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I have a final question, which is about 16-year-olds. Someone spoke earlier about whether 16-year-olds have the capacity to make a decision on assisted dying. However, we allow them to make decisions about healthcare in general. Can you explore that idea? Perhaps Dr Provan could start.

That is quite helpful. The questions that I am trying to get at are in relation to assisted dying being an adjunct to palliative care. They are two separate systems, but if the bill became law, there might be an integrated pathway where the two systems would have to interact with each other—it is about considering how they could mutually benefit the patient.

In the interests of time, I will move on and let Dr Mills and perhaps Rami Okasha answer as well.

I remind members of my entry in the register of members’ interests: I am a member of the Humanist Society Scotland.

We have already touched on the issue of capacity, but I would like to explore it a wee bit further. Some submissions to the committee set out concerns about the ability of doctors and specialties outwith psychiatry to undertake capacity assessments as part of the assisted dying process. Conversely, last week, we heard from the mental health witnesses that they did not share those concerns, and they argued instead that undertaking capacity assessments was a core part of medical practice. However, they did share a concern that the bill turns an incapacity test into a capacity test, which is different to what they do as part of their work. They were also looking for the reference to mental illness to be removed altogether, and they suggested that more senior doctors be involved in the capacity assessments, as we touched on previously.

Do the witnesses have any concerns about the approach to assessing capacity as set out in the bill, and could you explore a wee bit more what specialist training needs to be undertaken?

Colin Poolman, you are looking at Dr Provan, so we will start with him.

I will explore that a bit further. If an individual determines that they are not going to proceed with treatment—they are taking a decision that will absolutely result in their death—what is the difference between having a stand-alone consultant or GP assess their capacity to make that decision versus requiring a specialist service to assess someone’s capacity to make a decision around assisted dying?

I will cover the theme of assisted dying as an adjunct to palliative care. We have heard quite clearly that we have to look at assisted dying and palliative care as two separate things, and I think that that is absolutely right. We have had written submissions and oral evidence saying that palliative care can be complemented by assisted dying as an alternative. People have stressed that there is a therapeutic value to having a choice of an assisted death and how that can remove an element of suffering not addressed by palliative care, even if it is ultimately not exercised.

Conversely, we have also heard that the two are not compatible and that assisted dying would divert resources away from palliative care and erode its quality and availability.

I would like to explore that a little bit. Do witnesses recognise the potential therapeutic value that accessing assisted dying can have for individuals approaching the end of their life, especially those individuals for whom the best palliative care would perhaps not be enough to relieve their suffering?

I will start with Amy Dalrymple and work across from left to right.

I am actually going to ask you whether you can lengthen your answer a little bit for me. I want to explore the therapeutic effect that access to assisted dying has reportedly had for some people who may not eventually exercise their right to it but who report that unpacking those really difficult conversations with palliative care specialists—availing themselves of that opportunity to explore all the options—allows them to live as best they can for the remaining time, even though they do not exercise that right at the end.

Does anyone else have any thoughts on that?

Given that that report was from 2020, it would be helpful if the cabinet secretary could update the committee on what is going to come out of it and how the issues raised in it are going to be addressed.

Can you also update us on the code of good practice commitment in the vision for sustainable aquaculture? Where are we with that?

The Atlantic Salmon Trust has told the committee that the issue is quite vital to the protection of wild salmon numbers in Scotland, because it is concerned about the genetic introgression that could happen. Is it possible for you to come back to the committee once you have a further understanding of the actual prevalence of genetic introgression?

I have one final question, which is about escapes from fish farms. In the REC Committee’s report, recommendation 37 noted that there were

“strict penalties ... in Norway to deal with escapes”

and recommended that

“appropriate sanctions should be developed and introduced in Scotland.”

The salmon interactions working group at that time endorsed that recommendation, calling it “powerful”, and we know that it is seeking that moneys accrued from fines be ring fenced and given over to the improvement of wild salmon conservation. How and when will the commitment set out in the “Vision for sustainable aquaculture” on

“appropriate fines for fish farm escapes”

being

“redistributed to support wild salmonid conservation and research”

be achieved?