The Scottish Parliament had the final vote on Liam McArthur MSP’s Assisted Dying for Terminally Ill Adults (Scotland) Bill yesterday.
The vote was 57 For, 69 Against and 1 Abstention (the Health Secretary abstained as the Scottish Government retained a neutral position).
Throughout the whole legislative process, from my first meeting with Liam’s team in November 2021, to amendments at Stage 2 and Stage 3, I have wrestled with the following questions:
- Are you against the principle of assisted dying?
- Does this Bill provide enough safeguards to create what is being proposed?
On both questions, my answer was no.
I have never had a strong belief either for or against assisted dying. Family circumstances where relatives have suffered a terminal illness (dementia, cancer and Huntington’s Disease) has led to me being supportive of the idea, but I’ve never been 100% convinced.
In many ways, my decision on how to vote would have been much easier if I had a strong opinion either way.
Crucially, my vote at Stage 3 was based on the Bill in front of me. Has the Bill been strengthened in parts? Yes. Has the Bill been weakened in parts? Yes.
During my speech last night, (Official Report 9.45pm) I referenced Ross Greer MSP’s comments in his contribution regarding the increased safeguards in this Bill (Official Report 7.47pm). In addition to those, I also welcome increasing the age of those who can apply from 16 years to 18 years.
Furthermore, I welcome the clause that an individual must be resident in Scotland for at least 12 months before the first declaration of wanting an assisted death is made.
However, there were changes to the Bill which removed safeguards.
This includes allowing doctors to raise the issue of an assisted death with their patient, and allowing the doctor, who must remain at the time of ingestion of the drug, to be able to assist the patient. I disagree with both amendments.
I also disagree with the lack of opt outs for hospices and other organisations. There were a variety of amendments at Stage 2 and Stage 3 seeking conscientious objection opt outs for religious organisations who operate care facilities, but these were rejected.
There are also aspects of the Bill which the Scottish Parliament does not have powers over, such as employment law and decisions on which drug(s) are to be used.
Under a process known as a Section 104 Order, from the Scotland Act 1998, these aspects were removed from the Bill and would be a matter for the UK Parliament to deliberate and decide. The Scottish Parliament would have no scrutiny function on these matters.
Section 104 Orders have been used before so are not a new process, but I don’t believe they’ve been used in such contentious matters before.
During both Stage 2 and Stage 3, I submitted an amendment to have a referendum on the final proposal, i.e. the finalised Bill and the draft Section 104 regulations to be passed at Westminster. I believe affording the electorate the opportunity to have their say on the complete legislative proposals would have allowed for a better understanding of what has been proposed and whether the public support this or not.
Sadly, this wasn’t accepted.
I did have other amendments accepted though, some of which I worked on with Liam McArthur MSP.
I do want to pay tribute to Liam for the way he has engaged across the Chamber on this Bill. Compared to other Member’s Bills, this subject evokes strong feelings but the way Liam handled his engagement helped to keep MSPs focussed on the issue respectfully, in the main.
Since Liam announced his intention to bring forward this legislation, I have had hundreds of emails and letters from constituents, including up to Decision Time last night. The overwhelming majority of constituents who contacted me directly asked me to vote against the Bill. I took on board ALL views but came to my decision based on the contents of the Bill.
During the final day of amendments (Friday 13th March), MSPs started receiving emails from health professional organisations including the Royal College of Psychiatrists. These organisations have remained neutral on the principle but have engaged throughout. Following the removal of Section 18 from the Bill, (Section 104 Order aspect) they believed vital safeguards had been removed. The quote below is from their letter.
‘However, while the College remains neutral on the principle of assisted dying, the decision to remove the entirety of section 18 from the Bill has drastically weakened essential safeguards for psychiatrists and other healthcare professionals. As a result, the Bill now poses unacceptable risks to the general public and the psychiatric workforce, meaning that we have no option but to oppose the Bill.
‘Section 18 previously provided crucial statutory protections, ensuring that healthcare professionals could choose not to participate in assisted dying without fear that this would affect their employment, regulatory standing, or relationships within clinical teams. Its removal eliminates clear legal guarantees and moves these protections into uncertain future secondary legislation, leaving clinicians exposed and the public inadequately safeguarded.’
Other bodies have also now rejected this Bill because of a lack of safeguards including from the Royal College of GPs in Scotland, the Royal Pharmaceutical Society, Medical and Dental Defence Union of Scotland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons in Edinburgh, Cerebral Palsy Scotland, Law Society of Scotland, Alzheimer Scotland and the Glasgow Disability Alliance, to name just some.
As you might imagine, conversations about assisted dying naturally lead onto conversations about palliative care and what it might look like post this Bill process.
In Inverclyde, we are extremely fortunate to have Ardgowan Hospice. There are few people in the area who haven’t been touched by the hospice’s work in some form or other, and I know how deeply the community cares for its services and staff.
No matter what happened with this Bill, I have been clear that palliative care in Scotland needs reform – particularly how it’s funded.
Currently, there is no clear funding model which has meant that the government funding has been dispersed by health boards, resulting in disparity across the country. I firmly believe we need a funding framework which provides greater clarity over what each hospice receives with regards to government funding, and most importantly, reflects the invaluable role that hospices provide.
While accepting that this Bill has opened dialogue about assisted dying in Scotland which is unlikely to ever go away, I believe we must now focus on the necessary reforms to improve access to high-quality palliative care and how this is funded going forward.
In conclusion, after reading the amended Bill over the weekend and considering all the above, I decided to vote against the Bill.
Yours,
Stuart McMillan MSP
