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I feel Mr McArthur’s pain in debating such a massive group. These discussions are substantial and substantive in relation to whether the legislation passes. In relation to schedule 2, it would appear that, at the moment, simply stating that the medical professionals are content, that criteria have been met and that there is no coercion, and signing off on that, is effectively it. From what I can see, there is no rationale requirement whatsoever. The report would give a rationale argument and show the working, if you like, Mr McArthur, which would protect the medical practitioners as well as supporting any post-legislative scrutiny work to consider how robust the process is.

The proposed safeguard, which I and the Scottish Partnership for Palliative Care are trying to put into the bill, is a key tool. I also note that there are a variety of amendments in relation to coercion, not all of which have been disposed of yet, including some in my name, which I hope that the committee will be persuaded to vote for later today or at another time.

My amendment 101 would ensure that, where a person is at risk, a social work assessment would be mandated. The same would be required if a qualified medical practitioner had any doubt at all. To do otherwise would allow the assisted dying process to operate outwith the existing frameworks and without drawing on well-developed expertise. Irrespective of our views on assisted dying, I do not believe that that is something that any of us wishes to see, and I hope that committee members will be persuaded by my amendments.

That query is really helpful, because that is not how the amendment is drafted and it is not the policy intent. Having a terminal illness in itself does not debar someone from seeking assisted dying. That would be counter to the policy intention of the bill, so that is not the intent.

However, you could imagine a whole range of situations such as when someone loses their job, there is a marital breakdown, there is estrangement from family members, or there are significant care costs—you could imagine a series of factors that could then be pieced together to create additional vulnerabilities and, if the adult is at risk under current legislative frameworks, that should be identified. That is the policy intent that we are trying to get at here. A narrow, purely medical-based process is not the strongest safeguard—that is the point that I am trying to make.

That is backed up quite strongly—I will not quote all these organisations because of time constraints—by the Royal College of Physicians, the Royal College of General Practitioners and the British Geriatrics Society in its position statement on assisted dying. The Royal College of Psychiatrists in Scotland has stated:

“Assessing coercion is not a medical skill, though evidence of it may emerge during medical assessments.”

If assessing coercion is not a medical skill, we have to look at other ways of assessing it, and the risk register is surely one key way of doing that. It is surely reasonable that all requests for assisted dying should trigger a search of local authority data to identify any grounds for considering the person to be vulnerable or at risk.

Amendment 100 seeks to ensure that any co-ordinating medical practitioner carrying out an assessment must request a statement from the local authority where the applicant resides about whether it knows or believes that the person is an adult at risk, within the meaning of section 3 of the Adult Support and Protection (Scotland) Act 2007.

For clarity, section 3(1) of the 2007 act defines adults at risk as adults who are

“unable to safeguard their own well-being, property, rights or other interests”,

are

“at risk of harm,”

and

“because they are affected by disability, mental disorder, illness or physical or mental infirmity, are more vulnerable to being harmed than adults who are not so affected.”

Crucially, all three of those criteria must apply. I believe that that is a reasonable prerequisite before any co-ordinating medical professional can consider taking an informed position on whether to progress further any application under the assisted dying legislation that we are considering.

Amendment 101 seeks to ensure that a co-ordinating medical practitioner carrying out an assessment must refer the person for a social work assessment if the person says that they want one, if a statement from the local authority raises a concern or if the co-ordinating medical practitioner has any doubt as to whether the person is being coerced.

That last point is crucial, because balance comes into play right across this legislation. The co-ordinating medical practitioner would not take an on-balance position on whether there was coercion. Rather, if there was any doubt, a social work referral would have to be made.

Amendments 102 and 103 would give powers to the Scottish Government to specify timelines for local authorities to produce a statement and to conduct any assessment. I have heard the interaction between Fulton MacGregor and other MSPs on the committee and I think that that is a very reasonable way to do it—with no timescale specified and using the affirmative procedure to introduce more details. That would allow discussions to take place with COSLA, the Scottish Association of Social Work and others, as you would expect. I think that the convener has made that point during her observations.

More generally, however, Scotland has a well-established legal and procedural framework for protecting adults who might be vulnerable, including the maintenance of records of such individuals. My amendments and the substantial amendment by my colleague Fulton MacGregor—to which I am sympathetic, as I can see what Mr MacGregor is trying to do—should be viewed in that context.

The Scottish Partnership for Palliative Care and its membership are clear that such protections should be put in place as a key safeguard in the legislation. The partnership takes no view on whether the bill should pass or otherwise—this is about putting in place a robust series of protections. The SPPC has noted that, in addition to pre-existing vulnerabilities, a terminal diagnosis can often create new vulnerabilities, which might be due to physical, psychological or circumstantial changes. Elder abuse, for instance, is distressingly common, and care costs might provide a motivation for implicit or explicit pressure towards assisted dying. I will not list other factors that can be taken into account, because of time constraints, but you can see the importance of ensuring that there is not a vulnerability.

As drafted, the bill leaves the potentially difficult assessment and judgment as to whether any individual seeking assisted dying is being coerced to the co-ordinating medical practitioner and the second medical practitioner.

May I nudge you more on that helpful answer? Is there a possibility of attributing some of the responsibilities of the commissioner that would be established to existing commissioners and broadening their remits, rather than setting up a new commissioner?

I thank all four of you. However, you are not finished yet. Sarah Boyack, the member who is in charge of the bill, has sat patiently throughout all of this. I know that she will be bursting to ask you lots of questions, and we have a wee bit of time.

I am just showing my ignorance, but who would seek the judicial review?

Could any other bodies reflect on that idea? For example, we have the Scottish Environment Protection Agency and Environmental Standards Scotland, so we have a pretty cluttered landscape in that regard. Do you have further reflections on that?

I am not trying to put words into your mouth, but both you and Ellie Twist mentioned putting things on a statutory footing. Is the culture change the most important aspect, or is it the statutory footing?

The underlying question was about the Welsh experience. Do other witnesses have any comments on the Welsh experience and what we can learn from it? Have I misinterpreted the evidence that we have had to date? I am more than happy to be contradicted.