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I have been interested in those surveys. Going back to the response that I gave about how many people are likely to be involved in the process, as we see from jurisdictions with similar models, it is a relatively low number. It is likely to be a very low number in the first and second years, but over time, it is likely to increase.

At the end of last year, I spoke at the Hospice UK conference in Glasgow. It was clear to me from the exchanges there that there is a considerable amount of discussion and debate about the issue in the palliative care sector. There are certainly people who strongly oppose a change in the law, and people who are similarly strongly in favour of it. A great many people have questions and simply want to know how it would impact on the care that they deliver to their patients. As I said to them, I think that introducing the choice of an assisted death as one of a range of end-of-life choices allows them to do what they do well, which is meet the needs and limit the suffering of the people they support.

Attitudes to legislation before it is in place often change, and can change dramatically, after the legislation is introduced, when people have a clearer understanding of what the implications may be. I do not see any reason why the situation here in Scotland would be any different from that in states in Australia and the US where practitioners have engaged in the process and, as I said, have often found that one of the most rewarding things that they are able to do is give those whom they are supporting a good death. That seems to be at the heart of what palliative care is about.

I have heard the concerns, and I have tried to do my best to engage with the sector to provide a degree of reassurance. Obviously, the bill, which includes a conscientious objection clause, does not compel anybody to engage with the process, but I am confident that there will be sufficient doctors to support it. As I said, those numbers are likely to increase over time as understanding and confidence increase and as the training is rolled out to practitioners.

That evidence was very interesting. It is also fair to say that the BMA and the Royal College of GPs seemed to be fairly relaxed about the way in which that part of the bill was expressed.

I recognise that this is an element of the bill on which the detail is probably more appropriately set out in secondary legislation and in guidance. Training would be required for doctors to undertake the work that is involved in providing support to patients around assisted dying—we touched on some of that earlier.

As it stands, the bill probably goes as far as it can in expressing who is likely to be involved in this process, but there is an opportunity there. My expectation is that the Government would work with the professional bodies to identify how best to express that through secondary legislation and guidance.

That would certainly be my view; I am conscious that others take a different view on that. I think that there is a way of ensuring that the information that is needed is captured appropriately.

As I said, I was reassured to some extent in my discussions with the CMO and his colleagues that there is a way of navigating the matter so that it is undertaken sensitively but makes absolutely sure that the relevant information is available so that we have the understanding that we need about how the legislation is working in practice.

The slippery slope argument is made consistently. I point the committee to the report published by the House of Commons Health and Social Care Committee in February last year, at the end of an 18-month inquiry into assisted dying and end-of-life choices, which concluded that there was no international evidence of a jurisdiction that has introduced a terminal illness mental capacity model that is similar to the one that I am proposing and that is being considered by Westminster, where the eligibility criteria have changed. That was confirmed in the evidence that the committee heard from the witnesses who are involved in the process in Australia.

The argument that one of the witnesses made to try to substantiate the claim of a slippery slope in Oregon is that different conditions among those accessing assisted dying were featuring to a greater or lesser extent, but that does not necessarily say anything other than that patient confidence and medic confidence in the procedures perhaps evolve over time, and that those with certain conditions find that the palliative care that is available meets their needs up to a point, but they find themselves beyond that point at a certain stage.

Although minor changes have been made to the residency requirement in Oregon—over the years it was found that the requirement did not provide any meaningful safeguard, so it was removed—the eligibility criteria on terminal illness and mental capacity have not changed.

I have always acknowledged that the models in Canada and the Netherlands are more expansive; they have always been more expansive models. In the Netherlands, that has been the case for many years.

The Canadian model, which is often cited, has evolved through court process, which is sometimes brought into the debate here as something of a risk, but the constitutional arrangements in Canada are very different from those in Scotland and in the UK. The legislation was introduced as a result of a case that was brought before the supreme court in Canada on the basis that the ban on assisted dying was unconstitutional. The Parliament then introduced legislation, which was not felt to go far enough, so it was then legally challenged on appeal, which was upheld, and the scope of the legislation was expanded.

The arrangements in Canada and the Netherlands, both of which enjoy overwhelming public support, are very different from what is being proposed here. As I say, there is no example of a terminal illness mental capacity model having been introduced, whether in the US, Australia or New Zealand, where the eligibility criteria have changed.

I will bring Amanda Ward in on the specifics. The capacity assessment that would be required in order to be eligible relates to the choice of an assisted death, not to a broader capacity issue. It would be expected that support be provided to allow an individual to make that assessment, which, I would hope, would allow access to a wider range of individuals to meet the eligibility criteria to have that choice. Amanda, can you add anything to that?

I think that the only relevant point at which a reassessment would be required is the point at which medication might be provided to an individual who sought to act on their initial request. Such an individual would have been through the full process and would have made a second declaration. There is no time restriction on such a declaration—it would remain valid—but at the point at which medication might be provided, as I said earlier, there would still be a requirement to establish capacity and intent. Any change in that would prevent the process from proceeding.

It is important, for the reasons that were discussed with Ms Harper, that people can choose to pursue an assisted death at different stages. Some people might have the relative luxury of going through the process relatively early, in order to provide themselves with a degree of comfort and reassurance, but there are others whose diagnosis might come far closer to the point of death and who need to act with greater speed, so to speak. They will need to get things in order in a shorter timeframe. However, as I said, the point at which the medication is provided is the point at which capacity and intent would be established.

Individuals with a terminal illness will receive on-going support, whether that is from their GP or a consultant. They will almost certainly be in receipt of on-going treatment or palliative care, so those discussions will be on-going. Therefore, although I find it difficult to imagine a situation in which the issue will not arise in the background, I suspect that the focus will still be on the treatment and palliative options that are available, which might change over time. As the committee has heard on numerous occasions, it is not only the prognosis period that is difficult; the way in which the terminal illness develops over a period can be difficult to predict. The discussions will need to continue on an on-going basis.

I have sat in on the oral evidence sessions that the committee has held, and I was encouraged and reassured by the evidence that was taken from the panel that included witnesses from the British Medical Association and the Royal College of General Practitioners. They did not appear to have any concerns about the way in which terminal illness had been defined in the bill; I think that they were comfortable with the way in which that was set out and with the further explanation in the supporting documentation.

However, the question that you raise is one that does crop up. There are clearly many treatments that can be tried and applied, and some might have some benefit in slowing the progression of a terminal illness. Defining “terminally ill” on the basis of a “disease, illness or condition” from which the patient will not recover is important. That separates it out from some of the conditions that have been raised in evidence that, to my mind, would not meet the eligibility criteria, because there are options that would lead to a recovery. Whether the patient chooses to take those options is a matter for the individual patient, but such conditions would not meet the eligibility criteria that are set out in the bill.

Although it maybe did not feel that way at the time, it was helpful to hear from the Cabinet Secretary for Health and Social Care. Although the Presiding Officer has deemed the bill to be competent in the context of the Scottish Parliament’s powers, I have always acknowledged that putting in place a fully functioning process of assisted dying in Scotland will require matters that are the preserve of Westminster to be addressed, in particular in relation to medicines, the Misuse of Drugs Act 1971 and so on. However, as the committee heard on numerous occasions last week from Mr Gray, those matters can be resolved only at the point at which the Scottish Parliament decides that a change in the law is required.

I do not think that I am breaching any confidences by saying that I have had early and occasional discussions with the UK Government as well as the Scottish Government. Those discussions have really just been to keep the Governments updated on the bill’s progress. I think that it was June 2021 when I first announced that I was planning to introduce the bill, and it has been important to keep people up to date with what has been going on in the background and to reassure them that it would emerge at some point.

However, those discussions have taken place in the context of a recognition on both sides that the UK Government and the Scottish Government have, quite understandably and justifiably, taken a position of neutrality and are awaiting the outcome of the stage 1 vote, at which point the mechanisms that can address the issues of legislative competence can be addressed. I am confident that that can happen in a timely fashion.

It is worth bearing in mind that this is a sensitive issue that needs careful and sensitive handling. From the outset, I was very conscious that I did not want to use the bill as a mechanism to push the boundaries of constitutional arrangements, so, as Ms Bennett has articulated, I have operated in that framework. I am very confident that the mechanisms to resolve those issues exist. Given that a very similar bill is going through the Westminster Parliament, coincidentally at the same time as the bill that we are considering, I think that that enhances the opportunities to ensure that relatively speedy progress can be made in this area once the Scottish Parliament decides whether it is supportive of the general principles, in support of a change in the law.

In response to your question about the doctors being two GPs in the same practice, that would not be permitted. The doctors need to act independently of each other, and one of them must have had no prior relationship with the patient themselves. The second doctor will have the medical notes, but they will carry out their assessment of terminal illness and mental capacity.

Dr Ward, did you want to add anything?