Meeting of the Parliament 17 March 2026 [Draft]
At stage 1, I said that I supported the principles of the bill but not the specifics. I believe that the circumstances of our deaths should be as safe and compassionate as possible, but for too many people suffering prolonged and undignified deaths in Scotland, that is not because of a lack of effective palliative care. There is a total consensus in this Parliament on the need to improve Scotland’s palliative care services, but that is not enough for everyone at the end of their life. People still suffer over their final days and weeks, whether they effectively starve to death or lose their autonomy and the dignity that, for them, is rooted in that autonomy.
The first draft of the bill did not strike the right balance between affording the option to those who are at the end of their lives and giving sufficient protection to vulnerable individuals, but it is to the credit of Liam McArthur and a great many other people inside and outside this Parliament that the bill has been so significantly strengthened. Daniel Johnson secured the most important change—the requirement for the six-month prognosis. I recognise that that will disqualify some people who, perfectly legitimately in my view, and without any external pressure, wish an assisted death because of their illness, but it hugely reduces the risk of vulnerable people being coerced into something that they would not otherwise choose. It is not perfect, but it ensures that the system is only for those who are approaching the end of their life.
I am grateful to the Health, Social Care and Sport Committee for agreeing to my proposal for an advocacy service for any patient who wants it, and to all MSPs who supported the further changes last week to make that service stronger. The advocates would provide an essential service, helping patients to navigate the system and know their rights and options, and acting as an additional safeguard against coercion.
On top of that, the patient must have palliative care options presented to and discussed with them. In addition, the doctor must inquire about indirect pressures, including issues such as financial pressure, and they must discuss potential coercion.
The assessments by both the medical practitioners who are involved have been strengthened to include requirements for assessments to take place in person and by medics who have met the patient on more than one occasion. Thanks to Ruth Maguire, there is an additional structured assessment at the point of the second declaration that must take place in private. That is an important protection against coercion, particularly by partners or caregivers.
I am frustrated, though, that the very late concerns about legislative competence created so much uncertainty last week. We can be absolutely clear now that, if the bill is passed, it will not commence until arrangements are in place to ensure that no worker is ever required to participate in the process, that any worker who exercises their right not to do so is protected from any detriment as a result and that training and qualification requirements have been set for the professionals who are involved. That leads me to an important point.
This is the final vote on the principle of the bill, but, if it passes, it is not the final vote on whether a system commences. Once those provisions are in place to protect staff and to set training and qualification requirements, commencement regulations will be laid before this Parliament. If Parliament considers any of those to be inadequate, the commencement regulations can be rejected and the system will not start. The guidance that is necessary for the system to operate will also be subject to a resolution of this Parliament—a further safeguard and a further opportunity for Parliament to exercise its rightful control. I respect that that might not feel like a sufficient safeguard for some, but it is for me.
I will close by repeating what I said in the stage 1 debate. I sincerely believe that this is not an issue that should be decided by opinion polls. Organisations on both sides have shown that we can get whatever answer we want, depending on how the questions in polls are worded. The public have put their trust in us to make this decision on their behalf. It is the most important decision that I can imagine this Parliament making. For my part, I cannot reconcile myself with the prospect of denying those who face a life-ending illness the dignity of dying on their own terms. I will vote for the bill this evening.