Seòmar agus comataidhean

Good morning, and welcome to the 29th meeting in 2025 of the Social Justice and Social Security Committee. We have received apologies from Collette Stevenson. David Torrance is substituting for her; thank you for joining us, David. I also welcome Sarah Boyack to the meeting. I hope that Michael Marra will join us later.

Under agenda item 1, we must decide whether to take item 3 in private. Do members agree to do so?

Members indicated agreement.

My only follow-up would be that, irrespective of what the Government thinks or what the committee recommends, we need to know whether there would be a fix for that issue if the bill were to pass. Is there a fix that would ensure that public bodies and the proposed commissioner could co-exist without there being a messy overlap?

My apologies to anyone who is watching this session who is not a bit geekish in this field, as it all sounds a bit abstract. It would be helpful if the Government could give us any examples of where the NPF and the outcomes are being scrutinised—even imperfectly—and public bodies are, to a degree, being held to account or encouraged to improve their standards in that regard, rather than talking in the abstract.

That is helpful. I know that members will refer to the national performance framework in the questions that they will ask shortly. I have written down that there are other ways to address the gap that has been referred to, rather than primary legislation. However, the committee has received evidence that obligations on sustainable development

“must be fulfilled before and at the time when a particular policy is being considered or decision taken”.

How can we ensure that that happens without legislation?

Elena Whitham would like to come in.

The committee would find that helpful, minister.

We will have time for supplementaries later, Marie. Let us know if you wish to ask one.

We move to questions from Carol Mochan, who is joining us online.

Mr McArthur, you are making some really important points. With regard to making an informed choice and the information that the practitioner may give to the person who is seeking an assisted death, if the practitioner is not a palliative specialist or if the individual does not have a palliative care package or has a non-specialist palliative care package, how can the individual make an informed choice unless there is a referral to a specialist palliative care practitioner, to see what options there are to assuage their suffering or mitigate some of their concerns?

Ms Duncan-Glancy is making a powerful case. Better training for the practitioner who takes someone who is seeking assisted dying through the process is, of course, to be welcomed, but that would not be in place of, say, a social work referral or a palliative care referral, when that is deemed to be required. I ask for clarity on that. Would both be required, or just the provisions that you are setting out?

Before I get into the meat of the four main areas that I seek to amend, I will identify some amendments in this group that are consequential to amendments that we have previously debated. As the convener mentioned, amendments 88 and 89 are part of the group on assessment, but they are consequential to my section 7 amendments 100 and 101 on vulnerable adults. Likewise, my amendment 92 is a consequential amendment to the same section to afford a proxy the right to request a social work assessment. I wanted to put that on the record.

I turn to my amendments in this group, which cover new themes to be explored. They aim to strengthen the assessment process and they are proportionate and sensible safeguards. Together, the intent and effect of the amendments is to make the assessment process more robust, transparent and consistent. I have worked closely with the Scottish Partnership on Palliative Care on the amendments. It believes—and I agree—that significant amendment is required in those areas.

I will try to put my amendments together in such a way as to allow proper scrutiny while being as concise as I can, despite the fact that I need to explore four chief areas. The first is that amendment 90 would require assessing practitioners to inquire about and discuss the person’s reasons for wishing to be lawfully provided with assistance to end their own life. Understanding people’s reasons and motivation for seeking an assisted death is vital and central to assessing whether the process can safely and legally proceed. It is also central to understanding how the bill operates in practice, and I will return to that. However, the assessment process set out in the bill says absolutely nothing about eliciting and documenting the reasons why a person is seeking an assisted death. Amendment 90 would simply require that there is a discussion around that reason.

Amendment 106 would add to the bill a requirement that the statement made after assessments by medical practitioners

“must specify the reasons given by the person for wishing to be lawfully provided with assistance to end their own life.”

We assume that that would happen anyway, but there is nothing in the bill to say that it should, and amendment 106 addresses that.

Amendments 110, 111 and 113 to 115 would amend schedule 2, which sets out the form of the statements by the co-ordinating and the independent medical practitioners, so that both statements would document appropriately the reasons for requesting assisted dying.

Importantly—this is the bit that I wanted to return to—section 24 of the bill sets out what information Public Health Scotland must report, which includes

“the reasons given by persons wishing to be lawfully provided with assistance to end their own lives.”

However, it will not be possible for Public Health Scotland to do so unless the reasons have been identified and documented during the assessment process. Those amendments would address that particular gap.

I move to the second area that I wish to see amended, which is around the discretion that is afforded to the assessing medical practitioners. As drafted, the bill provides sweeping discretion and there is not a clear baseline for clinicians to start from when seeking to make assessments. As things stand, assessing practitioners do not have to discuss any of the following at all with the patient:

“diagnosis and prognosis ... treatments available, palliative ... care”,

or

“the nature of the substance that might be provided to ... end their ... life.”

Amendment 91 would rectify that and ensure that such matters were discussed with the person being assessed. I point out to members that, of course, that is not to say that the person who applies for assisted dying would engage with that discussion. However, at the very least, a practitioner should ask about those matters.