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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.

Will the member give way?

It is a fair point. In my engagement with the RCN, it has made requests, which I have been happy and able to accede to. I think that the requirement for a second nurse to be present is disproportionate. There is nothing in the bill that would prevent that from happening, and I am sure that that would happen. We discussed at stage 1—and the committee will have heard—that, in other jurisdictions, over a period of time, one has seen an increase in the number of people who are able to access this, partly through increased public awareness but also through the growing familiarity of medical professionals with the process and procedures, and a willingness to engage with that process.

I would not be at all surprised if, in the early stages, nurses sought to have an additional nurse present but, as we have seen in other jurisdictions, that tends to cease to be the case over time. The current provision would allow for that to happen; my concern is that amendment 79 would mandate it in every instance. That is disproportionate and would certainly have an impact on access to this choice for some terminally ill adults.

I thank Patrick Harvie for setting out the rationale for the amendments and wish Ross Greer a speedy recovery—he is lined up to speak in a few debates this week.

It is fair to say that I fully support folk being available to help people to understand and navigate the process. That is why section 23 of the bill allows ministers to make guidance on matters relevant to the bill. It is also why I have lodged an amendment to strengthen that provision by requiring ministers to provide or ensure the provision of information about the process in an accessible and understandable format, for the benefit of terminally ill adults, certainly, and of medical, social care and social work professionals, as well as the wider public.

I am also aware that structures exist to ensure patient safety and supported decision-making. Health boards in Scotland must observe equal opportunity requirements. Although not strictly advocacy, the patient advice and support service provides support to patients, while the GMC provides guidance to doctors on supporting patients in their decision making.

Under my bill, proxy arrangements can be made to support a person in accessing assisted dying services and the Patient Safety Commissioner will also have a role to play. However, through my engagement with third sector organisations, I am aware that many stand ready to provide assistance, advice and support through a navigation service. That would be my hope. As Patrick Harvie rightly said, we have seen that in other jurisdictions that have assisted dying legislation in place. As with some other amendments, the Scottish Government might be best placed to comment on how the provision would fit with existing structures, policies and services.

Ross Greer’s amendment 283 would provide for the Scottish ministers to commence the substantive parts of the bill by regulation. That reflects that ministers are responsible for ensuring that all aspects of the assisted dying service are workable and that they tie in with all other aspects of health and public service delivery in an integrated and safe way. The Scottish ministers will have the necessary oversight, and I expect them to commence the various substantive parts of the act only when all relevant health, social care, social work and other services are appropriately prepared and all necessary measures are in place to enable assistance to be requested and provided. Singling out in statute particular steps that must happen before the act can be commenced risks undermining the process and further delaying the availability of assistance to those who need it.

I note that the Scottish Government has highlighted that it is unclear from the amendments whether the conditions will have to be met by the individual advocate or the service provider, and how the service would be funded or monitored. That said, I am sympathetic to what Ross Greer is seeking to achieve through his amendments in this group. I will be happy to speak with him once his voice returns and, ahead of stage 3, to see what more the bill can provide to address the concerns that he rightly raises.

At this stage, however, I urge him, through Patrick Harvie, not to press the amendments, but I am pleased that the committee has at least had an opportunity to engage with the issue, which reflects what we see in other jurisdictions. There is a balance to be found as to whether we put the provisions in statute or allow the process to develop organically, as has been the experience in many of those jurisdictions.

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.

I am grateful to Brian Whittle for taking my intervention and for his generous comments about the approach that I have taken to the bill. That remains the case, and I observe that I have been supportive of amendments from pretty much every member who has lodged an amendment. That is not to say that I have supported every amendment, but I have, in many instances, accepted the point that has been made.

I ask Brian Whittle to reflect on the fact that, even if the principle behind an amendment could be supported, it is in nobody’s interest to pass amendments that may have unintended consequences, or an amendment that would not do what it is that the member who has lodged that amendment would wish it to do. That is why, at stage 2, we have an opportunity to explore those issues, and at stage 3, we will have an opportunity to refine amendments, which I have committed to doing in many instances.

This bill is like any other bill. A lot of amendments are lodged at stage 2 to allow a debate to take place; they will not all necessarily be accepted, but that process should strengthen and improve the bill as it moves on to stage 3, where it can be further strengthened and improved, as I have committed to doing.