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I thank Douglas Ross for that intervention. The committee took evidence at stage 1 from witnesses in Australia that went some way to allaying many of the concerns around the efficacy of the substance, but I certainly appreciate that complications might arise in some instances. That is why it is important that the medical professional remain present on the premises. There would be a discussion ahead of the self-administration of the substance about what is expected to happen.

In other jurisdictions, there are instances where the medication is not provided in person by a medical professional and concerns do not appear to arise as a result. My bill has an additional safeguard that does not exist in other jurisdictions. The fact that the medical professional would be there and available allows us to balance, on one hand, the need to ensure that there is no coercion or undue influence being brought to bear and that self-administration takes place, with, on the other hand, respecting an individual and their family members’ wish for additional privacy, while maintaining the robustness of the safeguard.

Yes.

Let me respond to that intervention first, Ms Baillie, and then I will come back to you.

The member makes an entirely fair point. As the convener and Jackie Baillie have intimated, there are examples in which there is such a requirement at present, but it would be wrong to assume that, from those instances, one could draw parallels with the actions being undertaken by nurses acting independently in a person’s home. I suspect that that is the point that the Scottish Government is making in its commentary on the amendments.

Sue Webber makes a reasonable point. However, my point about variability was more in relation to specifying a time that might be deemed “reasonable” or by which death is expected to occur.

As I was suggesting, I think that, on reflection, ways of strengthening the bill by recording considerations that have been outlined not just by you, Ms Webber—

Let me respond to Sue Webber, Mr Doris, and then I will let you in.

I am responding to the concerns that are reflected in a number of amendments, each of which is trying to do something similar but in a different way. This is an issue that I am happy to look at; I am not sure that I am necessarily supportive of any of the amendments that have been lodged, but I am happy to work with members and the Scottish Government ahead of stage 3 to see whether there are ways of better reflecting the issue in the bill.

I will take the amendment—I mean, the intervention—from Bob Doris.

As in many other areas, there is a balance about the extent to which we leave matters to the discretion of individual medical practitioners and the bill laying out a requirement on them to act in a particular way. There will be different views on that. I suspect that the BMA and others may be distinctly uncomfortable with the bill going down the route of having requirements and cutting across the professional judgment of medical practitioners or, indeed, interfering with the doctor-patient relationship. I recognise that the procedure that we would be dealing with feels more significant than other areas of medicine, but the safeguards in the bill are more likely to operate effectively if they are consistent with the way in which medical practice operates more generally.

Will the member give way?

I start by expressing the hope that Stephen Kerr has not gone the same way as Ross Greer and lost his voice, too. I thank Brian Whittle and the other members who have had an opportunity to set out the rationale for their amendments in this group, and I look forward to hearing the comments from others who have lodged amendments, too.

I must apologise at the outset, convener, with regard to your plea to be brief. I have only one amendment in this group, but I am conscious that there are many amendments in it, lodged by many members, so my remarks will probably be lengthy. I will do my best to recoup some of that time in later groupings.

I will start with my amendment 33, although it is probably worth acknowledging at the outset that all the amendments in the group relate to section 15, on the provision and use of an approved substance. I again remind members that all the bill’s provisions must be within the competence of the Parliament. I am aware that the Scottish Government is working with the United Kingdom Government to ensure the full operation of the bill, should it be passed. The Scottish Government will consider many of the amendments in the group in the context of those discussions, and we certainly urge the cabinet secretary to keep the committee and other members updated in that respect.

Amendment 33, in my name, requires the co-ordinating registered medical practitioner or authorised health professional who attends on the day that the person intends to take the authorised substance, and who will provide the substance to the person, to stay with the person in the same room until the substance has been used. As introduced, the bill states that the attending co-ordinating registered medical practitioner or authorised health professional must be on the premises but need not be in the same room as the person while they decide whether to be provided with, and use, the substance. Where the person has chosen to use the substance, the co-ordinating medical professional or authorised health professional must stay on the premises until the substance has been used and the person has died.

Amendment 33 responds to questions that were raised by Police Scotland, and which were echoed by Douglas Ross and, I think, Brian Whittle, by amending section 15(6) to the effect that the attending co-ordinating medical practitioner or authorised health professional must remain with the person in the same room until such time as the person has decided to take, and has taken, the substance. As before, it will then be at the discretion of the attending medical professional as to whether they remain in the room after that point or be elsewhere on the premises. That is intended to address any potential concerns as to whether the substance has been self-administered.

Amendments 178, 180 and 179 offer alternative approaches to the same issue, and I thank Brian Whittle and Douglas Ross for lodging them and for allowing this debate to take place. Brian Whittle’s amendments 178 and 180 seek to ensure that the co-ordinating registered medical practitioner or authorised health professional remains in the same room as the terminally ill person throughout. In addition to what I said in speaking to amendment 33, I believe that it is important that, after the substance has been taken, the terminally ill adult and any attending loved ones be afforded some privacy, if they wish it, while having the attending health professional close at hand.

Section 15(5) sets out that

“The coordinating registered medical practitioner or ... authorised health professional must remain with the adult until the adult decides whether to use the substance ... and, if they decide to do so, until the adult has died.”

Amendment 179 would add to that by requiring the co-ordinating registered medical practitioner or authorised health professional to remain with the person until they have died or the attending

“health professional determines that the substance has failed to take effect.”

I understand what Mr Whittle and Mr Ross are seeking to achieve. They are motivated by a concern that I fully recognise, but I believe that amendment 33 deals with the issue more proportionately, allowing privacy for a terminally ill adult where necessary and appropriate.

I will address my amendments before I turn to the other amendments in the group. Amendments 37 and 38 alter the death certificate requirements in section 17 to require the death certificate to record—secondary to the primary cause of death, as covered by section 17(2)—that an approved substance was self-administered under the bill’s provisions. Amendment 36 is a consequential drafting amendment.

The bill requires that the death certificate for a terminally ill adult who has had an assisted death under the bill’s provisions must record the terminal illness as the primary cause of death. The explanatory notes add that it is expected that the substance that the person used would also be recorded on the death certificate as a secondary or additional cause. My policy has always been that both the terminal illness and the substance that is used should be recorded on the death certificate. I note that the committee’s stage 1 report concluded that

“both the illness, disease or condition which led to an individual requesting assistance to end their life, and the approved substance provided to enable them to do so”

should be

“detailed on the death certificate.”

My amendments will ensure that that is the case.

After further consideration following discussions with the chief medical officer and others, I have lodged my amendments to ensure that my policy is reflected in the bill and that death certificates capture both the underlying terminal illness as the cause of death and the fact that an approved substance was used. That will ensure appropriate transparency.

I note the Scottish Government’s confirmation that that will require consultation with Public Health Scotland, National Records of Scotland, Healthcare Improvement Scotland and health and social care services to ensure that deaths continue to be recorded in an accurate, consistent and helpful manner, that new processes and investment will be needed to support that level of data collection, development and reporting, and that alignment with other UK jurisdictions will also need to be considered. I welcome that helpful clarification and am keen to work with the Government if further work is required ahead of stage 3.

Pam Duncan-Glancy’s amendments 246 and 247 would change the death certification provision so that the approved substance used is listed as the primary cause of death and the terminal illness is recorded as an underlying condition. I certainly acknowledge the different perspectives on the issue, and although I remain of the view that the right and most transparent thing to do is to record the primary cause of death as the terminal illness, with the substance also being noted on the death certificate, I want to hear what Pam Duncan-Glancy and other members on the committee have to say when speaking to her amendments before deciding whether to press my amendments.

I move amendment 36.

I thank Pam Duncan-Glancy very much for lodging the amendments and for walking me through the rationale for opening up the debate that we absolutely need to have on the issue. I reflect that the one change that I made subsequent to the consultation on my proposals all those years ago was to beef up the requirements on data gathering, because it is crucial. To some it might feel a bit dry or bureaucratic, but data will be critical in understanding how the act is operating, who is accessing it and in what circumstances, and so on.

Data gathering also has wider implications, which Brian Whittle spoke to very pertinently. Those who are eligible for assisted dying under the provisions of my bill will have an advanced and progressive terminal illness, with there being little doubt that the terminal illness will lead to their death. We have had the debate about a prognosis period, and I am certain that we will come back to it at stage 3.