I think that I have explained that the conversations that would be had as part of the assessment of the rationale for why a request has been made are not happening at the moment. Therefore, the bill would not only provide protections but extend them far more widely to those who are currently left vulnerable.

Moving on to amendments 85 to 87, 104, 105, 107, 112, 118, 120, 124, 139 and 140, lodged by Bob Doris, I consider that personal choice and autonomy is at the heart of the bill, which provides appropriate and proportional safeguards, while allowing those who wish to have assistance to be able to access it in a reasonable time and within a reasonable framework. It is fundamental that a terminally ill adult makes the choice to request assistance themselves without coercion or pressure by another person. The bill clearly provides for that and makes it an offence to coerce or pressure a person into requesting assistance and, as I have said, I have also lodged an amendment that adds the offence of coercing or pressuring a person into using an approved substance.

However, I am very wary about widening the current definition of coercion or pressure from some form of illegitimate influence being brought to bear by another person, to something that is done by the person themselves, societal expectations, or by the health and social care system, as opposed to individuals within the system or in the state. I am concerned that defining coercion and pressure in such a way would risk introducing new definitions of legal terms, which would create confusion and make the detection of coercion or pressure and the prosecution of offences in the bill more difficult.

I understand what the member is getting at with those amendments and I understand that there are various factors that may express a person’s vulnerable status and situation, which would potentially make them prone to influence and could affect their decision making. However, I believe that retaining the need for coercion or pressure to be an act that is done by another person, supported by the offences in the bill and the ability for other health, social care and social work professionals to input into the assessment process, is the best way to proceed.

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 am using you as an intermediary between me and Mr Doris. The approach needs to be consistent with the GMC guidance. Consistency across other areas of healthcare is important in reducing the scope for confusion or uncertainty, so I am happy to look at that. Putting guidance in the bill seems potentially problematic, but I am happy to work with Mr Doris and Mr McMillan on how to express that better, if that is felt to be necessary.

I am sure that that guidance will be updated as understanding of coercion develops. Putting it in the bill might be problematic, but I understand Bob Doris’s and Stuart McMillan’s points, and I am happy to work with them ahead of stage 3.

I thank Jeremy Balfour for that, and for clarification that amendment 143 is more of a probing amendment. As I say, it is important that we have this discussion, because it is a live debate. As I will touch on shortly, similar prognosis periods are applied in other jurisdictions.

Although a prognosis period of six months was initially proposed for the Social Security (Scotland) Act 2018, Parliament’s view was that, because of the practical difficulties with that, it would be more appropriate to set no timeframe.

Many who gave evidence to the committee at stage 1 took that view, noting how difficult it can be for a professional to estimate with any confidence how long a terminally ill patient has to live. That will depend on the condition. The committee’s stage 1 report concluded:

“on balance, the Committee recognises the rationale ... for not including a prognostic timescale in the definition of terminal illness set out in the Bill and for arguing that it is ultimately better to leave determination of whether or not an individual meets that specific eligibility criterion to clinical judgement.”

As the chair of the cross-party group on palliative care, Bob Doris will be aware that the debate on such care was nothing like as prominent as it has been since I announced my intention to introduce the bill. That bears out the evidence that the committee heard from witnesses in Australia that, as a result of the conversations and the safeguards that are in place on assisted dying, engagement with palliative care improves. Simply asserting that there is a zero-sum game here would be inappropriate and is not borne out by the evidence.

Elena Whitham made the point that discussions on palliative care need to be voluntary. Tying that to the requirement for there to be a plan—whether it is an anticipatory care plan or a palliative care plan—runs the risk that someone who would be eligible under the criteria would be unable to access the choice that they wish to make.

This is probably more a question for the representatives of the fishing sector, but I will not be here for the session with that panel, so I will chuck it in now.

With regard to the discussions that Phil Taylor and Calum Duncan mentioned, to what extent is there an understanding of the likely impact of displacement of effort on other areas? If there is a displacement, there will be increased effort in those areas, albeit that they might be better able to sustain such activity. Phil or Calum, would you like to address that?

I am grateful for that answer.

As I say, “ordinarily resident” is a legal concept that is understood. I noted the concerns that Police Scotland raised. I would be interested to know whether Police Scotland feels that there is an alternative definition that would address its concerns. The concept is fairly well established, and I do not know whether there is a way of defining it in the bill any differently from what is set out in the explanatory notes and policy memorandum, which I think make the policy intent clear.

That is another area where I would be happy to reflect on any proposed changes. However, the fact that the “ordinarily resident” requirement sits alongside a requirement for people to be registered with a GP probably gets around the concerns.

I understand where Police Scotland is coming from because it engages more often with the criminal law, and perhaps that is where some confusion arises, but I am fairly comfortable that that concern has not been raised by others and that the concept is pretty well established and understood.

I was interested in those exchanges. To go back to Ms Mochan’s questions, I note that that element might well fall more appropriately into guidance. However, the self-administration element is an integral part of the process.

It is worth reflecting not so much on the differences between the bill that I have introduced and the bill that is being considered by Westminster but on the fact that, in other jurisdictions that have similar legislation, very often, the medication is dispatched to the patient and the medical professional is not present when the medication is delivered.

I am happy to look at whether further refinement of that is necessary. It is an important safeguard that the medic is there, not least to ensure that a final assessment of capacity and intent is made.

There is a feeling that an individual may wish, in their final moments, to have a degree of privacy. How you manage that while ensuring that there are safeguards is probably a question to reflect on further. As I have said, the safeguard that is in the bill seems to be robust; it is absent from other jurisdictions, which does not seem to be a problem, but that is for those jurisdictions, rather than me, to justify.

As you will be aware, the schedules to the bill are effectively the forms for this and other aspects of the reporting requirements. It is important that death certificates reflect the underlying progressive advanced terminal illness that gave rise to the application, as well as the fact that medication had been administered to allow for an assisted death. For clarity and transparency, both those things need to be captured, which is what the schedules to the bill set out.

From my initial discussions with the chief medical officer, I recognise the legitimate concern that there may be some sensitivity about the way in which the information is expressed and the distinction between suicide and assisted dying, which goes back to an earlier point. The chief medical officer and his colleagues helpfully suggested that codes are used for registrations that may allow for that information to be captured in a way that respects and acknowledges the sensitivity of what we are discussing.

I am keen to explore that further, but it is important that we understand who is accessing the option of assisted death, what conditions are involved, when people are accessing it and their sociodemographic characteristics. We need as much information as possible—anonymised, of course. As we might touch on later, it will be crucial to report on and understand the picture of how the legislation is working in practice. There are the annual reports, which will feed into the five-year review that is also set out in the bill.

If we look at other jurisdictions, we see that there are a lot of similarities in who is accessing assisted dying, the reasons why they are doing so and the demographic profile, but to my mind it is absolutely essential that we gather information in Scotland. In fact, the only element of my proposals that changed between the initial consultation and when I brought the bill to Parliament was in respect of tightening up the data-reporting requirements that were envisaged. For public confidence, and for the confidence of patients and medics, the more robust those requirements are, the better.