Meeting of the Parliament 13 March 2026 [Draft]
Much of the debate over the past few days has revolved around the identification and consideration of indirect pressures, which may affect the decision-making ability of a person seeking assistance to end their life. Debate on the skill set that clinicians currently have and the challenges involved in identifying and taking account of such pressures have also been discussed. I thank Parliament for supporting my amendment 27 and consequential amendments 160 and 33, which will bring in the requirement to ask and discuss indirect pressures with the person applying for an assisted death.
Amendment 54 would require guidance to be produced on the identification and consideration of indirect pressures, which may affect the decision-making ability of a person seeking assistance to end their own life. That is important. Identifying indirect pressure can be complex and nuanced and, beyond that, judgments about whether such pressure is undue add a further level of complexity. Practitioners will want support and guidance on how to make those life-and-death assessments and judgments. Having guidance will also support a greater degree of consistency, while recognising that every individual and every set of circumstances will be different and unique.
Of course, existing guidance from professional bodies in the UK does not cover assisted dying scenarios but is more general in nature. If the bill becomes law, they are likely to update their guidance, and my amendment 33 would require practitioners to have regard to the guidance from those professional bodies. I tried to address that at stage 2, but I think that requiring practitioners to have regard to that guidance, which could be updated from time to time, is a much more effective way of doing it. When the professional bodies update the guidance, they will look at the act to understand the parameters that they are working within. That is why it is essential that indirect pressure is addressed in the bill, and not just coercion by a person.
The Scottish Government states that careful development of guidance would be required to avoid creating expectations that all forms of indirect pressure can be identified or mitigated in a uniform way. However, it is surely the case that all guidance must be carefully developed in all circumstances at all times. Also, I have no expectation that all forms of indirect pressure can be identified and mitigated. That is one of the issues that I have with the bill, but I am trying to build in safeguards where I can. If we pass assisted dying legislation, we must make every effort to ensure that it contains as robust a system of safeguards as possible, imperfect as that may be. Amendment 54 seeks to do that.
Amendment 55 would require the Scottish Government to produce guidance on how concerns about an assisted dying case may be raised and dealt with. It is inevitable that, at some stage, a family member or other person will want to raise a concern about some aspect of the process and practice that is set out in the bill. Currently, however, the bill makes no particular provision for such a scenario. Amendment 55 is deliberately drawn broadly. It does not seek to require a specific process, because it is unclear at this stage which organisations might be involved in delivering assisted dying. Organisations might have their own relevant policies and processes, which might or might not be relevant to my policy intention. The amendment is therefore deliberately not prescriptive. It simply seeks to give the Scottish Government latitude to bring in appropriate processes.
On amendment 262, I welcome Liam McArthur’s support for the eligibility requirement that the terminally ill adult must be reasonably expected to die within six months. However imperfect and challenging in practice that would turn out to be, it helps to make the eligibility requirements less open ended and vague. However, we have heard that clinicians agree that they cannot reliably predict with any substantial degree of accuracy whether someone will die within six months. Given those circumstances, it is reasonable for there to be guidance on how to interpret and apply in practice the eligibility requirement that the terminally ill adult must reasonably be expected to die within six months. The guidance that is provided for in amendment 262 would support a more consistent approach to identifying prognosis and it could be updated regularly to reflect changes and developments in treatments and the science of forecasting.
There is evidence of public confusion between assisted dying and some aspects of existing clinical practice in palliative care. I mentioned that yesterday. Amendment 267 seeks to ensure that any guidance that is produced in connection with the bill, should it become law, will not conflate assisted dying with palliative care. That is an important practical consideration. People who are referred to palliative care need to know that the practice of palliative care does not seek to hasten death and that the focus will be on supporting them to live as well and as comfortably as possible for the full course of their natural life. That is what palliative care seeks to do. Whatever views members of this Parliament hold—there are many nuanced views—we recognise that assisted dying is something very different, and my amendment 267 seeks to recognise that.