This week, MSPs have been debating the more than 300 proposed amendments to Liam McArthur’s assisted dying bill. Some notable changes have been made to the bill, which should help the required number of MSPs to back change when the final cote occurs on March 17. Discussions on amendments will continue into Thursday and Friday. Here’s a summary of the key amendments agreed so far:
- Eligible patients must be “reasonably expected to die within six months”.
- Assessing doctors must ask whether the person has accessed, or been informed about, palliative care, in addition to appropriate social care relevant to their terminal illness.
- Discussions on palliative, social care, and all alternative treatments available are now mandatory.
- All discussion on palliative care and the options available to a person must be formally recorded, as must the fact that they understand these options.
- Assessing doctors must refer patients to a palliative care specialist where they believe appropriate care has not been offered or provided, or where uncontrolled symptoms (or fear of these) are a reason for accessing assisted dying.
- All assessments for assisted dying must take place in person.
- At least one of the assessing doctors must have met the patient on more than one occasion.
- Assessing doctors must enquire about any indirect pressures a person might be feeling to access assisted dying, including whether they feel a burden, or whether they are under financial pressure.
- Assessing doctors must now advise patients to tell their GP practice and those “close to them” about their decision to access assisted dying.
- An accompanying medical statement must be providing, giving information on the relationship between the two assessing doctors and the patient.
- During the second declaration, the co-ordinating assessing doctor must carry out a structured assessment with the patient to ascertain any evidence of coercion, pressure, or undue influence. This assessment must take place in private and an additional statement on the outcome must be written and signed by the assessing doctor.
- People making a first declaration will be given the opportunity to make an advanced care directive, in the event that they lose capacity before the end of the AD process. To be clear, this would not allow people without capacity to access AD. It will, however, allow them to make their wishes known regarding resuscitation, medications, ventilation, assisted hydration or nutrition, organ donation etcetera.
- The Scottish Government would be required to produce an advanced care directive template, making it easier and more accessible for people to make their final wishes known.
These changes are evidence of the extraordinary level of care and scrutiny that has gone into consideration of this bill at Holyrood. The Scottish parliament could not have produced a more detailed or robust bill than the one facing MSPs in the debating chamber next week. We hope our lawmakers will make the right decision for terminally ill people, for their families, and for Scotland.
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