Hansard

Almost four years since I announced my intention to introduce a bill to allow terminally ill, competent adults the choice of an assisted death, Parliament finally has the opportunity to debate and vote on the general principles of that bill. I confess that I do not recall having felt this nervous since I gave my maiden speech in 2007, not because this will be—by some margin—the longest contribution that I have ever made in the chamber during my 18 years as an MSP, although that is a thought, but because I know how much the bill matters to those dying Scots and their families who are desperate to see the law changed to allow more choice, compassion and dignity at the end of life. It is their voices, needs and interests that must be at the centre of this debate, at the heart of our considerations and at the forefront of our minds as we come to vote this evening.

I know that there are colleagues across the chamber who feel conflicted, are wrestling with many profound, complex and sensitive issues and are anxious not to be seen to make the wrong decision. That is entirely understandable. However, the decision that we have been asked to make here is not on the final bill but on the general principles of a potential change in the law and on whether Parliament should be given more time to see whether it can agree on a bill that commands majority support.

I say this to members: if you simply believe, on the basis of faith or for any other reason, that change should not happen, I regret but respect that. However, if you accept that the current ban on assisted dying results in too many bad deaths, which traumatise patients as well as the families and friends left behind, if you recognise that legal uncertainty is placing patients, families and medics in an invidious position and if you believe in the principle of allowing dying Scots more choice of and control over the way in which they die, you must, even if you feel that my bill needs to be amended and have its safeguards strengthened, vote to allow Parliament the opportunity to consider amendments. If you remain unpersuaded at stage 3, you are free to vote the bill down, but it is surely not tenable for Parliament to say once again that this is all too difficult and to refuse to undertake the work required to find out whether a bill that commands majority support and public confidence can be agreed to.

Before turning to the substance of what is and what is not in my bill, I want to recognise the contributions of some of those who have helped to get it to this point. My staff, past and present, have performed heroics over the past four years, doing much of the heavy lifting, and the campaign groups Dignity in Dying, Friends at the End and the Humanist Society Scotland have been magnificent in their support. I refer members to my entry in the register of members’ interests as well as to the detailed declaration that I made to the Finance and Public Administration Committee and the Health, Social Care and Sport Committee when giving evidence.

My thanks also go to the non-Government bills unit, along with my apologies for only belatedly coming to the realisation that it is a hidden gem in the way that this Parliament operates. I thank all the stakeholder groups and individuals, both here and overseas in jurisdictions where assisted dying laws are operating safely and successfully, who have spared time to share with me their thoughts, insights and expertise. There are too many to mention, but all have been invaluable in informing my understanding of assisted dying and end-of-life care more widely.

I thank the committees, and particularly the Health, Social Care and Sport Committee, which I know was inundated with written and oral evidence, but which worked its way through that and has come forward with a detailed, thorough and balanced report. It is owed a debt of gratitude.

Colleagues around the chamber, too, have been generous in taking time to speak to me over the past four years. I have come to recognise the look of mild terror in the eyes of colleagues when I saunter into the canteen or the coffee lounge, as it suddenly becomes clear that a short chat on assisted dying is now unavoidable. It is, I think, no coincidence that invitations to parties have rather dried up over the past four years. However, whatever views colleagues may have, I am so grateful that those discussions have never been anything other than respectful and considered.

I am confident that this afternoon’s debate will be conducted in the same measured and respectful manner, doing justice to the seriousness and sensitivity of the issue, but also reflecting the fact that, whatever our respective views on whether to allow for a choice of an assisted death, we all come from the same place of wanting to reduce suffering and protect the vulnerable.

What will the bill do? As I said, it will allow terminally ill, mentally competent adults in Scotland a choice to be provided with assistance to end their life and avoid a potentially painful and distressing death. It is a choice that, for so long, so many of our constituents have asked us to provide clearly and safely in Scots law and a choice that they see is now available to more than 300 million people, and rising, around the world.

No two assisted dying laws are the same, but the model that I am proposing reflects one that is legally available across Australia, in New Zealand and in many US states. Closer to home, assisted dying has recently been legislated for in the Isle of Man, it is being progressed in Jersey, and it is currently being debated at Westminster, where a bill applying to England and Wales will have its third reading in the House of Commons on Friday.

We can learn from that international experience, but we need to get the detail right, reflecting our circumstances, legal framework and health and care arrangements. My bill sets out strict eligibility criteria and processes for multiple assessments, including specialist referrals if necessary. It contains what I believe are appropriate safeguards that balance this tightly controlled option and access, and it includes requirements on data gathering, reporting and review to ensure proper oversight.

To access assistance, a person must be aged 16 or over, be resident and have lived in Scotland for at least 12 months and be registered with a general practitioner in Scotland. Assessment would be required by at least two doctors acting independently of each other, who would need to be satisfied that the individual had a terminal illness, was sufficiently mentally capable and was acting on their own free will without being coerced or pressured.