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I understand the point that Pam Duncan-Glancy has made, which is why I am supportive of the assessments being carried out. However, the assessments will not necessarily speak to the specific circumstances of any individual who is going through the process. As I have said, it is incumbent on ministers to ensure that all the requisite steps are being taken in relation to aligning health, social care, social work and other services to ensure that the provisions under the bill can be safely provided for and delivered. On that basis, I am content to support amendment 54 and consequential amendment 64 but urge the committee to resist amendments 57 and 61.

On Jackie Baillie’s amendment 55, as with amendment 57, I note that the Scottish Government has made some points in relation to data gathering responsibilities and resource implications; I share those concerns and do not support the amendment.

On Pam Duncan-Glancy’s amendment 258 and consequential amendments 280 and 284, although I am fully supportive of anything that would assess and support the social care sector, I question whether that is best placed in my bill, the primary purpose of which is to allow mentally competent, terminally ill eligible adults to voluntarily choose to be provided with assistance by health professionals to end their lives. Again, the Scottish Government has identified the need for new processes and investment, and investment in supporting social care is almost certainly better targeted elsewhere.

With regard to amendment 284, which would prevent the bill being commenced before an assessment of social care services had taken place, I refer members to the previous concerns on such provisions in the bill and the comments that I have just made in response to Pam Duncan-Glancy’s intervention.

On Stuart McMillan’s amendments 259, 281 and 285, if the Parliament passes the bill after rigorous, thorough debate and amendment—which has been anything but rushed—I cannot see the case for holding a costly and time-consuming referendum on the act. As I recall, there was no call for such a referendum during stage 1. It is not a feature of our legislative process and would come at considerable cost while also delaying the ability of those terminally ill adults who meet the criteria and wish to access the choice of an assisted death from doing so.

If this is any consolation to Mr McMillan, I point him and members of the committee to the recent Scottish Parliament information centre briefing, which stated that

“public opinion polls and surveys”

since 2005

“have generally shown that a majority of adults in Scotland and the rest of the UK support a change in the law to allow assisted dying for someone who is terminally ill.”

On Miles Briggs’s amendments 21, 22 and 23, the bill provides for the collecting and publishing of data. It is crucial that the assisted dying process be transparent and that relevant anonymised data be made publicly available. The collected data will help to inform understanding about the impact and effect of the bill. Amendment 21 might aid transparency and provide useful information, but it and amendment 22 appear not to link to the data-collecting requirements under the bill, which provide that declarations, doctor statements, cancellations and the final statement after a person’s death are recorded in the adult medical records. That is the information that is then drawn on by Public Health Scotland, as per section 24, for the purposes of the reporting provisions of the bill.

I am not opposed to amendment 22, but I note that it might place added burdens on healthcare professionals to research for themselves or even patients to assess what is available. There are some questions to consider, such as how quality would be judged and how healthcare professionals would investigate the distribution. Medical records might be useful in providing some of that information. Although I am not opposed to them, I feel that amendments 21 and 22 would benefit from further refinement ahead of stage 3.

I turn to amendment 23. Section 27 of the bill provides that the Scottish Government

“must, as soon as reasonably practicable”

after a review period, review and report on the operation of the act. That period is set at five years, beginning with the day on which section 1 of the act comes into force. Amendment 23 sets out that the report must include “the Scottish Ministers’ assessment” of matters relating to palliative care services, as described.

As I have stated, the bill provides for the collecting and publishing of data that is focused on the assisted dying process. That will assist the Scottish ministers in assessing how the legislation is operating. As for the last part of amendment 23, it is not clear how the methodology would show a direct correlation—that is, the impact of assisted dying on palliative care—given so many variables. That point has also been picked up—

Very briefly, yes.

I begin where I concluded at the last meeting by reminding the committee of my declaration of interests. I am supported by Dignity in Dying Scotland, Friends at the End, and the Humanist Society Scotland.

With regard to Jackie Baillie’s amendments 54, 55, 57, 64 and 61, I wish to express in general my support for any work that is undertaken to assess the status of palliative care, hospice and end-of-life services, and anything that seeks to support such services. With regard to the potential impact of the bill on palliative care, I again refer to the report on assisted dying that was published by the House of Commons Health and Social Care Committee just under two years ago, which concluded:

“In the evidence we received we did not see any indications of palliative and end-of-life care deteriorating in quality or provision following the introduction of”

assisted dying. It goes on to say that

“indeed the introduction of”

assisted dying

“has been linked with an improvement in palliative care in several jurisdictions.”

Amendment 54 would require the Scottish ministers,

“as soon as reasonably practicable after Royal Assent, to carry out an assessment of”

and publish a report on

“the likely impact of the provisions of this Act on hospices and providers of palliative and end of life care services.”

Amendment 57 would require the review of the act to set out the impact of the act on hospices and palliative care providers.

An assessment of the likely impact of the act may be difficult at such an early stage but, from my engagement with Hospice UK and Jackie Baillie, I understand and am sympathetic to amendment 54. On amendment 57, I believe, and evidence suggests, that the bill will not negatively impact palliative care, hospice and end-of-life services. However, the existing provision requiring a five-year review of the operation of the act is intended to deal specifically with the function of the act—in other words, supporting terminally ill adults in being lawfully provided with assistance to end their own lives. The bill also provides that any concerns with the operation of the act that have been raised must also be covered in the report, alongside the Scottish Government’s response. That would allow for any concerns about palliative care, hospice and end-of-life services in relation to the act to be raised, reported on and for a response to be provided.

I am mindful that amendment 57 would add aspects that are not directly related to the legislation to the review of assisted dying legislation. Bringing in other matters may risk diluting the review process. I am also mindful that amendments 54 and 57 duplicate each other to a certain extent. I note the Scottish Government’s view:

“From a delivery perspective, it would be challenging to measure the impact of the Act on hospices and palliative care.”

It notes that that would be reliant on data from Public Health Scotland that it does not currently collect in the necessary manner. Furthermore, the Scottish Government adds that

“if any data collected were to show changes in relation to hospices in and palliative care, it may not be possible”

to attribute those changes to the act

“rather than other factors such as delivery of actions outlined in the Palliative Care Strategy Deliver Plan, the ageing population in Scotland, changes in the palliative care workforce, etc.”

Amendment 61, which seeks to prevent the substantive provisions of the act being commenced by the Scottish ministers until they publish a report as outlined in amendment 54, could delay implementation, even though all necessary measures are otherwise in place. Therefore, it would prolong suffering for people with terminal illnesses who wish to access the choice.

As I have said about other similar amendments, the bill provides for the Scottish ministers to commence the substantive parts of the bill by regulation. The Scottish ministers will have the necessary oversight, and I expect them to commence the various substantive parts of the act only once all relevant health, social care, social work and other services are appropriately prepared and all necessary measures are in place to allow assistance to be requested and provided in that way. Singling out in statute particular steps that must happen before the act can be commenced risks undermining that process and potentially delaying the availability of assistance for those who wish it.

I am sorry, Mr Kerr.

My view is also informed by the experience in other jurisdictions. Two years would be too short for the first review, and a recurring review every two years thereafter would be excessive, particularly given the bill’s requirement—as I said—for annual reporting data. I do not think that a perpetual state of review is in anyone’s interests.

With regard to Brian Whittle’s amendment 202, I can see that the requirement in it could pose a number of difficulties. For example, who would carry out such a review, on the basis of what information, and from whom? I know that Brian Whittle has been rightly concerned to ensure input from, and the confidence of, medical professionals. However, I worry that the amendment may work against the latter.

In relation to Stephen Kerr’s amendment 130, I have already set out the purpose and scope of the provision in my bill that requires a five-year review on the operation of the act. I also refer members to my earlier comments in relation to amendment 57.

Murdo Fraser’s amendment 203 appears consequential to amendment 189, which has already been debated. Again, I refer members to my earlier comments.

On Stephen Kerr’s amendments 131 and 132, I observe that the bill does not prevent the Scottish Government from consulting any organisations or individuals that it considers relevant in undertaking the five-year review, and I would expect it to do so. As such, I do not believe that those amendments are necessary.

With regard to Daniel Johnson’s amendments 14, 15, 271 and 272, I am wary of adding a sunset clause to the bill, which could impact on both the engagement of health professionals and the views of some people who wish to request assistance to end their own lives. For example, people may feel that they need to make a more hurried decision based on a belief that assisted dying may be available for only a time-limited period. Evidence from other jurisdictions, such as California, has indicated that sunset provisions in assisted dying legislation are not helpful and end up being further amended or, indeed, removed—as has been the case in California this year.

Sunset clauses are not a feature of our legislative process, except in very limited circumstances that often relate to issues that are felt to be time-limited and over a short period. That is demonstrably not the case in this instance. I believe that it is imperative that the legislation be subject to detailed review, and I have provided for that to happen after five years. That is in addition to annual reporting, as well as any additional scrutiny that Parliament wishes to undertake.

I note that Mr Johnson’s amendments offer a range of timeframes for such a sunset clause—five, 10 and 15 years. The first of those timeframes would certainly be far too soon, but even the longer time periods appear problematic for a mechanism that is, so far, confined to matters affecting Parliament as an institution, such as MSP pensions and lobbying—as the Scottish Government has observed.

I understand the rationale and accept that such provisions have been a feature of similar legislation elsewhere, but we would be interested in the views of committee colleagues on the principle. For much the same reasons, I do not support Stephen Kerr’s amendment 218, which includes a three-year sunset provision and might also conflict with the rolling review envisaged in Mr Kerr’s earlier amendments.

On Michael Marra’s amendments 280, 282 and 286, I note the Scottish Government’s view that, from a delivery standpoint, the timing of the review could be challenging. Should the bill pass, there would need to be a substantial implementation period and consultation with relevant stakeholders to develop the policy framework for the bill, during which the Scottish Government would undertake its own assessment of the financial impact of the bill. The review proposed by Mr Marra, therefore, could result in duplication and would be curtailed by decisions needing to be made on implementation. As far as I can tell, it is also out of step with the approach to any other piece of legislation, and it would have significant financial implications.

With regard to Paul Sweeney’s amendment—

I had a lengthy exchange with the Finance and Public Administration Committee on my financial memorandum about my understanding of costs. I know that the Government has taken a different view, and it is for the Government to explain its rationale.

Paul Sweeney’s amendment 269 appears to relate to amendments 245 and 275 and the issue of complications, which we debated in the previous meeting. Although those amendments were not agreed to, others were. If I can do more on that particular issue ahead of stage 3, I will be happy to work with Mr Sweeney on that.

Finally, Pam Duncan-Glancy’s amendment 287 seeks to delay the commencement of the act until legislation is introduced to remove charges for non-residential social care for terminally ill adults requesting assisted dying. I note and echo the Scottish Government’s concern that, from a legal standpoint, it is unusual to prevent provisions of any bill—other than provisions that come into force the day after royal assent—from being brought into force until some other action has been carried out. I do not believe that that would be appropriate in this instance.

With that, I bring my remarks to a close.

That exchange was, if somewhat unusual for stage 2 proceedings, very helpful. It is probably worth reiterating that the bill is predicated on a terminally ill adult requesting assistance to begin the process. On the point about Dignitas that Miles Briggs referred to, in relation to his amendment, because that is not a procedure that is covered by the bill, there would not be a protection in relation to that. Therefore, to some extent, that issue remains pertinent. We need to allow discretion and medical judgment to apply and to avoid creating an environment in which assistance under the legislation becomes stigmatised or is not subject to free, open and transparent consideration.

As it stands, the bill almost certainly covers that. To some extent, Miles Briggs’s amendment might be more for the avoidance of doubt, but the debate that we have had on it has, if nothing else, perhaps demonstrated the need for greater clarity on that, and I am certainly sympathetic to that.

Turning to Jackie Baillie’s amendment 53 and Daniel Johnson’s amendments 53A and 53B, I note that Sandesh Gulhane’s amendments to change the eligibility age from 16 to 18 have been agreed to, which means that no person under the age of 18 will be eligible to request assistance under the legislation. I have previously set out why I do not support changing the age limit to 25.

As I have made clear, the bill does not require, nor does it actively permit, any health professional to raise assisted dying with a person. It is predicated on a terminally ill adult requesting assistance to start the process. That said, I absolutely accept some of the arguments that Jackie Baillie and CHAS have been making about how the process for younger people will almost certainly be very different, in every instance, from the process for somebody in later life with late-stage cancer or whatever it may be.

That said, I ask members to consider whether amendment 53 is necessary, given that those under 18 are not eligible to be provided with assistance. I suppose that the same factors apply in relation to Daniel Johnson’s amendments. The rationale for introducing them relates to a point that I have accepted before: the training that will be required for the practitioners involved is likely to be different from that relating to patients at a later stage, and some of how the process works in practice will almost certainly be different, not least because a wider team is likely to be involved—not just medical practitioners but social work and other experts in particular fields.

Aside from those observations about the age limit, which we have already discussed, I have no strong views on the amendments in this group.

You are not alone, Mr Whittle. Your point is entirely pertinent. In my discussions with the chief medical officer, there was no strong view that this must be done in a particular way. However, there was an absolutely clear understanding that both aspects would need to be captured on the death certificate. My amendments propose one way of doing that, and Pam Duncan-Glancy has helpfully given the committee an opportunity to consider an alternative way of addressing the issue.

At this stage, rather than leave the issue unresolved from my perspective, I will press my amendment, but I give the assurance that I am happy to work with Pam Duncan-Glancy and others at stage 3 to see whether further refinements are needed in order to address the points that she and Brian Whittle raised. It is difficult stuff, but I do not believe that the difficulty is insurmountable. However, it is important that the bill is amended at stage 2 to address what I think is a shortcoming in its drafting.

On that basis, I will press amendment 36.

Amendment 36 agreed to.

Amendment 246 moved—Pam Duncan-Glancy.

I thank Stuart McMillan for setting out the rationale behind his amendments. I echo his point about the importance of the openness of the conversations that ideally should happen. In earlier groups, we had quite a bit of discussion about anticipatory care plans. Underlying all of this is the desire for more people to take more care in setting out their wishes and discussing them with loved ones or family and friends as early as possible.

I, too, have engaged with the Salvation Army, although much earlier on in the process and not specifically in relation to this issue. I am not aware of the issue being raised at stage 1 or in the consultation on my proposals way back in 2021. I note that, in Scotland, unlike in England and Wales, there is no specific statutory offence of assisting somebody’s death. Therefore, I consider that the bill’s provisions are sufficient in providing protection from civil liability, and I urge Stuart McMillan not to press amendment 250 or to move amendment 251.

As I said, I am not sighted on more of the background to the issue, and the Salvation Army might be able to help me with that, along with Stuart McMillan, so I am happy to continue those discussions. However, at this stage, I do not see the need for the amendments.

I appreciate that. As you will be aware, we have added a number of for-the-avoidance-of-doubt provisions to the bill through various amendments, so I am certainly not averse to doing that. However, I would need to have a better understanding of what we are seeking to achieve with the amendments. Even if they are for the avoidance of doubt, there are potential risks that we could cause more confusion in trying to go down that route. However, my offer is there.

I thank Murdo Fraser and Miles Briggs for talking through their amendments. The bill contains offences relating to coercing or pressurising a terminally ill adult into requesting assistance and it also provides that it is not a crime to provide assistance under the provisions of the act and that there is no civil liability for doing so.

It therefore follows, as you suggested in your intervention, convener, that there remains criminal and civil liability if a person is provided with assistance outwith the provisions of the bill. If any person believes that another person has been provided with assistance who has not been eligible for such assistance to be provided, it is a criminal matter and should be reported to the police and investigated by the relevant authorities. I appreciate the point that, more often than not, it might be family members who have such concerns, but I do not think that we should say that the right to call for an investigation needs to be reserved entirely to them.

It is perhaps worth reflecting that, in the stage 1 evidence that was taken on the role of the COPFS Scottish fatalities investigation unit in investigating fatalities on behalf of the Lord Advocate, the view of COPFS was that independent scrutiny would already exist. As members will recall, the committee heard at stage 1 about the role of the unit in investigating all deaths in Scotland that are sudden, suspicious, unexpected or unexplained. Indeed, the head of the investigation unit set out the independent scrutiny of the circumstances of death that currently exists, covering not only potential criminality but wider investigation to establish any systemic issues or issues of public concern requiring further investigation. COPFS also confirmed to the committee that medical practitioners are already provided with guidance on the deaths that require to be reported to the Crown Office.

I note that the Scottish Government highlighted various drafting and resourcing issues with amendment 189, and I urge Murdo Fraser not to press that to a vote.

Miles Briggs’s amendment 200 would establish an assisted dying review panel to review whether the act is complied with in each case and analyse information that is provided. I agree with his points about the importance of learning from the way in which the act is developing, and some of the data gathering that we referred to in earlier groupings will help to facilitate that. I am not opposed to the principle, but I am concerned that any such oversight panel might duplicate existing roles or processes. I have already touched on and set out in detail the evidence from COPFS and the responsibilities of the Scottish fatalities investigation unit.

The Scottish Government also notes that amendment 200

“seems to cover a similar role as the provision under Section 27”,

and that amendment 214 is consequential to amendment 200.

At this point, I do not believe that the review panel necessarily adds an additional safeguarding layer. There might be elements in what Miles Briggs is trying to get at with the review panel that might be helpful in augmenting what is already in section 27, but, at this stage, I encourage Miles Briggs not to move amendment 200, and I urge the committee not to support it.