Assisted Dying for Terminally Ill Adults (Scotland) Bill: commentary

Commentary on the Bill as amended at Stage 3

The Assisted Dying for Terminally Ill Adults (Scotland) Bill is a Member's Bill, which means it was introduced by an individual MSP (Liam McArthur MSP) rather than by the Scottish Government. It was introduced in March 2024 and is progressing through the Scottish Parliament.

The following commentary sets out our assessment of the Bill as amended at Stage 3. This supplements the rolling critique of non-government amendments and previous communications to the Health, Social Care and Sport Committee.

17 March 2026 update: Liam McArthur MSP has lodged a further five amendments to the Bill, under Rule 9.8.5D of Standing Orders, and these will be debated and voted on immediately before the Stage 3 debate on the Bill. We consider these to be necessary minor and technical amendments to correct some of the cross-references within the Bill, as amended at Stage 3.

Introduction

The Cabinet Secretary for Health and Social Care has written to the Health, Social Care and Sport Committee outlining our views on the Bill and amendments to it on a number of occasions. These communications include the memorandum of 30 September 2024, which set out our view that “the Bill in its current form is outside the legislative competence of the Scottish Parliament”. It also noted that “it is difficult to assess the accuracy of the estimated costs/savings in the Financial Memorandum, given the uncertainty around the likely number of cases and, in particular, how they will increase over time”, but indicated areas (most specifically training costs and unit costs of staff time) where it was suggested that costs had been underestimated, or not included.

We note that Mr McArthur provided an updated Financial Memorandum following Stage 2, which attempted to take account of these points, and we provided a view on this updated Financial Memorandum on 26 February 2026. We thank Mr McArthur for his response to the Committee, of 4 March 2026, offering clarity on some of the points we raised.

We also published commentaries on amendments lodged at stages 2 and 3 of the Parliamentary process, outlining our initial assessment of the technical, legal and deliverability implications of proposed amendments, with a view to supporting MSPs to ensure the Bill is workable in practice, if passed at the Stage 3 vote.

The initial comments on the Bill, as amended at Stage 3, below, are intended to supplement, rather than replace or repeat, our previous comments on the Bill and amendments to it. It should be noted that, with the final debate on amendments having only concluded on Friday, 13 March 2026, we have had very limited time to fully consider the Bill.

Legislative competence

It must be recognised that nothing in this commentary has any bearing on the right of the Lord Advocate to determine whether or not to refer the Bill to the Supreme Court under section 33 of the Scotland Act, as she considers appropriate.

Having considered the Bill, as amended at Stage 3, we are of the view that it appears to be within the legislative competence of the Scottish Parliament. This is on the basis that those provisions that we previously highlighted may be outside of legislative competence have been removed, and other amendments which were lodged, and which we indicated may be outside of legislative competence, were not agreed to. The Bill has also been amended to reflect the section 30 Order, which conferred additional competence on the Scottish Parliament for the purposes of this Bill.

Financial implications

As outlined in the Cabinet Secretary for Health and Social Care’s letter to the Health, Social Care and Sport Committee, of 26 February 2026 (referenced above), we recognise the challenges of accurately estimating the costs of delivering this Bill. This is, in large part, because the Bill does not set out a model of delivery. The amendments agreed to at Stage 3 do not change that.

It also remains our view that the costs associated with delivery of the Bill, should it pass, are likely to be high, and will require a degree of reprioritisation, although, as indicated previously, we would always seek to keep any negative impact on other services to a minimum.

Amendments agreed to during Stage 3 of the Parliamentary process are likely to increase the costs of delivering the Bill further. In particular, many of these amendments have increased the complexity of the assessment process, which will impact on both the length of that process, and the amount of training that healthcare professionals responsible for delivering the service will need to undertake. That will, therefore, have a knock-on effect on the costs associated with staff time and training.

Furthermore, a large number of amendments relating to data and reporting were agreed to. As outlined during Stage 3 consideration of amendments, should the Bill pass, this will require new processes and additional investment to be put in place to support this level of data collection and reporting.

Deliverability

Having considered the Bill, as amended at Stage 3, our view is that, whilst amendments to the Bill have increased the complexity of the assessment process, which could prove challenging, and would, should the Bill pass, require new processes and additional investment to support additional data collection and reporting, the Bill is ultimately deliverable.

With that being said, and as set out above, the model of delivery is still unclear, and would require serious consideration to ensure patient safety and equity of access, as well as value for money.

Should the Bill pass, there will be a significant implementation process, including consideration and preparation of a large amount of secondary legislation, as well as guidance (which will need to be subject to Parliamentary scrutiny and approval by resolution, as also agreed by Parliament at Stage 3). This will be in addition to the agreement of a section 104 Order, as agreed to in-principle by the UK Government.