Chamber and committees

Before I speak to my amendments, I draw members’ attention to the fact that, in the past few minutes, we have received an email from the Royal Pharmaceutical Society in Scotland, which has stated its opposition to the bill following the removal of vital protections to protect pharmacists who conscientiously oppose assisted dying.

That goes to the heart of what some of the amendments in this group are about. We should make decisions that are driven by data. My amendments 115 and 116 seek to strengthen reporting and accountability in relation to the use of approved substances under section 15(1). They would require any complications, side-effects or adverse reactions, which were experienced by persons who were provided with an approved substance, to be documented in detail. Those details should include the type and frequency of the side effects, the substance that was used and any clinical or professional recommendations that were made to address those issues.

All drugs have side effects. Last week, we heard from a palliative care doctor about how specialised the service that they offer is, how every patient is different and that drugs act differently in every patient’s circumstance. I made those points when I spoke to my amendments at stage 2, but they were cast aside by those who claim to be nurses.

We know that the cocktail of drugs that is used in assisted dying is a toxic combination that includes paralytics. We are not sure what a person who undergoes an assisted death goes through, because the paralytics act first and quickly. It is a not a Disney death, and serious side effects happen. For some people, the drugs do not work, and other people take hours to die. We heard about those people earlier this week from Ruth Maguire and Audrey Nicoll.

The term did not relate to what your mother experienced. [Interruption.]

The term related to many people’s perception of what an assisted death would look like. We have heard from other members that that is not the reality. We must stop pretending that that is the reality, because it is not. Serious side effects happen. For some people, the drugs do not work, and other people can take hours to die. If we did not monitor and record those situations carefully, we would be unable to ensure that the service was as safe as it possibly could be.

As we have just heard, this is clearly an incredibly difficult subject. I may or may not be getting my point over succinctly, but emotions in the chamber are—and have been—high.

Studies from the Netherlands and the US have noted that, although complications are infrequent, they do occur, with some reports citing rates of 1.2 per cent to 7 per cent, depending on the methods—that is, whether the method is intravenous or oral. Those complications can and do cause distress and often require the administration of additional medication to complete the process. We have not yet had clarity in the debate about what would happen if the drugs did not work.

Amendment 116 would also impose a statutory duty on the Scottish ministers to ensure that all recommendations were acted on

“within 6 months of receiving a report”,

and to publish a statement describing the measures that have been taken. The purpose of the amendment is to improve patient safety, enhance transparency and ensure that lessons from adverse outcomes are systemically applied to prevent reoccurrence.

Colleagues, this is a flawed bill. We can tinker around the edges and try to make it safe, but it is fundamentally flawed. Within the powers that this Parliament has, we are unable to pass a safe bill, and we should therefore not pass this bill. We cannot legislate for the drugs that would be used, for the training of healthcare professionals or for what would happen if the drugs did not work.

I am sorry, but I do not accept that. We have asked Mr McArthur today, yesterday, last night and at stage 2 what would happen and what a healthcare professional should do if an individual takes a substance and it does not lead to their death. Do they then perform their traditional role—I think that was it—and intervene to save their patient’s life, or do they take steps that would lead to that patient’s death? That is the answer that we have been seeking.

The clarification is in the amendments that we have presented today, because the provisions that we are considering demonstrate that the bill falls short of that. Without the amendments in this group, the bill will be deeply silent on the serious scenarios that we have outlined. What if that lethal substance does not end a person’s life?

Perhaps Mr McArthur can help me to understand. When he is talking about that informed discussion between the healthcare professional and the patient seeking the assisted death, is he suggesting that there would be a conversation between those people, in which the patient said, “Should I take the substance and it did not kill me, I would want you to make sure that my life ended”?

Yes, I will.

As a University of Edinburgh alumna, I am pleased to speak in this debate to recognise 300 years of medicine being formally taught at the university and celebrate the profound legacy of its renowned medical school. I thank Martin Whitfield for bringing the topic to the chamber for debate.

Three centuries of medical scholarship is an extraordinary milestone. Established during the Scottish enlightenment in 1726, Edinburgh medical school quickly became one of the world’s leading centres of medical teaching and research, attracting students from across Europe and beyond. Its influence is global: graduates went on to found medical schools at Harvard University, Yale University, McGill University and the University of Sydney, among many others, which demonstrates the truly international reach of Edinburgh’s medical tradition.

For me, as a student between 1990 and 1995—I hate to give away my age—that sense of continuity was ever present. Walking into the category‑A‑listed Teviot Place medical school building—which was designed by Sir Robert Rowand Anderson and built between 1876 and 1886 in the Italian renaissance style—was a reminder that we were entering a place shaped by generations of discovery.

My studies included forensic medicine for lawyers, which was taught by Professor Busuttil, whose meticulous approach to medico‑legal evidence left a lasting impression. They also included medical microbiology, where the classes, lab work and tutorials made even the smallest organisms fascinating. However, members should still not ask me about Gram-positive and Gram-negative bacteria.

All those courses were delivered in the iconic square tower, which made them even more memorable. I still remember the sense of vertigo in the lecture hall where I had my forensic medicine classes, which is where anatomy lectures used to take place many decades ago—perhaps I will make some remarks about Burke and Hare later on. Those courses exemplified Edinburgh’s unique ability to blend scientific rigour, clinical relevance and interdisciplinary thinking.

As we mark 300 years, this anniversary gives us not only a reason to celebrate but an opportunity to reflect honestly on the past. We have not only exceptional achievement in our history but some challenging periods, such as the infamous Burke and Hare murders of 1828, which were driven by the intense demand for cadavers during the city’s rise as a global centre of anatomical teaching. Confronting the whole of that history is vital to understanding the evolution of medical ethics and the responsibility that accompanies scientific advancement.

The university’s medical story has always been intertwined with Scotland’s healthcare system. From the founding of the royal infirmary in 1729 as one of the earliest teaching hospitals in the UK to the post-war development of the national health service, Edinburgh’s clinicians and researchers played central roles in shaping public health and clinical practice. That legacy continues today through world-class research at sites including the royal infirmary and the Western general, which remain key teaching centres for the medical school, although the medical school has moved out of the city centre to Little France.

The programme marking Edinburgh medical school 300 embraces that heritage while looking ahead. It features a series of lectures, exhibitions, interactive digital timelines and historical explorations that uncover newly documented stories from the school’s past. At the same time, cutting-edge research is still going on across life sciences, digital health, innovation and clinical medicine, reflecting the institution’s on-going contributions to global scientific progress. Community engagement is also central to the anniversary programme. Public events and festival-related activities give residents and visitors an opportunity to explore Edinburgh’s medical heritage and understand the medical school’s continuing economic and societal contribution.

Edinburgh medical school’s impact over the past 300 years cannot be overstated. It has shaped modern medicine, contributed profoundly to global scientific knowledge and continues to train the clinicians, researchers and innovators on whom the future of healthcare will depend.

I congratulate the organisers of Edinburgh medical school 300 for curating such a rich and forward-looking programme, and I wish all the staff, students and alumni every success as they celebrate that significant milestone.

13:11

On a point of order, Deputy Presiding Officer. I am trying my best to listen to the remarks and the debate between Mr Doris and Mr Kerr, but all I can get in the background is another member who is chuntering away because they do not accept the order from the chair—[Interruption.]

Amendment 119 would strengthen the statutory review by requiring Scottish ministers to examine, document and report on potential risks, failures and unintended consequences arising from the operation of the legislation. It would ensure that the review considers clinical safety, the effectiveness of safeguards against coercion or undue influence, the accuracy of eligibility assessments and any differential impacts on vulnerable groups. The amendment proposes transparency, evidence-based evaluation and informed parliamentary scrutiny of how the legislation operates in practice.

We have discussed the importance of recording key outcomes of the bill, and I have spoken about the side effects of the drugs. However, we must also record other differentials. Last week, we heard from Tanni Gray-Thompson, who reminded us that the six-month prognosis can be very different for someone who has economic means compared with someone who does not. Doctors might consider someone who is homeless or without family support as having a shorter prognosis than someone who has money to spend on treatments and care and who has a supportive family around them. Earlier in our stage 3 considerations, we also heard about the difficulties in making an accurate prognosis and the factors that can affect that. All those things must be recorded and reported on to ensure transparency and safeguarding.

We cannot have a bill that impacts the vulnerable differently. Amendment 119 would simply ensure that those differentials are recorded and monitored so that we can act if we see those who are homeless, those living in poverty and the disabled being pushed into an assisted death due to circumstances rather than illness.

Colleagues, that will happen. The length of prognosis for someone living in poverty will be different from that for someone who is not living in poverty, and, as I have said before, the bill is deeply flawed and will impact those who are already struggling to a greater extent than those who are living with means. It is shocking that we have to consider such a situation and that I have to lodge an amendment that does nothing to stop it and only records it, but that is where we are. Although I remain steadfastly against the bill, I am doing what I can to raise awareness around some of the issues that it contains and around the ways in which we can protect the most vulnerable in Scotland.

Indeed, Mr Kerr. I believe that the original text fails to define the scope of immunity with the precision that legislation of this gravity demands. Without that clarity, doctors and carers could find themselves unsure of their legal position if a patient survives the initial attempt.