Stage 1 report: Assisted Dying for Terminally Ill Adults (Scotland) Bill

PDF Published: Wednesday 30 Apr 2025 (HSCSS062025R02)

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Overview
Report

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Overview
Report
- Membership changes
- Executive summary
- Introduction
  - Overview of the Bill
- Background to the Bill
  - Legal position
  - Previous attempts to legislate in the UK
  - Legislation around the world
- Health, Social Care and Sport Committee consideration
- Consideration by other committees
- Views for and against assisted dying
  - Suffering
  - Dignity
  - Autonomy
  - Devaluing the lives of certain groups
  - Risk of coercion
  - 'Slippery slope'
- Palliative care
- Legal and human rights considerations
  - The risks of a legal challenge extending the eligibility criteria in the Bill
  - Views on whether the Bill sufficiently protects vulnerable groups
  - Views on oversight of decisions to protect human rights
  - Views on options for challenging decisions made by doctors
- Eligibility and capacity
  - Definition of terminal illness
  - Additional eligibility criteria
- Initial request for assistance
- Period of reflection
- Signing by proxy
- Provision of assistance
- Death certification
- Implications for the health service and healthcare professions
  - Overall service model
  - Conscientious objection
  - Staff training, qualifications and guidance
- Coercion
- Limitations on effect of Act
  - Views on the impact of competence issues on the Bill
- Provision of information, reporting and review
  - Views on the information, reporting and review provisions
- Concluding recommendations
- Annexe A: Extracts from Committee minutes
- Annexe B: Evidence and information gathered
  - Oral evidence (and associated submissions and correspondence)
  - Other correspondence
  - Notes of fact-finding visits and engagement activity
  - SPICe briefings and blogs
- Membership changes
- Executive summary
- Introduction
- Background to the Bill
- Health, Social Care and Sport Committee consideration
- Consideration by other committees
- Views for and against assisted dying
- Palliative care
- Legal and human rights considerations
- Eligibility and capacity
- Initial request for assistance
- Period of reflection
- Signing by proxy
- Provision of assistance
- Death certification
- Implications for the health service and healthcare professions
- Coercion
- Limitations on effect of Act
- Provision of information, reporting and review
- Concluding recommendations
- Annexe A: Extracts from Committee minutes
- Annexe B: Evidence and information gathered
Sources

Image: Figure 1: Which of the following factors are most important to you when considering the issue of assisted dying? Please rank a maximum of 3 options. Number of responses (’000s) that ranked each factor (whether 1st, 2nd or 3rd) …

Scottish Parliament. (2024). Assisted Dying for Terminally Ill Adults (Scotland) Bill [as introduced] - SP Bill 46. Retrieved from https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/assisted-dying-for-terminally-ill-adults-scotland-bill/introduction/bill-as-introduced.pdf

Assisted Dying for Terminally Ill Adults (Scotland) Bill Policy Memorandum. SP Bill 46-PM. (2024). Retrieved from https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/assisted-dying-for-terminally-ill-adults-scotland-bill/introduction/policy-memorandum-accessible.pdf [accessed 28 2024]

Scottish Parliament Information Centre. (2024, November 19). Analysis of the responses to the detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://www.parliament.scot/-/media/files/committees/health-social-care-and-sport-committee/assisted-dying-for-terminally-ill-adults/detailed-cfv-analysis--revised.pdf [accessed 28 February 2025]

Scottish Government. (2024, September 30). Letter from the Cabinet Secretary for Health and Social Care to the HSCS Convener concerning the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://www.parliament.scot/chamber-and-committees/committees/current-and-previous-committees/session-6-health-social-care-and-sport-committee/correspondence/2024/ad-bill-sg-position [accessed 27 February 2025]

Scottish Parliament. (2024). Assisted Dying for Terminally Ill Adults (Scotland) Bill Financial Memorandum - SP Bill 46 FM. Retrieved from https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/assisted-dying-for-terminally-ill-adults-scotland-bill/introduction/financial-memorandum-accessible.pdf

Scottish Parliament. (2025, January 21). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16218 [accessed 7 February 2025]

Scottish Council on Human Bioethics. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=scottish+council&uuId=580892948

Scottish Parliament. (2025, January 14). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16205 [accessed 11 February 2025]

Scottish Parliament. (2025, February 4). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16246 [accessed 11 February 2025]

Scottish Parliament. (2024, November 5). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16078

Scottish Parliament. (2024, November 11). Official Report, Health, Social Care and Sport Committee. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16093 [accessed 29 January 2025]

Scottish Parliament. (2025, February 4). Official Report, Health, Social Care and Sport Committee. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16246 [accessed 17 February 2025]

Scottish Parliament. (2024, November 12). Official Report, Health, Social Care and Sport Committee. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16095 [accessed 29 January 2025]

Rachel Kemp. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=more+msps&uuId=581914858 [accessed 3 March 2025]

Scottish Parliament . (2024, November 19). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16111 [accessed 11 February 2025]

Edinburgh Napier University Centre for Mental Health Practice, Policy and Law Research. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=proxy&uuId=360176551

Law Society of Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=law+society&uuId=412364309 [accessed 19 February 2025]

Scottish Parliament. (2025, January 28). Official Report, Health Social Care and Sport Committee. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16231 [accessed 5 February 2025]

Edinburgh Napier University Centre for Mental Health Practice, Policy and Law Research. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=napier&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=360176551 [accessed 18 February 2025]

Equality and Human Rights Commission. (2024). Written response to the detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=equality+and+human+rights&uuId=816520740 [accessed 26 February 2025]

Scottish Parliament. (2024, November 19). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16111

Scottish Parliament. (2025, January 14). Health, Social Care and Sport Committee, Official Report. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16205

Children’s Hospices Across Scotland (CHAS). (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=CHAS&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=506424451

Scottish Association of Social Work & Social Work Scotland. (2025, January 9). Joint Letter to the Health, Social Care and Sport Committee. Retrieved from https://www.parliament.scot/-/media/files/committees/health-social-care-and-sport-committee/correspondence/2025/letter-from-the-scottish-association-of-social-work-on-assisted-dying-bill.pdf [accessed 11 February 2025]

Scottish Parliament. (2024). Assisted Dying for Terminally Ill Adults (Scotland) Bill: Explanatory Notes. Retrieved from https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/assisted-dying-for-terminally-ill-adults-scotland-bill/introduction/explanatory-notes-accessible.pdf [accessed 29 January 2025]

Dignity in Dying Victoria Inc. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=treatment+option&uuId=410396839 [accessed 21 February 2025]

Dr Juliet Spiller. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=montgomery&uuId=307101312 [accessed 21 February 2025]

Scottish Parliament. (2025). Official Report: Meeting of the Health, Social Care and Sport Committee, 14 January 2025. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16205 [accessed 29 January 2025]

Dr Sandra Lucas and Dr Rhona Winnington, University of the West of Scotland. (2024, February). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=training&_b_index=60&uuId=806932585 [accessed 20 February 2025]

Mental Welfare Commission for Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=register&_b_index=60&uuId=318235270 [accessed 21 February 2025]

SAMH (Scottish Action for Mental Health) & See Me. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=period+of+reflection&uuId=216691380 [accessed 19 February 2025]

Christians Supporting Choice for Voluntary Assisted Dying (Australia). (2025, October). Submission to the detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=initial+request&uuId=920002558 [accessed 19 February 2025]

Scottish Parliament. (2024, October). Jordon Anderson: Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=initial+request&uuId=380894467 [accessed 19 February 2025]

End of Life Ireland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=period+of+reflection&uuId=968182037 [accessed 19 February 2025]

Totara Hospice, New Zealand. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=period+of+reflection&uuId=778697886 [accessed 19 February 2025]

Parkinson's UK Scotland. (2024, October). Written submission to detailed call for view on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=proxy&uuId=703097770 [accessed 19 February 2025]

Scottish Parliament. (2024, October). Dr Michelle McMurray: Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=proxy&uuId=414445594 [accessed 19 February 2025]

Logos Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=proxy&uuId=620116965 [accessed 19 February 2025]

MND Scotland. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=mnd+scotland&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=758779191 [accessed 12 February 2025]

Police Scotland. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=police+scotland&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=816173892

NHS Education for Scotland. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=Education+for+Scotland&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=423254593 [accessed 10 February 2025]

Nursing and Midwifery Council. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=separate+service&uuId=597229951 [accessed 19 February 2025]

BMA Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=BMA+scotland&uuId=1009747644 [accessed 28 April 2025]

Hospice UK. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=opt+in&uuId=814610503 [accessed 19 February 2025]

Humanist Society Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=conscientious+objection+clause&uuId=949787413 [accessed 25 February 2025]

Delegated Powers and Law Reform Committee. (2024, September 20). Report on delegated powers in the Assisted Dying for Terminally Ill Adults (Scotland) Bill at Stage 1. Retrieved from https://bprcdn.parliament.scot/published/DPLR/2024/9/20/541e19a7-5c9d-4860-828d-968be137934d/DPLRS062024R55.pdf [accessed 27 February 2025]

Christians in Pharmacy. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=conscientious+objection&_b_index=60&uuId=807527535 [accessed 26 February 2025]

Scottish Parliament. (2024, October). Tamsin Nicholson: Submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=duty+to+raise&uuId=626584616 [accessed 19 February 2025]

Royal College of Nursing Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=discrimination&uuId=498255651 [accessed 27 February 2025]

Humanists UK. (2024, February). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=discriminat&uuId=913964502 [accessed 27 February 2025]

Social Work Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=opt+in&uuId=1036132155 [accessed 19 February 2025]

Royal Pharmaceutical Society Scotland. (2024, October). Written submission to detailed call for written views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=opt+in&uuId=726281560 [accessed 19 February 2025]

Scottish Episcopal Church. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=opt+in&uuId=532250072 [accessed 19 February 2025]

Scottish Parliament. (2025, January 21). Official Report, Health, Social Care and Sport Committee. Retrieved from https://www.parliament.scot/api/sitecore/CustomMedia/OfficialReport?meetingId=16218 [accessed 29 January 2025]

NHS Education for Scotland. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=training&uuId=423254593 [accessed 20 February 2025]

Together for Short Lives. (2024, October). Written submission to detailed call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=training&uuId=104989922 [accessed 20 February 2025]

M Mackay. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=mackay&_q_question-2021-10-07-9548647634-radiosubquestion=Individual&uuId=130397564 [accessed 11 February 2025]

Royal College of General Practitioners Scotland. (2024). Response to the call for views on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://yourviews.parliament.scot/health/ecdded04/consultation/view_respondent?show_all_questions=0&sort=submitted&order=ascending&_q__text=RCGP&_q_question-2021-10-07-9548647634-radiosubquestion=Organisation&uuId=803557040

Katherine Waller. (2024). Request for further evidence during Stage 1 Scrutiny of the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://www.parliament.scot/-/media/files/committees/health-social-care-and-sport-committee/correspondence/2024/k-waller--request-for-evidence--assisted-dying-for-terminally-ill-scotland-bill.pdf [accessed 2025]

Assisted Dying for Terminally Ill Adults (Scotland) Bill - Statements of Legislative Competence, SP Bill 46-LC. (2024). Retrieved from https://www.parliament.scot/-/media/files/legislation/bills/s6-bills/assisted-dying-for-terminally-ill-adults-scotland-bill/introduction/legislative-competence-accessible.pdf [accessed 26 February 2025]

Scottish Government. (2024). Letter from Neil Gray MSP, Cabinet Secretary for Health and Social Care, to Clare Haughey, Convener of the Scottish Parliament's Health, Social Care and Sport Committee, dated 20 September 2024 - introducing a memorandum on the Assisted Dying for Terminally Ill Adults (Scotland) Bill. Retrieved from https://www.parliament.scot/-/media/files/committees/health-social-care-and-sport-committee/correspondence/2024/sg-position-on-ad-bill.pdf [accessed 26 February 2025]

Last Updated: 17/7 8:08pm

Image: Figure 1: Which of the following factors are most important to you when considering the issue of assisted dying? Please rank a maximum of 3 options. Number of responses (’000s) that ranked each factor (whether 1st, 2nd or 3rd) …

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