Kim Leadbeater MBE, Labour MP for Spen Valley, yesterday published the details of her Private Members’ Bill to legalise assisted dying. She says the Bill would allow terminally ill adults to request assistance to end their own life in a “safe and regulated” manner.
The campaigning organisation Dignity in Dying said the Bill is the “strongest proposal” Parliament has ever considered on improving choice and protecting for dying people.
“Compassion and safety are the cornerstones of Kim Leadbeater MP’s assisted dying bill; bringing choice to those who want and need it as they die, but also introducing regulation and scrutiny where there is currently none. That benefits us all,” said Sarah Wootton, Chief Executive of Dignity in Dying.
However, some campaigners are concerned about the impact the Bill could have on disabled people. For instance, Disability Rights UK (DRUK) has opposed the assisted dying Bill, with support from more than 350 disabled people’s organisations.
In a statement, Chief Executive of DRUK Kamran Mallick said given the severe inequalities disabled people face, the charity could “no longer maintain a neutral stance” on the Bill. Mallick says the government must focus on giving disabled people “dignified and equitable lives” before they consider a change in the law.
It comes ahead of the Bill’s Second Reading on Friday 29 November – the first time MPs will vote on proposed assisted dying legislation for almost a decade – with several stages of scrutiny and debate to follow if MPs support it at this stage.
After winning this year’s Private Members’ Bill ballot, Kim Leadbeater published the full text of her Terminally Ill Adults (End of Life) Bill yesterday. It sets out to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life; and for connected purposes.
It states that a terminally ill person who has the capacity to make a decision to end their own life can request assistance if they are aged 18 or over at the time, a resident in England and Wales and registered as a patient with a general medical practice in England or Wales.
They must have a clear, settled and informed wish to end their own life, and have made the decision that they wish to end their own life voluntarily (not been coerced or pressured by any other person into making it).
Two independent doctors, with a seven day gap between evaluations, would have to be satisfied someone is eligible and has made their decision voluntarily. Although, it is not clear whether the person can start the process again with different doctors if they request is initially turned down.
Requests would also have to be approved by a High Court judge and it would be a further 14 days after a judge’s ruling before a person could be assisted to die, except when the person’s death is expected imminently.
The individual would be allowed to change their mind at any time, and it stipulates that no doctor would be under any obligation to participate in the process.
Lethal medication offered would be self-administered. In addition, anyone found coercing someone to end their life — or make a false declaration as part of the process — could receive a prison sentence of up to 14 years.
The proposal defines a terminally ill person as someone who “has an inevitably progressive illness, disease or medical condition which cannot be reversed by treatment” and the person’s death in consequence of that illness, disease or medical condition can reasonably be expected within six months.
It highlights for the avoidance of doubt that a person is not to be considered to be terminally ill by reason only of the person having one or both of:
It is expected that the Chief Medical Officer will prepare and publish further guidance relating to the operation of this Act.
Earlier this year, the Policy Institute and the Complex Life and Death Decisions (CLADD) group and Focaldata conducted a nationally representative survey of 2,063 adults in England and Wales on issues relating to assisted dying. The poll revealed that around two thirds (63%) of people in England and Wales say they want the government to make assisted dying legal for terminally ill adults in the next five years, with 20% opposing a change in the law and 17% unsure.
However, three in five (61%) of those who supported a change to the law raised concerns about some people feeling pressured to have an assisted death, and just under half (48%) said they would change their position if a person’s decision to end their life was motivated by poor access to care and support. Similarly, those who opposed a change in the law were mostly concerned about people feeling pressured into an assisted death (72%), followed by beliefs that healthcare professionals should focus on saving lives, not assisting in taking them (69%).
While the proposed law would only allow adults who are terminally ill to be provided with assistance to end their own life, Inclusion London, an organisation run and led by disabled people, are concerned the Bill’s criteria could be widened in the future to include disabled people, as it has been in other countries. In a statement they said: “We know that many in our society think our lives are not worth living… Legalising assisted dying will only reinforce and perpetuate this.”
Another staunch opposer of the Bill is actress and disability advocate Liz Carr, who calls assisted dying ‘assisted suicide’.
In her documentary Better Off Dead?, which aired earlier this year, Carr argued that legalising assisted dying creates a ‘two-tiered’ system: suicide prevention for some and suicide approval for others.
“If a non-disabled wants to commit suicide, it’s a tragedy. As soon as a disabled person does, it’s a release,” she said.
Carr points to Canada’s assisted dying law to highlight how legalising the practice can be a ‘slippery slope’. When the Canadian law was passed in 2016, only people with a terminal illness were eligible for ‘medical assistance in dying’, known as MAID. However, by 2021, the law was changed to include those with serious and chronic physical conditions, even if that condition was non-life threatening.
This has caused a huge surge in assisted dying in Canada, with 1,000 people choosing to have a medically assisted death in 2016 rising to 13,000 in 2022. Canada is now considering extending the law to include people with mental illnesses and minors as young as 12.
Similarly, in the Netherlands, the law states that anyone who is experiencing “unbearable suffering with no prospect of improvement” is eligible to access assisted dying. Research from the country shows there is evidence that learning disability and autism have been cited as reasons for suffering, with factors associated with both described as the sole cause of suffering in 21% of cases and a major contributing factor in 42% of cases.
However, Leadbeater says the law wouldn’t be amendable if it was passed, and it is more about creating an option for those who are already dying to “ease and shorten” death.
Currently, around 650 terminally ill people end their own lives ever year and Leadbeater says the new law would help to prevent people having to resort to this option, which often happens in “lonely and traumatic ways”.
Some medical professionals argue that what we really need is better palliative care so that terminally ill patients can better cope with their illness.
Writing on X, palliative care doctor Dr Rachel Clarke said: “I just cannot understand why MPs are considering rushing this bill through at breakneck speed when doctors like me who work with dying people daily are screaming from the roof tops that better palliative care will make fewer people feel life is unbearably bad with their illness.
“Fix the care first. Fund palliative care properly. Give dying people the best possible chance of living well – please. And then – once we’re confident people aren’t being driven by lack of care into premature suicide – revisit assisted dying in parliament with confidence.”
However, Palliative Care Minister Stephen Kinnock announced that he will vote for the assisted dying bill, contrary to Health Secretary Wes Streeting’s concerns.
Talking to ITV News, Kinnock said: “I don’t think it’s an either-or question on hospices and palliative care. We of course have to work hard to improve hospices and palliative care, but evidence shows that often countries and places that go with assisted dying actually see improvements in palliative care coming from that.”
