 The next item of business is a debate on motion number 13258, in the name of Patrick Harvie on stage 1 of the Assisted Suicide Scotland Bill. I will try to call all members who wish to participate in the debate, and it is my intention that there will be a balanced debate. Can I welcome members of the public to the gallery, but can I draw your attention to the code of conduct that applies during debates while you are in attendance? Can I remind people from the gallery that this is a meeting of the Parliament held in public? It is not a public meeting, so I do not expect any interventions at all from the gallery while the debate is going on. I now call Patrick Harvie to speak to you and move the motion. Mr Harvie, 14 minutes. Thank you, Presiding Officer. I would like to express my gratitude for the opportunity to bring this debate to the stage that it has reached today. I would like to thank the Health and Sport Committee, the Justice Committee, the DPLR and Finance Committee for the work that they have done in informing Parliament of their consideration. I also thank Parliament officials Andrew Milne and Louise Miller and the campaigners from Friends at the End, My Life, My Death, My Choice and Amanda Ward, who has acted as my adviser through the process of the bill. There are also colleagues from across the political spectrum who have expressed support either to me personally in taking forward the issue or their support for the principle that the bill embodies and I would like to thank all of them. In doing so, though, I could hardly fail to acknowledge that this was never supposed to be me. I agreed when Margaret MacDonald asked if I would serve as a second member in charge of the bill on the basis that she knew that her condition gave her good days and bad. On a good day, she was still very, very good, but she knew that it was possible that she would not be here to bring the bill to Parliament or that she might simply be unwell and unable to attend a committee meeting. I agreed to act as understudy in that sense and my role has grown since we have lost Margo. Members will be well aware of her long-standing commitment not only to this issue, but the fact that it was by no means the only example of her commitment to an issue which might divide opinion and which might be uncomfortable for members and for members of the public as well to debate. I think that that is the first thing that I want to recognise about this bill. It addresses an issue that is inherently complex, difficult and, for many of us, uncomfortable to talk about in politics or in our own lives. In inheriting the bill, though, I will fulfil the commitment to present it as best I can to Parliament, but I am also very aware of the flexibility that that position gives me. That is not the bill that I drafted, it is the bill that Margo MacDonald drafted. I can see areas in which parliamentary scrutiny has already shown examples of areas in which it can be improved. Most bills can be improved through parliamentary scrutiny, and that is true of this one. Whatever view members take of the detailed operation of the legislation where we to pass it, I hope that all members who understand the basic principle, who accept the idea that human beings have a right to make a decision in circumstances such as a terminal or life-shortening illness, I hope that members will give the bill the opportunity to come forward to the next stage and then we can begin to debate the amendments that may come forward. I think that the case has been made very clear during the consideration of this bill that a change in the law is justified, that the current law is not only inadequate but also unclear. Members who have looked at the exchange of evidence between the law advocate and legal experts such as Professor James Charmers will have struggled as anybody will to come up with a clear, comprehensible understanding of what the current law actually means. People in Scotland who are faced with a terminal illness or one of those other conditions which would be captured by this bill, who feel the need to ask for assistance to take control at the end of their lives. People who are asked by a friend or a loved one for such assistance, none of those people are being given any clarity about what actions might be subject to prosecution and on what charge. In fact, after the exchange of evidence between Professor Charmers and the law advocate, Professor Charmers says that it at least leaves open the possibility that the provision of the means of suicide would be regarded as the legal cause of death. If the provider knew the purpose for which they were provided, they would almost certainly have the necessary men's rear for murder or at least culpable homicide. Is that really the treatment that we expect to see put into practice in all of these circumstances? Under the current law, any such circumstance leaves a person asking for or offering such assistance, leaves them subject to the possibility that they would be prosecuted for murder or culpable homicide. I think that the case for a change in the law is very strong. Is this the right change in the law? Does this bill capture the change that those who agree with the need for change would wish to see? Well, there are clearly, as I have said, some areas with us room for improvement. I thank many of those who have pointed out some of those areas, and I will work with them if the bill is passed at stage 1 to ensure that amendments can address areas such as better recording and reporting of information. The most obvious and simple example being reporting to the procurator fiscal instead of to police in all circumstances. There is perhaps some room for improvement around clarity of definitions. For example, on specific acts, which a facilitator, the licensed facilitator, may or may not undertake. I think that there would be a danger in going too far in the direction of very prescriptive sets of definitions. That is what the ministerial regulations called for under the bill would be there for. Some of the arguments on the lack of clarity in this bill are overstated and should be compared to the law as it stands, not compared to some imagined world in which no grey areas exist. The bill asks us to acknowledge and engage with the inherent complexity of the subject. Rejecting it does not remove those grey areas from our lives or from the way law and medical practice deal with us at the end of our lives. There have been some suggestions on improving the bill in terms of taking care that dangerous prescription drugs do not fall into the wrong hands. That is a concern that we would all share, and it is by no means beyond our whip to come up with a solution for that. There is an open debate about the scope and eligibility. Some may feel that the arguments are sufficiently different in respect of terminally ill people and that they could accept the bill covering terminally ill people but not others. I would not personally agree with that approach, but the only way to debate that difference of approach is to agree to the general principles and debate amendments at stage 2. On the time limits that are built into the process for seeking assistance, for making a request for assistance, the committee has quite rightly acknowledged that there is a balance to be struck between having a recent test of mental capacity and, on the other hand, ensuring that people do not feel pressure to act before they feel truly ready. At the moment, the way that the bill is drafted, a final 14-day time limit ticks away after that second request for assistance. If that time limit is reached, the means for someone to act on their decision to seek assisted suicide will be taken away. There are other options. The committee has suggested some options for change. In my response to the committee's report, I have suggested another, which would be to make the second request for assistance require that it be renewed at that 14-day time limit rather than that it simply falls away completely. All of those areas are areas where people of good will can come together and make the bill better. There are also some concerns that unite supporters and opponents of the bill. Many of us are asked why we should focus on the right to die and why we are not focused on the right to live. I think that supporters and opponents of the bill can be absolutely on the same page in the commitment to and support for high-quality medical support, palliative care and particularly for the social, economic and physical factors that ensure that disabled people are able to live full lives. Those are areas where none of us would disagree. I do not think that there is any evidence from other jurisdictions where a system of assisted suicide exists. I do not think that there is any evidence that such a system undermines the political, practical or financial commitment that is given to those priorities. However good the availability of those other facilities is in our society, even under the best conditions that we can imagine, they do not overcome the issues raised by this bill or answer the concerns of those for whom palliative care and other forms of support are not or may no longer be when they reach a certain point adequate. This bill seeks to widen the choices that people have before them, not to narrow them down. Another area of concern that should unite us, I think, is on the question, does a right to die become a duty to die, the risk of coercion or a vulnerability? I agree that the risk of coercion can never be eliminated, but colleagues, this is true under the current legislative framework. That would be true under any legislative framework. It cannot be assumed that the absence of a legal route to assisted suicide provides protection from coercion. Indeed the opposite may be true. It is not possible to be definitive about the number of terminally ill people who commit suicide in Scotland each year, but it is reckoned to be measured in the dozens, perhaps in the order of 50 people. It is an estimate. At present, people are making that decision, exercising that choice not only in a legal vacuum, but without the ability to do so in a supported way and to give the opportunity to those who care for them, both their family and friends but also the medical and professional carers around them, to explore with them proactively the alternatives that may exist. We are leaving people to make those decisions in that vacuum, in the absence of that care and support to which I think they are entitled. This bill cannot be capable of entirely removing the risk of coercion, but people in that circumstance now are, I believe, more vulnerable than they would be under this bill should coercion exist. There are other concerns, which I understand, but which I cannot accept as reasons to oppose the bill. Some, of course, are religious arguments, those for whom life is a gift from their God. I am not part of that worldview, I cannot take that viewpoint, but this is secular legislation, which binds all of us whether we choose to subscribe to a religion or not. In any case, there are a range of views among the religious communities in Scotland and around the world about the question of assisted suicide. Others have argued that passing the bill would, in some way, normalise suicide more widely. Again, I see no evidence from the other jurisdictions that have a system of assisted suicide to suggest that attempts to prevent suicide in the wider population are undermined. I think that people know the difference between suicide in the wider sense and the ability of people to take control if they are facing the end of their lives. The committee suggests that passing this bill would be, in some way, crossing a Rubicon. I disagree. We are human beings engaged in the moral and ethical complexities around the end of life, whichever legal framework we choose. Do we allow people to end or refuse treatment or to make other active choices, even in the knowledge that that will end their lives? Yes, we do. Do we facilitate those choices, giving practical and emotional assistance when people need it? Yes, we do. Are those ethically and morally straightforward, uncomplicated choices? Not at all. There are many situations, not theoretical but practical situations, faced in the real world on a daily basis by medical professionals. The bill asks us not to imagine or wish those away. It asks us to engage positively with those and respect the right of human beings to make a decision in the context of the relationships and the care around them. I ask members who see the case for a change in the law whether they are convinced by the detail of the bill or not. Let us go on after today and debate the detail, make changes if necessary and send a clear signal that society is moving away from a paternalistic approach to care at the end of life and toward one that empowers people to make their own informed decisions and respect people on those terms. I move the motion. Thank you Mr Harvey. I now call on Bob Doris to speak on behalf of the Health and Sport Committee. Mr Doris, around 11 minutes. Thank you very much, Presiding Officer. As deputy convener of the Health and Sport Committee, my role this afternoon's debate is to present to you the findings and the recommendations that our committee has made to the Parliament on the Assisted Suicide Bill. The Parliament's mace, the front of our chamber, bears just four words—wisdom, justice, compassion and integrity. Those are the ideals that the people of Scotland expect their MSPs to aspire to. The bill is not one that people are divided along political lines, but a decision is to be taken based on an individual member's conscience. The importance for each individual member in ensuring that they have applied those four attributes that are engraved on our mace to the decision that they will take this afternoon is therefore heightened. I am sure that this is an approach that Margo MacDonald would have endorsed, and I wish to take the opportunity to place it on record on behalf of our committee the recognition of the commitment, personal investment and social conscience Margo had in pursuing this change to the law over many years. The committee's consideration of this bill has involved complex moral and legal issues, admirably informed by Spice by the Parliament's legal office and by our committee adviser in the bill, Dr Mary Neil, when I would like to thank Dr Neil for her assiduous contribution to the work of the committee. Looking at the volume of written submissions alone, we received over 900. The vast majority being from individuals—I hope that you would agree, Presiding Officer, that this is engagement, which makes a positive contribution to the work of our nation's Parliament. We as a committee would like to thank everyone who provided written and oral evidence as part of its consideration of the general principles of the bill. The proposed legislation touches life in a deeply personal way, and we would like to be particular or thanks to those who provided personal accounts of their experience of caring for seriously ill loved ones or being present in the lead-up to their death. Many of those in favour of the bill argued that, when intolerable suffering or distress exists, it is compassionate to provide relief from that suffering and it is cruel to refuse it. Jennifer Bucking of the Human Society Scotland spoke movingly of her experience. I am a nurse who has worked in hospitals and the community. I have worked with people who have dreaded the time when living would become unbearable for them. I have sat on the beds and held the hands of people who have asked me to help them to go every day for weeks, and I have not been able to do that. I have just had to sit on their beds. In contrast, the committee received evidence that there were other ways to respond compassionately to such suffering. Dr Sally Witcher from Inclusion Scotland believed that negative attitudes towards illness, old age and disability already exist and are factors in creating demand for assisted suicide. Dr Witcher told the committee that much of the support for bills such as this one is driven by the profound fear of becoming disabled, ageing and becoming ill. Rather than saying that we should make it easier for people with that profound fear to end their lives or letting them feel confident that they could do so should that terrible thing happen, we need to challenge those negative attitudes and have public policy that ensures that when people are old, ill or disabled, they get the best quality of life possible and that the right sort of support is available to enable full and independent living as equal citizens for as long as possible. The committee acknowledged that a desire to be compassionate towards those who are suffering is a key factor in motivating the bill and its supporters. The committee also acknowledges the concerns of opponents of the bill who argue that whilst this is laudable in aims, it carries with risks that they consider to be too high, the risks associated with crossing a legal and moral Rubicon. The committee notes that opponents believe that there are other ways of showing solidarity and compassion with those who are suffering distress short of helping them commit suicide. Autonomy is a key underlying principle within the bill. The member-in-charge described the bill as the continuation of a decades-long change in healthcare and medical practice that has involved a considerable move away from a slightly top-down approach, as some witnesses acknowledged, to one that is much more focused on patient empowerment, patient decision making and the principle that each of us has the right to determine major choices about our own lives. However, in contrast, Dr Stephen Hutchison of Highland Hospice told the committee, we function as a relational and interdependent society, so we need to look at choice with responsibility. To me, that puts a completely different emphasis on the issue, and it is then not only about what the individual chooses and demands. That is part of the equation, but it has to be balanced with careful scrutiny of the implications for the rest of society, and in particular for the vast numbers of frail, vulnerable and frightened people whom commissions look after. I am grateful. I did not agree with everything that Dr Hutchison said in evidence, but I did agree very strongly with that point that Bob Dorr's point that human beings are relational in nature. Is not it clear, though, from many instances, including south of the border, an instance that has been in the newspapers this week, that, even when people have the ability to choose assisted suicide, if that is in accordance with their own wishes, they do so in the context of the relationships with the people around them, and that a respectful notion of that is one that embraces their ability to make a choice in context? I thank the member in charge for that intervention. I am sure that Mr Harvie will realise that I am restricted in what I can say this afternoon, because I am speaking on behalf of the committee, but you have now put that on the record, and I think that it is also reasonable to say that the point that the committee is making is that making an independent choice does not necessarily have no consequences for other people in society, be they frail, elderly or others that are terminally ill. I believe that that is what the committee concluded in relation to this area, but I thank the member for putting his views on records in relation to that. As I say, the committee concluded that if assisted suicide were to be permitted, robust safeguards would have to be required to protect the rights of others, including some of the very vulnerable people that I mentioned just there. Safeguards to address public safety considerations would also be necessary. The committee was not persuaded that the principle of the respect for autonomy on its own requires the legislation of assisted suicide. I would like to turn now to some concerns over the lack of definitions within the bill. Our committee noted concerns that, for instance, no definition is given of either euthanasia or of assisted suicide. Our committee found that surprising. The bill also does not specify the means of suicide. It seems to be widely assumed, including by representatives of pharmacists' professional bodies, that the bill envisages the ingestion of a lethal dose of drugs. However, the language in the bill refers to any drug or other substance or means. That further complicates attempts to establish what the line between assisted suicide and euthanasia might look like in practice. The committee appreciates that, for some, that gives rise to concern that, because it does not define either term, the bill does not specify precisely which actions it intends to shield from liability. It can be argued that that is further obscured by the lack of clarity in the bill regarding the means of suicide. The terms, terminal and life shortening, appear on the face of the bill. Those are absolutely central in delineating the range of persons who would be eligible to receive assistance in ending their lives with the bill to be passed into law. Neither of those terms are defined, however. Terminal entails nothing specific in terms of remaining life expectancy. Doctors for assisted suicide said in their written statement that, we welcome the fact that no time limits are laid down by the bill, doctors are often inaccurate in predicting how long someone has to live. However, David Stevens and QC for the Faculty of Advocates also observed that, therefore, seems to follow from the lack of definition that any illness that shortens a persons life expectancy is life shortening. The Faculty of Advocates submission pointed out that many everyday conditions are likely to be life shortening, for example type 2 diabetes. The committee considers that the bill's failure to define those key terms leaves far too many people potentially eligible to receive assistance. The bill does not provide for a general clarification of the law on assisted suicide. Assisted suicide, which took place outside the scope of the bill, would still be dealt with under the common law. The common law and uncertainty therein would remain the fallback position. It is in that context that we must view section 24 of the bill that provides protection from liability for those who make incorrect statements or do anything else that is inconsistent with the bill's provision, so long as they are acting in good faith and the intended pursuance of the bill and have not been careless. That is commonly called the savings clause. The rationale behind section 24 is a sense that it would be undesirable if people who made minor or technical errors and complied with the procedure set out in the bill were at risk of being charged for a common law crime. The term careless is not defined, nor is the phrase acting in good faith or in intended pursuance of the bill. In this area, the committee concluded that it seems clear that numerous respects, some of which go to the heart of the bill's purpose, the language of the bill would introduce much uncertainty. In the context of a statute that makes an exception to the law on homicide and permits one person to assist and the death of another, such significant uncertainty must be unacceptable and would require to be addressed by the Parliament to prove the bill tonight at stage 1. A number of witnesses raised concerns about the potential for coercion of vulnerable people if the bill were to become law. The committee suggests that, should the Parliament approve the bill, the member in charge may wish to consider some of the suggestions from witnesses regarding measures aimed at minimising the risk of coercion. However, the committee notes the observation by the BMA that that is no way guarantees the absence of coercion in the context of assisted suicide. I want to have time and my contribution this afternoon to talk about issues that the committee raised in relation to the conscience clause. Maybe other members will do that in relation to the role of the licensed facilitator—very important, I am sure that other members will do that—or in various other areas. In the short time that I have remaining, let me just reiterate the final conclusions of the Health and Sport Committee in this area. We recognise the strength of feeling expressed by those who have given evidence both in support of and in opposition to the general principles of the bill. The committee believes that the bill contains significant flaws. Those present major challenges as to whether the bill can be progressed. While the majority of the committee does not support the general principles of this bill, given that the issue of assisted suicide is a matter of conscience, the committee has chosen to make no formal recommendation to the Parliament on the bill. Thank you, Mr Doris. We now move to the open debate. I am first to call Shona Robison, who will be followed by Christian Allard. Five-minute speeches throughout the open debate. I want to first, as others have done, recognise this afternoon the work of the late Margot MacDonald to ensure that the issues within the bill have been presented to Parliament. I also want to acknowledge Patrick Harvie's role in progressing the bill as a member-in-charge or the understudy, as he described it, following Margot's death. Whatever the outcome of the debate this afternoon, I want to commend the raising of this important and sensitive issue in Parliament. For the mature discussion that has taken place over recent months, the importance of the issue being debated today is reflected in the number of those in attendance, both in the chamber and also in the public gallery. I am aware that many MSPs want to speak in the debate, so I will keep my comments on behalf of the Government as brief as possible. The Government believes that the current law is clear and that it is not lawful to assist someone to commit suicide, and the Government has no plans to change that. However, notwithstanding the Government's view, Government ministers will, like other MSPs today, be entitled to vote on the bill according to their conscience. Therefore, I will speak personally now. After careful consideration, I have concluded that I will vote against the bill for many reasons informed mainly by the areas of concern highlighted by the committee in their report. In doing so, I appreciate and have sympathy for all those individuals who have expressed their views about the bill and what they would want for themselves when they are faced with a terminal diagnosis. It is hard not to have sympathy with those views. However, in reaching my personal conclusions, I noted the committee's many concerns. The Health and Sport Committee's stage 1 report recognised that the bill, as is currently drafted, contains significant flaws that present major challenges as to whether the bill can be progressed. It considered that it did not clarify the existing law and offered no advantages over the current legislation. I was struck by the committee's concerns that there are insufficient safeguards, unresolved issues about timescales, public safety concerns and inadequate provisions regarding the role of licensed facilitators, and that the bill, as drafted, may result in individuals facing the prospect of additional fears through a change in societal attitudes, including the very real prospect of pressure to end their life. The committee also noted the bill's failure to define key terms. I am concerned that those omissions may leave far too many people potentially eligible. Losing a loved one to a terminal or incurable illness is something that touches many of us in our lives, whether it be a member of our family, a friend or a much-loved colleague. Coming to terms with death and the process of dying involves a complex set of reactions that can involve intense levels of distress and fear of loss of control, functioning and, of course, dignity. It is very important that we work to address those fears and ensure that everyone receives the best palliative and end-of-life care available and that their dignity is preserved through personalised and compassionate care. Everyone should receive high-quality, comprehensive palliative care, uniquely tailored to their symptoms, their fears and, of course, their life circumstances. It is my view that we must focus on further improvements to that palliative and end-of-life care building on what we have at the moment. We must ensure that that is provided for a wider range of conditions across the whole of Scotland. On the point that she raises, I think that that is one of the clearest things that comes out of all of this, is that the end-of-life care is not good, and I do not see that in any partisan way. I think that that is something that should concentrate the minds of us all. Well, as I have already acknowledged, a lot of work is under way to improve palliative and end-of-life care and the framework that is being developed I will say more about in a moment. I think that that is something that we can agree today that we should focus our attention on. Our commitment to develop a new framework for action was made in the recognition of the need to ensure equity of access to palliative and end-of-life care, no matter where you live or indeed what clinical condition you have. It will provide a focus on improvement. I have best we can support teams across health, social care and the third sector to implement improvements. It must also include support for our staff to engage directly with people's fear of death and dying to provide care, comfort and compassion built on respect and to value every life in Scotland. I want to pledge to this Parliament that I will certainly engage members with the framework as we take it forward. I am very happy to bring that back to Parliament in recognition of members' interests in palliative and end-of-life care. I make a commitment today to do that, but I want to end by again praising the way that our Parliament has dealt with this very difficult and complex issue both in the past and again today in our debate. Despite the strongly held views on both sides of the debate, we have been able to conduct this debate in a constructive and sensitive manner. Many thanks. I now call on Christian Allard to be followed by Mary Fee in five minutes, please. Thank you, Presiding Officer. Let me first thank all the people who contacted us, all the members of this Parliament. I got my good share of emails coming from both sides of the argument. I hope that I answered them all, but some were coming again today at the last minute. I don't know if you had time to do it. Many were coming from my constituency in the north-east. The lead committee has examined the bill as we had in its entirety. As a member of the secondary committee, the justice committee, we focused our scrutiny on the bill's criminal and civil liability aspect, particularly the legal and practical application of its provision and human rights issues. From the outset, I had reservations about this bill and in our report to the lead committee we noted about the approach taking in the bill of defining what is not a crime rather than what is a crime to be unusual. This was always my main concern, Presiding Officer. I may not be against the roddable intentions of the many members who I'm sure would support this bill as stage one, but I'm definitely against the principle of the bill as introduced. An act of the Scottish Parliament, I quote, to make it lawful in certain circumstances to assist another to commit society and for connected purposes. At the time, I shared my frustration with the member introducing it. I felt that such important legislation required to be drafted very carefully without appropriate levels of protection, but I did not feel that it would be satisfied all my concerns. After reading the stage one report, I'm now in the opinion that despite the will of the member to listen, and he had done a lot of listening, Armand Monsmondu. It is the bill itself that is not fit for purpose. The principle of this bill is flawed. It's objective to provide a means for certain people who are approaching the end of their lives to seek assistance to end their lives at the time of their own choosing and to provide protections in law for those providing that assistance whilst never achievable. More research for clarity, more questions were asked, more certainty we sought, more incentive to be found. I was pleased to read in the stage one report of the health and support committee by David Stevenson QC for the faculty of advocates on the 13 of January 2015, give evidence and made the following statement. If we criticize the existing system for uncertainty, we should do our best to remove uncertainty when creating a legislative regime. We do have a system in place and the lack of legislation on any matter should never be seen automatically as a problem. Presenting officer, if it's one of those bills that attempt to redefine a law that doesn't exist in the first place. The same David Stevenson QC told our Justice Committee earlier on the 20th of October 2014, my concern is that there would be a danger that individuals would fall through the gaps and would do to uncertainty find themselves exposed to prosecution. I can't see how people will know if they are protected when we act to assist with bringing about the end of life. All that because the task the member has given itself is impossible to complete the way it was originally designed. This bill was flawed from the outset. If I could help like he asked us to do repeatedly, I would, of course I would. The reality is that historically in Scotland we heard that there has been very little in the way of prosecution of people who have assisted suicides. England and other countries have a statutory offencing law. We don't. This bill does not provide a general clarification of the law on assisted suicide. The member in charge has clearly fell at the first order. The present law assistance might not be perfect. In my view, this bill is back to front and we must reject it at stage one. Today I will be speaking in support of the Assisted Suicide Scotland bill. I welcome and respect that this will be a debate invoking passion, reason and arguments based on ethics, morality and religion. When talking about death, we must remember that each individual person treats death differently through a wide range of emotions and feelings such as but not limited to fear, reluctance and, importantly, acceptance. To be diagnosed with a life-changing illness does lead one to accept that death is not a choice but a reality and how one faces death can make a difference. Even with the greatest pallet of care, an illness can still make life insufferable for some. Legislating for assisted suicide is not a matter of choice and dignity for those wishing to use these powers but, in my view, a matter of equality. Exercising the power to ask a doctor for the option to seek assistance to end suffering where medicine and care cannot places an enormous level of trust with the practitioner and would give the recipient control of their own destiny. The level and access of care will always be paramount to easing pain and, while medical advances are researched, this should not suffer as a result of legislating for assisted suicide. There is no evidence to suggest that access to pallet of care would be a detriment to assisted suicide. I support what Patrick Harvie said in his response to the stage 1 report that he is open to proposals to amend the bill and will work with those who seek to strengthen it or improve definitions without being too prescriptive. With that in mind, the only way to have that further input is to have the bill passed at stage 1. The principles and motive behind the bill are clear, yet there is always room for improvement on any piece of legislation. Moving on to the specifics of the bill, part 1 would remove any criminality that a person may face after assisting in the compassionate suicide of another. At this point, it is important to understand the distinction between assisted suicide and euthanasia. There are massive differences between what is proposed and euthanasia, and for anyone to equate the two, as has happened throughout the wider discussion and consultation, is an unfair disservice to those who are suffering and wishing to end their life. However, I note that the Health and Sport Committee report showed that there needs to be further clarification of what the difference is due to what Stephen McGowan from the Crown Office called a fine line. I hope that we can take that to stage 2 to further distinguish the term assisted suicide and euthanasia. Part 2 deals with safeguards, and I am aware that this is where reservations are greatest for members. For others, there can be no assurances at the level of safeguards or the strongest they would like, which is why it is important that this debate continues. The criteria for considering assisted suicide is pertinent to the safeguards posed. I have read in communications from constituents that they are worried that children may be exposed to assisted suicide. That is contradictory to what the bill sets out to secure, which is the right for adults over 16 years of age, where a diagnosis of an illness or progressive condition that is terminal or life limiting will reduce life quality without any sign of improvement. I believe that there are comprehensive measures contained in the bill to protect those wishing assisted suicide—the facilitator, the witness, the practitioner and the family. For many of us who have lost a loved one, we have witnessed them suffer in pain, endure agonies that we would not wish on anyone. However, allowing dying people the dignity of choosing for themselves is what this is really about. I hope that we can continue the debate by agreeing today to the principles of this bill. I now call on Dr Nanette Milne to be followed by Mike McKenzie up to five minutes, please. May I say at the outset that I will not be supporting this bill? I voted against Margaret MacDonald's end-of-life assistance bill five years ago, having been a member of the committee who scrutinised it at stage one, and as a member of the current health and sport committee, I have studied the evidence presented to us at stage one of the successor bill. I determined to approach it with an open mind and to give very full consideration to all the evidence put before us and to listen very carefully to all those putting the case, either for or against the proposed legislation, which would allow protection from prosecution for a person licensed as a facilitator to assist someone with capacity and a life shortening or terminal illness which to them has become intolerable to take their own life. It does not allow euthanasia. As previously, I found the help given to us by the committee clerks, by spice and by our advisor, absolutely invaluable. I would like to put on record my thanks to them and to the many witnesses who give evidence to us for their assistance throughout the stage one scrutiny of the bill. In the end, after lengthy and very careful consideration of all the evidence, as shown in our committee report, we decided not to make a specific recommendation to Parliament but rather to allow members to come to their own conclusions. Personally, as a former health professional, the idea of actively and deliberately hastening death by assisting someone to die is deeply disturbing for me and I share the view of many professional colleagues that, to legislate for this, would risk undermining patient trust and doctors and medical advice and I cannot come to terms with what is proposed. There have been significant improvements in palliative care in recent years and, for me, that is the way forward, to enable the vast majority of patients to experience a dignified and comfortable death in the place of their choice when that inevitability arrives. I do accept that there will be a few patients and indeed there are very few for whom palliative care cannot be 100 per cent effective but I am not convinced that this is sufficient reason to legislate for what some see as a merciful act nor are the palliative care specialists who deal personally with those very difficult and complex cases. Persistent requests for assisted suicide or euthanasia are extremely rare if people are given good care which addresses their physical, psychological, social and spiritual needs and I sincerely believe that to achieve a good death is as vital a part of health care as any which a patient receives throughout life and that good palliative care is far preferable to legally assisted suicide. Unfortunately at the present time there is a gap in palliative care provision with many people who would benefit from it not being considered for this form of holistic end-of-life care. Like the manicury organisation I believe that this should be planned as soon as an illness is deemed to be terminal and that could mean death within days, weeks, months or years and apply to people with a wide variety of conditions such as COPD, heart failure and dementia and of course cancer and progressive neurological conditions. I think as MSPs that we should be giving very serious consideration to end-of-life care as the health and sport committee plans to do and government should be persuaded to put more resource into the holistic care of the terminal ill. So Presiding Officer I simply cannot agree with the basic concept of the assisted suicide bill but even if I could support its underlying principles the proposed legislation is flawed in many respects and would require very significant amendment ready to get past stage 1. I cannot deal with the shortcomings in the bill in the short time left to me although I have no doubt my colleagues will as indeed some have been by the deputy convener of the committee. I want to finish by referring to a letter that I received some months ago from a constituent who has been tetraplegic for nearly 40 years following a road accident. He gives a very moving account of his battles with depression and despair as he gradually adapted over time to his changed life which he achieved only after prolonged counselling and help to find and develop new avenues of activity. He expresses his dismay that young people with paralysis like his following sporting injury can resort to assisted suicide in Switzerland, saying that they still have mind and voice and probably other capacities depending on the exact level of injury but they would need the sort of care of which he'd received to bring them to terms with an alternative way of life. My constituent is therefore appalled that the bill does not insist on medical and psychiatric assessment before starting along the path to assisted suicide and provides no requirement for counselling or for filling the gap in cases where their only experience has been of some unsuitable medical facility without experience of rehabilitation. His closing words are, I beg you to reject this bill. Above all, do not destroy the trust between patients and the medical profession. Hospitals must not become places where patients fear those who care for them. The aim must be to help the family in their supporting role and to strengthen counselling, rehabilitation and hospice facilities. Presiding Officer, I would like to start by thanking all those organisations who sent briefings indicating their concerns with this bill. I would especially like to thank all the many constituents who wrote to me. I would like to thank those on both sides of the issue who are keen to see this bill passed and those who are not. I very much respect both viewpoints. I respect the fact that this is a difficult issue. I respect the fact that, for all of us here in this chamber this afternoon, this is a difficult issue. However, my principal argument here this afternoon is that we owe it to all those people, all those people who have written to us, all those people who are concerned about this issue, all those people who may fall under the scope of this legislation. We owe it to everyone to scrutinise and debate this issue properly. To do that, we need to take it all the way through the parliamentary process. We owe it to all those people to vote yesterday so that we may do full and proper justice to this most difficult of issues. Whatever the outcome is, we can all look our constituents in the eye and explain to them exactly why we voted as we did. I would also like to thank my colleagues on the health and sport committee, who I think provided an excellent service on behalf of the Parliament and of the public in shedding light on the issues that caused most concern with this bill. I hope during the committee's discussions that I was able to articulate my position adequately, which is that if we have it within our means to relieve suffering, then we should do so. That is my default position. I note and acknowledge the arguments that have been made against the bill. There are concerns that the bill may result in the lowering of the standard and availability of palliative care. I would argue the opposite. Perhaps it will give an added impetus to palliative care, especially from those who do not believe in the principles of assisted suicide. They will have the opportunity to persuade and to provide palliative care to anyone contemplating assisted suicide if the bill is passed. The bill does not call for psychiatric assessment to be automatic, but neither does it rule it out. This option will be available if it is felt to be necessary in the opinions of either of the two doctors who have to sign off the request for assisted suicide. We either trust our doctors or we do not. I trust them. There are those who criticise the bill because it is not specific enough that it is vague or uncertain in certain areas. I think that this is a strength rather than a weakness. Our criminal law is comprehensive, complex and sometimes confusing. Few of us are experts in criminal law and the ignorance of the law is no excuse. It behoves us therefore to stay well on the right side of the law as the vast majority of us do. This moral hazard is necessary. This uncertainty will ensure that anyone participating in the process of assisted suicide will stay well on the right side of the law. Perhaps the issue that concerns me most is the possibility of coercion. It seems to me that some people take a dim and a dark view of their fellow citizens. I am afraid that I do not share this view. I think in the main that we are good and we are moral. Nevertheless, I do not accept that it is beyond our intelligence, our wit and our wisdom in this chamber to provide safeguards against coercion and against a number of other criticisms that have been made about this bill. It is beyond dispute that there is avoidable suffering across Scotland. Paiative care is not always effective and it is not nearly as widely available as it ought to be. Suffering can only be understood and defined by those who are suffering, not by those who are not. We passed laws, bills in this chamber that are subject to considerable amendment. I am sure that this bill can be amended in ways that will deal with most if not all of the concerns. We may not be able to reassure everyone that this bill is fit to pass into law, but to my mind we owe it to everyone. We owe it to all those who are suffering or who face the prospect of suffering. We owe it to Margo MacDonald, whom we held in high esteem as a person of integrity, of common sense and of wisdom, to give it our best effort. That means voting yes this afternoon. I now call on Rhoda Grant to be followed by Liam McArthur. This is an emotive debate. People will be passionate about the view that they hold either for or against the bill. It is my hope that, regardless of that stance, people will respect a differing viewpoint and respect the reasons for which it is held. I am instinctively against the general principles of the bill. I believe that life is precious. We only have one life. However, life is not always easy, and that is why we have a suicide reduction strategy. We recognise that too often people come to a stage in their lives where, for whatever reason, they do not seem to wish to go on. We, as a society, recognise this and try to put supporting mechanisms in place to help people through these difficulties, believing that suicide should not be an option. Many who have been in such a position and have overcome these feelings have gone on to live fulfilled and happy lives. The bill changes this belief for people with a life-limiting condition, and it also presupposes that the final days of their lives cannot be happy and fulfilling, or indeed continue to be a source of strength and inspiration for their loved ones. I am grateful. The member suggests, as others have, that passing the bill would, in some way, undermine efforts to reduce suicide in the wider population. Is the member able to point to any other jurisdiction in which some form of assisted suicide has been put into law, where there is evidence to show an impact on undermining suicide prevention in the wider sense? I think that it is very clear that if we see suicide as a bad thing, something to be prevented on one hand, but then single out another proportion of society where it is actually a good thing, and indeed something that should be encouraged, it changes our whole relationship with suicide. Presiding Officer, there are challenges to managing life-limiting conditions such as pain control and indeed loss of personal control, but surely we must manage those challenges to make sure that everybody's last days are fulfilling. A good quality palliative care must be a right, and we fall way short of that, as other speakers have said. You only have to compare the availability of maternity care and palliative care to see the difference, and we need the same quality of care leaving the world as we get when we are entering it. The bill would change the way that our society views suicide, making it a right rather than something to be prevented. It is argued that suicide prevention strategies will remain, but certain people will be excluded from them under the bill. There is no requirement for them to seek help with that. Judgments will have to be made regarding the quality of life and what is subjectively seen as unacceptable alongside a life-limiting illness. People with mental illness are deemed to lack capacity under the bill to make such a decision, and therefore are excluded. Could that be discriminatory if someone is suffering from a mental illness that is incurable and is causing suffering? They will be unable to use the legislation. However, the bill does not consider the impact of a terminal diagnosis on a person's mental health and on their ability to face the future. The bill is often compared with the assisted dying bill in Westminster, but our law is different. Suicide is a crime in England, and it is not in Scotland. Therefore, there is an argument that assisting someone to commit suicide is not in itself a crime in Scotland, and that is a grey area that the bill is seeking to clarify. The argument surrounds whether the assistance was the cause of death. If it was, it could lead to a charge of culpable homicide. However, it was clear from evidence to the committee that the bill would not necessarily protect someone assisting another person's suicide from being investigated or charged. For example, if there was a suspicion that the person committing suicide was coerced, even if they fulfilled the requirements of the bill, the person who assists could still be investigated and charged under the common law. There are many aspects of the bill that make it unworkable, and that is acknowledged by those who support the legislation as well. I would argue that, to clarify the law in this way, it could have a number of unintended consequences and could lead to more prosecutions rather than less, and indeed lead to an increase in the level of suicide overall in Scotland. We fear death, fear of the unknown is natural. However, there is a lot known about death, but it seldom discussed or talked about, and that makes the fear even greater. If our death was given the same focus and care of that as for a birth that I believe a lot of that fear would be removed, we need to learn to deal with death and to appreciate it as a consequence of life, and I would urge members to vote against the general principles of the bill. Thank you very much. Now Colin Lear MacArthur to be followed by Dave Thomson. Thank you, Deputy Presiding Officer. Shortly after first being elected in 2007, I sat in this chamber listening to a member's debate led by my former colleague Jeremy Purvis. He was the sponsor of an earlier bill aimed at achieving many of the same objectives as the one we are considering this afternoon. I had no intention that evening of speaking or even making an intervention, I just wanted to listen. I remember coming away genuinely proud, as I am today, believing that this is how our Parliament should be. The exchanges were unencumbered by false consensus or in the main by personal or political ranker. Those participating, I felt, did themselves in this Parliament great credit by arguing their case passionately with sincerity and conviction, even where those convictions had evolved over the years. That bill fell, but the late Margo MacDonald then took up the cudgels and without any disrespect to Jeremy or indeed Patrick Harvie, even now Margo remains posthumously synonymous with this issue and these proposals. A charismatic advocate for change, Margo nevertheless took care to nurture cross-party support. It is an approach continued by Patrick Harvie, and I thank and pay tribute to him, as well as to my life, my death, my choice and others for all they have done to progress this bill since Margo's untimely death. My thanks too to the health committee and the other committees for their diligence and for producing the lead report that seeks to reflect the divergent views of its members while also identifying areas of legitimate concern. This bill, while an improvement on its predecessors, is certainly not perfect, as I acknowledged by Patrick Harvie earlier. There are those who feel it goes too far, others who do not believe it goes far enough. My constituents, who are generally measured in thoughtful input that I have greatly valued, fall into both camps and pretty much all places in between. I am grateful also to the many groups and organisations who have contacted me. I respect the positions that they have taken, but I am acutely aware that within and between different faiths and disability groups, as well as across the medical and legal professions, individuals hold individual views both for and against change. As members will be aware, I am supportive of the general principles of this bill. This stems not from direct personal experience of a loved one left suffering on Julie at the end of their life, though I have close friends for whom that ordeal was very real and unbearably painful to witness. Over the years, I have come to the conclusion that the status quo is no longer tenable, that change is necessary, that finding ways of allowing individuals dignity and death as in life is now essential. It is a conclusion that growing numbers of people in Scotland have reached, often I suspect, based on direct experience of what has happened to a family member or good friend. Of course, majority public support is not in of itself reason enough to change the law in such a complex, sensitive and profoundly emotive area as this. However, it must give us confidence that this is a debate that we should be having, that there is an appetite for a move away from the status quo and that, hopefully, there will be patience as we explore a solution that can command the broadest possible support and confidence. In the terms of the bill itself, the crux for me and for many of those I speak to on both sides of the debate is the issue of safeguards. The three-stage process with cooling off periods between each, the need for uninvolved witnesses, the requirement for two independent doctors and four separate consultations, the presence of a facilitator and the compulsory reporting of cases to the police set, I think, a very high standard of protection. With regard to specific concerns about those suffering poor mental health, I understand why those are being expressed, but GPs are accustomed to diagnosing and treating depression and assessing mental capacity. Any suggestion that an individual is suffering from a mental illness will bar them from entering this process of assisted suicide. In doubtful cases, a GP can refer a patient to other doctors, including a psychiatrist, for an opinion. I believe that these safeguards will ensure that vulnerable are protected but would welcome proposals on what might reasonably be done in addition. With regard to the argument that this bill represents a slippery slope, I simply do not accept that to be the case. It will allow individuals—and I would argue only those who are terminally ill—to seek assistance in bringing their life to its conclusion while giving legal protection to those who provide such assistance. I also struggle to see why support for this bill might imply a lack of commitment to palliative care. Such care will still be the preference for the vast majority, and Mary Curie is right to point out that at least 11,000 people in Scotland are missing out on that care every year at present. That is something that must be addressed, regardless of this bill, as Patrick Harvie rightly highlighted. The right to life is not the same as a duty to live. This is about providing dignity, respect and choice at the end of life. I hope that Parliament will agree this evening to allowing this bill to proceed to the next stage. If it cannot be satisfactorily amended, there will be still an opportunity to vote it down at stage 3. However, I believe that we owe it to those looking to this Parliament to reflect the public desire for change to at least allow that debate, those detailed deliberations, now to take place. I welcome the opportunity to take part in today's debate, and I thank all those within and out with the Parliament who have been and are involved in it. To put my own position into context, I have lost close family to breast cancer, pancreatic cancer, stroke and dementia, and also through suicide. I have a Christian faith, but I am not arguing against the bill today from a faith perspective, although there are strong moral, theological and spiritual reasons to oppose it. I accept that it is difficult to argue against a person retaining control of their faith as their health declines, but in writing assisted suicide into law, I believe that the opposite effect would be achieved, as control would be subtly placed in the hands of a third party. Another important factor that we must bear in mind is that not everyone is good, so we cannot be sure that people will not succumb to pressure to end their life from unscrupulous, selfish or financially motivated parties. As I acknowledge in my opening remarks, I accept that such circumstances, as Mr Thompson describes, do take place. The question for us is not should they take place, but should we allow them to take place in a legal vacuum and without the ability of people to seek support in a well-defined and well-regulated way? Passing it, rejecting it, does not avoid the threat of coercion in certain circumstances, but passing it would give us some legal clarity about how best to identify and remedy that situation. I do not accept the premise of the point. The cabinet secretary mentioned when she spoke earlier that that legal point was not accepted. Additionally, as the Health and Sport Committee heard, we humans are relational. We are community dependent, where our decisions do affect the views and decisions of others. In a society where sporadic thoughts of self-harm and suicide are common, I do not believe that we can allow the law to increase pressure on people to end their life. Even for those surrounded by family who care for them, the affected individual may still feel like a burden. The drip effect of this in a person's psyche could be very potent in their decision-making processes, and some may feel that they have a duty to die. Those who are terminally ill often experience mental health problems such as depression. Depression is an illness that many sufferers report feeling suicidal when they are in the depths of despair. However, with support and treatment, they are often later grateful that they did not act on those thoughts when they were in that dark place. We must not allow irreversible decisions to be made when a person is extremely vulnerable, but instead support and help them in every way possible. In acting, this legislation would be a retrograde step, particularly when good palliative care is available and we must strengthen this, not erode it. We must not normalise suicide. Since 2011, the Scottish Partnership for Palliative Care has been advocating greater uptake and awareness of those choices and mechanisms through the Good Life, Good Death and Good Grief Alliance, which I support. Doctors and nurses, those potentially charged with administering assisted suicide, are overwhelmingly against the proposal, which ought to serve as a warning to those making the case for it. The bill fundamentally conflicts with the principles of medical care. At the Health and Sport Committee hearing in January, it was held that, when considering any legislative proposal, it is essential to reflect not only on the rights that may be conferred on benefactors but also on the negative or harmful aspects. In this context, the availability of assisted suicide would add to the psychological distress of patients when they are extremely vulnerable. Do not just take my word for it. Dr Stephen Hutchison, a former consultant at Highland Hospice, is 100 per cent sure that the availability of assisted suicide would compromise the care of patients. I recognise the intentions of the bill in aiming to introduce additional choice, subject to conditions for people with terminal life-shortening conditions. None of us want to see another human being or ourselves in prolonged or severe pain. However, enshrining assisted suicide into law takes us into dangerous territory. It shortcuts proper compassion and destroys our social responsibility. I fear that this would be the thin end of a large wedge, and the policy memorandum accompanying the bill explicitly looks forward to further widening of the categories of those eligible for assisted suicide, which confirms my fears. Whilst accepting the good will of those who support the bill, I believe that this legislation is a trajectory to a society that no longer places value in life, no longer values are disabled and no longer values are elderly or ill, and where would it end? The bill may well have come forward in compassion, but I believe that it is a dangerous bill, and I cannot support it. Thank you, Presiding Officer. Until a few days ago, I was very much undecided on how I would vote to come decision time tonight. To be honest, I am still not 100 per cent there yet, although Patrick Harvie's response to the stage 1 report and his remarks today have gone some way towards persuading me that we ought to allow the bill to pass to stage 2 in order that the amending that it undoubtedly requires might take place. Like many people, I am instinctively inclined towards the principle of individuals having the right to decide whether to end their lives when confronted by an intolerable end to those lives, and that conviction was only strengthened by the loss of my father some six months ago. Watching a loved one die, albeit not in quite the circumstances covered by this bill, inevitably has a bearing on one's views on such matters. I recall at various times over those awful three days telling myself that I absolutely would support this bill when the opportunity arose, and yet I found myself torn because the bill that it has drafted contains, as we have heard, a number of serious flaws. I do not intend to rehearse each of those areas of concern, especially as colleagues across the chamber have already highlighted some of these, and others are seeking the opportunity to contribute to the debate. I want to focus my contribution on what for me is a critical issue, that of respecting the views of health professionals who, for perfectly understandable reasons, would not wish to involve themselves in any way in the assisted suicide process. Last year, the Parliament found the means of reconciling conflicting opinions on the equal marriage legislation by framing it in such a way as to ensure that faith groups or individual celebrants who, for genuine, deeply held convictions did not want to be involved in the process could not be compelled to carry out marriages. We were right to do so. In the case of this bill, we are told that a majority of doctors, many pharmacists and psychiatrists are opposed. On all sides of the argument, there appears a recognition that some kind of opt-out would be appropriate. Even in my life, my death, my choice, who support the legislation that I have admitted, it is important that no doctor should be forced to take part. We do not, of course, have the option of making statutory provision in this area, seeking to deliver protection if individual practitioners' rights of conscience through professional guidance would not provide a cast-down protection. In principle, it might be possible under section 104 of the Scotland 1998 Act for a UK Minister to deliver a conscience clause. I therefore welcome Patrick Harvie's commitment to explore this option if the bill's general principles are agreed later today. For me, it is essential that medical practitioners should not be forced to participate in a process that runs contrary to their beliefs. However, all of that said, if we were to respect the views and rights of medical practitioners, where would that leave us in protecting individuals from coercion or influence in coming to a decision? I was struck by the comments of Professor David Jones when, in evidence to the health committee, he pointed out that people are vulnerable not only to coercion but to influence which we could include their own subjective sense of becoming a burden. Now, as both the health committee and Mr Harvie have acknowledged, the risk of coercion can only ever be minimised, never eliminated completely, but in seeking to respect the rights of medical practitioners might we be reducing the protection against coercion or influence compared to introducing the bill without a conscience clause? I think that there's a dilemma there. It's been suggested that perhaps when we have a very small number of doctors who would be willing to play a part in delivering the aims of this bill, if that's the case, then where is that local knowledge of patients and their circumstances which might identify where a vulnerable individual is being leaned on or is being influenced by their own concerns at becoming a burden to the family? Now, of course, the days of some of your own GP within a practice of all but gone, and even if that were the case, there's no way of removing entirely the possibility of coercion or influence being at work. However, I do think that if people found themselves having to troll around for a GP who'd be willing to participate, then the possibilities of coercion or influence might not be picked up on or increased. So, again, I welcome part of Harvie indicating at least a willingness to discuss possible amendments in the area of coercion. Although I do accept, it's a difficult issue to address. We must surely, in the first instance, accept that, above all else, we have to provide medical practitioners with a conscience clause. Presiding Officer, as I indicated at the beginning of my contribution, I've been quite conflicted in my views on the bill. I don't believe that, as drafter, it's a particularly good piece of potential legislation and one of those who, part of Harvie, describes not to be unconvinced to the detail of the bill. However, I am now inclined to support the principles at decision time in the hope that the parliamentary process thereafter can make it fit for purpose and, without in any way committing to supporting it then at stage 3. Thank you. I now call on Michael McMahon to be followed by Jackson Carlaw. Thank you, Deputy Presiding Officer. Legalising assisted suicide is a slippery slope towards widespread killing of the sick. Those are not my words. Those are not the words of any anti-Euthanasia group. They are not the words of any religious leader. No, those are the words of Professor Taylor Bohr, who is an academic in the field of ethics who himself had previously argued that good euthanasia law would produce relatively low numbers of deaths. Professor Bohr is based at Utrecht University and has been a member of a review committee charged with monitoring assisted suicide deaths in Holland. He is a one-time advocate of assisted suicide, who, based on the evidence that he now has available to him, believes that the very existence of euthanasia law turns assisted suicide from a last resort into a normal procedure. Assisted suicide is now becoming so prevalent in the Netherlands, according to Professor Bohr, that it is, as he says, on the way to becoming a default mode of dying for cancer patients. Having monitored the situation in Holland for the past 12 years, Professor Bohr now admits that he was wrong to have believed that regulated assisted suicide would work. We should not dismiss that conclusion today. Instead, we should, as others have done this afternoon, advocate greater awareness of the so far untaught potential of good palliative care. Too many terminally ill people are not receiving the care that they need at the end of life, which can have a detrimental impact on the quality of life that they have in their last years and months. Action needs to be taken on that situation, but this legislation is not that action. Proponents of assisted suicide often refer to autonomy as over a generally accepted principle in itself on which to base this bill. In fact, the law exists to protect us all and often curtail individual autonomy in order to safeguard others. Undoubtedly, there is still much work to be done to ensure that people retain as much control as possible as they approach the end of their life and receive the best possible care. That is why I believe that the focus on end-of-life issues must be on addressing unmet need and ensuring that people who could do not miss out on palliative care that they should get. Legalising assisted suicide in my view is a retrograde and negative step that does not promote good care or challenge the lack of medical assistance that is required to actually die with dignity. What will address that is a good palliative care approach. Done properly, this is the active holistic care of people with advanced progressive illness, delivered in a wide range of settings, including hospices, using both specialist palliative care and more generalist care. Many people face with a terminal illness fear the future and that is understandable when they are not certain to access such palliative care. Our task therefore should not be to cultivate any fear that may exist but to promote a culture in which people with terminal illnesses know that whatever their future they will benefit from having access to palliative care and end-of-life care. I began by quoting Professor Bohr from Holland and I will finish with his words also. In 2007, he conquered the views of supporters of the bill and he wrote that there does not need to be a slippery slope when it comes to euthanasia. A good euthanasia law in combination with the euthanasia review procedure provides the warrants for a stable and relatively low number of deaths from euthanasia. Bohr noted at that time that most of his colleagues drew the same conclusion. Now, he says, but we were wrong, terribly wrong. In fact, I used to be a supporter of the Dutch law but now, with 12 years of experience, I take a very different view. Don't go there. Once the genie is out of the bottle, it is not likely to ever go back in again. I urge Parliament today to heed the words of Professor Bohr. Don't go there. I now call on Jackson Carlaw to be followed by John Mason. As a co-sponsor of the bill, I have to say that I have wrestled over the content of anything that I might say in its support this afternoon more than I have over any other speech that I have given in this Parliament, because in five minutes there really is not the opportunity to make the detailed argument that one would like and one therefore falls back slightly on generalities. It is a significant issue of substance that we are entrusted in this Parliament to resolve and one where we defer to our conscience. The most recent example of this, of course, was of equal marriage. Outside of this chamber, in participating in the public debate, I have to say that there have been some familiar faces on the other side of the argument, as I have gone around. One consistent fact that I have come across has been the end of the world of nigh tendency, which I have come across. That debate, of course, was a life and death matter. For some, this is literally a life and death matter. I should say that some members might want to leave at this point, because this morning I received a very violent and abusive phone call from a member of the public who told me that if I spoke in this debate this afternoon in its support, I was in every sense of the word doomed and that a greater force would strike me down during the course of my speech. I sat very deliberately next to Mr Fraser in those circumstances, believing that a bit of rough justice would be appropriate in those circumstances. I have read about 20-year-olds who might be fed up with life queuing round the block because they would want to opt for assisted suicide. I have heard about all those greedy relatives that are apparently going to be coercing all their loved ones into assisted suicide, which, as Patrick Harvie said, could do now outwith the framework of the law. I have heard of people saying that it will be the end of palliative care. What I say is, Luke, there must be a more measured debate and I am grateful for the tone struck in here this afternoon. I think that the nadir of all of this was in a debate where I was engaged with the care not killing organisation who, after a bloodless power point presentation of nine points, as a tenth point said to an audience of elderly people that this was all initiated by Hitler during the Second World War, I draw no conclusions from that, he said. I leave you to draw your own. That is absolutely shameful because all sides in this argument, irrespective of the perspective that they take, I think would want to ensure that we are this legislation to pass, that the post-legislative scrutiny, that everything that this Parliament did thereafter was designed to ensure that there was no coercion and that the legislation had passed operated entirely on the spirit that was intended. Now, as Patrick Harvie has said, this is Margo's bill. He hasn't brought forward amendments respecting that, but if you read the exemplary evidence that he gave to the health committee on 17 February, it's perfectly apparent that the proponents of this bill are open to a whole series of amendments being brought forward to make it a more perfect piece of legislation. There are many from the Law Society of Scotland, which I think makes perfect sense to which I'll return. I respect that many colleagues may be opposed to this for different reasons, some through conviction, some through faith. I'm an unconfirmed agnostic, as I've said before, so I can't share that objection based on faith, but I notice that many of faith are in fact supporters of the principles of the bill. Some are opposed to it either because they object to the aims or they object to the particular workings of the bill as drafted, which is why I support the calls that were made by Mike McKenzie, by Liam McArthur, by Mary Fee and others to allow this bill to pass to stage 2, specifically because we've been here before. If we're not going to keep coming back to this Parliament with this issue, then I think that what we have a duty to do to the—what we understand to be a majority of the population sympathetic to its aims—is to create as working a bill as we possibly can, and then let this Parliament divide on the principle of whether we think it should go forward or not, so that, outside of here, Scotland knows that the bill isn't passing if it's not passing because there's some clauses in there that people aren't sure are workable, but because they either agree with it or because they do not agree with it, and I think that that would be far clearer and greater service done if we went to that phase. I have heard talk of palliative care. I do want to talk about one constituent who suffered from vascular Parkinson's, who has endured a distressing end of her family and suffered a death that she had sought to avoid. I say to those who talk about palliative care. First of all, we've relied on the voluntary sector far too much. With an ageing population, we are going to have to invest much more heavily in palliative care as we go forward. For some of the 80 people and just 80—not the thousands who benefit from palliative care who might exercise the option of assisted suicide—their particular condition is one that is not relieved by that palliative care option. That gives them the option to choose. I finish just by saying this. Jeane Clementsmouth-Carlo, my late grandmother of some 20 years now, was a passionate advocate of this cause. She helped shape and informed the convictions that I eventually settled upon. Grandparents are great things. They've lived long and they've seen much. In her name, who endured, unfortunately, the very end that she sought to avoid, I speak today and the many others like her suffering today and those who hope not to have to suffer in the future. John Mason, to be followed by Elaine Murray. Thank you, Presiding Officer, for the opportunity to speak today. This is clearly a subject that divides opinion. I think that most of us can accept that there are arguments on both sides. Of course, none of us wants to see unnecessary suffering, especially if it is someone close to us. Death is not a subject that many of us are comfortable talking about, and yet maybe our society today is unusual in that respect, as our culture in previous times and other cultures these days do seem more comfortable with the whole process of dying, and even within our society there are a variety of customs. As against the desire to reduce suffering and to manage one's own death, there are clearly a range of arguments against assisted suicide. We are hearing a number of those arguments today, so I just want to concentrate on a couple. Firstly, the impact on our suicide prevention strategy. I thought that the committee's report on this topic was good at paragraphs 269 to 280. Clearly we do have problems with suicides, especially in Glasgow and the west of Scotland. Over the four years 2009 to 2012, there were 3,059 suicides, with 73 per cent of them being male. The highest number of deaths were in the 40 to 44 age group, but still there were over 150 male suicides in the age range 20 to 24. Glasgow has the third highest rate in Scotland, with 17.2 deaths per 100,000 over the four years. I just think that it is so tragic to hear these figures, where people feel that ending their life is the only way out of their problems, be they financial, health, relationship or whatever. We need to do all we can to show such vulnerable people that there are other and better ways of sorting out their problems. I cannot really put it better myself than the committee does in paragraphs 275 and 276, where it says, first, that enacting a bill of this kind would undermine the aim of preventing suicide in two ways. One, by seeming to contradict the wider suicide prevention message, or by watering it down with exceptions. And two, by normalising suicide. This argument is that when law permits a practice, this is perceived as endorsement, and as society absorbs that endorsement, the general perception of the practice changes. I do note Patrick Harvie's comments that he does not see evidence in other jurisdictions of increases in suicide generally. However, we have been given evidence that shows Oregon's suicide increasing, certainly in comparisons to Scotland, which thankfully has been reducing in recent years. Is the member asserting that that increase has coincided with the introduction of legislation or the uptake of legislation on assisted suicide? Having looked at the figures, I see no connection whatever. I think that my general argument is that it is very difficult, because if we are changing the atmosphere on suicide and moving from a position where suicide is always regrettable and always a tragedy to saying that it is sometimes acceptable, it is difficult to go somewhere else and say that sometimes it is okay and sometimes it is not. I did not read the whole of the committee paragraph, but we could send out a message to society at large and to vulnerable individuals that are not all lives are equally worthy of protection or equally valuable or worthwhile. I think that that is my main concern on that area. The second area that I wanted to focus on was on coercion. Paragraph 194 quotes the BMA as saying that there is no way to guarantee the absence of coercion. At paragraph 186, Professor David Jones referred to as saying that there is also the wider area of influence, and I think that that concerns me the more. In particular, the point about some individuals, especially elderly ones, not wanting to be a burden rings true with me in my experience. By normalising suicide, the danger is that it opens up possibilities for vulnerable older people whom we should be constantly reassuring that they are not a burden. When it comes to coercion or influence from third parties, let us be blunt about it, there have always been some people who wanted to end other people's lives for a variety of reasons. Families who stand to get an inheritance if an elderly relative dies earlier, or even the NHS and social work departments of councils who stand to make financial savings and care costs if a patient dies sooner rather than later. Will every accountant who works for those organisations be totally non-pressurising on staff or patients? We do not know. No, not at this stage. The finance committee did not spend much time on the financial memorandum, and I wonder if we should have looked more into that angle in more detail, because clearly there could be financial implications for a number of groups. In summary, I say that I will be voting against this bill today, while we must have compassion for those who are suffering, we must also remember the many whose lives could be threatened by such legislation. In general, I could ask members to try and keep to the five minutes, please, we do not want any members to not get the opportunity to speak. Elaine Murray, to be followed by Alison McInnes. Thank you, Presiding Officer. Like many members, I have been thinking long and hard about how I should vote tonight. In doing so, I am grateful to the constituents who have contacted me describing their families' experiences and expressing their views, and I am also grateful to the health committee for their helpful and considered report. I have no religious, moral or ethical objections to assisting terminally ill people to decide the time and manner of their passing should the patient wish to take that decision. Where someone is on that final journey, where they are irrevocably on the path towards death, they have, I believe, the right to decide to shorten that journey and to have assistance in doing so if required. But I believe that the clauses on life shortening conditions should be removed from the bill. A constituent, Dr Alison McInnes, the rehabilitation consultant at Dumfries and Galloway, Royal Infirmary, wrote to me last December describing her professional concerns about the inclusion of life shortening conditions in the bill. Most of her patients have life shortening conditions. The range of time, however, can be six months to 30 years. She has given me permission to quote from her letter to me. In the last few weeks, we have had a young patient on the ward wishing to die and actively considering suicide. Her disabilities meant that she couldn't carry anything out, but her pain and distress at the awful situation that she was in was heartbreaking. We supported her with sympathy and medication and time. It was a very hard few weeks and her requests to die were repetitive. Her situation looked bleak in terms of prognosis, and it was this reality that had hit her hard. Today, I watched her slowly wheel herself down the ward in therapy with a huge smile on her face. She was so proud of her achievement. Her prognosis remained similar, her pain is still there, but she has grieved and started to adjust expectations and has found that life is still good. For all of us, patient, family and team, I am so glad that we didn't have the option to give up and take the easy way out and give her what she was requesting. Dr MacKendrick has encapsulated my principal concern about this bill, though I do have others, which I will outline later if I have time. Grief is not a mental health condition, it is a natural reaction to loss. It could be the loss of health and mobility, of a loved one, of an important relationship, and when somebody is suffering severe grief and the anger which can go with it, they may feel that their life is unacceptable and they may wish to die. However, in all those other cases, when someone's grief is so unbearable that he or she feels suicidal, our reaction would not be to help them to kill themselves. We would want to assist the person through their grief and towards realising that although life will never be the same, it can still be fulfilling, and we should not treat ill health and disability differently. I consider that the scope of the bill should be restricted to people who are terminally ill, whose death is imminent and irreversible. I believe that there should be a definition of terminal illness, for example, where two medical practitioners agree that the patient is unlikely to live more than six months and there is no reasonable prospect of stabilisation or remission. I have some other concerns. I think that 16 is too young to be a licensed facilitator or a preliminary witness. In other legislation passed by this Parliament, somebody under 18 is defined as a child. We do not permit 16-year-olds to buy alcohol or tobacco, and yet the bill, as drafted, would allow a 16-year-old to assist with suicide. I also agree with witnesses who express concern about the 14-day window of opportunity between the recording of the second request for assisted suicide and the act of suicide itself. I understand that the intention is to prevent significant deterioration in the person's capacity between making the second request and the act. However, it is possible that the short timescale could make the person feel that they are obliged to go through with the act, because if they do not, they will not get a chance at a later date. I further consider that there should be legislative protection of the conscience. No black medical professional should feel obliged to participate in any of the procedures that would be required if the bill was passed. Their objections may be founded in their faith, but they may not, and there should be no requirement to provide a reason for not being prepared to take part and willingness to do so should be enough. If this were stage 3 of the bill and it was like this, my vote tonight would be straightforward. I would be voting against it. However, like Graham Day earlier, the question for me at stage 1 is whether it can be amended to take account of my concerns. It is possible—I am not sure—that it will be amended to take account of my concerns, not fully in the way in which I would wish, but I believe that I should allow this bill to go through to stage 2 to enable those discussions to take place. Therefore, I will be voting for the bill tonight. Many thanks. I now call Alison McInnes to be followed by George Adam. Thank you very much. I come to this debate as a liberal and as a humanist. As a liberal, I seek always to balance the fundamental values of liberty, equality and community. As a humanist, I try to resolve ethical issues through reason and reflection and empathy rather than petitioning a higher being, though I respect others, of course, who live their lives according to religious scriptures. Like other members, I have had many representations on this matter. Indeed, many constituents on both sides of the argument shared with me deeply personal stories about the value of life and about their family member's experience at the end of life, and I thank them for that. I think that everyone is agreed that compassion, the dignity of the individual and alleviation of pain and suffering should be at the forefront of our consideration, but there is profound disagreement over whether legislating for assisted suicide is a safe way forward. Some have argued that the bill allows a small number of people, difficult cases, to be helped at the end of their life, but it is actually cast very widely and includes, as others have said, life-shortening illnesses. They argue that the bill brings certainty and clarity to the law, and yet there is a lack of definition of key terms, such as assistance in the role of facilitators. Some say that there are robust protections against abuse and coercion, while many others warn that the safeguards are totally illusory. The significant flaws and major challenges to progressing this bill are set out clearly in the stage 1 report, and the questions and caveats within it illustrate graphically just how dangerous it is to try and make the state the gatekeeper of who can die at a time of their own choosing and who can't. So today we need to decide whether we agree with the principle of assisted dying. Do decisions about the timing and manner of death sit exclusively with the individual? Is the value of a person's life no more than the value that they ascribe to it? Is it equivalent only to a possession that can be given away? Or, as many of us believe, both of faith and of no faith, is the intrinsic value of life more profound than that? Are some rights so profoundly ours, as a liberal philosopher Locke argued, that we cannot give them up even with consent? So if the right to life is paramount, is it not the case that we inevitably weaken the prohibition against killing if we count an in-state assisted suicide in some circumstances? I do not accept that there is a right to die. Patrick Harvey himself has acknowledged that autonomy is not absolute. We are not entitled to exercise freedom that undermines or endangers the freedoms of others. There is a reciprocal principle that operates. We need to have choice with responsibility. In his evidence, Dr Hutchison of the Highland Hospice argued that it cannot only be about what an individual chooses and demands, rather that it has to be balanced with careful scrutiny of the implications for the rest of society and, in particular, for the vast number of frail, vulnerable and frightened people whom clinicians look after. For me, that is where the bill founders. It utterly fails to address the very real risk that the right to die becomes in a vulnerable person's mind a duty to die. If we value the principles of equality and community as well as autonomy, it seems to me that the state must not sanction assisted suicide. Now, many lobbying for change have argued that allowing assisted suicide does not harm those who find it morally wrong. They have argued that it is a case of each to their own that it is just one more option. But changes in the law bring about changes in the way we understand ourselves and our place in the world. In elevating the status of individual autonomy, we reduce the status of those who are dependent. It would, over time, change the way we view and treat the elderly, the disabled and the infirm. Inclusion Scotland has argued persuasively that much of the support for the bill is driven by a profound fear of becoming disabled, of ageing and becoming ill. I agree with that and also with its conclusion that, rather than saying that we should make it easier for people with that profound fear to end their lives, we need to challenge those negative attitudes and have good public policy that ensures that everyone has the best possible quality of life. There needs to be greater importance placed on prioritising wider access to good palliative care. Dame Cicely Saunders, founder of the modern hospice movement, said, you matter because you are you. You matter to the last moment of your life and we will do all we can to help you to die peacefully but also to live until you die. We should be doing everything possible to make that the reality for everyone at the end of their life. It is precisely because there is an inalienable right to life for everyone equally that the so-called right to die for some cannot be countenanced. I will not support the bill this evening. I thank the health and sport committee for all the work that they have done in this very difficult debate, because it was obviously extremely passionate and there were people for and against. However, I welcome this debate and I urge the chamber to follow Patrick Harvie's lead in allowing this bill to progress. We need to ensure that this idea is allowed to develop further, like any other bill, and has the opportunity to be discussed in full at stage 2 and 3. Is it not correct that we use the full parliamentary process to challenge and test this potential legislation further? I take on board Jackson Carlaw's points as well when he mentioned the fact that we've already had it at the floor here before, so is there not a case that we do take this to its full conclusion at this point? I understand that this proposal can stir passions in both sides of the debate, and of course many will say that I'm once again, Presiding Officer, coming at this debate from a very personal perspective. I can't help it, it's the way I'm hardwired and it's the person that I am, but, as you all know, my wife, Stacey, has multiple sclerosis and, ironically, we're having this debate on world MS day. There are an estimated 11,000 people in Scotland with MS, 100,000 in the UK, and it's a neurodegenerative condition which affects the brain and central nervous system. I've said before that there are three types of MS and it's related to this debate today as well. There's relapse and remitting MS that Stacey had when we first met. There's primary progressive MS, which effectively means that you primarily start at a bad place and you get worse as time goes on, potentially dying as an outcome as well. There's secondary progressive MS which Stacey currently has. Primary progressive MS affects about 10 to 15 per cent of people diagnosed with MS, and we may find, like others, ourselves in that position one day. We've had that discussion as a family. We've discussed what would happen if we ever got to that position, and it's a difficult debate for anyone to have because, you know, Stacey and I have discussed it, and when I do say we've discussed it, well, I've been told of Stacey's opinions on it, and I've been told exactly what her preferred options are if she deteriorated so badly. I can be as positive about our life together and our future together as much as I like, but it's not me who's living with the condition and potentially having to deal with any dramatic changes in our illness. I am not the one who's going through those changes. I can be there, I can be supportive, but I'm not the one who's actually going through it. Those are things that Stacey and her family have spoken about for years, and don't get me wrong, those of you who know her know Stacey loves life. One of her most endearing attractive qualities is her sheer lust for life. What happens if she's so ill that she no longer has that quality that she currently harms? What happens if she can't enjoy the very basic parts of life and what happens if she becomes terminally ill, or if there are questions that we have to continually ask as a couple? One of the reasons why we support the bill is because of Stacey's admiration and love for Margo MacDonald, and also because Margo passionately believed in the bill. I believe that it's for Margo's sake that we need to take that to the very least to the next stages, but there appears to be no middle ground in this debate. You're either for it or against it. At the moment, we're talking about people getting the choice to end their life if they're physically unable to do so. If we do not do this, are we not saying that some members of our community are to live their last days on earth in constant extreme pain? Is that just or is that right? No one likes to talk about death because we're all too aware of our own mortality. I mean suffering because we often don't like to use the word suffering in this chamber. When we're talking about people who are living at the end of their life with extreme pain, excessive pain, day by day, hour by hour, minute by minute, second by second, they need to have that choice on how they leave us. Should that day come, no one knows how we would deal with it ourselves. I don't even know if I could go through with Stacey's wishes if I would want to go down that route. If I was able to let go at that point, I don't know what my emotional state would be at that time. Is that not the point? Is it not about the choice, the ability to have this option, should the individual choose it? Plus, the bill states that such a decision would be agreed upon by at least two doctors and the patient themselves as to what the final action would be. I've had, like many of my colleagues, letters and emails from constituents, and I had one in particular from a woman who's both parents died of cancer over a 10-year period, both in complete and utter agony. The father would have chosen not to take that route, but the mother had said that she would because she experienced the pain and anguish. All they could do was say that they could see their grandparents and parents suffering during that process. And she's promised that she would never ever allow her family to go through that. So, Presiding Officer, I would say that we need to take this debate forward and discuss it further. This bill is not about faith, either your faith in the proposed legislation or your religious faith. It's about equality and choice. It's about our people, our communities and our families. This bill needs to pass stage 1 so that the discussion can continue. Thank you very much. I now call Neil Findlay to be followed by Mary Scanliff. Apologies, Presiding Officer. Hearing about Stacey Lust and George Adam has put me off my stride, but I'll try my best to continue. First of all, I pay tribute to the work of the late Margo McDonald and, of course, to Mary and Peter, who worked in our office and for Patrick Harvie for continuing that work and getting this bill to where we are today. For me, this is without doubt the most difficult issue that I've had to consider in 12 years as an elected politician, and so it should be, because this is about life and death itself. It's about the fundamentals of human existence and whether we, when our time here ends, our body gives up of its own accord or life is brought to an end deliberately and artificially with the help of someone else, and I am deeply, deeply torn over this proposal and have been for many years. Time and information has made it no easier for me. From initially being certain I would vote against this, I'm now not at all clear in my own mind. I've listened very carefully to the debate. I've had many conversations with constituents, like others. We've been lobbied by both sides. I've asked for opinion on social media, and many people have came forward with their comments, offered their opinion and shared family experiences. Friends and relatives who work in the health service, family members, doctors, patients, nurses and charities have all offered a wide variety of views, and I thank them all for taking their time to do so. Most of them have done so very respectfully, but a minority of those who offer an opinion have done their particular side of the debate, I believe, a disservice by presenting their views in a very simplistic way, a very blunt way, a black and white dismissive way. Let me tell you, this is not simple. It's not black and white, and those with other views should not be dismissed because this is too important to be presented as a polarised, I'm right, you're wrong issue. Neither is it the case that those who oppose assisted suicide nor those who support it lack compassion or have a monopoly of it. All of them, I believe, want what's best for people at the end of their lives, including themselves, and to suggest otherwise is disingenuous. I recognise that Patrick Harvie has indicated his willingness to make changes to the bill to address a range of concerns. Of course, there are very important process issues and technicalities relating to the bill, but for me this is not about technicalities, it's about human life and how we treat our sick and dying and how we face up to our own mortality and that of our loved ones. Those are the most profound of issues and simplistic answers simply won't do. In my conversations with people about this bill, it has been the personal stories from health professionals who let's not forget care for the dying every day and the families of loved ones that have been so powerful, honest and very humbling. It's almost impossible to discuss this issue without humanising it through personal experience and that is exactly what makes it so difficult. We'll all have been told of relatives suffering, lingering painful deaths with families desperate to end that suffering, but we'll also have met or been told of people just as desperate to milk every last second out of a life well lived and who would do it all over again if they could and we'll all have had our own powerful personal experience to back up our own position. One thing that has come out of this debate is that we've begun talking about death, something we all avoid until it confronts us. We can't avoid it any longer because death and end of life care and indeed wider social care, which I believe is one of the biggest scandals in our country, is very firmly back on the political agenda and more prominent in the public's consciousness. We have the sponsors of this debate and the people who have participated in the debate to thank for that. So whatever happens today, we must as a society go on further to debate how we provide and pay for high quality, respectful and dignified end of life care. We must address the issues of inequality and death just as we see those gross inequalities in life and we should accept the simple fact that end of life care in Scotland is simply not good enough, despite the often herculean efforts of hospice, NHS staff and social care staff. With so much doubt and conflicting emotion in my head over this bill, I should abstain, but I won't abstain because that would be the easy way out of an extremely difficult situation. My head tells me to support the bill, but my heart and soul and the very personal experience that I've had tell me not to. Whatever way I vote and we vote tonight, a lot of caring and compassionate good people will be disappointed, but they have contributed to this great debate and I thank them for that, despite the fact that they've tortured me with their opinions. Thank you very much. I now call Mary Scanlon to be followed by Dennis Robertson. Thank you. It's just over a year has passed since Margo MacDonald passed away and on days like this I expect to just turn around and hear her intervening about this subject which she cared passionately about and very few speeches reached their five minutes without an intervention from Margo. Although I signed Margo's original motion to get her bill debated in this Parliament, I always told her that I wouldn't support it unless everything was done to minimise or eradicate abuse or exploitation of the principles underlying end-of-life assistance and now turned assisted suicide. Like others, I would like to thank the health committee for their due consideration of the bill and put on the record that I have read their report cover-to-cover. I also chaired the cross-party group on chronic pain after Dorothy Grace elder left this Parliament and I did so for many years. Like many others, I spoke in the last debate on this issue. I raised the issue of uncontrollable pain in the context that Neil Finlayley has spoken about of the fear of pain and I reminded members at that time five years ago that chronic pain services had improved but there was still some way to go and I remain of that view. I watched the friend's mother in the lead-up to her death in dreadful pain, not caused by her dementia, not caused by her medical condition but caused by the NHS with poor and inadequate bed-sore management and the truth is that this shouldn't happen with good nursing care. I commended Nicola Sturgeon and the Scottish Government on their living and dying well strategy five years ago but today I can say that it's definitely not being implemented in a dignified and respectful manner with the minimum of distress as promised. So if more training, energy and resources was invested in high quality pain management and equality of access to pain services, we might not have the fear of pain that exists at present whether related to terminal illness or not but again within this bill paragraph 4 of the policy memorandum states the fear of protracted, painful and undignified death is very real for many people whether or not they have themselves been diagnosed with a terminal illness or condition. The policy memorandum goes on to say that not everyone can be assured of good death in which pain is kept at bay and a reasonable quality of life is maintained until the end and the final months or years can be dominated by pain or discomfort. The policy memorandum is giving us the fear of pain so the government in my view should be focusing much more on services to bring reassurance to patients rather than this bill bringing forward policy memorandum heightening the fear of pain. I heard what the health secretary said today about the living and dying well strategy well I'm sorry but better palliative care was promised five years ago and my second point relates to what I described as undue influence five years ago and is now crossed more accurately as coercion. There's no doubt as others have said that it can be difficult to interpret the wishes of a terminally ill patient if they are delirious, confused in pain or in many cases depressed. How can a clinician be absolutely confident that a request for a life to be ended sooner does not arise from a person's state of mind and whether or not that state of mind is treatable. Coercion need not even come from a third party if a person is made to feel that they are a burden and many older people do feel that. If they're made to feel they're a burden to their family, to the health service, to the care home, to the state they could personally be unduly influenced by those factors and how can any doctor face with an adamant patient be sure that that patient is seeking to shorten their life because it's intolerable whether there may be other reasons of greater influence. The last time the health committee accepted it would not necessarily be possible to determine with absolute certainty that there was no undue influence. This time, the committee again raised serious issues relating to concern. I will be voting against this bill. That wasn't where I started. I hoped that I may vote for the bill this time, but I can't. It does not provide clarification of the law on assisted suicide. It does not define key terms such as terminal and life shortening. I'm concerned that the bill does not distinguish adequately between assisted suicide in euthanasia, paragraph 139 of the health committee. The BMA state, it's hard to conceive of a way in which a doctor could be certain there was no coercion and the policy contradictions between preventing suicide on the one hand and passing legislation that would provide for some suicides to be assisted and facilitated leaves me with much discomfort. I regret for these reasons, I cannot support the bill. Thank you very much. I now call Dennis Robertson to be followed by Christine Grahame. Thank you very much indeed, Presiding Officer. If there's anyone who could have influenced me to support this bill, Presiding Officer, it was Margo MacDonald, but she failed to do so. It was strange because the last time this bill was debated in Parliament, I wasn't here. I wasn't a member of this Parliament. It was astonished at the vote and I couldn't think why so many people had voted against Margo's bill. However, this time, Presiding Officer, I came as someone who thought I could support the bill. However, during the evidence of health and support, as a member of that committee, I put on record my thanks to not just my colleagues in the committee in the way that our evidence sessions were held, but certainly to the clerks and to all who provided evidence and all the witnesses that came to the committee. During that period, I listened greatly and I asked questions, and it was during that time that I started to ask myself the question, can I support this bill? I started to reflect perhaps on personal issues, and maybe bringing personal issues as a parliamentarian to the chamber is not the best way to legislate. However, looking at the briefs that we have had from various organisations and certainly the letters and correspondence that I have had from individuals and the many meetings that I have had with both sides of the argument, I had a snagging doubt in my head, and it remains a bit like Neil Finlay trying to come to terms with his heart and with his heart and soul in terms of one way he is going to go against the bill, although his head may be told him something different. I started to reflect on personal issues, and I remember sitting at my mother's bedside, and my mother was given a few weeks to live, but that few weeks extended to many, many, many months, and I was the only person with her when she died. But just before she died on the weeks coming up to her death, she'd asked to be freed, she'd asked let me go, and it wasn't because she was in pain. Her reasons for wanting to go and wanting to be free was she started to see the pain of the family, the grief of the family, the despair of her family, and that's what her concerns were. It wasn't for herself, it was for the family, the people that she'd cared for and loved throughout her life. But we as a family didn't want to let go, and it really wasn't her wish. It was only because she didn't want to see us, and to some extent, suffering that pain. And then I remember with my daughter, and we've talked about coercion. Coercion did happen in respect of my daughter, and it was from me. She wanted to die. She said on several occasions, let me die. I can't live with this illness. You need to help me die. Please help me die. I didn't. I held her. I held her in my arms. I gave her what we call the North East of Ozy, and I said no. I couldn't do that. I loved her too much. I wanted her to live, but I didn't want her to live in agony. I didn't want her to live with suffering, but I wanted her to get well. I wanted her to see a way through her illness. And that's where I come to this dilemma, to some extent. Should we embrace life to the full? Should we embrace it to the point that our love overcomes the pain and perhaps the suffering? It is very difficult, Presiding Officer. And I think Jackson Carlaw made a point when he said, it's been to Parliament before and it is with Parliament again. But, Presiding Officer, that doesn't mean that it can't come back. And if a bill does come back, it would have to be stronger than it is now. It would have to show that there is care and the compassion. All the aspects that we are asking the questions about in this bill now are answered, and then maybe perhaps. Perhaps I would come to terms with the ways of helping people to let go with the love and the dignity and respect that they need. Thank you, Deputy Presiding Officer. I thank the Health and Sport Committee for their considered report. I commend the member in charge for his sensitive, thoughtful presentation of the argument for the bill proceeding, and indeed all contributors in the debate, and of course Margo for her commitment and grit, not the least in the face of her own debilitating condition. I support the purpose of the bill as introduced quotes to make it lawful in certain circumstances to assist another to commit suicide, but I would stress that I am entirely respectful of the views of those who, for moral, ethical, religious grounds or any other grounds, cannot accept that purpose, no matter what the procedures and processes are in place. My arguments here in favour of the bill proceeding to stage 2, I hope, persuade those in doubt to that difficult, I shall call it the moral question, together with the procedures that form the major part of this bill. They deserve further testing. Those latter issues, processes, procedures were addressed by the Justice Committee, a secondary committee that reported to the Health Committee on 8 January. For those moral questions, I start from the autonomy of the person, my rights over my body which remain until but not beyond death. I am persuaded that if a person has an illness that for them is terminable and detailed in schedule 2, then you should have the option. I stress the option, the choice to, in advance and subject to procedures and protections, be assisted in ending their life if and when they are physically unable to do so themselves, but would have so done had they the physical capacity. I stress in particular terminal, life-shortening is problematic, terminal is problematic, but life-shortening certainly is. However, this is a stage 1, and imperfections in legislation at stage 1 are the norm. Indeed, in my 16 years here, I have seen legislation exiting Parliament into our courts after stage 3 bearing blemishes. Procedures regarding inter alia capacity informed consent, the ability to withdraw that consent were scrutinised by the Justice Committee to test the concerns of many that even if you are persuaded that the individual's choice over this last act should be available, can we be assured that the process, those procedures, would not be open to or unintentionally capable of abuse? Here are a few. As I have already said, the interpretation of life-shortening in terminal, the definition of capacity has to be consistent with existing legislation, when it is tested in the courts. A lack of clarity in the bill raised already as to whether everyone with a mental illness would be excluded. I note that Patrick Harvie was open to looking at this when he came to the Justice Committee, clearly defining recording requirements and ensuring secure storage of drugs or other substances between prescription and use or retrieval, if required. Issues that others have raised at the 14-day time limit between issuing the prescription and the act itself might put pressure on the individual to proceed. A range of issues were raised concerning licensed facilitators, for example, that they should not unwittingly fall foul of the provision that they should not act if they were to gain financially from a person's death. They might be a beneficiary in the will and not know it. Is 16 too young? That consideration should be given to whether a conscience clause for professionals should be on guidance, codes of practice or, indeed, on the face of the bill, which I personally would support. In terms of human rights, there is a conflict between what the Human Rights Commission said. Professor Miller said that, from a human rights point of view, the real test will be whether the person exercised free will and whether the decision was based on information that was sufficient to satisfy us, that the person who was seeking to bring an end to their life did so with free will and the law society, suggesting that the bill may be in direct contrast and possibly completely incompatible with the human rights law, in particular article 2, the right to life. Does the bill enhance or undermine human rights? I think that we should test this. In summation, I support in principle the right of each one of us to choose or not to choose to end our own life with assistance in certain limited circumstances and within the strict confines that should be explored in this bill. I would hope that enough members will support stage 1 tonight to test whether the bill can be amended or not. Let's find out. I think that the time is right to further test this proposition. At the end of her life, Margo needed and received excellent palliative care. For her and for us, it is not palliative care versus assisted suicide. The proposition is that assisted suicide should be an option, only an option, no more than that. I would like to start by thanking the many people across Central Scotland who have contacted me to express their views on the bill. I understand and I respect all the views that have been expressed to me. However, it will come as no surprise to anyone who has contacted me in the past few months to know that I will be opposing the bill at decision time this evening. I would like to focus my remarks, if I may, on the issue of disability. I have a number of concerns regarding this proposed bill, but the most worrying part is around the definition of life-shotting conditions. As the chas briefing states, the phrase life-shotting is unclear because a young person can have a condition—for example, cystic fibrosis—which will shorten life but could nevertheless allow them to live for several decades more. My disability is life-shotting. I will or not probability die before someone of my age should, as a result of my condition. When I do die, I will or not likelihood have lost all function or my right arm and leg, and will have come to rely on those around me to feed, clothe and bathe me, as well as assist me with my toilet needs. I will also be in considerable pain. This will not come as a surprise to me or to my loved ones, however, I am to prove the medical professionals wrong. You see, when I was born, my parents were told that I wouldn't walk or attend mainstream school or indeed do anything worthy of my life. My dad's recollection is that he and my mum received a list of all the things I wouldn't be able to do in my life. Thankfully, that hasn't been my experience to date. My prognosis has been wrong so far, so who's to say it won't be wrong in the future? To give me the choice to end my life based on this prognosis, or indeed my health, would simply be wrong and signal to me that my life is worse less than those of my able-bodied peers. It would validate societal attitudes towards those of us who are disabled and that is simply wrong. I believe that if past this bill would reinforce the concept that my life and those of others with life-shortening conditions are not worth living and are not of the same value as those without those conditions. This is a societal perception that I have come across throughout my life and it is one that I am constantly challenging. I believe that if past this bill would give this notion credence, I further believe that it reinforces the stereotype that disabled people are a burden and do not contribute to society. As I have highlighted many times in my speeches, particularly during the disabled history month, the stereotype could be further from the truth and must not be given validity today, tomorrow or any time in the future. I think that it would be remiss not to take notice that there isn't a single disability organisation that is supporting assisted suicide. There are, of course, some organisations that have remained neutral on the matter, but I find it extremely significant that the bill has failed to attract support from this section of society. A survey by the disability charity Scope found that 65 per cent of people surveyed and three quarters of young people believe that disabled people are often seen by the public as a burden on society. In addition, the survey also found that 76 per cent of 18 to 34-year-olds have experienced someone explicitly making negative assumptions or comments about their quality of life due to their disability. We only have to look at the attitudes that disabled people have faced as a result of the welfare reforms currently taking place and the role the media has played in demonising this section of society to see that this feeling has met it. I strongly believe that proposals that we are discussing today further add to this view. I do have further concerns regarding the proposed bill, which I do not have time to discuss in detail, but which I would like to record today. Those include the fact that the proposals do not contain a no-conscience cause, which would protect medical professionals who do not wish to take part in assisted suicide, the fact that the proposed bill does not define what assistance actually is, who will determine this and how, the fact that a 16-year-old could act as a facilitator for the suicide or the fact that the act of suicide must occur within 14 days of the second request being made. I endorse some of the questions that the Law Society of Scotland has asked regarding that particular matter, including how is the 14 days to be monitored, will the person be advised that the 14 days is about to expire, how will that information be given, will this place a person under increased pressure to end their lives, and finally, what happens if the person asks for more time? However, returning to the main crux of my argument, I believe that, if passed, the bill would imply that the only solution to pain, life-limiting conditions and terminal illnesses is to offer assisted suicide, but there is another way. We could invest in palliative care services so that they become something that we can rely on no matter what our condition is. Mary Curie estimates that there are currently 11,000 people missing out in palliative care each year in Scotland. They have also found that people with a terminal illness other than cancer, such as dementia, are less likely to be referred to palliative care. The time to take action on this matter is now. The solution to the problem is investment in our palliative care services, our NHS, our social care and our welfare benefits. The solution to the horrendous problem will not be found in the proposed bill. It is not a medical condition that makes disabled people's lives intolerable. It is a lack of social care, health services, accessible housing, transport and well-funded welfare benefits. I would urge action to be taken to address those problems and hope that the proposed bill will be rejected by Parliament tonight. Many thanks. I now call Kevin Stewart to be followed by Nigel Dawn. Thank you, Presiding Officer. As he took his seat after his speech, Dennis Robertson said that it is nae easy and he is absolutely right on this issue. I have thought longer and harder about this piece of proposed legislation than any other that we have had to deal with in my time in this Parliament. The proposed bill is far from perfect and, in my opinion, there is much room for improvement to ensure that all possible safeguards are in place. I thank those who have scrutinised the bill. I have read the reports that have come forward from the health committee, I looked at the official report of the justice committee and I have looked very carefully at all of the correspondence that I have had. Other jurisdictions have already looked at this matter and many have scrutinised similar proposals. I would like to look at some of the evidence from elsewhere rather than repeat some of the things that have already been said today. Professor Sir Graham Cato said at the House of Lords select committee on 21 October 2014 that legislating to enable doctors to assist patients to die whether directly or indirectly goes further than to acknowledge that, in some circumstances, it would be generally regarded as humane to end a person's life. He said that a number of issues, apart from the wider issues of society's attitude to the value of life, need to be considered. Those include possible effects on patients' trust in the medical profession, the impact on the development of palliative care and on the psychological effects for individuals. First of all, let us look at the situation regarding trust in the medical profession that Professor Cato mentioned, which has been raised with me by a number of opponents of the bill. The Netherlands has legalised assisted dying and yet it has the highest rate of trust in doctors of any country in Europe. 92 per cent of Dutch people trust their doctors. Surely that shows that enacting assisted dying will not necessarily erode that trust. On the subject of the development of palliative care, Professor Cato told the House of Lords, I think that the two things do not need to be in conflict. It would seem to me that it would be perfectly possible to proceed along the lines that are being considered on the assisted dying bill without, in any way, impeding the progress and desirable developments in palliative care. I do not see that there is a necessary conflict between those two. I share Professor Cato's view and I am quite sure that everyone inside and out with this chamber, no matter what side of the debate they are on, wants to see continued improvements to palliative and end-of-life care. I do not think that there is any conflict in this issue at all. On the run-up to the debate, I have had numerous conversations with those who are both for and against the proposed bill. I have read many, many pieces of correspondence, reports and articles, and many of those have touched me greatly. Sir Graham Cato's third issue to the House of Lords was that about the psychological effects on individuals. Many of the emails, letters and articles that I have mulled over have touched upon the psychological effect of not allowing assisted dying. In a heart-wrenching article in the British medical journal, consultant dermatologist Tess McPherson tells the harrowing tale of her mother, Dr Ann McPherson's long battle with cancer, and the devastating effects that the final weeks of pain and suffering had on Ann and her family. In the piece, Tess McPherson says, it is an honour to care for someone you love, but it is no longer felt honourable to care for someone who wanted to be dead. I would urge everyone who has not read this article to do so. Patrick Harvie has recognised that the proposed bill requires amendment, but we can only do that if we allow it to proceed to stage 2. I would like to finish with a quote from a constituent. Of course, this bill is a long way to go to ensure that adequate safeguards are in place to ensure that vulnerable people should not feel pressurised in any way, but it has to start somewhere. You will know that a large majority of people in Scotland support a change in the law. I gather the bill needs to pass to stage 2, where amendments can be discussed fully and openly. I hope that colleagues will agree to allow those discussions about amendments to take place at stage 2 and will vote accordingly today. By doing so, that does not commit me or anyone else to vote in favour at stage 3, but it allows the debate to continue to see if we can formulate a bill with all the right safeguards and protections in place. Many thanks. I now call Nigel Dawn to be followed by Jean Urquhart. Thank you very much, Presiding Officer, and we can be absolutely clear that this isn't easy. I'm very grateful to Patrick Harvie for the way in which he's brought this bill forward, and I'm very grateful to the committee for the way in which it's interrogated isn't for their very lucid report. It seems to me, Presiding Officer, that if we need a bill on assisted dying, then we need to ensure that it's focused on the actual problem. And I'm grateful therefore that the committee at section 49 makes the point that the current lack of clarity as it sees it in the current law is no justification for bringing forward this bill. If there is a need to clarify the law, then that can be regarded as a separate issue. It also seems to me that this bill is drafted too widely. I'm entirely with Elaine Dr Elaine Murray here and others I might add, Siobhan McMahon being one, that anything that talks about a progressive life shortening condition is surely far too wide, because what I have, I think very clearly discerned from all the correspondence that I have had with my constituents and the many other bits of correspondence that we've had, is that the real issue is actually suffering at the end of life. Now, we recognise that it may not be terribly easy to know when we've got there, but I think actually people very often do. The bill as it stands, forgive me, the bill as it stands seems to me and to many others to undermine the value of life by allowing some shortening of life to be a justification for suicide and it seems to me that that is entirely wrong. We need to address, I think, issues of the end of life and as many others have said, the answer to that is clearly palliative care and I don't need to repeat that. I'm grateful to Nanette Milne for pointing out that most of the time that works, but she recognises and I'm grateful for expertise that sometimes it doesn't. Now the doctors I have spoken to on this agree with that view, but they do seem to take the view that sedation is something which they can provide and in their view that is a better route forward for those for whom genuine pain relief is not available. Now, I've not heard any further comments about that presiding officer and it does seem to me that that is an issue on which we could do with some research and some advice. But the major point that I'd like to focus on is the argument that I've heard now several times, I'm not even going to read you the list of members who've made it, which is that we can amend this at stage 2, we ought to pass it today in order to allow it to go forward so we can amend it at stage 2. Let us be clear, we can amend it at stage 2. There would undoubtedly be many amendments, evidence could be taken on those amendments and I have no doubt that the committee could fairly and reasonably weigh them and I have no concerns that it would be a relatively small committee. But the point that I would make to the chamber presiding officer is that once we get to the end of stage 2, even if we have in front of us the perfect answer, we won't know and we won't be in a position to take the evidence that will then tell us whether we have got the perfect answer. And that is why I am actually with Dennis Robertson on this but I think he's the only voice that's expressed it this way that actually whilst we may feel there is a bill in there trying to get out and there is a legal point that needs to be addressed, actually what we need to do is to turn it down this evening, which is what I am proposing to do, ask those who have reflected on what has gone on to try and bring forward another bill in due course and I know that builds in a delay but we should be able to get to the point where at stage 1 we have a committee able to report in terms other than the bill has significant flaws and major challenges because I think at that point we would be in a position to say well are there some amendments which we need to make? I am most uncomfortable with the idea that we go through stage 2 to try to deal with significant flaws and major challenges and then hope that at the end of the day when we get to stage 3 we can decide whether or not we've got a good enough product. I actually just don't think the process allows of that and that's why I do actually commend to members that they should reject it at this stage in the hope that in time we can bring something correct back to the chamber. Thank you. Thank you very much. I now call on Jean-Arcourt to be followed by Dr Richard Simpson. Thank you Presiding Officer. This Parliament has never shirked its responsibility in dealing with a number of controversial subjects which have brought about societal change and bringing them to this chamber. It follows that we hear many differing and often strong opinions informing and allowing for the best kind of debate. I thank the many individuals, organisations and groups as others have done who took the time to articulate their reasons for offering their support for or objections to the assisted suicide bill. I will be supporting the motion today and I guess for different reasons I mean it seems listening to the different contributions to this debate that have all been I think really considered and quite powerful many of them that there are two things. First of all my own instinct is to will that there should be a bill of this nature and so my reasons for that I have to kind of set aside but and join with those who are asking for the bill to be passed to today even though their instinct is that it shouldn't be or that it should never come into law and I think that does allow for the greater debate and perhaps even more public involvement in what is for most of us quite an issue about which we feel very strongly so it's not I think it's really not an issue that that we can be uncertain about in the in the end as it were if you'll excuse the pun but my main reasons where we debating the bill is firstly for the want of choice and fairness and as an act of human kindness and compassion and possibly and thirdly for respect for any individual and his or her needs and beliefs and I too spoke to Margot McDonald at some length about her bill and I'm really pleased that to hear her name checked so often today because she is synonymous really with this bill and her desire to see it become law to an extent the bill as is maybe you well still far from perfect and what is clear from the health and sport committee report is that there are still many questions to be answered and detail to be articulated clearly and understood by everyone and in such an important issue of course the devil really will be in the detail but I believe that all of that can and should happen the right of an individual to be released from from life at their own request should be acknowledged as their choice and they should be supported it would appear that the majority of people in Scotland if we can believe recent reports in journals and newspapers of recent times now do broadly agree that it is a matter of choice Scotland does have an aging population many of whom will suffer degenerative conditions and the debate about the quality of life and how we can live and how we can live it will continue for years to come meantime anyone who out of compassion and love wants to help a friend or relative to die will remain open to prosecution and inevitably more and more people who can afford to do so will travel abroad in order to have their wishes met this cannot be right i acknowledge those who are of a religious faith and that i'm not and they do appear certainly in my mailbox to be the largest group opposing this bill have their reasons to do so and i can respect that and they would not ever consider using the permissions that this bill would allow and that is their right but i would ask that they respect those of a different belief it would be very wrong presiding officer if this bill were to fail today on any religious grounds this problem will not go away but rather will increase and therefore this bill is timely there is a strong feeling across the country i believe that recognizes that and supports the generality of the bill every contribution in the chamber today has been interesting thoughtful and considered and this parliament is surely here to allow the debate to continue and not to shut it down prematurely please do not shut down this important debate support the motion this afternoon thank you thank you so much now call on doctor richard simpson to be followed by calling here thank you presiding officer patrick harvey and the proposals of the bill the proposal of the bill has made a very eloquent case for a change in the law and it is absolutely right that this chamber and the members in it should wrestle with this issue but the committee is as the deputy convener bob doros said summarised very well today has an extensive list of concerns the bill has two main principles the patient the person must be diagnosed with an illness or progressive condition that was terminal or a life shortening condition and the second principle was have the legal capacity to make such a decision these two principles behind the bill create for me two immediate problems other bills such as the falcon a bill debated in the house of laws did get as far as stage two and i think this was in part a reflection of a much more tightly drawn set of basic principles that bill still had difficulties in definition but at least it sought to limit the application to those in the terminal stage of an illness this bill by including short life shortening conditions is far too widely drawn let me just give a couple of examples diabetes is a life shortening condition on average and conditions of poorly controlled diabetes the complications are unpleasant amputation even repeated amputations might make someone feel that life was intolerable and yet we know that many amputees enjoy a full life and the improving situation with prosthetics actually is improving the quality of life and that's an important point many of these things are actually about improvement i'm sorry mr hobby i think i know the point you're going to make but i'll maybe let you in later those with a severe and enduring mental illness on average have also got a much shorter lifespan but if their lives are intolerable it is in main because we as a society have still to support them adequately i have particular sympathy for those with neurological conditions because i don't believe that the palliative care we offer is yet good enough my close friend's son was diagnosed with multiple with mnd motor neurone disease at the age of 30 the doctors gave him two years as a likely maximum lifespan 11 years on he is now an event later and peg fed but fully supported he's been in that situation for over two years now during these last few years when he has been essentially entirely dependent on other people he's funded a neurological research centre at edinburgh infirmary he's developed a voice bank which christianine mcelvie alex salmon and myself have contributed to for those who lose their voices as part of this process and he's established uan's guide for the disabled and looking in from the outside his state looks totally intolerable yet he is like gordon aikman and melanie reid and inspiration and the contributions of these individuals are vital to our society and they are making those contributions in part because of the problems that they are facing but they like all of us all of us have a fear of dying not of death itself we will all have come to our own conclusions about what that means but the process of dying is one that is fearful and that is part of the human condition and that is exacerbated by the fact as many speakers have already said by the quality of our palliative care being wholly inadequate and that's despite the fact that we have a hospice system in scotland i was proud to be one of a group who founded struth garden hospice in the late 1970s but we have still got a huge length of way to go in actually achieving good palliative care it is clear however that this bill colleagues is massively flawed for the failure to define assisted suicide against euthanasia for the failure to define terminal as opposed to lifelong shortening conditions the failure to define what is unacceptable suffering the failure to adequately protect those with undiagnosed depression or indeed to define fully the capacity tests the failure to adequately protect vulnerable adults from being into assisted suicide many with disability will have periods of self-doubt or depression or even despair and i believe this this bill would not be a step forward in supporting them the line between assisted suicide and euthanasia is a fine one and this veil really does fail at that very first step to clarify the bill would not remove the uncertainty of the current laws regards causation nor does it make clear what actions and by whom are to be protected the bill does not protect doctors there are serious issues are young young adults as the children's hospice has reminded us in their briefing the conflict of interest for this community and our chamber between our desire for suicide prevention and assisted suicide is a difficult one i acknowledge the supporters of the bill believe in autonomy as an absolute and that compassion should lead us to support assisted suicide but similar laws in other countries have been expanded gradually over time and i believe that this bill unfortunately will not do and is not capable of amendment and i will vote against but if the chamber decides otherwise i will strive for this to be a court decision and not one that is done in terms of the current bill many thanks now call on call on cure to be followed by murder Fraser thank you Presiding Officer like a number of people here it's incredibly difficult i started off with a speech and i've been scribbling around notes as the afternoon has gone through to which have something slightly different to what i i started with could i still start though thanking my colleagues on the health and sport committee for the way that they handled the deliberations on this bill we all have different views strength of views and i think it was handled very well and i believe that the report came out in a very fair measured manner and i could also thank those who are who came in as witnesses it was very difficult for many of them some of them would rather torture stories of personal relationships and of course you had those i think jeane urquart mentioned from the religious side of life who held very very strong views on this and very much against at this moment in time if this bill as it's written at this moment in time was handed out as a stage three i couldn't possibly support it i believe like others that it is possible that this can be amended and i would really like to commend patrick harvey for a part from a very very good speech that was brought through actually showed how inclusive that this bill is that started off with margo and i would congratulate patrick on that speech margo obviously had her problems with the physical difficulties that she had in having sat down many occasions talking about this bill i believe like mike mckenzie has just actually said earlier on today that we ought to those not just who are suffering but those who actually sent in as a part of the consultation because i think it's absolutely vital that we give this full parliamentary scrutiny because like it or lo that it's going to keep on coming back i would imagine over future sessions and i would just think i can't remember who it was that mentioned that it will come back and if we don't at least take it to the point where we can actually say well it really does need completely rewritten then we're just stacking up more troubles for next time out so as far as the religious beliefs go i fully respect those people who hold those beliefs i it's something i don't personally have but i believe that strength of inner strength that comes with those beliefs obviously brings out these very strong feelings in many ways and it's a very very highly emotional period of time here certainly on a personal note my father had a neurological degenerative disease and from being a very big burly guy i found them at the end to be almost like a photograph of someone in Auschwitz now when you see that and you see someone crying someone who you've looked up to for the your strength in your family and looking you know asking to be helped it is absolutely horrifying now in terms of the palliative care the palliative care that my father received was i have to say excellent in the su rider home green law when it was open the problem was of course at that time in the 90s there was no place really suitable for that particular type of illness here in Edinburgh and it meant a rather long drive down south to green law and back again so all these things everybody here is of an age none of us are teenagers you know we all have stories we all know of people and it hurts and it's hurting not just as i think michael might be michael mic man who said that you know we look at the people who actually look to their families and they see the pain that it causes them and of course that is a point but you know we shouldn't be scared some people will never ever take the option of this type of action i know it's gone very quickly i noticed but there are controversial issues here absolutely no two ways about that i'm skipping through most of my notes much to my surprise i find myself really now down on the side of wanting to see this expand into something that we can make it how far can we go with this surely the legal and medical problems of clarification and the actions of facilitators can be overcome and i'll leave it there since the time thank you very much i'll call on more the phraser to be followed by mark mcdonald thank you deputy presiding officer we debate many matters of great importance in the chamber but very seldom do we have to discuss the fundamental issues that we wrestle with this afternoon issues of life and death issues of suffering and of the nature and quality of human existence other members throughout this debate have raised issues in relation to matters of detail in connection with the bill before us but i would rather address the issue as a matter of principle what sort of people are we what sort of society do we want to be what is our response to this bill tell us about the nation that we seek to represent and at the heart of this debate is essentially a philosophical question one acknowledged by allison mckinnis earlier in an excellent speech who owns our life who has the right to take decisions over it and do we have the right to take our own lives the victorian poet william earnest henley in his famous poem in victus wrote these lines it matters not how straight the gate how charged with punishments the scroll i am the master of my fate i am the captain of my soul of anyone who takes an essentially liberal view of the world as i try to do the notion of sovereignty over one's life makes sense as christian graham said truly it should be up to the individual and the individual alone to decide not just how to live but how to die and law should be made that complement and assist that decision now i sense that jackson carlaw is starting to fear a lightning strike again so quickly state that while i find that superficially attractive even for someone with a liberal outlook on life it seems to me too extreme a form of individualism to claim that the action of taking our own lives is one for us entirely alone that cannot have an impact on those around us no man is an island wrote the dean of st paul's john dun nearly four centuries ago any man's death diminishes me because i am involved in mankind we regard suicide as a social ill the Scottish government has a suicide prevention strategy and for good reason suicide can have a devastating effect on those who are left behind and only those who have experienced the loss of someone close in this way can fully appreciate the pain and loss that are generated we may be individuals presiding officer but we cannot pretend that our actions in so serious a matter are decisions we can take unilaterally without considering the effect on wider society the case was made very strongly by the health and sport committee the much more needs to be done to provide palliative care to those in end of life situations and i entirely agree with that conclusion has been echoed many times during this debate but even so i believe that those of us who are opponents of this bill should be gracious enough to accept that palliative care however excellence will not be the entirety of the answer in every case no matter how good it is there will still on occasion be pain distress and suffering and grief but surely that is part of human existence as much a part as peace and joy and happiness and just because there is pain and suffering should not mean that a life is regarded as no longer worth living or without any value in a powerful contribution to this debate the scottish council on human bioethics state that legalising assisted suicide means that that it is the whole of society and not just the person wanting to die which is accepting that a person has lost all value worth and meaning in life this would have a brutalising effect on society and dangerously undermine the legal protection established in the concept of equal and inherent human dignity. Presiding officer it is little wonder that so many disability rights groups are opposed to this legislation as Siobhan McMahon reminded us many human beings have lives which are far from perfect many live daily with disability with pain and with suffering but that does not make them any less human or any less entitled to human dignity and to pass a law saying that those who are suffering should be entitled to assistance to kill themselves suggests that this parliament believes that some lives are worth less than others. I started by saying that how we handle this legislation was a measure of the sort of society we wanted to be and the question we have to ask is this have we really become a society which says the best answer we can provide for those in suffering in end of life situations the best we can do is to help them kill themselves is that really the best we can offer for that sounds to me a desperately cold soulless society and I think that in Scotland today we are better than that so for all these reasons I oppose the bill before us. Many thanks. I call on Mark McDonald to be followed by Paul Martin. Thank you very much Presiding Officer at the time of Mark McDonald's passing one of the things that I said I would remember quite fondly is that whenever she or I were called to speak in the chamber we found ourselves having to exchange a furtive glance to work out if the Presiding Officer had said Mark or Margo McDonald were being called to speak and I couldn't help but think that today of all days I would have quite welcomed the opportunity to have that exchange of glance because I think it is a great testament to the work and dedication of Margo on this legislation that we've got to this stage and I pay tribute also to Patrick Harvey who has taken on the legislation and brought it forward and I also would pay tribute to the members of the health and sport committee who I think have done a very fine job of scrutinising the legislation. I don't necessarily share all of the health and sport committee's concerns but I do think that they have gone through their work diligently and I appreciate the fact that although they had a committee which clearly had a majority of members who did not support the legislation they took what I think was the correct approach of looking at this bill from a dispassionate perspective and saying what would be required from our perspective for this to be a workable piece of legislation and I pay tribute to them for being able to take that approach. Now many of us have spoken in this debate from a range of experiences that have shaped our views on this legislation and that is only natural as human beings we our views are the the accumulation of absorbed experience whether that is professional experience such as our medical professionals who are in the chamber with us today whether that is through personal experience through looking at the situation as it affects ourselves our family our loved ones whether that is through our beliefs as they are shaped by our faith or our lack of faith all of that is playing a role in today's debate and I think given that it is a debate on which we will vote in relation to individual conscience that is as it should be. I've been open for a number of months that I am in favour of this legislation and will vote in favour of this legislation at stage one that is not to say that I believe that the bill that sits before us today is the finished article or is perfect there are elements of this bill which I believe do require amendment and if it passes today I will look at whether I myself will table amendments for in particular one of the areas I have concerns in is around the inclusion of life shortening as a definition I believe that that as members have pointed out leaves too wide a scope for potential application of the legislation but I don't believe that that in itself and the existence of that term within the bill at stage one in and of itself justifies rejecting the bill at stage one I believe that this bill is amendable I don't share the view that some are subscribing to that it is beyond amendment or beyond salvation now my my my good friend and colleague Dennis Robertson spoke of his own personal experience in relation to his mother who was given a diagnosis of I think weeks to live but it lasted significantly longer than that my own grandfather was diagnosed with lung cancer when I was 16 years old and was given a diagnosis of six months to live he lived far shorter than that he died long before the prognosis was was that was offered to him we can never be 100 sure that a person will live to the length of time that doctors state and that is why I think we have to look at this from the best judgment of medical practitioners and I believe that that is what the legislation seeks to do it's what other forms of legislation seek to do as well but above all else this is about empowerment of the individual and it we've had much literary quotation in the debate today and I always come back to a quote from my great literary hero Atticus Finch into Cullum Walkingbird that you never really understand a person until you consider things from his point of view until you climb inside his skin and walk around in it and with the greatest due respect that is impossible in this situation we cannot for one second fathom the situation and the circumstances in which an individual who has reached an intolerable stage at the end of their life find themselves in until we ourselves may at one stage hopefully not but may at one stage find ourselves in that situation and when that time comes if that time comes we I think must look at ourselves and say did we at the time that we had the opportunity to put in place a system which would give effect to the wishes of those individuals did we do the right thing this is the second great moral question that this parliament has faced in this term parliamentary term presiding officer the last time I voted in favour of same sex marriage because I said to myself what would my message be to a family member who wanted to take the opportunity to get married if I had voted against their right to do it for the same reasons today because I could not look a family member in the eye if they said at the end of their life that they would wish to take this option and I had voted to deny them the right to do it I will vote in favour of this legislation and seek to amend it at stage 2 thank you and I call on Paul Martin to be followed by Jim Eadie Presiding Officer Margo Mcdonald sometime ago advised me that her method of seeking public opinion was a visit to her local hairdressers now it's not a particular method I've followed but I would say that in seeking local public opinion on this issue I take issue with the point that Patrick Harvie and others have made is that the public opinion is in favour of changes in the law all of the representations I've received in respect to this I think have fallen in favour of well over 70 per cent of those have been opposed to changes in the law for a number of reasons and I would commend the work of the health and sport committee and their diligence and indeed an excellent presentation by Bob Doris in what I'm coming forward with which I think was a considerable report and recognise that there are a number of flaws in what has been presented before us today and that has been as a result of a comprehensive consultation exercise evidence received from experts across the world I'm not the first time that this parliament has received such evidence and can I draw the parliament's attention to paragraph 71 of the report report that says there is a need for a thorough investigation and scrutiny of the country provision and future plans for part of care in Scotland is it not a poor reflection of the Parliament that after 15 years we continue to have this very debate in connection with part of care there's a cross party group that's been in existence led by Michael McMahon since the early years of the Parliament there have been many reports in respect of how we deliver part of care and we still can't get this right and it's not a partisan point that I make today but surely it is a point that has to be taken up by the current Government that it is unacceptable that organisations such as the Marie Curie which was formally in my constituency when I represented Glasgow Springburn to do some excellent work along with other organisations who provide such services and I think they are to be commended for their good work over the years in supporting patients at the end of life in the work that they've been doing but surely this is now the time and I know this is not the debate necessarily to be focused on today but surely we should take this opportunity today to make that very point that the necessary resources should be put in place and I would welcome a response from the Government I don't want to hear any more about frameworks I don't think we want to hear any more about working groups we want to hear from real action from the Government as to how we're moving forward in this issue Presiding Officer protecting those who are vulnerable I have absolutely no doubt is a vision for every single member of this Parliament I have no doubt that what Patrick Harvey is proposing today he's doing in the context that he would like to support those in some context that are vulnerable but I do not accept that his proposal here before us would protect those who are vulnerable and I think could potentially subject him to being vulnerable in respect of what he's proposing can also air caution in what has been proposed by members today that somehow we could amend this legislation at stage 2 I think it sets a quite a significant precedent by members of this Parliament are we seriously suggesting that every member's bill that's placed before us and air caution to the members of the government parties who have represented here in the chamber that every member's bill proposal that's put before us where we don't accept the principle that's put before us and there's a particular group of recommendations that recommend that there's a number of flaws in what has been put before us that we should continue to pursue with that legislation I think we would be setting a very dangerous precedent in respect to that and I think it would be wrong for the Parliament to continue in that process quickly and I see the conclusion Presiding Officer there's nothing I've heard unfortunately from Patrick Harvey and others I think there's been constructive and robust points that have been made today there's nothing here in what's been proposed that would convince me to vote for Patrick Harvey's bill and I would urge members to vote against what's proposed today thank you very much I now call on Jim Edie to be followed by Stuart Stevenson thank you Presiding Officer it is a privilege to follow the many fine speeches which there have been this afternoon on both sides of the debate but I agree with Patrick Harvey that there is a need for legal clarity and that the law as it stands is unfit for purpose it is my view sincerely held that the status quo is no longer an option I believe that the people are ahead of the politicians in their consideration of this issue and in their growing support for assisted dying no one in this debate on either side of the argument has come to a view lightly I didn't I was a signatory to Margo's bill to allow the debate to continue but I was not then minded to support it but I have now changed my mind I'd like to pay tribute to all of my constituents who have contacted me on this issue I have received profound personal testimony and I've received sound rational reason and evidenced arguments from constituents who are in favour of the bill and equally from constituents who are opposed to the bill and I wish to thank each and every one of them supporters of the bill wish first to end suffering and pain and the palpable distress it causes to the individual and their family supporters of the bill also passionately believe in good palliative care and end of life care which allows people to die with dignity and is properly resourced across the country no one who believes in the principle of assisted dying believes that vulnerable people should be pressured or coerced into ending their lives prematurely no one I remember the excellent care which my own mother received and my sister and I will forever be grateful to the staff of st Margaret's hospice and Clyde bank for the way in which they cared for our mum in her dying days but there is no evidence that assisted dying will lead to the erosion of palliative care on the contrary the european association for palliative care has found that palliative provision has improved in Luxembourg the Netherlands and Belgium Belgium has actually introduced a universal right to palliative care alongside the right to die in Oregon the hospice association had opposed the dignity in dying act but after eight years experience of it they stated that absolutely none of the dire consequences that had been predicted had occurred indeed the percentage of terminally ill people in Oregon receiving palliative care had risen from 22 per cent to 51 per cent however I do accept that there are questions serious questions searching questions for the proponents of the bill and the first of these is why has life shortening condition as well as terminal illness being placed at the heart of the bill and that was a point that was well made this afternoon by Elaine Murray and by Nigel Dawn a further question is of course what further steps are necessary particularly in terms of legislation to ensure that there is a conscience clause which would allow for and enshrine the right of doctors and nurses to opt out if they did not wish to carry out tasks pertaining to assisted dying and here I'm mindful of the fact that the regulation of our health professions is currently reserved to Westminster and that that would require legislation under section 104 of the Scotland Act 1998 and how do we ensure that the legal safeguards are stringent and robust such that no one is subject to undue pressure how do we ensure that in allowing for the autonomy of the individual to take their own life in specific and regulated circumstances we do not erode the autonomy of vulnerable people and finally can we strengthen the legal protection so that there are appropriate penalties for contravention of the bill psychiatric assessment of capacity and the day the day the 14 day window are also issues that have been raised which I believe need to be explored further but none of these questions and none of these issues are in themselves a reason to oppose this bill today each of them are reasons for further legislative scrutiny of the bill and further investigation and discussion of its contents at stages 2 and 3 and anyone who has sat at the bedside of a loved one knows what a deeply personal and profoundly moving experience that can be I had that experience with my own father and I remember spending the last night of his life in his hospital room with me sleeping in a camp bed beside him during the early hours of the morning the alarm went off and the nurses came to change his drip and to change him and I remember lying there sobbing and begging for his release and I do not know if my father was in pain or how much pain he was in as he was heavily sedated and I do not know if he would have wanted to end his own life at that point I do know that his last days and hours were as comfortable as the doctors and nurses were able to make them but what I also know is that his quality of life had deteriorated to the extent that he could not eat he could no longer speak and he could not go to the toilet is that the dignified death that we would choose for ourselves if we had that choice of course the right to die should never become a duty to die but the issue surely is one of dignity and autonomy for the individual presiding officer the conclusion that I have come to is that in denying people who are terminally ill and of sound mind the choice to end their life after meeting strict legal safeguards what do we as a society are doing albeit in a small number of cases is to extend human suffering I cannot and do not believe that that is any longer acceptable and it is for that reason while respecting at all times the views of others that I will vote for this bill tonight many thanks I know Colin Stewart Stevenson after which we'll call on Patrick Harvie for the closing speech let me start by congratulating me presiding officers team I find myself the 32nd speaker in this debate a well balanced well organised debate and the presiding officers deserve congratulations let me also recognise the integrity of those on the other side of the argument from me it's a genuine issue growing greater with time as medical science and practice changes of how we support our fellow citizens as their faculties decline with age infirmity or disease now while I agree with Patrick Harvie's sentiments if not all these words when he criticised the present arrangements as the most open and ill-defined legislative framework we could possibly have I've come to a different answer to this contundrum from him now is the last speaker before Patrick Harvie I will try and very briefly sum up some of my responses to what's happened in the debate in particular I picked up on Richard Simpson's really fascinating description of the contribution of a profoundly disabled individual who was dying and he emphasised how significant the contribution of that person could be and there would be fears in my part and I think in others in the debate that this kind of measure might deprive us of all benefiting from that kind of opportunity. Alison McKinnis what I took from what she said not her words was that she was concerned about the normalisation of suicide and I think that was again many of us now George Adam on the other side of the argument for me powerfully said the potentially bereaved should not oblige the terminu ill to live on and I think that's an absolutely fair point Liam McArthur expressed it slightly differently the right to live is not a duty the right to life is not a duty to live and Michael McMahon I think powerfully in quoting Professor Bohr journey from support to examining the practical effects moving to opposing I think it's very much informed the debate that we're having today now from the start my instinctive reaction in any event was to be opposed to the proposal I was brought up in a doctor's household steeped in support for life compassion and assistance for the dying it probably could hardly be otherwise my father was proud to work and live under the strictures of the Hippocratic oath he took as a medical student and not all medical students did or do and yet the origins of that oath in a great cult focusing on excluding patients from doctors decisions about the future and in keeping secret the details of medicines used in their treatment is hardly an encouraging basis for decision making but with the time my father took the oath it was seen more simply and discarded its primary objective of protecting the physicians monopoly and preserving the secrecy of his or her methods it used to say I will neither give a deadly drug to anybody if asked for it nor will I make a suggestion to this effect and the physicians who continue to wrestle with this issue he are here confronted with a choice between helping people who can have a quality of life before them and assisting people who wish to leave life a bit early in the past it was simple enough doctors did not need to struggle to maintain life when life itself would not do so those without perception of the world in which we live those without prospect of resuming a meaningful quality of life need not be treated nature could follow its course now Nanette Milne referred to the relationship between doctors and patients and certainly our relationship with doctors at critical times in our life is a very asymmetric one we throw ourselves into their hands and we may be insensible of their life sustaining life threatening actions which are taken by them to promote what they understand to be our best interests I congratulate those who've wrestled with this issue in committee they've risen to the challenge and the report is a model of clarity with integrity of reasoning it informs us it makes clear as many contributions to the debate today have that the bill at best leaves unanswered questions and and others have described it is fatally flawed and I share that analysis but ultimately this is not a whip debate it is one where we all individually have to engage with bodies before us and we have to make our individual decisions and be accountable for them we're talking about people's lives for my part I have talked with the dying about their end I've agreed actions and inaction with relatives and with friends about them and about my future I've sat at the bedside of death I have laid out the debt for me death is no passing stranger and I will not be alone in this chamber in saying that at the end of what essentially has been a discussion with myself I found it boiled down to the simplest of questions how would I feel when I knew that the doctor approaching me to provide treatment in my extremity had assisted another to an early exit from life when I so eagerly wished to stay even the slightest appearance of their bias towards death would damage my relationship with that professional and for that reason I will follow my instincts and vote against this measure later today thank you mr Stevenson and can I now call on Patrick Harvie to wind up the debate mr harvie you can go to six o'clock I'm very grateful for the many thoughtful and considered contributions which have been made on both sides of this debate by members across the chamber I want to highlight in particular Alison McInnes and Mordo Fraser both of whom made speeches against the bill speeches clearly disagreeing with the position that I've taken but doing so in a particularly thoughtful and nuanced manner Jackson Carlaw did so as well but trust him to make the chamber laugh even in the middle of a debate on such difficult topics but he did so without ever undermining the seriousness of the subject there are some shared concerns as I said in the opening speech some shared concepts which I think are equally important to those who support and those who oppose the bill the place of compassion the need to ensure that compassion is shown in a meaningful way which relates to people's needs and the value of life the need to ensure that all of our lives have equal value why why do all of our lives have equal value it can be difficult sometimes given the subjective nature of these issues to put that into words for many people for many people it is because we are thoughtful intelligent feeling and yes relational beings capable of exercising agency in our lives for many of us that is precisely why our lives have value and should be valued equally for many people denying that agency is what represents a denial of the true value of our lives and the equal value that should be afforded to us all there are those who've cited very serious concerns concerns which I place on a very high level of importance around the social attitudes the cultural attitudes the practical physical and economic circumstances that people live in which can imply the devalued status of some people's lives I think that's something which supporters and opponents of this bill share as a concern passing this bill is not an alternative to reinforcing our commitment to the social economic cultural and physical conditions which allow people to live as one member put it full and independent lives for as long as possible for as long as possible that prompts the question then what because the discomfort in this debate is a recognition that many of us will face difficult circumstances at the end of life and even with the highest level of social provision even with the best level of medical and palliative care there will come a point at which we're no longer able to live that full independent life at that point do we have the right to make a decision there are also those I think Siobhan McMahon, Rhoda Grant and others who've questioned whether the bill is too broad particularly in terms of life shortening conditions one member I think cited type 2 diabetes it's very clear that there is a debate to be had about the scope and eligibility of the bill but as it is drafted as it is drafted it is not a simple tick box exercise life shortening condition therefore eligible this is a test which requires a medical to medical practitioners to certify that a person's quality of life is unacceptable to them that that is consistent with what is known about the condition they suffer from and that they see no prospect of improvement this is about someone who has reached the end of the the life that is of an acceptable quality to them I give way I'm selling my like thank you very much I like many other members in this chamber have been debating this very same issue long and hard and that's exactly the point that I get stuck at when you say where practitioners make a decision whether their life's level is unacceptable or not it's not there's choice and that and I'm not actually finished you want me to stand down or you want me okay thank you and I think there are there are a lot of issues where in terms of people making that decision I think what's a lot of fear in a lot of people's hearts and minds is those decisions decisions are likely to be made by others and that's the that's the fear that people have thank you I understand the point the member makes but he is quite wrong in his reading of the bell he's quite wrong in his reading of the bell the judgment about the acceptability of a person's quality of life is for the person themselves that is abundantly clear the medical practitioner has to certify that that judgment is consistent with the fact of the condition as known to the to the medical practitioner there are many personal stories as I think bob doris initially and various others have talked about personal stories in our own lives and in the correspondence we've had with constituents about this which can be taken as support or opposition to this bill and we will all have constituents who are on on both sides of this one story cited by Elaine Murray related to a patient with a life shortening condition the the point of this debate we may discuss if the the bill passes at stage one whether to restrict that to terminal conditions only but the the person that Elaine Murray was talking about very clearly would not have been able to secure a statement from medical practitioners saying that they had no prospect of improvement in their condition there are others who've who've cited a range of objections I won't have time to address every single one of them shona robison talked about the need to improve palliative care and again I said nothing nothing in this bill prevents us from doing just that in fact as Jim Eadie and Mary Fee argued there is no contradiction at all between providing a system of assisted suicide and investing in high quality palliative care and as we've seen from the organ from the Netherlands from Belgium increased investment in palliative care and increased uptake of palliative care are quite consistent with passing legislation in this area Doris Mr Doris's microphone can I have Mr Doris's microphone on please yeah thank you yeah thank you I thank Mr Harvey for giving way just in terms of clarity for the committee report we heard evidence both for and against the this piece of legislation here this afternoon based in Oregon which were directly contradictory towards each other and just for the Parliament's information the committee agreed that whilst information from other jurisdictions was informative it provided a limited basis for reflection and the committee acknowledged that experience in other jurisdictions cannot be read across automatically to the Scottish context and I think it's important to stress that to the chamber this afternoon Mr Harvey I thank the member and in my response to the committee's report I acknowledged that conclusion I acknowledged that paragraph but it is also clear that if we're seeking evidence of the impact of assisted suicide provisions either on palliative care provision or on the alleged normalisation of suicide more generally there is no such evidence there is no such evidence Nanette Milne I think talked about the issue of the question of undermining trust in doctors in the medical profession a question which I think Kevin Stewart answered very well there is no substantial evidence from other countries to show a negative impact on that doctor patient relationship some members talked about the the requirement for a psychiatric assessment to be mandatory this is one of the things which was included in margo mcdonald's previous bill this was one of the subjects of criticism of margo mcdonald's previous bill it was argued at the time that there should be a facility which is always available but not mandatory now we may discuss in future whether there are particular circumstances where it should be a normal expectation but I think it's it's difficult to accept that one bill is criticized for making it mandatory and the other bill is criticized for not doing so Liam McArthur I think mentioned I think that this is posthumously synonymous as the as margo is bell and I acknowledge that that's the case I think probably it always will be but he talked about the balance of views which exist in favour of the legislation not just in the in the public at large but among religious communities and among health professions and disabled people as well there may be a great many organisations representing those interest groups who are opposed but the balance of views in the public is very clear we've had consistent opinion polling over many many years showing a strong degree of public support for this legislation as well as the social attitudes survey and I believe that research by disabled activists for assisted dying shows strong support amongst disabled people as well it's also worth noting that the bulk of the case law which has developed this argument both north and south of the border has been prompted by disabled people in proposing this bill Presiding Officer I'm not asking anybody to approve of suicide and I'm not asking anyone to welcome the thought that any person in any circumstance would take that choice but we have seen gradually over decades over generations a change in culture of patient care away from the doctor knows best paternalistic model toward one which empowers people to make informed decisions about their own lives and their own care autonomy is not an absolute and dr Simpson knows very well that the proponents of this bill have not claimed that autonomy is an absolute it never has been we are social creatures we are relational we live our lives in context but not because we're forced to not because we're forced to it's because of who we are widen the choices that people have before us and we will still be social relational human beings making our choices in the in the context of the love and care of those around us if we're fortunate enough to have it of course autonomy is not an absolute but it is a factor and it is any factor which has been increasingly important as we move away from that paternalistic model of care when when could it possibly be more important than when we face the end of what we define for ourselves as a tolerable quality of life with no prospect of improvement should only the wealthy have the right to assert their own wishes and have them respected albeit in unfamiliar surroundings since Switzerland say far from the warmth of their own home Neil Findlay and Mardo Fraser both acknowledged the most profound issues that this bill raises it's about life and death in recognising that this bill asks us to engage with difficult and uncomfortable issues those difficult and uncomfortable issues do not go away if we fail to pass this bill this bill may represent only one way of engaging positively with them but i appeal to members whether you intend to support amendments in one direction or another whether you intend to support or oppose the bill at stage three if it is amended let it pass stage one let us see a strong show of support for the principle that this bill embodies in the end we will have sent a very clear signal that even if this bill was to fall at stage three the laws it stands should not last it must change and i appeal to members who see the basic argument in favour to give us your support at stage one thank you that concludes the debate on stage one of the sister suicide scotland bill we now move to the next item of business which is consideration of business motion one three two six five in the name of joffords partrick on behalf of the parliamentary bureau setting out a business programme any member who wishes to speak against the motion should press request speak button now and i call on joffords partrick to move motion number one three two six five formally moved the members asked to speak against the motion therefore i now put the question to the chamber the question is that motion number one three two six five in the name of joffords partrick be agreed to are we all agreed the motion is therefore agreed to the next item of business is consideration of three parliamentary bureau motions i'd asked of its partrick to move motions number one three two six six on approval of an ssi motion number one three two six eight on designation of a lead committee and motion number one three two six nine on the remit of a committee moved on block the questions on these motions will put a decision time to which we now come there are four questions to be put as a result of today's business the first question is that motion number one three two five eight in the name of partrick harvey on stage one of the assisted suicide scotland bill be agreed to are we all agreed the parliament is not agreed we move to vote members cast their votes now the result of the vote on motion number one three two five eight in the name of partrick harvey is as follows yes 36 no 82 there were no abstentions the motion is therefore not agreed to the next question is that motion number one three two six six in the name of joffords partrick on approval of an ssi be agreed to are we all agreed the motion is therefore agreed to the next question is that motion number one three two six eight in the name of joffords partrick on the designation of a lead committee be agreed to A dogfyn yn ddim drus i ddod? The next question is at motion number 13269, in the name of Dolfet's Patrick on the Ream of a committee, be agreed to? Are we all agreed? The motion is there for agreed to. That concludes decision time. We're now moved to members' business. Members are in the chamber who are leaving, please do so quickly and quietly.