Assisted Dying for Terminally Ill Adults (Scotland) Bill – Stage One

Dear Constituent,

The Assisted Dying for Terminally Ill Adults (Scotland) Bill was debated and voted on by Members of the Scottish Parliament on Tuesday, 13 May.

I am one of the 129 MSPs who voted on the general principles of the Bill. This is known as Stage One in the legislative process.

When a Bill is introduced to the Parliament, there are three stages that it must go through to become law.

Stage One involves consideration of the general principles of the Bill by the parliamentary committee designated to deal with it. The committee engages with the public and relevant stakeholders and experts. The committee then reports back to Parliament and, if Parliament agrees to the general principles of the Bill, then it will be referred to the committee again.

Stage Two entails more detailed consideration of the Bill by the committee, including any amendments proposed by the Scottish Government and MSPs.

Stage Three is where final consideration of the Bill takes place, incorporating amendments passed during Stage Two, and the Parliament may debate and vote on further amendments, and ultimately whether or not the Bill should be passed in its final form to become law.

The intent of this Bill is to allow terminally ill adults in Scotland, who are eligible, to lawfully request, and be provided with, assistance by health professionals to end their own life.

As Deputy Convener of the Health, Social Care and Sport Committee, my committee has had the role of scrutinising the Bill in detail over the last year. The Committee’s Report on the Bill can be read here: Stage 1 report: Assisted Dying for Terminally Ill Adults (Scotland) Bill 

I am immensely grateful to everyone who has contributed to the Committee’s scrutiny of the Bill and to the hundreds of constituents who have contacted me with their views, questions, briefings, and personal experiences.

How Parliamentarians cast their votes at each stage of this Bill is a matter of personal judgement for each representative - we are not bound by the usual party whip. Therefore, the decision I make today is one based on my own assessment of the policy intent, the content of the Bill as currently drafted, and whether I am persuaded that issues identified whilst scrutinising the Bill can be addressed through amendment in subsequent stages.

In doing so, I have reflected on the many hours I have spent scrutinising the Bill in committee, as well as the thousands of emails and letters I have received, along with personal conversations I have had with my colleagues and constituents, often deeply moving in nature.

I am aware that there are sincerely held beliefs and views on both sides of the question of whether this Bill should pass Stage One. I respect these different standpoints and understand and sympathise with many of the arguments that have been articulated. Indeed, my own view and understanding of the Bill has been challenged and tested throughout this process. Even in the last few hours before the vote, I was in deep introspection about how to cast my vote.

I have previously expressed to constituents who have contacted me that I intended to support the general principles of the Bill at Stage One, so I voted Yes to the question on Tuesday 13 May.

My primary rationale is a belief in the liberty of the citizen to have freedom of choice and a respect for bodily autonomy. That is why I agree with the principle that eligible terminally ill people who are already dying should have this end-of-life choice available to them. It offers an element of control and comfort over how they die when death becomes inevitable and imminent.

I do however recognise that the Bill as currently drafted contains several deficiencies that I must see addressed at Stage Two if I am to consider supporting the Bill to become law. To support the Bill at subsequent stages, I must secure amendments to better define terminal illness and the proximity of death, to raise the minimum qualifying age to 18, to test how self-administration will work in practice, and to address equality of access to appropriate palliative care at the end of life.

There must be a comprehensive safeguard in the Bill to ensure that all palliative care pathways have been exhausted before assisted dying can be approved. I have a well-established relationship with Glasgow’s hospices, particularly Marie Curie at Stobhill. My visits there have deeply moved me, particularly in bringing the gross inequalities in our healthcare system into sharp focus. Too many Scots end up terminally ill and facing a premature death due to the lack of timely access to diagnosis and treatment, especially in cancer cases.

Irrespective of whether or not this Bill becomes law, we must not only strive to reduce these systemic inequalities in access to healthcare but also ensure that everyone who needs to is able to access good quality palliative care at the end of their lives. I hope that, regardless of the outcome, the current debate on assisted dying will provide a catalyst for the improvement of the quality and availability of palliative care services across Scotland.

I also wish to see clear regulations on the face of the Bill to ensure that clinicians approving an assisted death are suitably qualified and that there are safeguards against so-called ‘doctor shopping’ including the creation of a central register of psychiatrists or an independent body or ethics committee to oversee, monitor, and review medical practitioners' decisions.

There have also been important concerns raised about the risk of coercion, which can often be internalised and insidious in nature. I accept that there is a potential risk in this area, and I would be seeking amendments to safeguard against this risk were I to consider supporting the Bill in subsequent stages. For example, the Health Committee heard evidence of potential alternative models for assessing coercion such as the system of independent assessors responsible for assessing potential cases of coercion of living donors under the Human Tissue Act 2004. This model has proven effective in detecting cases of internalised coercion as well as more straightforward and explicit incidences. As the Bill has now progressed beyond Stage One, I will seek an amendment to adopt a similar model for the assessment of coercion under the current Bill.

There are additional safeguards I would also need to see but I hope that this helps to set out my rationale for supporting the general principle of the Bill at Stage One whilst setting out my concerns about the deficiencies of the Bill as drafted. My vote at Stage Three will therefore be dependent on how well those concerns are addressed by amendments during Stage Two. I will keep a sceptical and open-minded approach, should the Bill progress to the next stage, where it will be robustly tested through amendment and further debate at committee. I believe that it is important that Parliament has the opportunity to do this work.

I know that my position will disappoint some constituents who are opposed to this Bill on the fundamental point of principle and will satisfy others who agree with the Bill’s proposal. It is not a decision that I take lightly, and I remain doubtful about the Bill’s practical application, but in the end, I am persuaded that people deserve choice and dignity in dying, and that is the question before Parliamentarians at this stage of the Bill.

Separately from this Bill, I am supporting the Right to Palliative Care (Scotland) Bill that I hope will also underpin the fundamental right to dignity and a good death.

I believe that the status quo is not fair or acceptable, so my vote at Stage One is underpinned by compassion and the desire to give all citizens in this country who may face a terminal illness more autonomy, dignity and choice at the very end of their lives.

Yours sincerely,

Paul Sweeney MSP

Member of the Scottish Parliament for Glasgow

(Scottish Labour and Co-operative Party)

13 May 2025

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