Hansard

I express my gratitude for the opportunity to bring the bill to the stage that it has reached today. In doing so, I thank the Health and Sport Committee, the Justice Committee, the Delegated Powers and Law Reform Committee and the Finance Committee for the work that they have done to inform Parliament of their consideration of the bill. I also thank Parliament officials Andrew Mylne and Louise Miller; the campaigners from Friends at the End and the my life, my death, my choice campaign; and Amanda Ward, who has acted as my adviser during the bill process.

There are also colleagues from across the political spectrum who have expressed their support either for me personally in taking the issue forward or for the principle that the Assisted Suicide (Scotland) Bill embodies, and I thank them all. However, in doing so, I could hardly fail to acknowledge that it was never supposed to be me who was in charge of the bill. When Margo MacDonald asked me whether I would serve as second member in charge of the bill, I agreed on the basis that she knew that her condition gave her good days and bad. On a good day, she was still very good, but she knew that it was possible that she would not be here to bring the bill to the Parliament, or that she might simply be unwell and unable to attend a committee meeting. I agreed to act as understudy in that sense, and my role has grown since we lost her.

Members will be well aware not only of Margo’s long-standing commitment to the issue but that the bill is by no means the only example of her commitment to an issue that might divide opinion and be uncomfortable for members and members of the public to debate. That is the first thing that I want to recognise about the bill: it addresses an issue that is inherently complex, difficult and, for many of us, uncomfortable to talk about in politics or in our own lives.

In inheriting the bill, I will fulfil the commitment to present it as best I can to the Parliament, but I am also very aware of the flexibility that that position gives me. The Assisted Suicide (Scotland) Bill is not a bill that I drafted but the bill that Margo MacDonald drafted, and I can see that parliamentary scrutiny has already shown examples of areas where it can be improved. Most bills can be improved through parliamentary scrutiny, and that is certainly true of this one.

Whatever view members take of the detailed operation of the legislation were we to pass it, I hope that all members understand the basic principle and accept the idea that human beings have a right to make a decision in the circumstances of, for example, a terminal or life-shortening illness. I hope that members will give the bill the opportunity to go forward to the next stage, when we can begin to debate the amendments that may be lodged.

I think that, during our consideration of the bill, the case has been made clearly that a change in the law is justified and that the current law is not only inadequate but unclear. Members who have looked at the exchange of evidence between the Lord Advocate and legal experts such as Professor James Chalmers will have struggled—as anybody would—to come up with a clear, comprehensible understanding of what the current law actually means.

In Scotland, no one who is faced with a terminal illness or with one of the other conditions that would be captured by the bill’s provisions and who feels the need to ask for assistance to take control at the end of their lives, and no one who is asked by a friend or loved one for such assistance, is being given any clarity about what actions might be subject to prosecution or what the charge might be. In fact, after an exchange of evidence between Professor Chalmers and the Lord Advocate, Professor Chalmers stated:

“It at least leaves open the possibility that provision of the means of suicide would be regarded as the legal cause of death. If the provider knew the purpose for which the means were provided, they would almost certainly have the necessary mens rea for murder, or at least culpable homicide.”

Is that really the treatment that we expect to see put into practice in all such circumstances? Under the current law, any person who offers that assistance is left subject to the possibility of being prosecuted for murder or culpable homicide.

The case for a change in the law is very strong, but is the proposed change the right one? Does the bill capture the change that those who agree that there is a need for change want to see? As I have said, there are clearly areas in the bill where there is room for improvement. I thank those who have pointed out some of those areas, and if the bill at stage 1 is agreed to, I will work with them to ensure that there are amendments to address areas such as better recording and reporting of information. In that regard, the most obvious and simple example is that of reporting to the procurator fiscal instead of the police in all circumstances.

There is perhaps some room for improvement around the clarity of definitions—for example, of specific acts that the licensed facilitator may or may not undertake. There could be a danger that we might go too far in the direction of having very prescriptive definitions, which would be for the regulations that the bill calls for. Some of the arguments around the lack of clarity in the bill are overstated; the bill should be compared with the law as it stands and not with some imagined world in which no grey areas exist. The bill asks us to acknowledge and engage with the inherent complexity of the subject, and rejecting it will not remove those grey areas from our lives or from the way in which the law and medical practice deal with us at the end of our lives.

There have been some suggestions on how to improve the bill in relation to the need to take care that dangerous prescription drugs do not fall into the wrong hands. We all share that concern, and by no means do I think it beyond our wit to come up with a solution.

There is a debate to be had about issues of scope and eligibility. Some may feel that the arguments relating to terminally ill people are sufficiently different, and that they can accept the bill covering terminally ill people but not others. Personally, I do not agree with that approach, but the only way to debate that difference of approach is to agree to the general principles of the bill and debate amendments at stage 2.

On the time limits that are built into the process for making a request for assistance, the Health and Sport Committee has quite rightly acknowledged that there is a balance to be struck between having a recent test of mental capacity and ensuring that people do not feel pressured to act on the option of assisted suicide before they feel truly ready. In the bill as introduced, a final 14-day time limit ticks away after the second request for assistance, and if that time limit is reached, the means for someone to act on their decision to seek assisted suicide is taken away.

There are other options. The committee suggested some options for change, and in my response to the committee’s report, I suggested another, which is to require that the second request for assistance be renewed at the 14-day time limit, rather than its simply falling away completely.

People of good will can come together and make the bill better in all those areas.

There are concerns that unite supporters and opponents of the bill. Many of us have been asked why we are focused on the right to die and not on the right to live. I think that supporters and opponents of the bill can be absolutely on the same page in relation to the commitment to and support for high-quality medical support and palliative care and, in particular, the social, economic and physical factors that ensure that disabled people are able to live full lives. None of us would disagree in those areas, and I do not think that there is any evidence from other jurisdictions in which a system of assisted suicide exists that such a system undermines the political, practical or financial commitments that are given to those priorities.

However good the availability of those facilities is in our society, they do not, even under the best conditions that we could imagine, overcome the issues that the bill raises or answer the concerns of those for whom palliative care and other forms of support are not or may no longer be adequate when they reach a certain point. The bill seeks not to narrow down but to widen the choices that people have before them.

Another area of concern that should unite us is the question whether a right to die becomes a duty to die—I refer to vulnerability and the risk of coercion. I agree that the risk of coercion can never be eliminated: that is true under the current legislative framework, and it would be true under any legislative framework. It cannot be assumed that the absence of a legal route to assisted suicide provides protection from coercion—indeed, the opposite may be true.

It is not possible to be definitive about the number of terminally ill people who commit suicide in Scotland each year, but it is reckoned to be in the dozens—perhaps in the order of 50 people. That is an estimate. Currently, people make that decision and exercise that choice not only in a legal vacuum, but without the ability to do so in a supported way and without giving those who care for them—their family and friends, and the medical and professional carers around them—the opportunity to explore with them proactively the alternatives that may exist. We are leaving people to make those decisions in that vacuum and in the absence of the care and support to which they are entitled. The bill cannot be capable of entirely removing the risk of coercion, but I believe that, should coercion exist, people are more vulnerable now than they would be under the bill.

There are other concerns that I understand but cannot accept as reasons to oppose the bill. Some arguments are religious, of course. There are those for whom life is a gift from their god. I do not have that world view and cannot take that viewpoint. However, the legislation is secular and it would bind all of us, whether or not we choose to subscribe to a religion. In any case, there is a range of views among the religious communities in Scotland and around the world on the question of assisted suicide.

Others have argued that passing the bill would in some way normalise suicide in the wider sense. Again, from the jurisdictions that have a system of assisted suicide, I see no evidence to suggest that attempts to prevent suicide in the wider population have been undermined. I think that people know the difference between suicide in the wider sense and people’s ability to take control if they are facing the end of their life.

The committee suggested that passing the bill would be in some way crossing the Rubicon. I disagree. We are human beings engaged in the moral and ethical complexities around the end of life, whichever legal framework we choose. Do we allow people to end or refuse treatment or to make other active choices, even in the knowledge that that will end their life? Yes, we do. Do we facilitate those choices, giving practical and emotional assistance when people need it? Yes, we do. Are those ethically and morally straightforward and uncomplicated choices? Not at all. Every day, medical professionals face many practical—not theoretical—situations in the real world, and the bill asks us not to imagine or wish them away but to engage positively with them and respect human beings’ right to make a decision in the context of the relationships and care around them.

I ask members who see the case for a change in the law, whether or not they are convinced by the detail of the bill, to let us go on after today to debate the detail, make changes if necessary and send a clear signal that society is moving away from a paternalistic approach to care at the end of life towards one that empowers people to make their own informed decisions and which respects people on those terms.

I move,

That the Parliament agrees to the general principles of the Assisted Suicide (Scotland) Bill.

[Applause.]