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Does the member think that financial difficulty or the fact that someone is unable to get in and out of their own home—two examples of things that could make someone’s life intolerable when they have a terminal illness—are conditions for which it should be considered acceptable to seek assisted suicide?

Forgive me for asking, convener, but have we come to the end of the group on “Assessments of the terminally ill adult”?

If a similar amendment was brought back at stage 3 and it included the co-ordinating practitioner and the independent practitioner, would the member support it?

Given that amendments that define coercion have, so far, been rejected, does the member think that this proposed additional provision would be a further safeguard, so that people can recognise coercion?

Amendment 229 requires a medical practitioner to ask the patient for their primary reason for requesting assisted dying. If the reason is not related to the terminal illness or if it falls outside the scope of the act, the assessment must stop, ensuring that assistance is only considered for lawful appropriate motivations.

The bill sets out a defined pathway for assisted dying—who qualifies, under what circumstances and by what process—but it is silent on what happens when a person seeks assisted death for reasons that are outside that framework. We know from experience in other jurisdictions that people sometimes request assisted dying not because of their illness but because of their circumstances—they feel lonely, abandoned, impoverished or trapped in unsuitable housing. Under the bill as written, a person could begin the assisted dying process even if their motivation stems primarily from such factors. In other words, a cry for help could be mistaken for a considered request for death. That is a legal failure that we cannot afford to repeat.

When people suffer because of poverty, isolation or inadequate care, our response should be to fix those conditions, not to offer them an exit from life itself. Amendment 229 would ensure that such mistakes would not happen and that assisted dying remained within the narrow bounds that its proponents describe as an option for those truly at the end of life, not as a response to social or emotional suffering. I say that in the context of some amendments on proximity to death having, sadly, already been rejected.

The question, “Why do you want to die?” is not a bureaucratic formality but an act of clarity. It separates compassion from convenience and care from abandonment. Amendment 229 reminds us that the role of medicine and of the Parliament is not to end lives that have become difficult but to support lives that could remain vulnerable, even in difficulty.

Amendment 231 would make further provision on the inquiries that the medical practitioner must undertake. It would require medical practitioners to

“enquire about and discuss with the person being assessed what advice and support that person has received from the local authority within which they reside to enable that person to live independently in accordance with article 19 of the UN Convention on the Rights of Persons with Disabilities.”

The amendment would act as a further safeguard against societal coercion.

Amendments 234 and 235 would make provision on referrals to disability organisations and to local authorities for assessments. Amendment 234 would specify that

“A registered medical practitioner carrying out an assessment under section 6 may refer the person being assessed to disability organisations for further advice about support for living with”

their medical condition.

Amendment 235 would specify that

“A registered medical practitioner carrying out an assessment under section 6 may refer the person being assessed to the local authority within which that person resides for further assessment of support to enable that person to live independently in accordance with article 19 of the UN Convention on the Rights of Persons with Disabilities.”

Both would be required. There are amendments in later groups—including amendments in my name and, I think, in the member’s name—that would cover that. Amendments that we have previously discussed would also have encouraged such assessments, which are absolutely essential to safeguarding people throughout the process.

As committee members and others have noted, the point about identifying coercion is that coercion is a difficult concept to appreciate fully. From previous work that the Parliament has done on coercion, particularly in relation to gender-based violence and domestic abuse, it is clear that a specific, nuanced approach is required, so that people can understand the experience of each individual. In this matter, it is also important to understand the effect of societal pressures that can be considered to be coercive. Through time, the internalised ableism that I have mentioned in the past and which I spoke about in the stage 1 debate can begin to infiltrate into disabled people’s minds and lives, including people who are seeking assistance under the bill. Those areas are really important.

We know that training on the UNCRPD, on disability equality and on what is available to support disabled people to enjoy their lives in the same way as others, with freedom, choice, dignity and control, is hugely undervalued and not often provided, especially in financially constrained situations. That is important, which is why I have asked that it be included in the bill.

We are discussing not just aspects of independent living such as self-directed support, which is a right under the Social Care (Self-directed Support) (Scotland) Act 2013, but whether somebody will be assisted to die. Everybody around individuals needs to fully understand what resources are available to support disabled people in those contexts.

As it stands, there is no right for individuals to get a referral to such organisations, nor are such organisations resourced to the extent that many members in the room would hope or expect that they might be. We exist in a situation where that support is not readily available to disabled people. That is one of the reasons why I and others worry about the bill.

Sandesh Gulhane’s point is about difficulty with breathing. Many people have difficulty breathing, and it can cause great distress. My mum had chronic obstructive pulmonary disease and died as a result of it, and I saw some of the incredible distress that that caused. There are also people who live with support to help them breathe, such as Baroness Jane Campbell, who sometimes uses a ventilator while she is giving speeches in the House of Lords. With the right information, support and care in place, people have different tolerances of what they are able to live with or not live with. Having advice and support on what is available to people is incredibly important, which is why I think that amendment 229 is really important.

I move amendment 229.

I understand the concerns around that. However, most of those things are very important. The member will know that, if something is not in legislation, it becomes very much at the discretion of the co-ordinating bodies. When resources are tight, some of those things might not be supported or funded. Does the member agree that it is crucial to set out in the bill any aspect of what the amendment seeks to do, in order to protect against it being ruled out because a body does not have enough money to provide the training?

It is one thing to have those discussions, but it is quite another for those issues to be resolved. Nothing in the bill says that such issues must be resolved in order to consider that the decision is being made with all things being equal. Surely, a protection against such circumstances driving somebody’s decision to end their own life is an alternative to a provision saying that such situations—for example, financial or housing situations—must be resolved.

No, it is not. There is no requirement on practitioners to refer to such organisations, nor for those organisations to be supported to exist. That is one reason why I find the legislation to be particularly worrying and why my amendments could be quite important. Some of those organisations could really open the consciousness of someone who is experiencing a loss of function that could be associated with an illness, terminal or otherwise.

In my experience, those organisations have been hugely important in helping people to understand the emancipation and, conversely, the oppression that is experienced by disabled people. It is those organisations that often support disabled people to participate in society and lead an ordinary life. A referral at the point when things have reached the extent that somebody wishes to die, if not before, is really important.

The amendments would act as safeguards to ensure that the person requesting an assisted suicide had been able to access, or had been offered, appropriate support that allowed them to live a full and independent life.

Amendment 236 would require the Scottish ministers to ensure that disability organisations are properly resourced to provide further advice and support to individuals to live with their condition. That is really important, because those organisations are already hugely stretched by existing legislation, some of which does not support disabled people’s rights to independent living to the extent that we around this table might expect. Nonetheless, those organisations are working tirelessly, day in, day out, to support disabled people to live independent lives. It is important that, if the bill is added to the statute books, such organisations are supported to help people understand the consequences of their choices in that context.

Finally, with third sector organisation on their knees, it is pivotal that sufficient resources are in place to allow them to provide support and advice. That would provide another opportunity to ensure that individuals are aware of the support that they can access to help to live with their terminal illness. Many organisations operate without the back-up of necessary funding; nonetheless, they are crucial. If we are looking to legislate to support people to take their own lives, we should be genuinely looking to support and resource organisations to help them make that decision.

I think that Sandesh Gulhane wants to intervene.