Terminally Ill Adults (End of Life) Bill – Assisted Dying

MPs handled this Private Member’s Bill with sensitivity and care. When we completed over 100 hours of debate and scrutiny on Friday afternoon, there was a prolonged ‘pin-drop’ moment in the chamber. 600+ MPs frozen in silence. 

When announced, there was none of the usual triumphalism, or catharsis. No gasps, no anger, no derision. Unscripted, MPs collectively comprehended the weight and gravity of the decision. Though I believe we made the right decision, I was proud of all MPs, handling difficult matters with mutual respect. 

Behind the scenes – and crucially out of sight from a media anxious only for lurid headlines and attention-grabbing copy – many MPs were in quiet tears. Others – MPs who voted in opposite lobbies – silently embraced. No smiles, nor any sense of victory or dejectedness. The House of Commons at its best. Shared respect and awareness of the intense seriousness and gravity of the decision taken. But nonetheless resolved and clear-sighted. 

I’ve consistently made clear my, in principle, support for legislation which would permit the terminally ill the right to themselves decide, at the very end-of-life, how and when they die, and in a manner which may better protect them from avoidable suffering and indignity. Of course, as well as having this choice, there should be no let-up in efforts to ensure that all people have equal access to the very best palliative treatment and end-of-life care.  

I’ve received and carefully considered hundreds of communications, emails, correspondence from constituents and others – both for and against; attended meetings and briefings; and, as a Health Select Committee member, prepared for our imminent Inquiry into palliative care. 

A minority of MPs adopted what I describe as a “fence-sitting sophistry” approach to the debate. In this case asserting they were not opposed to the principle of such legislation, just that they felt this Bill was defectively drafted. However, few explained how it could be made sufficiently acceptable. It also implied there would be as many bespoke Bills as there were MPs with an opinion on the matter! The simple fact is that all legislation must be a compromise between the perfect and the expedient. This Bill achieved a sensible and workable compromise. Changes made to the Bill at Committee further strengthened it. 

I hope the following notes help to address some of the main claims, criticisms and concerns raised:  

1. “Disabled people will be under pressure – a ‘duty to die’”

Unfortunately, there has been an unscrupulous campaign which seems unconcerned about alarming disabled people and their loved ones. Proponents falsely claim that this legislation would put pressure on disabled people to consider assisted suicide; asserting that disabled people will be perceived as a burden, with assisted dying an implied solution! 

However, this legislation is about terminally ill adults (and nothing to do with disabled people) whose unequivocal medical diagnosis places them within a matter of weeks or months from death. Such an option would be available to any person who faced such a terminal status, whether able bodied or otherwise. 

2. “Vulnerable people would be coerced into earlier death”

The Bill was strengthened in Committee by replacing a single High Court judge with a panel of specialist professionals; better placed to cross-question and investigate the real intentions and pressures behind a person who applies for authority for an assisted death. Before this, any applicant would need to persuade two registered doctors, who must be independent of each other, and who would need to confirm the applicant is of sound mind, has only a matter of weeks or months to live and that their decision is not affected by mental illness, external coercion, “self-coercion” or any other undue pressure. Because of the way the legislation is drafted, and professions are regulated, these registered professionals would be bound to err on the side of caution, and to refuse. 

3. “Even people with eating disorders, such as anorexia, could opt for assisted death”.

No such scenario could arise. The legislation relates only to incurable terminal conditions. If an applicant has a curable illness – such as an eating disorder – no permission would be granted, and any doctor who supported the application would run the very high risk of being struck off.  

4. “This legislation will weaken government incentives to invest in palliative care”.

There is no binary choice between investing in palliative care or offering assisted dying. The Health and Social Care Select Committee will hold an imminent Inquiry into palliative care. Future investment in palliative care is unaffected by this decision. It’s also worth noting that even with the very best palliative career there are, sadly and shockingly, many circumstances and medical conditions which cannot be fully relieved even by the very best palliative care. 

5. “Health care workers would be ostracised if they refuse to cooperate.”

Each health and care worker is assured their personal ethical standpoint or religious beliefs will be respected under this legislation; and that their right to choose to or not to take part in assisted dying procedures would have no impact on their employment or career prospects.