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I am going to make a little more progress, Ms Duncan-Glancy.

Adding terms such as “substantially slowed down” is likely only to add to confusion.

Although I am sympathetic to the provision in amendment 144 that states that,

“For the avoidance of doubt, a person is not terminally ill if ... their illness is a consequence of voluntarily stopping eating and drinking”,

I believe that that is already covered in the existing definition. Indeed, it was not raised with the committee at stage 1.

Daniel Johnson’s amendment 4 similarly seeks to define terminal illness by reference to a six-month time period. I know from my discussions with him that he was keen to open up a debate on that, and I think that he has been successful in doing that.

As I have said, other jurisdictions generally operate with prognosis periods of six months, albeit that there are often slightly longer prognosis periods for neurological conditions. It is therefore entirely right that we are having this discussion. I have set out my concerns about how that might work in practice, but I am interested to hear the debate on it and to see where Parliament eventually lands.

I am happy to work with colleagues ahead of stage 3 on workable amendments that might deliver the intention, but it was important to put on record why I opted for the approach in the bill. I think that it is consistent with decisions that Parliament has taken previously on similar issues. I will listen to what colleagues have to say and, as I said, I am open to having further discussions about this.

I will take a brief one.

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.

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 Bob Doris for making that point. That was not the implication of my remarks, but it is very helpful that he set that out, and I take that point in the spirit in which it was made.

There are a number of areas in which provisions are contingent on other things happening. I would be very cautious about proceeding on that basis. I am sure that we will have debates about that in future groups, but I have set out my concerns in relation to that point.

As I say, other jurisdictions operate using prognostic periods and issues appear to be manageable within that context. Nevertheless, the argument is about establishing with any certainty the accurate time of anticipated death. It is an issue that the committee heard about in evidence, and it took the view that it did in its stage 1 report.

I agree with Fulton MacGregor’s final sentiment about the way in which we must embed the service. That is crucial. I thank other colleagues for setting out the rationale for their amendments.

Turning to Murdo Fraser’s amendment 148 and the issue of the administration and regulation of assisted dying services, the bill does not expressly establish a system within the NHS. It provides for a process with roles for health, social care and social work professionals; Public Health Scotland also has a role in data gathering and reporting.

My view throughout the process has been that assisted dying services under the bill should be provided predominantly through the NHS, although I can envisage that there might be scope for them to be provided in some private settings as well. I am concerned that the implications of the approach proposed by Mr Fraser would potentially exacerbate inequalities in access and disrupt existing pathways for treatment and care at a point when the individual is least able to cope with that.

In relation to that point on amendment 148 and its consequential amendment 208, I note the Scottish Government’s concerns about competence and about the possible duplication of the roles of Public Health Scotland and the Scottish ministers.

To some extent, that concern also applies to Jackie Baillie’s amendment 62 on the provision of assistance outwith the NHS. Amendment 63, which is consequential to that, proposes that the related regulations be subject to the affirmative procedure. I listened to the comments that Jackie Baillie made and her response to the interventions. I am reassured that she does not seek to set up a service outwith the NHS. The points that she makes about regulation are fair and reasonable. They lead me back to the point that Brian Whittle made earlier: this is one of those areas where engagement with the Scottish Government on the operability of the system would be welcome, especially ahead of and during stage 3. I am committed to such engagement and am happy to work with Jackie Baillie on those provisions and others that may relate to similar issues.

That is correct.

I start by thanking Murdo Fraser for setting out the rationale for his amendments in this group, and for his declaration of interest, which I take in good faith.

The bill requires the signing of a first and second declaration form by a terminally ill adult to be witnessed and signed by the co-ordinating regulated medical professional and another person, which, for the second declaration, cannot be the other regulated medical professional who assessed the eligibility of the person.

Following discussions with the Law Society, which had concerns—to some extent, along the lines of those of Murdo Fraser—about the way in which that provision was framed in the bill, and the potential implication of creating a relationship between solicitors and individuals, I lodged amendment 32, which changes the definition of who can be a proxy.

It replaces the definition in the bill with a definition that requires the terminally ill adult to have known the proxy for at least two years or for the proxy definition to be specified by Scottish ministers in regulations. Amendment 45 sets out that that would be subject to the negative procedure.

Schedule 5 sets out who is disqualified from being a proxy. That includes family members, those who would benefit financially from the person’s death, and a medical professional who has treated the person for the terminal illness. The conditions in schedule 5 remain and should therefore be read with this amendment.

I note that amendment 32 would pre-empt Mr Fraser’s amendment 170. In relation to that amendment, the proxy role should not be limited to a notary public. Doing so might risk making it difficult for a terminally ill adult to engage such a person, who might be needed urgently and at short notice, which could add to a terminally ill person’s stress and anxiety.

Amendment 45 is consequential and it ensures that the regulations that the Scottish ministers make are subject to the negative procedure.

I will discuss the other amendments in the group together. The role of the independent witness to the signing of the forms, in addition to the co-ordinating regulated medical professional, is just that—to witness the signing by a terminally ill adult. I see no reason why a notary public should also be required to witness as set out by the other amendments in the group. As I have said, we need to ensure proportionality and that safeguards are not simply barriers to eligible adults accessing the choice to which they should be entitled under the legislation. I therefore urge Mr Fraser not to press amendment 149, but, if he does so, I urge the committee not to support it.