Hansard

It is incredibly important that, in all aspects of people’s lives, we help them to understand the value of living and support them to continue doing so. That is one reason why the world-leading work that we do in suicide prevention in Scotland is incredibly important. That applies throughout the life course, including at the end of life.

Support at the end of life should not be limited to those who have identifiable psychological conditions, and support for psychological and mental health should not be limited to those who are at the end of life. As all members know from reading their inboxes, and from their families and neighbours, it is difficult for constituents to access the support that they might need for their mental health. Amendment 139 would help some people who consider the option of assisted dying, but it would not protect the thousands of people who need mental health support before that point. It would not give them the help that makes it easier to choose to live.

Amendment 140, in the name of Emma Roddick, would require specialist multidisciplinary information and support to be provided to people who have an intellectual disability or a developmental or cognitive condition. That would be an important safeguard, especially given that people with learning disabilities are likely to die 25 years earlier than others. Their social circumstances and other matters that impact them mean that, if they become terminally ill, they are less likely to access the care that they need.

There is a real risk that the bill creates an inequality that means that people with the most can see that life is an easier choice but others choose to die. The amendments cannot undo such deep-seated inequality, which also affects homeless people, disabled people and people who die early because of where they live—aspects that are related to society as opposed to their inherent health.

Although I urge members to support amendment 140, it would not go far enough to protect people or to ensure that it is easier to choose to live. The amendment is specific to the bill’s provisions, but before someone who is covered by the amendment gets a terminal illness, society has already discriminated against them. They have already experienced significant inequality that will affect their life and their view of themselves, and that will have already shortened their life. To address such issues goes beyond the bill, but that is the risk that it carries: that we pass it in a world that makes it easier to choose to die.

Amendment 140 would provide specific groups with access to clear information, specialist advice and multidisciplinary support, which I welcome, but such support should not be limited to particular groups; it should be available to anyone who considers accessing the assistance that is set out in the bill. It is the general absence of such support that worries me. Until it is made available, it could be easier for people to choose to die than to live.

Amendment 141 recognises that individuals might seek an assisted death not solely because of their illness but because of external pressures of suffering. Although I support the principle behind the amendment, I remain concerned that we can never really be certain whether such factors have influenced a person’s decision to seek assistance to end their life.

Research by Marie Curie highlights the scale of unmet need in Scotland. In 2022, around 18,500 people—roughly 30 per cent of those who died—experienced “unaddressed symptoms and concerns”, while also lacking sufficient access to general practitioner care at the end of their life. Every five minutes, someone in the UK dies without the care and support that they need. Ahead of today’s debate, the British Association of Social Workers said:

“Societal and institutional pressures, including pervasive narratives around being a burden, the cost of care, or the emotional and financial toll on families, can shape a person’s decision in ways that are profound and deeply difficult to detect.”

We will come on to some of those pressures when we discuss the amendments in group 4.

I remind members that rights for disabled people are not yet realised. The amendments in group 2 seek to address the issue, but it is difficult to argue that amendments can do that. Research shows that disabled families are 62 per cent more likely to fall into deep poverty, one in four disabled people do not get the palliative care that they need, and 10,000 people are stuck in their own inaccessible homes.

Taken together, the amendments in this group reflect a clear recognition that stronger safeguards and better support are needed. However, I do not believe that they can address the circumstances that lead to the deep-seated inequality that so many of our citizens face.