Chamber and committees

I do not consider that to be acceptable whatsoever. The point that I am trying to make is that we want to ensure that the bill includes the most robust safeguards. My contention is that clear, accurate and comprehensive reporting would be a significant part of that provision.

Amendment 295, in the name of Murdo Fraser, and my amendment 275 would better ensure that suicide prevention support for those who are vulnerable is available to people who are considering taking their own lives. Having reviews would mean that the Government would be better equipped to take corrective measures when issues arose, if the bill was passed. Safeguarding must be at the heart of any legislation that relates to the use of lethal drugs.

I will pick up on a couple of the points that were made during members’ contributions. Returning to amendment 64, I completely agree with the points that Bob Doris made about the importance of having qualitative data rather than just numbers. That is worth drawing out in the debate, although I acknowledge the points that have been made about the difficulty and the practicalities that might be involved in collecting the data that is set out in amendment 64. I am also drawn to Bob Doris’s comments about amendment 296, which I will certainly reflect on.

In closing, although I urge members to support the amendments in this group, I must warn that they can go only so far in pushing back against the incrementalism that could arise if we chose to endorse people taking their lives by voting to pass the bill.

I press amendment 275.

In opening the debate on this group of amendments, I described them as “straightforward.” However, that might have been to unintentionally understate the crucial importance of data and reporting, given that we know that, where assisted dying is legalised, reporting provisions have sometimes, sadly, served as mechanisms for either widening eligibility and relaxing safeguards or not taking corrective action when major issues are flagged. It is crucial that relevant and accurate information is captured, so that vulnerable individuals who could be harmed by assisted dying legislation—those with physical and learning disabilities, people with eating disorders, victims of domestic abuse, those in poverty and many others—remain protected by robust safeguards and so that the operation of the legislation does not drift over time.

Jackie Baillie’s amendment 280 would require the number of persons aged 18 or under who requested assistance to end their lives under this regime to be recorded. I welcome this amendment, which would increase accountability. We know that, shockingly, there have been successful efforts in some jurisdictions to broaden access to assisted dying to that age group. In Canada, a 2023 parliamentary committee review of Canada’s assisted dying legislation recommended the expansion of assisted dying to children, although I note that the recommendation has not yet been advanced. We know that public support in Scotland falls quite significantly when people consider the fact that, in the Netherlands and Belgium, children of any age may, in certain circumstances, be eligible for assisted dying. That tells me that the public view the risk of that becoming a provision in Scotland as being just too high.

I note Liam McArthur’s clarification on amendment 57. Although the amendment seems innocuous, I am worried about the unintended ramifications, given that it would replicate the type of recording that is used in Australia, which has subsequently been used by review boards and campaigners to argue for widening access.

14:00

I very much note and accept the member’s point about different models. To draw on his comments, perhaps it is the case that different models have different strengths and weaknesses.

My amendments 275 to 277 and the amendments in the names of Bob Doris, Emma Roddick, Miles Briggs, Sue Webber and Murdo Fraser all attempt to bolster reporting and increase accountability. I consider that they are proportionate and that they will strengthen and complement reporting. However, I am also mindful of the comments that have been made about overlap and duplication.

That brings me on to issues that have been flagged in Oregon, where more than two thirds of the data have been found to be missing in reports on matters such as complications. Annual reporting has shown that, in practice, the application of the terminal illness threshold has expanded well beyond a normal understanding. Despite that being clear in annual reporting, issues have not been rectified. I doubt that that was the original intent of lawmakers. In fact, last year, in Washington state, they decided that, due to budget restrictions, they would drop annual reporting on their operation of assisted dying altogether. The evidence from abroad flags for us the issue that, even with the best reporting, incrementalist expansion and a lack of corrective action remain a risk. I draw members’ attention to amendments 289, 296 and 116, in the names of Stuart McMillan, Stephen Kerr and Sue Webber, which attempt to address the issue.

I, too, commend the Scottish Government’s suicide prevention strategy, which is world leading, as Kevin Stewart highlighted earlier. I had the privilege of supporting the development of that strategy in its fairly early format—and that was certainly not yesterday. The strategy is essential when it comes to issues such as the vulnerability of terminally ill people who are considering ending their own lives. We know that, with proper support, the desire to die diminishes.

I seek clarification of the member’s earlier response to the Deputy First Minister on the question whether assisted dying is understood to be a “reasonable” treatment option under the Montgomery ruling, which says that, by law, a doctor must offer all reasonable treatment options.

I am concerned about the member’s response to that query. Some of that concern is driven by a conversation that I had with a consultant in my constituency, who is very anxious about this proposal in the context of the impact that it would have on the doctor-patient relationship.

During the consideration of stage 3 amendments, there has been on-going interest in how the bill might impact our palliative care provision, and not least our hugely valued hospices. As colleagues who represent constituencies that contain a hospice will know, they are very dependent on charitable giving; they rely on it for approximately two thirds of their income.

Therefore, we must tread carefully in crafting the bill to ensure that the already delicate funding situation for our hospices is in no way weakened. Amendments 251, 253 and 254 would alter section 22A to require formal assessment of the act’s impact on hospices and palliative care every three years after it comes into operation. The amendments would ensure on-going monitoring rather than a single discretionary review and would require publication within six months, which would enhance transparency.

I would not argue with those findings, and I am sure that that evidence is robust, but there is evidence elsewhere that reflects a very different picture. The thrust of my amendments is to ensure that we can monitor, using an on-going method, the impact of an assisted dying provision on palliative care.

By linking to section 22A(2), the assessments would cover staffing, operations, funding streams and regulation. That would provide clear evidence of how the act affects end-of-life care services over time, and would enable policy makers and the public to identify and address any emerging pressures or issues. Given the heavy reliance of hospices and palliative care on charitable donations, which can fluctuate depending on factors such as cost of living and sustainability of Government funding, that is significant.

As the anticipated costs of assisted dying have not yet been settled, we must take every precaution to ensure that there are no unintended consequences as a result of passing the bill, if it does pass. I trust that colleagues will feel able to support amendments 251, 253 and 254 as important additions to the bill.

I am keen to remind members that the provision of palliative care is not just the provision of that care itself; it includes workforce planning and staff training, often in specialist roles, and there are potentially significant additional costs for colleges, universities and other teaching environments.

I agree with the points that the member made, and the concerns about the impact of introducing assisted dying legislation on palliative care provision. I am aware that research in Europe shows that there has been a clear trend in palliative care funding being devalued. Where care funding has increased, it has not been anywhere near in line with funding in countries that do not have assisted dying. That has increased significantly. I take the point that the member made, and I agree with it.

I am interested in the issue around the word “independent”. I understand the rationale for the member’s amendments, but I am interested in what reassurance can be provided that an independent advocacy service is truly independent. That circles back to the issue of coercion, which has cropped up regularly over the past few days.

The strategic importance of the aerospace, defence and space industries to Scotland cannot be overstated, as they add £3.7 billion to the economy and currently employ just under 37,000 people. I welcome the fact that many Scottish colleges and universities are developing active partnerships with the sectors, a great example of which is the National Manufacturing Institute Scotland, which is hosted by the University of Strathclyde. I also note today’s announcement of the Scottish defence growth deal and the skills aspect within that.

However, a significant roadblock that is impeding future growth and prospects is the chronic skills shortage, particularly in science, technology, engineering and mathematics. Does the minister agree that, in order to address that challenge, we must see in the next parliamentary session an expansion in the scale of engineering skills provision, stronger industry collaboration and the expansion of models such as the National Manufacturing Institute Scotland to secure our future skills needs in such vital sectors?