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Summary of the Outcomes of SPPC Amendments to the Assisted Dying for Terminally Ill Adults (Scotland) Bill

SPPC worked with Bob Doris MSP to submit over 40 amendments to the Assisted Dying for Terminally Ill Adults (Scotland) Bill.  

Changes Proposed by SPPC/Bob Doris MSP and Agreed by the Committee 

Reasons for Seeking an Assisted Death 

The Coordinating Medical Practitioner (CMP) must as part of the assessment process “enquire about and discuss the person’s reasons for wishing to be lawfully provided with assistance to end their own life”. Strangely the Committee also voted against SPPC amendments requiring the reasons to be documented in the Statements which conclude the AD assessment (and sanction AD). 

Social Work Assessment 

The CMP must inform the person seeking AD that they can ask to be referred for a social work assessment, and inform them of the potential benefits of such an assessment. 

Reducing the discretionary nature of referral for specialist opinion during assessment for AD 

Where the CMP has any doubt about the capacity of a person seeking AD they MUST refer the person to a specialist. (previously the Bill said “MAY refer”).  

Where the CMP has any doubt about whether the person seeking AD is “terminally ill” they MUST refer the person to a specialist. (previously the Bill said “MAY refer”).  

Changes Proposed by SPPC/Bob Doris MSP and Rejected by the Committee 

Definition of terminal illness 

SPPC amendments to insert a 6-month prognosis into the definition were rejected. 

Coercion 

SPPC amendments to insert a definition of coercion into the Bill covering undue pressure or influence from: “the person’s own beliefs about themselves; any other person; the expectations of society; the health and social care system; the state.” were rejected. 

Mandatory Referral to Specialist Palliative Care 

Amendments to require anyone seeking AD to be referred for a specialist palliative care assessment were rejected. However, an amendment by Jackie Baillie MSP requiring the CMP to inform the person seeking AD that “that they can be referred for a palliative care assessment to explore whether any additional support could be provided to them” was agreed. 

Reducing the discretion of the CMP in terms of what may be explained, discussed and advised during assessment 

An amendment was rejected which would have required the CMP to explain and discuss the following (the Bill currently allows the CMP to explain and discuss these topics “in so far as the CMP considers appropriate”: the person’s diagnosis and prognosis; any treatment available and likely impact of it on the person’s terminal illness; any palliative or other care available; the nature of the substance that might be provided to assist the person to end their own life (including how it will bring about death).  

A similar amendment would have required, without qualification, the CMP to advise the person to: inform their GP they are seeking AD; discuss the request with those close to the person.  

Vulnerable Adults 

SPPC amendments which would have required the CMP, as part of the assessment, to ask the relevant local authority whether they held any information which might indicate whether a person might have a preexisting vulnerability was rejected. Related amendments which would have mandated a referral for social work assessment if vulnerability was identified or suspected was rejected. 

CMP Assessment Report 

SPPC amendments requiring the CMP to produce a report detailing: 

• The reasons the person gave for seeking AD 
• What evidence was gathered and used to inform the decision 
• The reasons the practitioner reached their judgement 

were rejected. 

Protracted Dying 

SPPC amendments to require SG to make regulations about handling cases where death does not follow the taking of the lethal substance within a reasonable time frame were rejected. 

Administration and regulation of assisted dying services 

SPPC amendments requiring that SG produce regulations about the regulation and oversight of persons who carry out AD under the act, to ensure the safety and wellbeing of the people provided with AD including: regulation of settings where AD may or may not take place; the role of HIS and the Care Inspectorate in regulation and scrutiny; and a process to raise concerns about the provision of AD to a person were all rejected.