Again, I reject the reference to “assisted suicide”. We can have a debate at another point about the difference between the mental state of someone who is seeking to take their own life and someone with a terminal illness who is seeking to take control over that process.

What I have said, and what is set out in the bill as it stands, is that this relates to someone with an “advanced and progressive” condition. Although I understand the argument for setting a prognostic timeframe—and I welcome the fact that we are having this debate—the committee concluded from the evidence that it took that doing so would be problematic. On that basis, I do not support the amendments on that, and I urge Bob Doris not to press them.

On amendments 145 and 207 by Brian Whittle and amendments 25, 30 and 31 by Rhoda Grant, I fully support the principle of a terminally ill adult having available information and options explained to them and having in place appropriate care plans—including for palliative care, where appropriate—if they wish. That is why section 7(1) would require the assessing doctors to explain and discuss the person’s diagnosis and prognosis, available treatment, palliative and other care options, and the assisted dying process and the substance that would be used. It is also why I lodged amendment 29, which aims to ensure that palliative care discussions include available hospice care, symptom management and psychological support.

As Sandesh Gulhane suggested in his intervention, greater use of advanced care plans would be welcome and would help to increase the likelihood of people having their wishes respected, but it is important that such plans remain voluntary. I am therefore not supportive of adding to the eligibility criteria in the ways that are proposed in the amendments, which would include a person having an anticipatory care plan or a palliative care plan in place. Doing so would risk adding a barrier to a terminally ill adult who is otherwise deemed eligible being able to access assistance because, for example, they did not want such a plan or did not wish to have palliative care, which can be a matter of personal choice.

I get the point that you are making. Ideally, one would want people to have as much advance planning, including in terms of palliative care, as possible. However, making such plans part of the eligibility criteria is highly problematic, for some of the reasons that I have touched on. I will come on to address those in more detail. Making such plans part of the eligibility criteria could result in a terminally ill adult, who would otherwise be eligible but has a short time to live, dying before such a plan could be put in place.

The Scottish Government has also highlighted the chief medical officer’s confirmation of a

“change in terminology from ‘anticipatory care planning’ to ‘future care planning’”,

while noting—and I agree—the following:

“The process of developing a future care plan should be holistic and person-led, with a focus on shared decision-making. As such, setting out that a person must have a plan in place which must include a plan for palliative care in order for them to be eligible for an assisted death goes strongly against this person-led ethos, given that some people may not want palliative care for a number of reasons.”

Regarding Pam Duncan-Glancy’s amendments 219, 221, 222 and 228, I fully support people with terminal illnesses having full access to social care. However, I am concerned about adding a requirement for a person to have such care in place in order to meet the eligibility criteria for assistance. I do not agree that a person should be ineligible for an assisted death if they have not accessed social care or if they have been on a waiting list to access social care for six continuous months. Adding such a requirement risks adding a barrier to a terminally ill adult who is otherwise deemed eligible to access assistance.

Regarding Ms Duncan-Glancy’s amendment 227—

First, I thank all members for setting out the rationale for their amendments. I have great sympathy with the motivation in every instance; I am particularly grateful to those who are opposed to the bill but who are seeking to strengthen it—in this case, in relation to eligibility.

I have not lodged any amendments in this group, but I will address those that have been lodged. I note that amendment 222, in the name of Pam Duncan-Glancy, is pre-empted by amendment 26 in the previous group on definition of terminal illness, and that amendments 2, 3 and 1 in the name of Sandesh Gulhane are direct alternatives to Claire Baker’s amendments 152, 168 and 215. I will return to those amendments shortly.

On Bob Doris’s amendments 83, 108, 119 and 97, for which he gave us a spoiler alert in the discussion on the previous group, I stated in relation to that group that I have concerns about adding a period of life expectancy to a terminal illness definition, and I have similar concerns about amending eligibility requirements so that someone must be

“reasonably expected to die within six months”.

I will not repeat what I have already said, but I note that the Australian Capital Territory, having learned from other states in Australia and elsewhere, has chosen not to set a fixed timeframe for eligibility. Instead, it requires that a person’s condition be

“advanced, progressive and expected to cause death”,

focusing on the reality of end of life rather than an arbitrary time limit. We see there the evidence of who is accessing this, and the point in their prognosis at which they are accessing it.

That is borne out by the research that the committee heard about by Professor Ben Colburn at the University of Glasgow, which should allay some of the concerns about disproportionate vulnerability or the extent to which those with a disability will access that choice.

I get the point that you are making. Ideally, one would want people to have as much advance planning, including in terms of palliative care, as possible. However, making such plans part of the eligibility criteria is highly problematic, for some of the reasons that I have touched on. I will come on to address those in more detail. Making such plans part of the eligibility criteria could result in a terminally ill adult, who would otherwise be eligible but has a short time to live, dying before such a plan could be put in place.

The Scottish Government has also highlighted the chief medical officer’s confirmation of a

“change in terminology from ‘anticipatory care planning’ to ‘future care planning’”,

while noting—and I agree—the following:

“The process of developing a future care plan should be holistic and person-led, with a focus on shared decision-making. As such, setting out that a person must have a plan in place which must include a plan for palliative care in order for them to be eligible for an assisted death goes strongly against this person-led ethos, given that some people may not want palliative care for a number of reasons.”

Regarding Pam Duncan-Glancy’s amendments 219, 221, 222 and 228, I fully support people with terminal illnesses having full access to social care. However, I am concerned about adding a requirement for a person to have such care in place in order to meet the eligibility criteria for assistance. I do not agree that a person should be ineligible for an assisted death if they have not accessed social care or if they have been on a waiting list to access social care for six continuous months. Adding such a requirement risks adding a barrier to a terminally ill adult who is otherwise deemed eligible to access assistance.

Regarding Ms Duncan-Glancy’s amendment 227—

I hear what Jeremy Balfour is saying in relation to the prognosis period, but I think that that uncertainty exists—we would find few, if any, health professionals who would not acknowledge it—and is a factor in decisions that are taken about many types of treatment over which we seem comfortable in allowing medical health professionals to use their best judgment in coming to a decision.

I think that Patrick Harvie’s point was that placing further undue pressure on them to come up with an accurate timeframe of diagnosis, which is particularly challenging in some conditions, is not in the interests of the health professionals nor of the patients who may be vulnerable and may have questions about the options that are available to them.

Yes—briefly.

I am afraid that I am going to proceed, Mr Balfour.

The Scottish Government has identified potential legislative competence issues. I am aware that the Scottish Government is working with the United Kingdom Government to ensure the full operation of the bill, should it be passed. Although the Cabinet Secretary for Health and Social Care is not here to update us on those discussions, it is important to acknowledge the issues that those amendments raise.

Amendment 256 seeks to amend the Public Bodies (Joint Working) (Prescribed Health Board Functions) (Scotland) Regulations 2014 by adding the assisted dying for terminally ill adults legislation to its schedules. I am supportive of that amendment.

On amendment 257, I have always taken the view—I think that it was reiterated by Sandesh Gulhane earlier—that it is for the healthcare sector to determine how to manage the assisted dying process within the parameters of the bill. Fulton MacGregor acknowledged that in his remarks. Therefore, my feeling is that it should be left to the health and care sector to determine whether it would be appropriate for each health board to set up a specialist assisted dying process.

Amendment 257 mandates that every health board set up a service, while amendment 256 mandates joint working with the local authority. I wonder whether the amendments are proportionate and not overly restrictive. I understand absolutely what Fulton MacGregor is driving at and the reasons why the RCN and others wanted the amendments to be lodged and want them to be agreed to. There are certainly examples in other jurisdictions in which provision is mandated in similar ways, which, ostensibly, is to ensure access. I am happy to work with Mr MacGregor ahead of stage 3 to see whether something more proportionate might be achievable.

Amendment 277 is a consequential amendment to ensure that—

I will in a second, Mr Doris.

In an intervention on Sandesh Gulhane, I recognised that the bill would put in place safeguards that do not exist at present. Those are in relation to access to an assisted death and more widely to those who are vulnerable, who may have a terminal illness and who, at the moment, are being left without support or the opportunity to discuss their concerns and the situation in which they find themselves.

I am happy to take the intervention. I think that it was from Bob Doris—or was it from Daniel Johnson?

Briefly, yes.

Will Mr McMillan take an intervention?