If that is truly the case, they should have no hesitation in supporting the amendment.

11:00

Jackie Baillie (Dumbarton) (Lab)

I have lodged amendments 76 to 79 on behalf of the Royal College of Nursing Scotland. As you know, RCN Scotland maintains a neutral stance on assisted dying, but it has serious concerns about section 15, specifically the expectation that registered nurses acting as authorised health professionals will carry out complex assessments of capacity and coercion, and the possibility of nurses providing assistance while working alone.

Amendment 77 proposes that final assessments of capacity and coercion be carried out by a doctor. Such clinical judgments are complex, especially when time has passed—there might have been earlier assessments, and factors such as pain or medication might affect cognition. It might have been months since the co-ordinating and independent doctors undertook the assessments to determine eligibility, and capacity can fluctuate in a person who is terminally ill. Similarly, identifying coercion is inherently difficult, particularly without a structured framework.

Although some nurses in advanced practice roles have the relevant expertise, the bill is structured in such a way that those specialists are unlikely to be asked to act as authorised health professionals. Instead, nurses in more general settings, such as community care, general practices or hospital wards, might be expected to take on the role infrequently. RCN Scotland believes that assessing capacity in this context requires a depth of knowledge and experience that goes beyond the scope of practice of most registered nurses, and the amendment seeks to ensure that the final assessments are undertaken by either the co-ordinating doctor or another authorised doctor. The RCN believes that that is a safer and more appropriate approach.

Amendments 76, 78 and 79 address RCN Scotland’s serious concerns about lone working. The bill, as it currently stands, allows nurses to provide the approved substance alone, which RCN Scotland considers unsafe. The provision of assistance will take place in a highly sensitive and emotionally charged environment, where complex family dynamics might arise. Nurses might then face distressed families; individuals who are unable to self-administer and therefore cannot receive assistance; or unexpected reactions to the substance. Current practice for controlled drugs typically requires that two registered nurses prepare and administer them, and that safeguard should apply here, too.

These amendments would require a nurse acting as authorised health professional to be accompanied by another health professional. In practical terms, that would mean that a doctor would carry out the final assessments on capacity and coercion, and either they or a nurse accompanied by that doctor would then provide the substance. Where a nurse provides the substance, either the accompanying doctor remains present, or the doctor leaves and another health professional arrives to accompany the nurse while the person decides whether to use the substance, and if they have done so, has subsequently died.

Although the bill allows a nurse to be accompanied, it does not require it; instead, it leaves it up to individual nurses to advocate for themselves when they are asked to attend alone, and we do not regard that as acceptable. RCN Scotland believes that these amendments would introduce essential safeguards and must be incorporated into the bill.

Sue Webber (Lothian) (Con)

I have lodged amendments 176 and 181 to 183 in this group, and I will start with amendment 176.

My remarks on this group might well sound similar to those that I made last week, because these amendments to section 15 seek to address the serious moral and medical flaws in the bill—by which I mean the presumption that the substances used in assisted suicide will always deliver a swift and painless death. Indeed, we have just heard from Jackie Baillie that the Royal College of Nursing acknowledges that there can be unexpected reactions to these substances, and we have to recognise that, too, because experience from other countries has shown that these substances can have severe side effects.

In places where assisted suicide is legal, there have been reports of vomiting, choking, fluid in the lungs, prolonged pain and even cases in which the person did not die as expected. That is not a swift and painless death, but the bill does not require that individuals be informed of those risks before making their decision. I believe that individuals must be fully informed and fully aware of what might or might not happen.

Section 15 deals with the end-of-life process and sets out how a person will be provided with assistance to lawfully end their own life. It is for that person to decide, after completing the second declaration, if, when and where they wish to be given an approved substance, and I believe that they need to be fully aware of every risk and every side effect that might occur. That omission undermines one of the core principles that this Parliament should uphold: informed consent.

Amendment 176 would correct that by requiring the practitioner to inform the adult of any potential side effects or complications, including the risk of pain, and to be satisfied that the adult has understood that information. That would ensure that people are given not simply a choice but an honest choice. It is not about endorsing assisted suicide but about recognising the reality that, if Parliament passes the bill, we have a duty to minimise harm and prevent unnecessary suffering. We cannot allow people to take those substances without their full consent and knowledge of what those substances can do to them.

Amendments 181 and 182 address what is perhaps the most chilling silence in the entire bill: what happens when the substances do not work. Nowhere does the bill explain what a doctor or nurse should do if the person remains alive after taking the lethal dose. That absence is not accidental; it flows from a dangerous presumption that the substance will always work, that death will always follow and that complications will never arise.

Brian Whittle

I am listening intently to what you are saying, and it brings me back to earlier amendments that I was trying to get the committee to agree to, but which were not agreed to, on advance care directives. Such directives would address the exact point that you are making about the patient’s request, should something go wrong. I feel the same as you that there is this idea that nothing will ever go wrong. Consequently, I believe that we need advance care directives. Do you agree with that, and with my suggestion that amendments be lodged at stage 3 to include them in the bill?

Sue Webber

I do agree. Every possible safeguard should be included in the bill. I have sat in committee both today and last week, watching safeguard after safeguard get turned down, and I am gravely concerned with the direction that the bill is going in.

Experience overseas shows that it is not true that the substance will always work. In countries where assisted suicide has been legalised, there are documented cases where death has not occurred, where people have awoken hours later or where they have lingered in distress. When we legislate for death, we must also legislate for when death does not come, and not doing so is of great concern to me.

Amendment 181 sets out a clear and humane procedure for such cases. I hate talking about such things in such a pragmatic, emotionless way, but my amendment would require a medical professional to take all reasonable steps to preserve life, including, where possible, reversing the effects of the substance, unless the adult at that time and with capacity refuses such an intervention. It would also require that the entire incident be recorded in writing, including details of the substance that is used and the sequence of events.

Amendment 182 would make it explicit that any person who administers further substances to bring about death after the initial attempt has failed will be subject to the existing criminal law on homicide. This is not a theoretical, but a moral, concern. When the state authorises the taking of a life, it must also face the consequences when that act fails. If we are to cross this line as a Parliament, we must at least ensure that, when death does not occur, life is protected, suffering is not compounded and the law does not turn its face away. Amendments 181 and 182 are, frankly, about confronting the reality and seeking to preserve what little humanity we can in a bill that risks abandoning it.

Finally, amendment 183, which I have already talked briefly about, would make it a requirement to record any complications that might arise after taking the substances. It speaks to the uncomfortable gap between how this bill imagines assisted suicide will work and how it has worked in practice elsewhere.

The bill proceeds on the assumption that the substance that is used to end life will do so cleanly, peacefully and without complication, but that assumption is false. The evidence from overseas tells a very different story. In countries where assisted suicide has been legalised, there have been cases of vomiting, choking, fluid filling people’s lungs and, in some instances, of the substance simply failing to end the person’s life. Despite those realities, the bill provides no mechanism to record or report when such complications occur. That is, frankly, an extraordinary omission.

If the Parliament is to sanction the deliberate ending of life, at the very least, it must ensure that the methods used are subject to proper scrutiny and improvement. Every other medical procedure undergoes that. My amendment would do precisely that, and it would require a medical professional to record any complications, adverse reactions or unintended effects arising from the administration of the approved substance in the adult’s medical records, and that an anonymised report be submitted to Public Health Scotland. It is an attempt to limit the harm that the bill might cause.

If Parliament insists on creating a system for assisted suicide, it has a moral duty to ensure that the process is safe, transparent and as humane as possible. Turning a blind eye to complications is not compassion; it is indifference. I want to confront the reality, not idealise it.

Daniel Johnson

I support the amendments that have been lodged by Jackie Baillie, which have the support of the Royal College of Nursing. We must have clarity on roles. The final provision of the substance is particularly sensitive. It is also important that we have clarity about not only the role of the registered medical practitioner but those of other medical professionals and in what combination those roles take place. The role of nurses and the points about accompaniment and supervision are very important.

I voted for the bill at stage 1 on the basis of the principle that people should have bodily autonomy, and because the bill is very much about people whose death is imminent and enabling them to make the final decision and to carry out the final act.

That last point is very important to me, which is why I have lodged amendment 10. Although I note the intent of the legislation and what is set out in the policy memorandum, I am concerned that there is not sufficient clarity that the final act will be that of the individual. My amendment seeks to specify that, for similar reasons to those that Marie McNair pointed out.

Throughout the discussion, great care has been taken about the language—whether this is assisted dying or suicide—and the bill very much rejects any notion that this could be viewed as euthanasia. I understand that. Those are important distinctions. It is important that this is about enabling someone to act for themselves and do this to themselves. It cannot be about enabling an act in which one person is administering a substance to another.

There is a big difference between enabling someone to end their life and enabling others to end others’ lives. One is about enabling one’s own death. The other is, quite simply—as a matter of moral distinction—killing another person. I use that word advisedly because there is an important moral distinction. It is easy in these settings to highlight the complexity and say that, in practical terms, there are not necessarily those distinctions, but the moral differences are important.

I also think that, practically, it is essential that an individual has the ability to withdraw their consent to ending their own life up until the very final moment, which is why self-administration is so important. My amendment seeks to clarify that, because there are also sensitivities about a person’s physical capacity to undertake that.

The amendment specifies that the act would be for the individual to carry out, and specifies that the co-ordinating registered medical practitioner may

“prepare that substance for use by the adult ... prepare a medical device which will enable the adult to use the substance”

and assist the adult for the final ingestion of the substance.

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My amendment further clarifies that, those points notwithstanding, the final decision must be made by the individual themselves and, further, that the co-ordinating registered medical practitioner may not administer the approved substance to the individual directly.

Those are important clarifications that state clearly and specifically what the bill would authorise. As I have stated, I think that it is important that we have that moral clarity and that moral distinction, but, ultimately, it is vital that it is the individual’s choice and that they can withdraw their consent right up until the final moment. That is the reason for my amendment 10.

The Convener

I call Douglas Ross to speak to amendment 179 and other amendments in the group, including Stephen Kerr’s amendment 126.

Douglas Ross (Highlands and Islands) (Con)

I have lodged amendment 179 to highlight and address one of the most disturbing assumptions that is at the heart of the bill, as articulated by other members who have lodged amendments in the group, which is the belief that every death will be swift, smooth and certain. That will not be the case; we know that from international experience in countries such as Canada and the Netherlands, as other members have said.

In countries where assisted dying is legal, there have been cases where substances have failed to bring about death as expected; people have regained consciousness and have suffered for hours, and have endured distressing complications such as choking, vomiting or prolonged pain. I do not believe that anyone who supports the bill wants that to happen, but it is the reality.

Under the bill as introduced, no medical professional will be required to remain in the room when a substance has been taken. If the death does not occur, the person will be left alone, frightened, vulnerable and in pain, with no qualified person to intervene. Amendment 179 seeks to address that. It would require a medical professional to remain present until death occurs or until it is clear that the substance has failed to take effect.

Even for those who support assisted dying, that is surely the minimum of decency. If the Parliament sanctions the deliberate ending of a life, it must take responsibility for what happens if the process fails. I do not support the bill—I oppose it in principle, as I believe that it will place unbearable moral and practical burdens on individuals, families and our health service. However, if it is to proceed, it cannot do so under the false comfort that every death will be peaceful, because we know that that will not be the case. My amendment 179 is about facing the truth, which is that death might not come and suffering might follow, and that the state has a duty not to look away. For those reasons, I encourage members to support it.

As the convener alluded to, I will speak to amendments 126 and 188, in the name of my colleague Stephen Kerr, who apologises for not being able to be here. I will read his words, so bear with me.

The amendments address a critical gap in the bill, which is the absence of any statutory requirement to record and report what happens when an assisted death takes place. At present, the bill assumes that every death will proceed as planned, swiftly and without complication. However, that assumption does not align with the evidence that we have seen from areas where assisted dying has been legal for some time—in particular Canada and the Netherlands, where there have been documented instances of complications during administration, delays before death occurred and unexpected physical reactions, as well as distress for those who are dying and the professionals who are present. If Scotland is to legislate in this profoundly serious area, we must do so with our eyes open, guided by evidence of what has happened elsewhere.

Therefore, amendment 126 seeks to ensure that the final statement required under schedule 4 to the bill records two specific pieces of information: first, the time that elapses between the administration of the approved substance and a person’s death and, secondly, any complications that have occurred or have been observed during the procedure. That information should not sit in a drawer.

Amendment 188 complements amendment 126 by requiring that the information be included in the annual report prepared under section 26 of the bill. In other words, Parliament and the public should be able to see transparently, year by year, what has actually occurred under this legislation.

The Health, Social Care and Sport Committee’s stage 1 report acknowledged the issues of information reporting and review and suggested that the provisions might require to be strengthened at stage 2 to ensure appropriate detail and transparency. The amendments from Stephen Kerr would directly meet that recommendation. They do not challenge the principle of the bill but insist that if Parliament chooses to legislate for assisted dying, it must also commit to rigorous, honest monitoring of the real-world outcomes.

This is not a partisan matter; it is about integrity in law making. If the bill is to command public trust, it must be built on full disclosure and a willingness to learn from experience. Transparency is the foundation of public confidence. Recording what happens at the point of death is not morbid bureaucracy; it is an essential safeguard that would ensure that the law operates safely, humanely and truthfully.

If the bill is passed, it will touch on the most sensitive boundary of human life and medical ethics. It must therefore be governed by truth, not by assumption, and by evidence, not by expectation. For those reasons, I, and Stephen Kerr, urge members to support amendments 126 and 188, which are modest, reasonable and necessary proposals that would strengthen accountability, uphold honesty and protect the integrity of our law.

Liam McArthur

I start by expressing the hope that Stephen Kerr has not gone the same way as Ross Greer and lost his voice, too. I thank Brian Whittle and the other members who have had an opportunity to set out the rationale for their amendments in this group, and I look forward to hearing the comments from others who have lodged amendments, too.

I must apologise at the outset, convener, with regard to your plea to be brief. I have only one amendment in this group, but I am conscious that there are many amendments in it, lodged by many members, so my remarks will probably be lengthy. I will do my best to recoup some of that time in later groupings.

I will start with my amendment 33, although it is probably worth acknowledging at the outset that all the amendments in the group relate to section 15, on the provision and use of an approved substance. I again remind members that all the bill’s provisions must be within the competence of the Parliament. I am aware that the Scottish Government is working with the UK Government to ensure the full operation of the bill, should it be passed. The Scottish Government will consider many of the amendments in the group in the context of those discussions, and we certainly urge the cabinet secretary to keep the committee and other members updated in that respect.

Amendment 33, in my name, requires the co-ordinating registered medical practitioner or authorised health professional who attends on the day that the person intends to take the authorised substance, and who will provide the substance to the person, to stay with the person in the same room until the substance has been used. As introduced, the bill states that the attending co-ordinating registered medical practitioner or authorised health professional must be on the premises but need not be in the same room as the person while they decide whether to be provided with, and use, the substance. Where the person has chosen to use the substance, the co-ordinating medical professional or authorised health professional must stay on the premises until the substance has been used and the person has died.

Amendment 33 responds to questions that were raised by Police Scotland, and which were echoed by Douglas Ross and, I think, Brian Whittle, by amending section 15(6) to the effect that the attending co-ordinating medical practitioner or authorised health professional must remain with the person in the same room until such time as the person has decided to take, and has taken, the substance. As before, it will then be at the discretion of the attending medical professional as to whether they remain in the room after that point or be elsewhere on the premises. That is intended to address any potential concerns as to whether the substance has been self-administered.

Amendments 178, 180 and 179 offer alternative approaches to the same issue, and I thank Brian Whittle and Douglas Ross for lodging them and for allowing this debate to take place. Brian Whittle’s amendments 178 and 180 seek to ensure that the co-ordinating registered medical practitioner or authorised health professional remains in the same room as the terminally ill person throughout. In addition to what I said in speaking to amendment 33, I believe that it is important that, after the substance has been taken, the terminally ill adult and any attending loved ones be afforded some privacy, if they wish it, while having the attending health professional close at hand.

Section 15(5) sets out that

“The coordinating registered medical practitioner or ... authorised health professional must remain with the adult until the adult decides whether to use the substance ... and, if they decide to do so, until the adult has died.”

Amendment 179 would add to that by requiring the co-ordinating registered medical practitioner or authorised health professional to remain with the person until they have died or the attending

“health professional determines that the substance has failed to take effect.”

I understand what Mr Whittle and Mr Ross are seeking to achieve. They are motivated by a concern that I fully recognise, but I believe that amendment 33 deals with the issue more proportionately, allowing privacy for a terminally ill adult where necessary and appropriate.

Douglas Ross

I understand the desire for privacy, but does Liam McArthur accept that international experience is that there have been instances in which people have not died as a result of the substance being used or have suffered significant complications? A person being in the same building does not mean that they are in the same room. A medical professional can provide privacy by standing well back while being present in the room and able to intervene if required.

Liam McArthur

I thank Douglas Ross for that intervention. The committee took evidence at stage 1 from witnesses in Australia that went some way to allaying many of the concerns around the efficacy of the substance, but I certainly appreciate that complications might arise in some instances. That is why it is important that the medical professional remain present on the premises. There would be a discussion ahead of the self-administration of the substance about what is expected to happen.

In other jurisdictions, there are instances where the medication is not provided in person by a medical professional and concerns do not appear to arise as a result. My bill has an additional safeguard that does not exist in other jurisdictions. The fact that the medical professional would be there and available allows us to balance, on one hand, the need to ensure that there is no coercion or undue influence being brought to bear and that self-administration takes place, with, on the other hand, respecting an individual and their family members’ wish for additional privacy, while maintaining the robustness of the safeguard.

Brian Whittle

As an addendum to Douglas Ross’s point, I am concerned that you have not considered the liability of the medical professional if he leaves the room. We talk about other jurisdictions, but our laws and legal processes are different. Has the protection of our medical professionals, and their liability if something goes wrong, been considered?

Liam McArthur

That is a very fair point to raise. It has not been raised with me either in the context of the bill as introduced or in relation to the additional safeguard that I seek to introduce through amendment 33. I am prepared to engage with other members and representatives of the medical profession to see whether any anxieties in relation to that point still need to be addressed. However, as I said, there is a safeguard in the bill. Notwithstanding Mr Whittle’s—rightly made—point about our legal set-up in Scotland, I believe that the safeguard is appropriate. As I said, it balances the need to ensure self-administration and that there is no evidence of coercion with respect for the right of an individual to have the privacy that they wish to have at the end of life.

I turn to the amendments that Brian Whittle lodged on the role of the pharmacist in the provision of the substance under section 15. I remind members that section 15 details that the co-ordinating registered medical practitioner or an authorised health professional can provide the approved substance if specified conditions are met. Amendment 173 would provide that the approved substance could

“only be supplied to a coordinating registered medical practitioner or an authorised health professional”

for that purpose

“by a registered pharmacist, in accordance with the directions of the coordinating registered medical practitioner.”

Amendment 173 is one that I can support on the understanding that it would not add to the competence issues that are being considered by the Scottish and UK Governments.

Amendment 177 would enable the co-ordinating registered medical practitioner or authorised health professional, where they are

“accompanied by any other health professional”,

which, as per section 29, could be a registered medical practitioner, a registered nurse or a registered pharmacist, to

“delegate their functions under subsections (1) and (7)”

of section 15 to that person. Section 15(1) deals with the provision of the approved substance, and section 15(7) deals with the removal of the substance where the terminally ill adult decides against using it.

However, amendment 175, which I understand should be read with amendment 177, would require that the co-ordinating doctor or authorised health professional, as the case may be, has to be present for the provision of the substance.

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I believe that Mr Whittle’s intention is that it is the role of a pharmacist to provide the substance to the person. However, I believe that there is merit in retaining the provision that it is for the co-ordinating registered medical practitioner or authorised health professional to provide the substance. I envisage the role of any other health professional attending at the discretion of the co-ordinating registered medical practitioner or authorised health professional to be limited to providing assistance to the CRMP or AHP as they see fit. I am wary of allowing functions under section 15 to be delegated by the CRMP or AHP, who must be in attendance and who will have the relevant skills, training, experience and qualifications to fulfil the functions set out in subsections (1) and (7) regarding the provision or disposal of the substance.

Amendment 185 would add registered pharmacists to the definition of an authorised health professional in section 15. I note that the Government suggests that, in order to fulfil that role, pharmacists would likely need additional training over and above that required by the doctors and registered nurses who fulfil the role. I agree with that assessment, and I note that, if the amendment is agreed to, there would be no distinction between who can be an authorised health professional in section 15(8) and a health professional as defined in section 29, which could lead to confusion.

I turn to Jackie Baillie’s amendments 76 to 79, which would require that, where the substance is to be provided by an authorised health professional who is a registered nurse, they must be accompanied by the co-ordinating registered medical practitioner or another AHP who is a registered medical practitioner. It would be for the CRMP or AHP who is a registered medical professional to make the determinations on a person’s capacity and whether they were being coerced. The registered nurse would have to be accompanied by another health professional for the purposes of subsections (5) to (7) of section 15.

The bill provides for the role of an authorised health professional to ensure that there is no unreasonable delay or barrier to a person who is eligible being provided with assistance. Limiting the section 15 role for a registered nurse in the way suggested might lead to such delays and a loss of access for some terminally ill adults. The bill requires the authorised health professional to be a registered medical practitioner or a registered nurse, authorised by the co-ordinating RMP. The co-ordinating RMP therefore already has a key role in deciding whether to appoint an authorised health professional.

Having engaged with the RCN, I have lodged amendments requiring the Scottish ministers to be able to regulate for any training, qualifications and experience that a registered medical practitioner or registered nurse should have in order to carry out the role of AHP. I believe that, if agreed to, the amendments will help to ensure that the role will be suitably supported. I should note that the amendments that I have lodged to section 18 are also relevant here in that they would ensure that no person would have to participate if they did not want to for any reason. I therefore do not believe that amendments 76 to 79 are necessary or would strengthen the bill—in fact, they could limit the availability of relevant health professionals who are able to provide the substance and be with the person on the day of death. The Scottish Government also appears to have noted that, while observing that such an approach

“may set a precedent of health and care professionals being accompanied when they have to attend people in their homes to deliver other services.”

The resource implications of that could be significant.

Daniel Johnson

I note what Liam McArthur is saying, and in a sense, he is right, but would he also observe that those amendments were lodged following the RCN requesting them, so the profession itself is asking for those restrictions? Why does he think that those observations—and, indeed, requests—should be rejected?

Liam McArthur

It is a fair point. In my engagement with the RCN, it has made requests, which I have been happy and able to accede to. I think that the requirement for a second nurse to be present is disproportionate. There is nothing in the bill that would prevent that from happening, and I am sure that that would happen. We discussed at stage 1—and the committee will have heard—that, in other jurisdictions, over a period of time, one has seen an increase in the number of people who are able to access this, partly through increased public awareness but also through the growing familiarity of medical professionals with the process and procedures, and a willingness to engage with that process.

I would not be at all surprised if, in the early stages, nurses sought to have an additional nurse present but, as we have seen in other jurisdictions, that tends to cease to be the case over time. The current provision would allow for that to happen; my concern is that amendment 79 would mandate it in every instance. That is disproportionate and would certainly have an impact on access to this choice for some terminally ill adults.

The Convener

I am minded to support Jackie Baillie’s amendment 79, and I do understand the rationale that Daniel Johnson has tried to narrate. Given that, under the current system, a controlled drug is administered by two registered nurses, I do not understand why Mr McArthur is so averse to the same thing being in statute as a protection for nurses who are carrying out their duties in participating in assisted dying.

Liam McArthur

As I have said, I understand the rationale behind the argument, particularly as we are dealing with the introduction of new legislation. I am just concerned about putting in place something that then prevails but which, in turn, reduces access to choice in what I believe is a disproportionate way.

The example that the convener and Jackie Baillie have cited is certainly the case. However, there are many instances in which that provision is not required, and yet additional nurses are still present to provide whatever support is felt to be necessary. Their doing so is not a statutory provision. This is all about striking a balance by allowing this to happen, in the expectation that, in the early stages, it might well be the case more often than not, but without binding it in statute as a requirement that could have an impact on being able to access that choice.

The Convener

I just want to expand on that. The current practice is for two registered nurses to witness the administration of a controlled drug—that is, the drawing up of that drug, if they are drawing it up into a syringe, or the pouring of it into a medicine cup. There is protection for those nurses to ensure that the drug that they have administered is the correct one, that the dose is correct and that it has gone to the right person.

I do not understand why the staff who would participate in administering something as final as the medication used in assisted dying would not have the same protections. This is about protecting the nurses—and at this point, I must put on record that I am a bank nurse with NHS Greater Glasgow and Clyde, as I have not done that yet. I just do not understand the member’s resistance to putting such a protection in place for nurses who might participate in this practice.

Liam McArthur

As I have said, I echo the concern that the Government has laid out in its commentary on the amendments that the application of that provision across the board could have significant resource implications.

Emma Harper

Will the member give way?

Liam McArthur

Yes.

Emma Harper

On the back of the convener’s own declaration, I should declare that I am still a registered nurse.

My understanding is that nurses do go into a patient’s home on their own to refill or recharge a syringe driver containing, for instance, morphine, fentanyl and anti-emetic drugs. I am concerned about nurses going in on their own in this instance, although I do take on board what you have said about their being able to choose to have somebody with them at the beginning. I am just seeking clarity on the point that nurses are already able to act independently in a patient’s home and to manage such devices.

Jackie Baillie

Will Mr McArthur give way?

Liam McArthur

Let me respond to that intervention first, Ms Baillie, and then I will come back to you.

The member makes an entirely fair point. As the convener and Jackie Baillie have intimated, there are examples in which there is such a requirement at present, but it would be wrong to assume that, from those instances, one could draw parallels with the actions being undertaken by nurses acting independently in a person’s home. I suspect that that is the point that the Scottish Government is making in its commentary on the amendments.

Jackie Baillie

We are not talking about an everyday occurrence; this is something very unusual and highly sensitive. Furthermore, as you have acknowledged, significant numbers of people will not be impacted by your bill. Consequently, issues of access being limited for some terminally ill adults are not valid in this instance.

It is very difficult for a nurse who is placed alone to advocate for themselves and say that they do not want to carry out that role on their own, thereby causing unnecessary delay. What I am seeking should be built in from the start—it must be the expectation. If we want effective implementation of your bill, we need to assure those who are likely to be significant participants in it—that is, nurses—that we have their interests at heart.

I urge you to accept the amendments, because they do add to the bill.

Liam McArthur

As I have said, I know from my direct engagement with the RCN how strongly it feels about the issue. I do have misgivings. Members of the committee will have heard expositions of both sides of the argument, and the points that Emma Harper was—fairly—making. The committee will have to take a view on the amendments accordingly.

Sue Webber’s amendment 176 relates to amendment 158, which has been previously debated, and it would require the co-ordinating registered medical practitioners to inform the terminally ill adult of potential side effects and the risks of complications when providing the substance. I note that it is already a requirement under section 7 that the registered medical practitioners, in carrying out their assessments, explain the nature of the substance to be provided, including how it will take to bring about death.

Marie McNair’s amendment 244 proposes an avoidance-of-doubt provision to confirm that a person cannot administer the substance to or on behalf of another person. I consider that the bill is already suitably safeguarded to prevent that, but I have no strong objections to Ms McNair’s amendment, and I thank her for lodging it.

Daniel Johnson’s amendment 10 adds details to the process of providing the substance. From the outset, I have wanted the end-of-life process to be set out in as much detail as possible, and I have been clear that the approved substance could be self-administered by the terminally ill adult in a range of ways. Given that the bill empowers Scottish ministers to approve the substance that is to be used, it was felt that the best approach was to leave further detail on how the substance was to be prepared and used to regulations and guidance. In policy terms, I have always been clear that assistance must be via self-administration by the terminally ill adult. Ultimately, assistance can be anything that contributes to the person’s own deliberate act but which does not tip over into administering the substance.

I also point members to the guidance provision in section 23(1), which allows Scottish ministers to “prepare and publish guidance” on the act. Section 23(2) lists particular areas on which ministers might wish to issue guidance, including

“the provision of assistance in accordance with section 15”.

Such guidance would be consulted on in advance, allowing input from medical professionals and others, ensuring that any resulting guidance reflects those views.

Part of the amendment seeks to allow the co-ordinating registered medical practitioner to prepare a device to allow the person to take the substance if needed. That issue came up at stage 1, and, as I suggested to the committee at the time, I am sympathetic in policy terms to considering what might be done to enable a person to self-administer in different circumstances.

The Scottish Government states that it recognises that the detail that is set out in the amendment

“is likely to be welcomed by healthcare professionals, based on the evidence provided to the Committee at Stage 1.”

It also noted that the amendment

“does not make any reference to the ‘authorised health professional’, who may also carry out functions under section 15.”

Daniel Johnson might wish to reflect on those comments, but I am supportive of the amendment in principle.

I turn to Sue Webber’s amendment 182, which seeks to insert a new provision into section 15 to the effect that the existing criminal law relating to homicide applies to any act by a person to provide additional substances, treatment and so on to the terminally ill adult after they have used the approved substance for the purpose of bringing about death. Section 1(2) of my bill details that

“Such assistance is lawfully provided if it is provided in accordance with the provisions of this Act.”

By necessity, any assistance that was not in line with those provisions would clearly be unlawful.

The bill’s explanatory notes make it clear that the exemption from criminal liability under section 19

“applies only where the substance of the case against the individual is (or would be) that they provided a person with assistance to end their life under the Bill. It does not apply to any incidental unlawful acts which an individual may have committed”.

Therefore, amendment 182 is not necessary and might, by singling out one specific situation, create uncertainty.

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There are, in this group, several amendments from various members that address the issue of recording and notifying instances of the substance not having its intended effect, including Sue Webber’s amendments 181 and 183, Stuart McMillan’s amendment 184, Paul Sweeney’s amendments 245 and 275, and Stephen Kerr’s amendments 126 and 188.

On amendments 181 and 183, the former seeks to cover situations in which the adult uses the substance that is provided but does not die or the substance does not produce its intended effect within a period to be specified by the co-ordinating registered medical practitioner or authorised health professional. It provides that, in such circumstances, the co-ordinating registered medical practitioner or authorised health professional

“must take all reasonable steps to preserve the life of the adult”

or reverse any effects of the substance. It also seeks to require that such incidents be recorded in writing and that details of what is required to be recorded be set out. The amendment also stipulates that no declaration or statements made by the adult under the bill’s provisions can prevent steps to preserve their life, unless the adult refuses any such intervention at the time and has capacity to do so.

As was made clear in the evidence at stage 1, the number of cases in which a person takes an end-of-life substance and does not die or complications arise is incredibly small. Even so, given that the bill provides for the co-ordinating registered medical practitioner or authorised health professional to be present when the substance is used and until a person has died, should any complications arise, the attending health professional would respond in a manner consistent with their skills, training, qualifications and experience, and provide necessary care to the person.

I refer the committee to the detailed evidence that it received from Professor Dooley, which confirmed the Australian experience that, although most deaths occur very quickly, the exact timing can be based on factors such as a patient’s condition, size, weight and overall health. Given that natural variability, Ms Webber’s amendment risks placing unworkable requirements on clinicians and potentially undermining the practical integrity of any medication protocol. I therefore support neither amendment 181 nor amendments 125 and 136, in the name of Bob Doris, which refer to dying within a “reasonable period”.

Sue Webber’s amendment 183 would require that the co-ordinating registered medical practitioner record in the adult’s medical records any complications arising from the used substance and submit an anonymised report to Public Health Scotland. Broadly, Stuart McMillan’s amendment 184 appears to duplicate amendment 183, as do Paul Sweeney’s amendments 245 and 275, along with his amendment 269, in a later group. That amendment also addresses the reporting of any complications, as do Stephen Kerr’s amendments 126 and 188.

I have considered the amendments carefully. Members will know that section 27 requires a five-year review of the operation of the act and is intended to deal specifically with how it is functioning in supporting terminally ill adults with being lawfully provided with assistance to end their own lives. The bill also provides that any concerns with the operation of the act that have been raised must also be covered in the report, as well as the Scottish Government’s response to those concerns.

However, I acknowledge that there is nothing specific in the bill about the recording and reporting of issues such as complications and, on reflection, I agree that the bill might benefit from being strengthened in that regard.

Sue Webber

You mentioned how clinicians might have concerns about dosage and how that might be affected by a patient’s physical state, which might include their being obese. Surely you agree that recording any complications and how death proceeds will help medical professionals learn and change their methods so that they can, in fact, address some of the issues that you have mentioned.

Liam McArthur

Sue Webber makes a reasonable point. However, my point about variability was more in relation to specifying a time that might be deemed “reasonable” or by which death is expected to occur.

As I was suggesting, I think that, on reflection, ways of strengthening the bill by recording considerations that have been outlined not just by you, Ms Webber—

Bob Doris

Will the member take an intervention?

Liam McArthur

Let me respond to Sue Webber, Mr Doris, and then I will let you in.

I am responding to the concerns that are reflected in a number of amendments, each of which is trying to do something similar but in a different way. This is an issue that I am happy to look at; I am not sure that I am necessarily supportive of any of the amendments that have been lodged, but I am happy to work with members and the Scottish Government ahead of stage 3 to see whether there are ways of better reflecting the issue in the bill.

I will take the amendment—I mean, the intervention—from Bob Doris.

Bob Doris

Unfortunately, Mr McArthur, you will be taking a lot of amendments from me during this stage 2 process.

My intervention is in relation to death happening “within a reasonable period” and the challenges in how we would arrive at that conclusion. Surely to goodness, if someone has ingested a substance and three hours have passed—and then four or five hours pass—there must be some guidance for the medical professional on when and how they should intervene and what powers they have to do it. I will say more about that when I get to my amendments, but there must, surely to goodness, be some kind of framework for medical professionals to operate within.

Liam McArthur

The disadvantage of speaking to my amendment, and the others, at this point is that I am doing so before I have had the opportunity to hear Mr Doris set out the rationale for his own amendment.

I have misgivings about the way in which Mr Doris’s amendment 125 is phrased, but I do recognise the point that he makes—and, indeed, which has been made in the range of amendments lodged in this area. The bill would benefit from further clarification in relation to those points. I am not sure that that clarification has been captured in any of the amendments that have been lodged, albeit that they have led to this discussion. I hope that we can address those concerns ahead of stage 3.

On Stuart McMillan’s amendment 187, the bill provides for Scottish ministers to regulate for the use of an approved substance and requires ministers to consult ahead of any regulations being laid. I fully expect such consultation to include the chief medical officer. The regulating power would also allow Scottish ministers, if appropriate, to regulate to remove a substance from the approved list. Therefore, I do not believe that amendment 187 is needed. I would also acknowledge the Government’s view that it is normally for the Medicines and Healthcare products Regulatory Agency

“to advise on the suitability, safety, side effects, quality, efficacy, ... dose, full product life cycle, and post licensing review ... of drugs licensed for a purpose.”

Finally, in relation to Patrick Harvie’s amendments 127 and 137 on safe access zones, I am conscious that I have not heard him speak to his amendments, but I do understand his rationale for lodging them, not least in light of legislation that this Parliament has recently passed. The purpose of that legislation—that is, the Abortion Services (Safe Access Zones) (Scotland) Act 2024—is to designate zones to protect patients and staff from activities that cause distress and intimidation. Given the sensitivities surrounding the debate on assisted dying, I understand the need to ensure that those who seek assistance and those who provide it are not subject to harassment and intimidation.

The amendments would allow, but not require, ministers to regulate for

“safe access zones for premises in which assistance may be provided”.

That is important, because the issue will need careful reflection and consideration, given that assistance might be provided in, for example, a person’s home. That alone would make requiring such zones to be established problematic. The Scottish Government appears to agree with that point, further noting that

“There are existing laws in place which would provide some protection”.

I do not believe that the provisions in amendments 127 and 137 are necessary, although I would observe that the proposed five-year review of the act would allow the issue to be revisited at a later date and with a clearer understanding of the experience in practice. It is worth acknowledging that such issues do not seem to be a feature in other jurisdictions where assisted dying laws are in place. However, as I have said, I am conscious that I am commenting on amendments that I have not heard the member speak to, and I will listen with interest to what he has to say.

The Convener

I call Bob Doris to speak to Stuart McMillan’s amendments 184 and 187, to amendments 125 and 136 in his own name, and to other amendments in the group.

Bob Doris

To make sure that I do not conflate Mr McMillan’s amendments with my own, let me start off with Mr McMillan’s amendments 184 and 187. I make a point that is similar to Mr Harvie’s when he spoke to Ross Greer’s amendments earlier: the words that I am using are Mr McMillan’s views rather than my own—some of them I agree with; others, perhaps not, but let us see how that goes.

The bill gives responsibility for approving substances to be used in assisted dying to the Scottish Government ministers. That sounds simple but, in practice, it creates two serious problems. First, if the ministers of the day are opposed to assisted dying, they could entirely frustrate the operation of the law by approving no substances at all.

The second and more concerning problem is that if substances are approved, the bill contains no mechanism to ensure that they are safe, effective or humane. International experience has shown us the dangers of that omission. It is contended that, in other jurisdictions, poorly monitored substances have led to choking, vomiting, pulmonary complications and tragically prolonged deaths, lasting many hours or even days. Parliament cannot, in good conscience, legislate for assisted dying while leaving the safety of such substances to ministerial discretion alone.

Amendment 187 establishes a framework for proper oversight and accountability. It requires that any substance approved for use under the act must receive parliamentary approval and renewal every three years. Before renewal, ministers would be required to lay a detailed report before Parliament on the safety, side effects and on-going suitability of those substances. In addition, amendment 184 would require co-ordinating registered medical practitioners to record and report any complications or deviations from the expected outcome.

Those amendments would ensure that the Parliament, and not ministers alone, retains responsibility for the integrity of the process. They would also ensure that, where substances have caused unnecessary suffering, action is taken quickly and transparently.

In the light of the reporting and better understanding of the safety of the drugs involved that would be ensured through amendment 184, amendment 187 would require Parliament to undertake a review after three years to ensure that the drugs are being used safely and effectively and that side effects are properly understood and monitored. That is vital to ensuring that deaths are not lingering, painful or distressing for the patient or their families.

From research in other countries, and as the committee heard at stage 1 and last week, the drugs used are potent and can have significant side effects. Monitoring their impact is the only responsible course of action for a Parliament that cares about how the legislation will work in practice. Allowing the Parliament to review after three years would give us the safeguards that we need to ensure that the legislation is working as intended.

Those are the comments from Mr McMillan in relation to amendments 184 and 187.

Do you wish me to move on to my comments, convener?

The Convener

Yes, please.

Bob Doris

My amendment 125, and the consequential amendment 136, address a gap in the bill regarding the duties placed on health and social care practitioners in the event that a person, following the planned ingestion of an approved substance provided to end their life, does not die within a reasonable timeframe.

Amendment 125 states:

“The Scottish Ministers must by regulations make provision about the management of cases where a terminally ill adult has used the substance provided to end their own life in accordance with this Act, but has not died within a reasonable period.”

What constitutes a “reasonable period” must also be specified in the regulations.

I do not wish to speculate on how often that scenario might arise. I suspect that there will be various opinions. We heard some of those during exchanges on day 2 of the committee’s deliberations at stage 2. There was an almost four-way discussion between Sue Webber, Emma Harper, Brian Whittle and, I think, Joe FitzPatrick about how often such things might happen.

However, that is to miss the wider point. Since the scenario will happen—if only occasionally—there is a need for guidance so that professionals and the public know what process should be followed in such circumstances. Such a scenario raises many complex and difficult questions of a legal, ethical and practical nature. Indeed, colleagues have been wrestling with all those questions with great thoughtfulness this morning.

For example, if the person is unconscious, should they be killed by the administration of further lethal or other substances, which, after all, would be euthanising that particular individual, against the policy intent of the legislation? Should or could such a step be taken without consent? What should the approach be if the person does not have capacity? What information should be given about such scenarios to people who request assisted dying?

Liam McArthur

Bob Doris is right that this is a very sensitive area. There is an understandable desire for as much clarity as possible. Does he accept that, at present, the guidance that is in place to medical professionals in relation to such situations is about making the patient as comfortable as possible? He is certainly right that the application of any additional substance is not what would be expected. However, the provisions in the guidance that exists at the moment would cover the situation adequately. There is a risk in putting that sort of detail in the bill—that has not been done in any other instance.

12:00

Bob Doris

I do not agree with Mr McArthur’s intervention because, currently, we have not legislated for assisted dying, and the purpose of ingesting the drug in question would be to bring about death, not to make the individual comfortable while they are still living. Right now, the guidance is silent on that and it has to be developed. I will say more about it in a moment, but my amendment 125 does not propose to include the detail in the bill, but rather to include it in regulation by affirmative procedure. Like Mr McArthur, I accept that it is challenging to include all the information in the bill. A wider consultation would be needed, which an affirmative process would provide for.

I know that we have discussed many amendments over the past couple of committee sessions, but if members recall, one of my previous amendments sought to ensure that the co-ordinating medical practitioners should have a conversation with the person who is seeking the assisted death about various matters, including about the provision of the substance that would be used at the end of their life. Amendment 91, which the committee disposed of this morning, was not agreed to, but would have made that happen. Mr McArthur has suggested that those conversations would not be required, because they are already provided for in section 7(1) of the bill. However, I think that it is important to put on record that section 7(1) includes a whole variety of items for discussion, including the nature of the substance that would be used, as I have just cited, but that it is caveated and qualified by the phrase,

“in so far as the registered medical practitioner considers appropriate”.

There is no requirement under section 7(1), which we would need clarity on. The clinician would be empowered, but not required, to have those conversations: those are two very different things, which it is important to put on record.

Liam McArthur

As in many other areas, there is a balance about the extent to which we leave matters to the discretion of individual medical practitioners and the bill laying out a requirement on them to act in a particular way. There will be different views on that. I suspect that the BMA and others may be distinctly uncomfortable with the bill going down the route of having requirements and cutting across the professional judgment of medical practitioners or, indeed, interfering with the doctor-patient relationship. I recognise that the procedure that we would be dealing with feels more significant than other areas of medicine, but the safeguards in the bill are more likely to operate effectively if they are consistent with the way in which medical practice operates more generally.

Sue Webber

Mr Doris—

Bob Doris

If possible, Ms Webber, I will respond to Mr McArthur first.

I would be very interested in the BMA’s thoughts on that. I do not want to rehearse arguments that we have heard before, but in the bill as drafted, clinicians are empowered, but not required, to discuss diagnosis and prognosis; available treatments; palliative care and other available care; and the nature of the substance, including how a death may come about. The outcome could be that an individual clinician does not have to discuss any of those things whatsoever. I think that there should be a framework to support clinicians to have those conversations. Of course, if the person who is seeking an assisted death does not wish to have those conversations, that would be their right. In some respects, my view is that the bill is silent on that, by caveating everything with the phrase,

“in so far as the registered medical practitioner considers appropriate”.

Sue Webber

Thank you, Mr Doris, for letting me come in. The member in charge of the bill has referred to the way in which medical practice operates more generally. However, from all the years that I have been working in healthcare, I am not familiar with any situation in which individual clinicians have been encouraged to do their own thing. Strict guidance and procedures apply to everything, and there are pathways for all sorts of treatments. Do you agree that not having something similar for procedures such as this would not represent medical practice as it operates more generally?

Bob Doris

Crikey, Ms Webber. I feel as though I am playing devil’s advocate on both sides of the debate. I believe that a framework is required for clinicians and that there should be supporting guidance for them but, ultimately, that a degree of discretion and professional judgment has to be used in those circumstances.

However, that professional judgment cannot be exercised in a vacuum, and I feel that Mr McArthur’s bill would lead to some of it being made in a vacuum. Similarly, although I agree with Sue Webber’s point, I am not sure that the framework should be too stringent. I will therefore go back to my amendments and say that that is why the issue should be dealt with not in the bill but by regulation and consultation. That is important.

Joe FitzPatrick

This has been a really interesting discussion. Given that even Bob Doris found himself on two sides of an argument, it might be better if he does not press his amendments. I am very sympathetic to what he is trying to achieve. If he does not press his amendments and instead has that discussion, we can see whether there is a way forward and whether we can get wider support at stage 3.

Bob Doris

Thank you, Mr FitzPatrick. I am not really on both sides of the argument, because the bill does not contain provisions on this issue. The member in charge of the bill says that we should not put that sort of detail in the bill. I agree with him to a large extent. I want it to be in regulations, and my amendment says that it should be in regulations. I intend to move the amendment to see what the committee’s views are. If it is not agreed to, I can always bring it back at stage 3, at which point I would be delighted to work with Mr McArthur to get the balance right in relation to that issue.

I return to my pre-prepared reflections. Complex questions such as this are best dealt with through detailed guidance—I have tried to make that point—rather than in the bill. However, the requirement for guidance must be in the bill, and that is what my amendment seeks. Those complex questions must be worked through, and the amendment places a duty on the Scottish ministers to consult on such matters before laying draft regulations under the affirmative process. For fairly obvious reasons, such regulations must be in place before applications for assisted dying are to be made, should the bill become law.

I am reminded of the exchange between Douglas Ross and Liam McArthur about whether the clinician should be inside or outside the room so that they can attend and take action as required. We are not sure what action would be permitted, so that has to be clarified before we have a debate about whether the clinician should be inside or outside the room. Amendment 125 and its consequential amendments would provide the certainty of a framework under which medical professionals should operate on such occasions. With that, I draw my remarks to a close.

Paul Sweeney

My amendments 245 and 275 aim to strengthen the practical framework for the administration of assisted dying safely and responsibly. They would require the Scottish ministers to provide proper training for doctors and to publish detailed guidance on what to do if complications arose, including what constitutes a “reasonable period” before death and how to respond to side effects or even failed medication, however rarely such issues might occur.

Without those provisions, clinicians could face serious medical legal risk if problems arose during the final stages of the assisted dying process. The amendments would also create a duty to report any such problems to Public Health Scotland, ensuring that issues of safety were captured and analysed to inform on-going review and improvement of the assisted dying service.

Together, I believe that those measures ensure safety and consistency during the most sensitive stage of the assisted dying process. I am also aware that the member in charge of the bill will be seeking engagement with UK Government ministers on safeguards. Such safeguards will certainly be being sought by ministers at UK Government level.

Patrick Harvie

I will speak to my amendments 127 and 137. As Liam McArthur anticipated when he commented on them, I lodged them largely as probing amendments for discussion. I was curious about how Liam McArthur and the committee would respond to the issue. As members will be aware, just last year, the Parliament, by an overwhelming majority, passed legislation to allow safe access zones for abortion services.

Abortion services can, of course, be a contentious and divisive issue within society, and they are, like the issues covered in this bill, generally regarded as a conscience matter by most political parties. In places around Scotland, we have seen a significant number of protests targeting the sites where abortion services are provided and impacting in a negative way on those accessing them, as well as on professionals working in those locations.

As Liam McArthur said, there have been protests in some jurisdictions where assisted dying takes place, but they have not necessarily been targeted at specific sites. The one instance where end-of-life issues have given rise to protests in this country relates to different circumstances, and not to assisted dying as such, and I think that it is probably fair to say that it was generated as much by online activity and information that was not necessarily accurate as by the issue itself.

I was mostly concerned that we were going to have this discussion in the context of the possibility that the Parliament might have agreed to organisational opt-outs, if our discussion last week had gone a different way. I was concerned that, if organisations—for example, providers of hospice or care home facilities—were under pressure to make an organisational decision whether they supported their residents in being able to access the assistance provided under the bill, they could become targets of the kind of protests that we have seen in relation to abortion services. Given that the committee, so far, does not seem to have gone down that route, I am minded at the moment not to move these amendments when we come to them. Obviously, though, I will want to see how the debate goes on other amendments and might revisit at least this discussion at stage 3, even if only for the purposes of debate.

The Convener

I call Brian Whittle to wind up and press or withdraw amendment 173.

Brian Whittle

I will press amendment 173, and, in doing so, I have to say that I am feeling increasing disquiet at the way in which a lot of these amendments are being dealt with, both by Liam McArthur and by the committee. These are amendments that I have lodged on behalf of the Royal Pharmaceutical Society and which Jackie Baillie has lodged at the request of the RCN, and I remind members that those are the actual people who will be at the delivery end of this bill, should it pass. I worry about the pushback against both of those groups, because, in my view, they are the experts and their views have to be taken into consideration.

Medicine is not an exact science and, as we have heard, there will be adverse reactions to medication, however rare those reactions might be. I have tried, through advance care directives, to put some protection in place with regard to a medical professional’s liability in the case that something goes wrong. Colleagues across the table here—Douglas Ross, Bob Doris, Sue Webber and Paul Sweeney—have all raised the same issues, and quite frankly, I do not think that the bill, as drafted, takes into consideration or addresses properly what happens on the rare occasions when something goes wrong.

Patrick Harvie

I am grateful to the member for allowing an intervention. I take his point, and I hear his discomfort with some of the discussion, but would he acknowledge that the member in charge of the bill has indicated openness to addressing some of the issues around how, in those rare circumstances that Brian Whittle has described, the correct information can be recorded? Liam McArthur has said that he is not convinced that any particular variant of that, as has been proposed at stage 2, is quite right, but he has indicated a willingness to work towards a consensual way of capturing that information at stage 3. Would it not be reasonable for all the members who want to see change in this area to collaborate in that spirit?

Brian Whittle

I recognise Mr McArthur’s on-going willingness to work with members and collaborate on the bill, but it seems that there is a presumption that none of the other members in the room have previously spoken to each other about their amendments.

12:15

In fact, many more amendments, including some duplicates, would have been lodged had we not spoken to each other. Members have, to date, lodged many amendments to address safeguarding issues and those amendments have been rejected, which concerns me. I have put it on the record that I voted for the principles of the bill at stage 1; I had not decided at that time which side of the argument I would fall on, come stage 3, but I said that there would have to be significant changes to the bill in respect of safeguarding if I was ever to support it at stage 3.

On the specific requests from the Royal Pharmaceutical Society and the RCN to me, Jackie Baillie and Daniel Johnson on lodging amendments, I note that the RCN is concerned because its members have to deliver on the bill, and to push back against that raises a concern for me.

Daniel Johnson

I wonder whether Brian Whittle would agree with me that there are two fundamental points here. First, it is important that safeguards are put in place, especially where those issues have been raised by the people who would be delivering the bill. Secondly, as we proceed, given the sensitivity of the issues, we have to be seen to be providing those safeguards. Those are two very important purposes. The second point is about providing strong signals and clarifying principles that we want to see if the bill is to be enacted safely with the confidence of the people who we are going to ask to deliver it. I wonder whether Mr Whittle would agree with those two distinct points.

Brian Whittle

I could not agree more with Daniel Johnson—the signal that comes out of the Parliament is incredibly important. As we have already held a session on the bill at stage 2, many of us will have already had responses by email and discussions with members of the general public and the medical profession who have raised concerns.

Liam McArthur talked about precedents for the way in which medication is delivered, but what the bill seeks to do is unprecedented. We are asking medical professionals, who operate on the “Do no harm” principle, to do something that they have never done before, so we have to take their views into consideration and ensure that the likelihood of there being any liability on a medical professional is minimised. That is why, at stage 3, I will bring back advance care directives, and should the committee push back against some of the amendments before us, they will be brought back again.

Liam McArthur

Will the member give way?

Brian Whittle

Of course.

Liam McArthur

I am grateful to Brian Whittle for taking my intervention and for his generous comments about the approach that I have taken to the bill. That remains the case, and I observe that I have been supportive of amendments from pretty much every member who has lodged an amendment. That is not to say that I have supported every amendment, but I have, in many instances, accepted the point that has been made.

I ask Brian Whittle to reflect on the fact that, even if the principle behind an amendment could be supported, it is in nobody’s interest to pass amendments that may have unintended consequences, or an amendment that would not do what it is that the member who has lodged that amendment would wish it to do. That is why, at stage 2, we have an opportunity to explore those issues, and at stage 3, we will have an opportunity to refine amendments, which I have committed to doing in many instances.

This bill is like any other bill. A lot of amendments are lodged at stage 2 to allow a debate to take place; they will not all necessarily be accepted, but that process should strengthen and improve the bill as it moves on to stage 3, where it can be further strengthened and improved, as I have committed to doing.

Brian Whittle

Again, I welcome the way in which Liam McArthur has engaged with members from across the chamber, but I disagree with him on one point. This bill is not like any other bill that we have ever had before us—it is very different from anything that we have been asked to consider previously.

My concern is that, if we do not manage to deliver some of the changes that we want and some of the safeguards that we have tried to put forward—be it that they must be reworded—it becomes increasingly difficult for people such as me, who have not made a decision one way or the other, to support that principle. I urge Mr McArthur and the committee to consider what has been said.

I press amendment 173.

Amendment 173 agreed to.

Amendment 174 moved—[Brian Whittle].

The Convener

The question is, that amendment 174 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 174 disagreed to.

Amendment 175 moved—[Brian Whittle].

The Convener

The question is, that amendment 175 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 175 disagreed to.

Amendment 76 moved—[Jackie Baillie].

The Convener

The question is, that amendment 76 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)

Abstentions

Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 4, Against 3, Abstentions 1.

Amendment 76 agreed to.

Amendment 77 moved—[Jackie Baillie].

The Convener

The question is, that amendment 77 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)

Abstentions

Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 4, Against 3, Abstentions 1.

Amendment 77 agreed to.

Amendment 124 not moved.

Amendment 176 moved—[Sue Webber].

The Convener

The question is, that amendment 176 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Sweeney, Paul (Glasgow) (Lab)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 176 disagreed to.

Amendment 244 moved—[Bob Doris]—and agreed to.

Amendment 78 moved—[Jackie Baillie].

The Convener

The question is, that amendment 78 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)

Abstentions

Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 4, Against 3, Abstentions 1.

Amendment 78 agreed to.

Amendment 10 moved—[Daniel Johnson]—and agreed to.

Amendment 79 moved—[Jackie Baillie].

The Convener

The question is, that amendment 79 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)

Abstentions

Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 4, Against 3, Abstentions 1.

Amendment 79 agreed to.

Amendment 177 moved—[Brian Whittle].

The Convener

The question is, that amendment 177 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 177 disagreed to.

Amendment 178 moved—[Brian Whittle].

12:30

The Convener

The question is, that amendment 178 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 178 disagreed to.

Amendment 179 moved—[Douglas Ross].

The Convener

The question is, that amendment 179 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Mochan, Carol (South Scotland) (Lab)

Abstentions

Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 179 disagreed to.

Amendment 180 not moved.

Amendment 33 moved—[Liam McArthur].

The Convener

The question is, that amendment 33 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Against

Whittle, Brian (South Scotland) (Con)

The Convener

The result of the division is: For 7, Against 1, Abstentions 0.

Amendment 33 agreed to.

Amendment 181 moved—[Sue Webber].

The Convener

The question is, that amendment 181 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 1, Against 7, Abstentions 0.

Amendment 181 disagreed to.

Amendment 182 moved—[Sue Webber].

The Convener

The question is, that amendment 182 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 2, Against 6, Abstentions 0.

Amendment 182 disagreed to.

Amendment 183 moved—[Sue Webber].

The Convener

The question is, that amendment 183 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 4, Against 4, Abstentions 0.

As convener, I use my casting vote to vote in favour of the amendment.

Amendment 183 agreed to.

Amendment 184 moved—[Stuart McMillan].

The Convener

The question is, that amendment 184 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Harper, Emma (South Scotland) (SNP)
Haughey, Clare (Rutherglen) (SNP)
Mochan, Carol (South Scotland) (Lab)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

The Convener

The result of the division is: For 5, Against 3, Abstentions 0.

Amendment 184 agreed to.

Amendment 245 moved—[Paul Sweeney].

The Convener

The question is, that amendment 245 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 245 disagreed to.

Amendment 185 moved—[Brian Whittle].

The Convener

The question is, that amendment 185 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 185 disagreed to.

Amendment 34 moved—[Liam McArthur].

Amendment 34A moved—[Liam McArthur]—and agreed to.

Amendment 34B moved—[Paul Sweeney]—and agreed to.

Amendment 34, as amended, agreed to.

Amendment 70 moved—[Jackie Baillie].

The Convener

The question is, that amendment 70 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

FitzPatrick, Joe (Dundee City West) (SNP)
Harper, Emma (South Scotland) (SNP)
Harvie, Patrick (Glasgow) (Green)
Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP)

Abstentions

Mochan, Carol (South Scotland) (Lab)

The Convener

The result of the division is: For 3, Against 4, Abstentions 1.

Amendment 70 disagreed to.

Amendment 186 not moved.

Amendment 35 moved—[Liam McArthur].

Amendments 35A and 35B moved—[Liam McArthur]—and agreed to.

Amendment 35, as amended, agreed to.

Section 15, as amended, agreed to.

After section 15

Amendment 125 moved—[Bob Doris].

The Convener

The question is, that amendment 125 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division

For

Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

Abstentions

Haughey, Clare (Rutherglen) (SNP)

The Convener

The result of the division is: For 2, Against 5, Abstentions 1.

Amendment 125 disagreed to.

Amendment 187 moved—[Stuart McMillan].

12:45

The Convener

The question is, that amendment 187 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 187 disagreed to.

Section 16—Final statement

Amendment 126 moved—[Douglas Ross].

The Convener

The question is, that amendment 126 be agreed to. Are we agreed?

Members: No.

The Convener

There will be a division.

For

Haughey, Clare (Rutherglen) (SNP)
Sweeney, Paul (Glasgow) (Lab)
Whittle, Brian (South Scotland) (Con)

Against

The Convener

The result of the division is: For 3, Against 5, Abstentions 0.

Amendment 126 disagreed to.

Section 16 agreed to.

The Convener

With the conclusion of consideration of section 16, I suspend the meeting until 6 pm.

12:46 The second part of the meeting will be published tomorrow, 21 November 2025, as soon as the text is available.

Assisted Dying for Terminally Ill Adults (Scotland) Bill

Health, Social Care and Sport Committee [Draft] Business until 12:46

Meeting date: Tuesday, November 18, 2025

Contents

Assisted Dying for Terminally Ill Adults (Scotland) Bill: Stage 2