The full text of the End of Life Bill tabled by Kim Leadbeater MP, has been published. With less than three weeks before politicians vote on it, James Mildred explains why it is imprecise, dangerous and should not be passed into law
The Labour MP Kim Leadbeater has finally published the full text of her Terminally Ill Adults (End of Life) Bill. While it is welcome that the text of the Bill has now been published, there are less than three weeks until it is due to be voted on - and that will be after a mere five-hour debate. Is this really enough time to consider passing into law something so important and wide-reaching?
Some might argue that MPs should pass the Bill at the second reading because further scrutiny, including line-by-line consideration, will take place at future parliamentary stages. However, this would be a grave error, and I want to explain why.
For legislation to be truly safe, it must be precise, but this Bill fails that test
It is striking that Leadbeater has claimed her Bill is safe. Whenever assisted suicide legislation is introduced, proponents always talk a lot about safeguards. This is central to their argument for law change. They know the weakest part of the case for assisted suicide is the very real prospect that cases of abuse and exploitation could take place.
So, by talking up safeguards, Leadbeater is hoping to persuade doubting MPs to back her Bill. Having now read the legislation in full, I want to highlight seven significant flaws that fatally undermine Leadbeater’s claim that this is the “strictest assisted suicide law in the world”.
1. The legislation relies on an accurate prediction that a patient has six months or less to live. But anyone who knows anything about medicine knows that predicting someone’s death is notoriously difficult. A recent investigation by The Telegraph found doctors wrongly predicted how long terminally ill patients would live in half of all cases.
2. The current proposed timeline suggests just three weeks from a person requesting assisted suicide to them being dead. This might be dressed up as a safeguard, but that is a really short period of time. Does this properly allow for due diligence? Are we confident that courts will have time to consider all the requests that will come their way? Courts are still dealing with huge backlogs. This could see requests rubber stamped rather than properly considered.
The weakest part of the case for assisted suicide is the very real prospect of abuse and exploitation
3. Complications can and do occur when taking lethal drugs that end your life. The legislation acknowledges this when it says doctors must discuss what happens in the event of complications with the patient. This concession is significant. In other countries, like Belgium, where both euthanasia (doctor administers the lethal drug) and assisted suicide (where the patient takes it) are legal, there was a recent case where a patient did not die after the lethal drug and so the doctor and nurses suffocated them. If that can happen in Belgium, why not here?
4. All the Bill says about talking with family is that, if the doctor thinks it appropriate, they should advise the patient to ‘consider’ discussing the request with their next of kin. That’s a shockingly low bar for family involvement given the gravity of the decision. This is one of the major flaws behind the Bill and is the product of our culture’s obsession with autonomy. But no one is an island. This legislation does not do justice to the role of the family.
5. Despite multiple doctors needing to be involved, if the “independent doctor refuses to make a statement” supporting the request for assisted suicide, the coordinating doctor may refer the patient to a different doctor. In other words, if you don’t get what you want the first time, you can try again – meaning you can ‘shop for a doctor’ who will approve your desire.
Doctors wrongly predicted how long terminally ill patients would live in half of all cases
6. While the courts will be involved, it is slanted one way. So, if the High Court says no to your request for assisted suicide, you can appeal. But if the High Court approves, there is no appeal process open to family members concerned about coercion or abuse. How is this right?
7. Patients can give their consent to assisted suicide by proxy “by reason of physical improvement, being unable to read or for any other reason.” Just let that sink in. “For any other reason”. How staggeringly vague and imprecise. For legislation to be truly safe, it must be precise, but this Bill fails that test.
In summary, this Bill is unworkable. It will cause chaos in our healthcare and justice system and will also create a pressure on some of the frailest in our society. People across the philosophical and political spectrum agree on this.
A far better approach is to properly invest in and support the provision of palliative care. The genius of this approach is that it provides holistic care for the patient, and in just about every instance, makes a good, dignified death possible.
That is where the focus needs to be, and MPs would be wise to reject Leadbeater’s Bill and push instead for more funding for palliative care.
