Chamber and committees

I want to explore a little bit further the issue of palliative care that Dr Gulhane raised earlier. I hope that I am not putting words in your mouth, Mr McArthur, but I think that you would agree that the ideal scenario is for people to have access to palliative care as well as assisted dying. However, we know that that is not the case; indeed, one in four Scots is not getting access to palliative care. As you have highlighted, the bill is shining a light on the provision of such care, and I think that that is very welcome.

The other thing that we have heard about is the inequality of access to palliative care between Scottish index of multiple deprivation level 1 and SIMD level 5 areas. My question, then, is this: do you want the bill itself to guarantee access to palliative care alongside access to assisted dying?

You are absolutely right that palliative care is not for everybody and that, if the bill passes, the fact that someone does not access palliative care should not prevent them from accessing assisted dying. I fully understand where you are coming from with that. The concern is that if someone seeks palliative care and it is not accessible, the pressure towards assisted dying grows. That is the concern. If somebody speaks to their GP and requests more information on or to start the process of assisted dying, at that point, should the GP discuss palliative care options and what happens if they are not available?

Good morning, Mr McArthur. I have a quick supplementary around the vulnerable disability group. We had a round-table session in the Parliament with a variety of really excellent contributors, one of whom was the father and guardian of an adult son who had a learning disability. He pressed us really hard around the human right of his son should he request assisted dying—however, he has guardianship of his son. Where does the bill fit with that scenario?

I will move to the topic of unassisted suicide. Some people have told us in evidence that the bill might have a positive impact in reducing the number of unassisted suicides, although others have said that it will have no impact.

I have a practical question. Have you discussed that with insurance companies and do you know their take on whether assisted dying would be deemed to be suicide and might therefore make insurance policies unworkable or those deaths ineligible for insurance payouts? Have you had that conversation?

You highlight the issue of those who have a terminal diagnosis. That will inevitably have some impact on their mental health, and, as you say, the suicide rate among that cohort is about two and half times the norm. I will push again on the issue of access—or lack of access—to other services. Are you concerned that the lack of access to other services would inevitably lead people down a certain path?

No, I completely understand.

If coercion is not currently an offence, I presume that it would become an offence within the context of the bill. We would be asking members of the medical profession, who are not members of the legal profession, to make a judgment on something that might break the law. Is that a fair comment?

One of the big wins from this bill—if “wins” is the word that I am looking for—is that it is shining a light on palliative care provision and the need for it to be equitable across the country. If you look back at some of the evidence that we have heard, you will see the concern with regard to palliative care and the potential for some people to consider assisted dying because of inadequate palliative care in their particular instance. I ask you to have a look at that, because it is a big concern for me. I would like to think—and I am sure that you will agree with me—that, if the bill were to be passed, everybody who wished to consider assisted dying could also access palliative care, that the matter would be raised by a GP or whatever at the time and that provision would be equitable.

I appreciate that answer, cabinet secretary. Presumably, given what you just alluded to, if the bill is amended to include mandatory access to palliative care for anybody who is considering assisted dying—that is to say, that they must be offered palliative care at the same time—the Government would support a financial resolution to ensure that the bill could go ahead as amended.

I tried before to cover this. It is a question that is buzzing around in my head about whether there is enough protection in the bill for healthcare professionals. I think that my question is this. If something goes wrong during the process of taking a substance, what then is the legal responsibility of the healthcare professional? Are they liable for prosecution if they step in and save the person, or are they under pressure the other way, if they do not step in and save the person? Does the bill clarify that enough to protect healthcare professionals?