Objectively, This Bill Deserves To Fail

If Ofcom is investigating a suicide forum, then it had better hope for the defeat of the Assisted Suicide Bill, or what would be the point? As Professor Kevin Yuill writes:

The Terminally Ill Adults (End of Life) Bill, which seeks to legalise assisted suicide in England and Wales, will get its third and final reading in the House of Commons later this month [in fact, it has been put back], now that the committee stage has come to a close.

The nine-week committee process was supposed to be a chance to interrogate and scrutinise the bill. But now that it’s over, MPs are none the wiser as to how the government will deliver an assisted-suicide service, who will be eligible for it or how the vulnerable will be protected from being coerced into killing themselves.

Anyone who has followed the bill’s passage through the committee stage will have been gobsmacked by what they saw, particularly from Kim Leadbeater, the Labour MP sponsoring the bill. Even some supporters of assisted suicide have felt compelled to criticise her tactics and the bill’s poor drafting. The Times, which has supported past attempts to legalise so-called assisted dying, described the bill as ‘not fit for purpose, its provisions a mess, and its journey through parliament an unconscionable waste of time’.

Leadbeater has clearly been stung by the backlash. In a letter to MPs this week, she said: ‘I completely respect any MP who fundamentally objects to the principle of assisted dying, whether from a religious standpoint or any other. But what has been frustrating at times is to see opponents of the bill suggest that it has been debated and amended in a way that is anything other than thorough, rigorous and professional.’

In truth, the process has been anything but thorough, rigorous and professional. From the outset, Leadbeater ensured the committee was stacked with MPs who back assisted suicide, with 14 proponents and just nine opponents. Opposing MPs who had the most relevant experience were deliberately excluded. Such as Conservative MP Ben Spencer, a psychiatrist with a master’s in mental-health law and a PhD on decision-making capacity, and Labour MP Rachael Maskell, a former member of the Health Select Committee with 20 years of experience working in the NHS.

Just about every reasonable amendment to make the bill safer was rejected by the committee. Several amendments that would have prevented those suffering from eating disorders from accessing assisted suicide were all defeated, despite warnings from charities that disorders like anorexia would meet the bill’s definition of a terminal illness. Research shows that, worldwide, at least 60 mostly young women have been granted euthanasia or an assisted suicide on the grounds of anorexia alone. Tragically, it seems the committee agree with Labour MP Simon Opher, who told his colleagues not to ‘get too hung up on anorexia’.

Any amendment that might even slightly slow the process of approving an assisted suicide, or might make a patient reconsider, was rejected. One proposal was that patients be required to meet a palliative-care specialist. But the UK government’s minister for care, Stephen Kinnock, raised concerns that this would ‘increase demand’ for palliative care, as if proper end-of-life care were something to be jealously rationed, rather than a right.

MPs also rejected an amendment that would have required doctors to simply ask why a patient is seeking assistance to end his or her life. This might be an opportune moment to detect if, say, coercion is playing a role in someone’s decision. But no.

Also voted down was an amendment that would have blocked doctors from raising assisted suicide with anyone under the age of 18. According to Leadbeater, ‘We shouldn’t prohibit open conversation with terminally ill young people… This creates openness.’

Leadbeater and Co even refused an amendment that would have prevented private companies from potentially profiting from administering assisted suicides. Kinnock said he was ‘comfortable’ with for-profit companies involving themselves in a new suicide service.

Most notoriously, the much-vaunted safeguard of requiring a High Court judge to approve each assisted death was removed by Leadbeater during the committee stage – even though around 60 MPs said this assurance had persuaded them to vote for the bill at its second reading in November. Now, instead of a neutral, independent judge, assisted deaths would be signed off by a panel made up of a psychiatrist, a social worker and a retired legal professional. As Tory MP Danny Kruger has noted, such panels would inevitably be filled with assisted-suicide enthusiasts. Who else would volunteer?

Moreover, the committee wouldn’t even be required to meet with or ask questions of the applicant and would have no real legal power to prevent a wrongful death. Staggeringly, Leadbeater tried with a straight face to call her new proposal ‘judge-plus’, even as she was removing the requirement for a judge to approve each assisted suicide.

Overall, more than 500 amendments were considered by the committee. Less than one in five of those accepted came from opponents of the bill. That alone ought to ring alarm bells. But even more worrying is what has been left unsaid. Indeed, the bill itself still says nothing about how suicide services will be delivered or regulated. Instead, it grants sweeping powers to ministers through a so-called Henry VIII clause. This means key details can be decided by a minister without parliamentary approval.

A vote for this bill at third reading means potentially opening the door to a profit-driven, privatised suicide service with no viable safeguards to prevent wrongful deaths. MPs cannot say they haven’t been warned.

And Lord Jackson, the former Stewart Jackson MP, writes:

In 2015, whilst serving as an MP, I voted against the last assisted dying Bill that came before the House of Commons, as I had serious concerns with the approach that was proposed for introducing assisted death.

With the Leadbeater Bill introduced this year, I had similar concerns but hoped that Committee Stage would strengthen the Bill and iron out some of its larger creases. Kim Leadbeater indicated her openness to listening to concerns expressed by MPs at Second Reading, and I hoped that a number of compromises would be made with opponents of the Bill to make her law safer.

The Bill committee meeting extended over two months and encompassed over 80 hours of debate and votes. As a busy Peer engaged in many different issues, I was unable to follow proceedings as closely as I would have liked, but I did pick up enough to be concerned. It was after Committee stage finished, though, when I had a chance to assess all the data and facts properly, that I became alarmed.

Some of the developments that took place at Committee attracted a lot of publicity, and most MPs will already be well aware, for example, of the High Court safeguard being removed from the Bill. Much of the other detail, however, may not be widely known.

Since the conclusion of the Committee, I’ve seen Ms Leadbeater and the proponents of the Bill claiming its safeguards have been strengthened and that everything is going swimmingly. Nothing to see here. However, when you scrape just a little beneath the surface, a very different picture emerges.

By my count, 393 amendments to the Bill were tabled by MPs who voted against the Bill at Second Reading. These account for more than half the number of amendments considered by the Committee. Of these amendments, the vast majority failed to receive the support of the Committee, by which I primarily mean that Kim Leadbeater and the Government chose not to support them. The pattern of voting and decisions on amendments at Committee went almost entirely along the voting lines at Second Reading, which is to say that, with a significant pro-Bill majority on the Committee, only amendments explicitly supported by Kim and her allies (and the Government) stood any chance of passing. The notable exception to this would be two amendments to give Wales a stay of execution from the provisions of the Bill, if you will pardon the phrase.

Again, so far as I can surmise from looking at the amendments tabled by MPs opposed to the Bill at Second Reading that were accepted, once you discount those that address drafting issues or issues that should have been anticipated in the drafting of the Bill, as well as those Kim Leadbeater didn’t want (Wales) or for which stronger amendment options were disregarded, just seven of these amendments appear objectively likely to increase safeguards in a way that would otherwise not have happened. Put another way, just seven (less than 2 per cent) of the 393 amendments tabled by MPs opposed to the Bill at Second Reading to improve and strengthen safeguards and protections in the Bill, and that could not have been achieved through other amendments tabled, were accepted.

This does not look like consensus-building to me. Can it really be true that less than 2 per cent of the 393 were needed?

These were not “bad faith” attempts to amend the Bill. They were not frivolous or “wrecking”. Rather, there were significant opportunities through these 393 amendments to strengthen the Bill and help to alleviate many of the concerns those of us who voted against the Bill at Second Reading had. For reasons I cannot understand, an approach to Committee stage to ensure broad consensus and to take colleagues along with her was rejected by Kim, which I find deeply disappointing. Moreover, in other ways, particularly by stripping out the High Court safeguard, the Bill has emerged from Committee stage weaker than it went in. Considering its deficiencies at Second Reading, this is quite an achievement, and I’m afraid the blame must land squarely at the feet of Leadbeater and her allies on the Committee (including the Government Ministers who conducted themselves with “neutrality” in name only).

I do not have space in this piece to outline all of the rejected amendments, but it is worth flagging a few of the key ones. For those with disabilities and mental illnesses, several amendments were tabled that aimed to address the concerns expressed about the Bill by different vulnerable groups. For example, the Down’s syndrome community worked with my colleague Damian Hinds to put forward an amendment that would have put onto the face of the Bill specific protections for those with Down’s syndrome. This was rejected, as were amendments focused on protecting those with anorexia, diabetes and autism. The Bill is not silent in relation to these matters (though glaring gaps remain), but the point is that the Bill, as amended, could have been stronger in protecting and speaking for these people. I regret very much that this is not the case.

Understandably, many within the disabled community are very anxious about this Bill and what it could mean for them, particularly at a time when the Government is proposing significant cuts to support for disabled people.

As I say, the list of amendments rejected is long and depressing, but to choose another at random, an amendment to require a 28-day cooling-off period between getting a terminal diagnosis and making a decision to opt for assisted suicide also failed to find favour. A requirement that every person considering assisted suicide meet with a palliative care specialist at the outset was also rejected. Many MPs at Second Reading raised concerns that the Bill allowed medical professionals to proactively and unprompted raise the option of assisted suicide with patients. Two amendments were tabled to address this troubling proposal. Both were rejected. An amendment that would have prevented doctors from discussing the option with anyone under the age of 18 was also rejected. The list goes on and is a very bleak read.

Far from the Committee stage alleviating concerns, it has only proven the fears of myself and my colleagues to be well-founded and, astonishingly, has given rise to further matters of concern. At this stage in the legislative process, major issues with the Bill should have been highlighted and even remedied, not exacerbated.

It is my significant concern that in the understandable pursuit of a “good death” for a relatively small number of terminally ill people, Kim Leadbeater and her allies are in danger of sacrificing the lives of the vulnerable majority to do so, not through malicious desire but unseeing hyperfocus. Hyperfocus can lead people to achieve extraordinary things, but it is also dangerous. Just ask the lemming who blindly follows his friend over the cliff whether he regrets it as he rushes groundward.

Vulnerable people across the UK require MPs to survey the horizon, assess the risks and legislate for the weakest. The Bill process so far has proven us to be inept in this. We must do better. Kim Leadbeater must do better. Objectively, this Bill deserves to fail.