Stuart McMillan
Scottish National Party · Scotland
“Can the cabinet secretary provide any details about when funding will be in place to replace the Port Glasgow health centre with a new health hub? Can she advise when there will be investment to improve the fabric of Inverclyde royal hospital?”
“Will the member give way? Mark Simpson: I would love to. Stuart McMillan: Reform’s policies are about taking money out of the public sector, but Mr Simpson is now asking for more money to be spent on throughcare support. Where is that money coming from? I am genuinely interested to know.”
“Millions of people globally are impacted by climate change today, and that will also be the case for future generations, as has already been touched upon by Sanne Dijkstra-Downie.”
“It is important that they are successful in delivering the heat that we all need, but the issue of their environmental impact is also vital. District heating systems play an important role in communities up and down the country, but they come in a range of scales. Are they operating effectively?”
“I touched on the CPA a minute ago, and the issue of AI data centres has been raised time and again at both international and regional conferences. We are not the only people who are talking about the issue. Helpfully, it is on the agenda for this year’s festival of politics.”
“I look forward to the contributions from MSPs in the open debate, which I am sure will help the committee’s discussions on Thursday, when we meet for the first time, and during the rest of the parliamentary session. I will touch briefly on three items, for wider consideration.”
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“That tells me that the public view the risk of that becoming a provision in Scotland as being just too high. I note Liam McArthur’s clarification on amendment 57. Although the amendment seems innocuous, I am worried about the unintended ramifications, given that it would replicate the type of recording that is used in Australia, which has subsequently been used by review boards and campaigners to argue for widening access. 14:00 Liam McArthur: I want to take Audrey Nicoll back to her earlier comment. As I have acknowledged, no two assisted dying laws anywhere in the world are exactly the same. As we have been discussing this morning and this afternoon, we must ensure how the legislation, if passed, will work in practice here.”
“Jackie Baillie’s amendment 280 would require the number of persons aged 18 or under who requested assistance to end their lives under this regime to be recorded. I welcome this amendment, which would increase accountability. We know that, shockingly, there have been successful efforts in some jurisdictions to broaden access to assisted dying to that age group. In Canada, a 2023 parliamentary committee review of Canada’s assisted dying legislation recommended the expansion of assisted dying to children, although I note that the recommendation has not yet been advanced. We know that public support in Scotland falls quite significantly when people consider the fact that, in the Netherlands and Belgium, children of any age may, in certain circumstances, be eligible for assisted dying.”
“Audrey Nicoll: In opening the debate on this group of amendments, I described them as “straightforward.” However, that might have been to unintentionally understate the crucial importance of data and reporting, given that we know that, where assisted dying is legalised, reporting provisions have sometimes, sadly, served as mechanisms for either widening eligibility and relaxing safeguards or not taking corrective action when major issues are flagged. It is crucial that relevant and accurate information is captured, so that vulnerable individuals who could be harmed by assisted dying legislation—those with physical and learning disabilities, people with eating disorders, victims of domestic abuse, those in poverty and many others—remain protected by robust safeguards and so that the operation of the legislation does not drift over time.”
“Amendments 289, 291 and 295 would have significant cost and resource implications. On amendment 296, I refer colleagues to my comments on amendments 298 and 299 in the previous group regarding the difficulties of collating the required data on palliative care. The Scottish Government has no comments on the remaining amendments in this group, other than the technical points that are to be found in the commentary. The Deputy Presiding Officer: I call Audrey Nicoll to wind up and to press or withdraw amendment 275.”
“Amendment 288 would require the report submitted by Public Health Scotland to include an assessment of the availability, quality and distribution of health and social care services to persons who made a first declaration. Public Health Scotland does not currently collect data on the availability, quality and distribution of health and social care services in the manner requested. As such, new processes and investment would need to be included to support that level of data collection, development and reporting. There might also be a need for duties to be placed on persons holding such information—such as health boards—to provide it to Public Health Scotland. From a legal perspective, there might be a lack of clarity as to the meaning of “quality and distribution of health and social care services”.”
“Although that goes some way towards addressing the concerns that I just raised in relation to amendment 279, it does so in a way that would put a further burden on Public Health Scotland’s resources. The Scottish Government’s view on amendment 284 is that it would place additional data collection and reporting requirements on Public Health Scotland and other bodies in relation to safeguarding concerns, referrals and outcomes. That would require careful alignment with existing adult protection processes, information sharing arrangements and data handling requirements, including distinctions between substantiated and unsubstantiated concerns.”
“He makes a perfect reasonable argument. Amendment 290 would impose requirements on Public Health Scotland in relation to obtaining information. From a legal perspective, it is not clear what remit Public Health Scotland would have that would require such information to be provided. I note that section 25 already provides for Scottish ministers to make provision by way of regulations about the provision of information to Public Health Scotland. Amendment 290 also provides that, where information that is required by section 24(2) cannot be obtained, the report must specify the information that is missing, explain the reasons why it cannot be obtained and set out the steps taken to obtain it.”
“On amendment 279, the Scottish Government is concerned that the removal of the phrase “in so far as known to Public Health Scotland” from section 24(2) would risk Public Health Scotland failing in its statutory duty, should such information not be obtainable. Brian Whittle: On a similar point to one I made earlier, it is not the collection of data that we should be worried about. We can collect as much data as possible to be potentially deployed in the future. If we do not reach the threshold that the cabinet secretary indicates in relation to retaining anonymity, we will just not use that data, but to not collect the data is the wrong way to go. Neil Gray: Mr Whittle has made his case and I have set out the Government’s perspective. It is for colleagues to decide. I have no further comment on Mr Whittle’s intervention.”
“By diverting limited resources to the reporting and monitoring mechanism, the amendment is also likely to have an impact on the ability to provide comprehensive information. Amendment 278 would create a requirement for periodic detailed reviews to take place. Given the small numbers of people who are expected to undergo an assisted death in the early years, it might be difficult to balance the need for those reviews with the privacy of the individuals involved. Legal issues could also arise if the publication of a detailed assessment of a sample of cases were to result in the disclosure of private, personal data.”
“Amendment 275 would add significantly to the information that is to be provided by Scottish ministers under section 23A. It appears to be resource intensive and could potentially impact on the clarity and accessibility of the information that is to be provided. Amendment 276, which is also to do with the information that is to be provided under section 23A, would be similarly resource intensive. In addition, from a technical perspective, amendment 276 is very wide ranging and lacks clarity. The Scottish Government’s view is that amendment 277 would be resource intensive and that, in establishing new processes and requiring the provision of an annual report setting out whether requirements have been met with regard to the duty to provide information, it would incur significant costs.”
“Furthermore, new processes and investment would need to be included in order to support that level of data collection, development and reporting. I would make a similar comment on amendment 287. From a delivery perspective, the requirements of amendment 116 would be resource intensive, particularly given the reporting requirements that are already addressed under section 26. It also seems that the amendment would require Public Health Scotland to provide clinical recommendations that are to be actioned by Scottish ministers. That appears to go beyond the organisation’s usual remit. Furthermore, it does not allow for Scottish ministers, in reviewing those recommendations, to make a final decision on whether they should be actioned based on the report or any other relevant information.”
“Amendment 63 would require Public Health Scotland’s report to include information about the number of persons who have completed training under the legislation. As I have outlined, the training provisions in the bill may raise issues of legislative competence and are therefore recommended for removal, with any necessary provision being made, instead, through an order under section 104 of the Scotland Act 1998. Amendment 64 would add to the list of characteristics by which information in Public Health Scotland’s report is to be broken down. From a deliverability perspective, it is very prescriptive about the data that is to be collected and analysed. Setting those requirements out in primary legislation would tie limited resources to statutory obligations and would not allow statisticians to adapt to changing needs.”
“Neil Gray: I open my contribution on the final group of amendments by asking all colleagues to be mindful of several consequential amendments that are among the raft of amendments that we will vote on at the conclusion of the amending stage. For instance, Bob Doris’s amendment 60 was contingent on amendment 37 being agreed to, and amendment 37 has been agreed to. I also referenced Bob Doris’s amendment 61 in my intervention on Mr McArthur. Amendment 23 inserted “and palliative care” after “appropriate social care” in section 6(2)(aa), but amendment 61 does not account for that addition. Although relatively minor, it is a technical issue that colleagues should be aware of as we conclude our voting today.”
“If there is such a thing as a “Disney death”—that is the phrase that has been used in the chamber over the past hour—that is the sort of death that I want. I would love to have a Disney death if such a thing exists. In the absence of fairytale death, what is the next best thing? Like others, I will have to wrestle with the fact that if I am willing on Tuesday evening to deny others the right to choose, I will be denying myself that right too. Equally, if I vote to give others the right to choose, I will be giving myself the right to choose. Each and every one of us will have to consider that over the next few days before we come back and vote on Tuesday. I ask members to reflect on that question, because it is the fundamental question that we have been asked to consider this weekend.”
“We all want palliative care to improve, and I welcome any reporting mechanisms that will help future Governments to make policy in the area, so I will support some of the amendments in group 20. However, the idea that people who are facing a terminal prognosis and who have months or weeks to live—as will be relevant under the bill as amended—are somehow naive about what the end might look like, I find incredibly insensitive and indeed patronising to those people. The question that some members have to grapple with—I am one of them, as I believe is Ross Greer along with a few others—is whether we want to grant people any choice about the manner of their death. At the moment, clearly, not everyone has that choice.”
“I include myself in that latter category of being in listening mode. Equally, a number of us will have to go away from the chamber in an hour or so and spend the next few days reflecting on what we have heard and on the state of the bill as amended. That is an incredibly important task that each and every one of us will take away, and I know that we will do it studiously in our own ways. In this morning’s session, like others, I was struck by the testimony of Ms Whitham, who gave a powerful and personal representation of the status quo. Mr Kerr and Mr Fraser are right that the whole discussion is uncomfortable, but it should be uncomfortable. Under the status quo, death is not always pleasant, no matter how far palliative care takes it. That has become sadly apparent to us.”
“Professor Michael Dooley, who was commissioned by the Government in Australia to research and find the approved substance, wrote to the Health, Social Care and Sport Committee and outlined 100 per cent efficacy of the drug protocol in Australia. Pharmacy stakeholders, including the Royal Pharmaceutical Society, Community Pharmacy Scotland and others, met Professor Dooley in Glasgow. We know that the drugs can work at 100 per cent efficacy—nobody has not died from those drugs. I am not a nurse, but I imagine that others in the chamber who are nurses would be offended by Ms Webber’s assertion when she talked about “those who claim to be nurses.” Jamie Greene: Over the past four days, it has been clear that a small number of MSPs have had a lot to say and a lot of MSPs have had not much to say.”
“A study by the Anscombe Bioethics Centre found that, between 2012 and 2019, palliative care funding increased in European countries that had assisted dying at a rate of 7.9 per cent. However, in European countries that did not have assisted dying, in the same period, the funding increased by 25 per cent. Countries with assisted dying saw increases in funding—that point has been made in the debate—but they had a much lower increase in funding that that in countries that did not have assisted dying. We should reflect on that. Whatever we think about the bill, let us agree that, in the next session of Parliament, we will do better on palliative care. Rona Mackay: I rise to speak against Sue Webber’s amendments 115 and 116.”
“All I am saying is that, as I argued earlier, suicide prevention services should be made available to those people, and we should do far more in society to promote suicide prevention. I will close with a comment on the wider debate about palliative care, which we have just heard about from Stephen Kerr and others. One thing that is clear in this whole debate is that there is unanimity in the chamber that we need greater support for palliative care. We simply do not have enough palliative care doctors and support services across the country. Regardless of where members stand in the debate, and regardless of whether the bill is eventually passed, I think that we would all agree that that needs to be addressed. We have had a discussion on whether palliative care would be aided and abetted by assisted dying.”
“Murdo Fraser: The member has put her view on the record. All that I have done is quote from the international experts on suicide prevention. Members can make up their own minds as to whether or not it is appropriate to quote those people in the context of this debate. Christine Grahame: I think that Murdo Fraser should consider that, if the mental state of somebody with a terminal illness is such that they have been driven to suicidal thoughts, that will be part of the assessment of capacity that will be undertaken by two of the medical practitioners, at the very least, with referrals, perhaps, to social work and others under the guidance. This is not a blank cheque. There are measures in place to ensure mental capacity. 13:45 Murdo Fraser: I do not think that Christine Grahame is disagreeing with me in that intervention.”
“It said: “We must ensure that all persons considering ending their lives or having their lives ended by others, have access to high quality suicide prevention assessments and interventions, regardless of their problems, circumstances and status of their eligibility for” assisted suicide. Those are not my words, but those of the International Association for Suicide Prevention. Clare Haughey: I thank Murdo Fraser for taking my intervention, but I want to point out that the organisations and the individual that he quoted are not members of this Parliament. They are not here speaking on behalf of their constituents and on behalf of the people of Scotland. For that reason, I ask Mr Fraser to moderate and de-weaponise his language and to use the language in the bill and proposed legislation, instead of using the terms that he has used.”
“Secondly, our late colleague Jim Wallace, the former Deputy First Minister, said in an interview in 2022 that the term “assisted dying” was misleading and that “what is actually being proposed is assisted suicide.” Of course, Lord Wallace was Liam McArthur’s predecessor as the Liberal Democrat MSP for Orkney. Perhaps most powerfully in this context, I want to quote the International Association for Suicide Prevention. The international experts in this field have said that there is “overlap and equivalence between … suicide … and assisted suicide.” In fact, I will quote directly from the statement that it made on 1 December 2025.”
“I know that this is an emotive area for colleagues; indeed, we have already discussed it in this morning’s debate. I know that there are colleagues who do not like the use of the terms “suicide” or “assisted suicide” and such language being used in reference to the bill. However, I just want to quote three things to them. First, Inclusion Scotland, which represents disabled people, has been clear in its view that the correct language in relation to the bill is assisted suicide, because that is the way in which its members, who represent the disabled community in Scotland, see it.”
“That includes the actual means by which this will be done, the nature of the structures and the costs—there are so many areas where the response to the questions raised by colleagues has been, “Well, we don’t know how this will work.” That being the case, and given that we will be so beholden to guidance, it is critical that the responsibilities of this Parliament do not end with the passing of this bill—if that is what we are going to do—as we have done with other measures. I ask colleagues to support amendments 291, 296 and 310. Murdo Fraser: My amendments 294 and 295 seek to build on other amendments in this group from Audrey Nicoll and others and to strengthen the annual reporting duty, which requires a review of the impact on palliative and end-of-life care services, by extending it to suicide prevention measures.”
“In concluding my comments in support of my amendments, I want to say that if we move down this path—and I hope that we do not—we have a duty to ensure that Parliament remains informed, that ministers remain accountable and that emerging risks are recognised before they become entrenched. I say for the last time— because this is the last time in the consideration of the amendments that I will have the opportunity to address colleagues—that, in legislation dealing with matters of life and death, the vigilance of this Parliament is not optional. It is the responsibility of this Parliament, if we take these decisions and move in this direction, to ensure that that we are vigilant and that we have continuing intense scrutiny of how all of this works out, given that so much of it is so vague. Indeed, Liam McArthur himself has accepted as much.”
“We should really look at how we provide that care across the board, and we should not have left so much of it to the charitable sector. Stephen Kerr: I am grateful for that intervention; I respect very much what Christine Grahame has said, and her long-standing advocacy for what she has just described. Douglas Ross said earlier that the current situation with palliative care is “a national disgrace”. It is a disgrace that there is such inequality in relation to the choices that Scots face depending what part of the country they live in and their circumstances, as other members have highlighted.”
“The bottom line is that if Scotland— Christine Grahame: Will the member give way? Stephen Kerr: I give way to Christine Grahame. Christine Grahame: I reiterate what I said earlier, and what the member in charge has said. For me, it is certainly not an either/or, and I fully hope that the bill makes members in the current session of Parliament, and in the next session and any subsequent session, really look at the provision of palliative care, because it has been a bit of a neglected area. What concerns me is that we can deal with the matter outwith legislation. It is a matter for policy and financial decisions by successive Governments as to how we address the issue of the increasing need for palliative care, not simply in the end-of-life context but in general. That includes babies and children and adolescents onwards.”
“Again, I lean heavily on what Liam McArthur, as the member in charge of the bill, has said repeatedly about his view as a proponent of the bill: that the assisted dying measures that he is proposing, and palliative and end-of-life care services, go together—it is not an either/or. That being the case, provision of those services—which Bob Doris and I both feel very strongly about; I pay tribute to the work that he has done in this area over many years—is the reason why amendment 296 is so important. Issues of palliative care and end-of-life services need to stay pre-eminent in the Parliament’s consideration. That has been at the root of a number of interventions that I have made over the past few days. I hope that Bob Doris is satisfied that amendment 296 is not what he thinks it is, and that he accepts my explanation.”
“I am willing to give way to the member again. Bob Doris: I will be brief. Proposed new paragraph (d) that would be inserted by amendment 296 talks about “additional funding” where there are “shortfalls” in palliative care provision. As a backbench MSP in the party of Government, I say that there are shortfalls in palliative care provision just now. Amendment 296 suggests—if I have read it correctly—that, irrespective of the legislation, we would be tying increasing palliative care funding directly to the provision of assisted dying. That presents a bit of an issue. Stephen Kerr: I am glad that Bob Doris has expanded on his intervention. That is absolutely not the case with my amendment—it is quite the opposite.”
“Throughout the debate, I have tried to say that the provision of palliative and end-of-life care services stands on its own and has to be independently funded—end of story—irrespective of assisted dying. Your amendment, Mr Kerr, potentially conflates the two. The Deputy Presiding Officer: Always speak through the chair. Stephen Kerr: I am not sure that I followed the last point—I am willing to give way to Bob Doris if he wants to expand on his last point about the conflation of the two issues. I am trying to safeguard the funding and the level of service, and—to be frank—secure the equality that should exist across Scotland with regard to access to such care. We have heard about that repeatedly today, as we have over the previous three days of consideration of amendments. That equality of access does not exist.”
“However, regardless of where we stand in relation to the principle of assisted dying, surely we can agree that, if Parliament takes a step of this magnitude, we must watch carefully what follows. Bob Doris: I have been listening intently to Mr Kerr, and I have read his amendments. Amendment 296 would ask the Scottish Government to identify “any shortfalls in funding, staffing, or other resources for these services” in relation to palliative care. It would also require a statement from Scottish ministers about “additional funding, recruitment, training, or other resources to ensure no reduction in palliative and end of life care” services. That is all very noble, and I have some sympathy with it, but I have a slight concern.”
“My amendment would instead require the affirmative procedure, meaning that they would not come into force without the Parliament’s explicit approval—a reasonable safeguard. If this bill passes and affects how life may end in Scotland, the systems for its operation—systems that we oversee and monitor—should not be changed quietly or inadvertently. They should be subject to full parliamentary scrutiny, and we have already rehearsed the arguments for that in the discussion on previous groups. I think that that case has been largely accepted by most members. As I started out by saying, members across the chamber will approach the legislation from different perspectives, but I have always been clear in my view, and other members have been clear in their views, which I respect.”
“Every day, dedicated professionals work with individuals who are experiencing despair, isolation and the overwhelming belief that life has become too difficult to continue. If assisted dying becomes part of the healthcare landscape in Scotland, it will inevitably alter the context in which those services operate. That change might be subtle at first, but if pressures begin to emerge, attitudes shift or unintended consequences appear, the Parliament should know. Amendment 296 would ensure that we do. Amendment 310 would address a related but equally important question: how the Parliament scrutinises the regulations that govern the reporting and monitoring framework. Under the bill as drafted, the regulations would be subject to the negative procedure.”
“Amendment 291 would require the Scottish ministers to consider the findings carefully and to “publish a statement setting out any action taken, proposed, or planned in response to those findings”, which would have to be laid before the Scottish Parliament. If ministers conclude that no action is necessary, despite serious findings, they must explain that decision openly. Collecting information is not enough. The Parliament must ensure that what we learn leads to reflection and, if necessary, to change. Amendment 296 would address another important dimension of that monitoring by requiring the reports that are produced under the act to include a review of the legislation’s impact on suicide prevention services. Suicide prevention is one of the most important responsibilities in our healthcare system, as has been mentioned today.”
“By the way, Jackie Baillie and other colleagues were right on that issue, and I agree with what Emma Roddick just said, too. I will vote for all amendments that call for more data and for greater levels of post-legislative reporting, because we need to get better at doing those things. Given that we are discussing such a significant piece of legislation, I hope that Neil Gray understands why I believe that we need a particularly high level of detail and data, so that the scrutiny that we give to the bill—should it become an act—differs from the run‑of‑the‑mill scrutiny that I have witnessed over the past five years. Amendment 291 would close that gap in scrutiny. Sometimes bills require reports, but they do not necessarily require ministers to respond to what the reports reveal.”
“Amendment 291 would address what happens when the reports that are required under section 24 of the bill are produced. Those reports will contain important information about how the law operates in practice. They will show trends, identify safeguarding concerns and reveal whether particular groups are affected in ways that the Parliament might never have intended. The bill currently requires those reports to be produced. 13:30 Neil Gray: Does Stephen Kerr accept that post‑legislative scrutiny is already in place as required, that a prescription is not required and that his amendments could add additional cost? Stephen Kerr: That is the whole point. My experience, having served only five years in the Parliament, is that we are not particularly good at scrutinising legislation.”
“In offering my comments today, I want to be clear that I understand the sensitivities of people who choose to support the bill, but I hope that those who support it understand how deeply felt my and other people’s opposition to the bill is. I will take group 20 as a whole, because it asks the Parliament to reflect on something that is often overlooked when legislation of this scale is debated, which is not just how a law begins, but the outcomes of what happens after it comes into force, and how the Parliament ensures that we remain alert to its consequences. One of our responsibilities in the Parliament is post-legislative scrutiny. As such, post-legislative scrutiny is baked in to the legislation and is a necessity for this bill, given its significance. My amendments are concerned with that responsibility.”
“We should not leave it to guesses and hope. We would have to know who was accessing it and what issues had come up as a result. Miles Briggs: Amendment 288 would require Public Health Scotland to report on the health and social care services that were available to individuals who made a first declaration, including pain and symptom management and psychological support. That should also include reporting on the availability of information about accessing palliative care services to persons seeking an assisted death. I believe that that complements amendment 299, which we debated yesterday in group 15. Stephen Kerr: I know how uncomfortable much of the dialogue around this debate is. We are facing uncomfortable truths about our own mortality and the mortality of the people we love. It is a matter that is dear to all of our hearts.”
“My amendments would ensure that we captured outcomes, too, and I hope that everybody would be reassured to know that people who were in a position to spot issues erred on the side of caution. Audrey Nicoll’s amendments in the group are also important as they seek to ensure transparency. The group is essential. We must be able to accurately review and reflect on the operation of the legislation if it becomes law. The intent of Bob Doris’s amendments is also important. I heard Elena Whitham’s arguments about the SIMD. However, knowing how unhelpful the SIMD can be in describing rural and island poverty, and knowing that I live in the highest- ranked SIMD area in the Highlands, I am not sure that that general data set is helpful in checking the socioeconomic status of people who would make use of assisted dying.”
“Amendment 284 would also require a summary of the outcomes of those safeguarding investigations. Concerns would undoubtedly be raised that amounted to nothing, with no risk to the patient found. That would be great and would show that the system was working as it should. I would, however, expect those who are involved in delivering assisted dying to be cautious, to instigate investigations when there were slight concerns, and to allow those investigations to determine whether or not the concerns were founded. It would be important to collect these data so that we could see that the overall picture was as expected and hoped for by everybody who has spoken to safeguarding in these debates, regardless of their position on the bill itself.”
“I would want to know whether the known risks to those groups in healthcare generally, the difficulties that they face in accessing support services and the higher prevalence of disability, degenerative conditions, poverty and sexually transmitted diseases were having an impact on why and when assisted dying was used. What we did with that data would be up to us, but I hope that the Parliament can agree that we should at least collect it. Amendment 284 would similarly require the collection of data on safeguarding concerns and ensure that, if the act worked as it should and resulted in referrals to adult protection, social work, police or other safeguarding authorities, the information on those referrals could be taken into account when any policy changes or adaptations were made to the legislation and how it operated in future.”
“UN experts have warned that disabled people and older people, especially older disabled people, might feel subtly pressured to end their lives prematurely because of the lack of appropriate services and support. That seems inevitable to me and I am deeply concerned about the inherent risk of ableism being promoted through the use of assisted dying, which is why I cannot support the bill. However, we know that those inequalities span more than disability. If assisted dying were offered in Scotland, I would also want to know whether poorer people, women, carers and racialised minorities were using it more or less than others.”
“Undoubtedly, without data collection on equalities trends, there would be compelling anecdotal evidence on both sides to claim that there was no equalities impact or that there were extreme equalities impacts. Amendment 287 would let us keep an eye on what was actually happening here, not on what we might think or claim or guess was happening and not on what was happening in only the best or worst cases, but on trends and biases over time. We would need to know whether groups with particular protected characteristics were using assisted dying more or less than expected in comparison with others. We have a duty to dig deeper into any trends and, to do so, we would have to know what those trends were.”
“Amendment 287 would require reporting under the act to include analysis of trends, patient safety risks and safeguarding concerns. There are international comparisons, which I have heard both sides of the debate—for and against the bill— pick apart and hold up as examples. We do not know who would access assisted dying in Scotland, how that would look for them or what impacts it would have. I expect that the picture would be different even in the Highlands and Islands compared with Glasgow. In the context of an island nation with pockets of deprivation, depopulation and even a lack of vitamin D, we do not know with certainty what impact protected characteristics would have on our population and the way in which it would seek to exercise rights under the bill if it is passed.”
“The purpose of the amendment is to improve patient safety, enhance transparency and ensure that lessons from adverse outcomes are systemically applied to prevent reoccurrence. Colleagues, this is a flawed bill. We can tinker around the edges and try to make it safe, but it is fundamentally flawed. Within the powers that this Parliament has, we are unable to pass a safe bill, and we should therefore not pass this bill. We cannot legislate for the drugs that would be used, for the training of healthcare professionals or for what would happen if the drugs did not work. Emma Roddick: Colleagues will know that, in general, I am a big fan of data. It is important that, if the bill becomes law, we collect the right data.”
“Studies from the Netherlands and the US have noted that, although complications are infrequent, they do occur, with some reports citing rates of 1.2 per cent to 7 per cent, depending on the methods—that is, whether the method is intravenous or oral. Those complications can and do cause distress and often require the administration of additional medication to complete the process. We have not yet had clarity in the debate about what would happen if the drugs did not work. Amendment 116 would also impose a statutory duty on the Scottish ministers to ensure that all recommendations were acted on “within 6 months of receiving a report”, and to publish a statement describing the measures that have been taken.”
“Sue Webber: The term did not relate to what your mother experienced. [Interruption.] The Deputy Presiding Officer: Members. Sue Webber: The term related to many people’s perception of what an assisted death would look like. We have heard from other members that that is not the reality. We must stop pretending that that is the reality, because it is not. Serious side effects happen. For some people, the drugs do not work, and other people can take hours to die. If we did not monitor and record those situations carefully, we would be unable to ensure that the service was as safe as it possibly could be. As we have just heard, this is clearly an incredibly difficult subject. I may or may not be getting my point over succinctly, but emotions in the chamber are—and have been—high.”
“I made those points when I spoke to my amendments at stage 2, but they were cast aside by those who claim to be nurses. We know that the cocktail of drugs that is used in assisted dying is a toxic combination that includes paralytics. We are not sure what a person who undergoes an assisted death goes through, because the paralytics act first and quickly. It is a not a Disney death, and serious side effects happen. For some people, the drugs do not work, and other people take hours to die. We heard about those people earlier this week from Ruth Maguire and Audrey Nicoll. Elena Whitham: I find that turn of phrase to be particularly distasteful. Will Sue Webber reflect on that, and will she think about whether my mother’s death, which was legal under the current law and took two weeks in which she starved to death, was a “Disney death”?”
“My amendments 115 and 116 seek to strengthen reporting and accountability in relation to the use of approved substances under section 15(1). They would require any complications, side-effects or adverse reactions, which were experienced by persons who were provided with an approved substance, to be documented in detail. Those details should include the type and frequency of the side effects, the substance that was used and any clinical or professional recommendations that were made to address those issues. All drugs have side effects. Last week, we heard from a palliative care doctor about how specialised the service that they offer is, how every patient is different and that drugs act differently in every patient’s circumstance.”
“In general terms, I share Bob Doris’s view that the more data-collecting provisions we include in the bill, the better, because this is a complex area of policy and legislation, and we must be able to understand how the bill, if it is passed, works in practice and whether it has any unintended consequences. With that, I draw my remarks to a close. Sue Webber: Before I speak to my amendments, I draw members’ attention to the fact that, in the past few minutes, we have received an email from the Royal Pharmaceutical Society in Scotland, which has stated its opposition to the bill following the removal of vital protections to protect pharmacists who conscientiously oppose assisted dying. That goes to the heart of what some of the amendments in this group are about. We should make decisions that are driven by data.”