We Stand Once More Upon The Precipice Today

Diane Abbott and Sir Edward Leigh write:

On the eve of its Second Reading two years ago, writing from very different political traditions as Mother and Father of the House, we warned against Kim Leadbeater MP’s “dangerous” assisted dying Bill. 

That Bill ultimately proved unable to bear the weight of the scrutiny it was rightly subjected to. Yet we stand once more upon the precipice today. While some facts remain the same, the context into which the new Bill has been introduced has changed, strengthening both our case and our concerns.

What is unchanged? Lauren Edwards’ assisted dying Bill is virtually indistinguishable from the Bill which floundered in the previous parliamentary session as its flaws were repeatedly exposed. Both bills are hampered by unanswered questions, insufficient safeguards, and a reliance on wishful thinking that is disconnected from documented realities. Based on our experience as long-serving MPs, proposals such as this, which lack a rigorous foundation, quickly unravel if they become law. In this instance, the consequences could be disastrous. 

What has changed? Quite simply, we know far more now than we did when the previous Bill began its legislative journey. Irrespective of one’s views on reform of the Upper House, our colleagues in the House of Lords indisputably spent considerable time, expertise and energy teasing out the intricacies and real-world impact of the proposed legislation. They did so more effectively than our House’s procedures allowed. Their deliberations revealed a Bill that raised far more questions than it answered.

On a matter of such significance, it is extraordinary that a “fill in the blanks” approach is taken, where 42 delegated powers remain in the Bill, giving Ministers wide-ranging powers to legislate on the fine details however they see fit. It is important to consider that another Government may exercise these powers in a future Parliament - this is not a party political consideration.

A further change since MPs last reviewed this legislation is the change in Prime Minister. Andy Burnham has been admirably clear that “the fixing of the funding of palliative care and social care” is “something that needs to happen first” before any serious debate around legalising assisted dying happens. His subsequent letters - to Ministerial colleagues, and to the Parliamentary Labour Party concerning his decision to abstain, clearly communicating that the Bill does not carry his support - sit within this context. 

On this matter, the public are with the Prime Minister, and not Bill supporters. In a recent poll of over 10,000 people, 60% of the public agreed that the UK Parliament should prioritise fixing the NHS and improving palliative, social and end-of-life care before considering whether to introduce assisted suicide. Fewer than one in five people disagreed with this assessment.

Experts have raised wide-ranging, evidence-based concerns that must be heeded; their collective silence regarding the legislation’s safety is notable. The Royal College of Physicians has made clear that “there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals”. The Bill in its revived form does not address this. The Royal College of Psychiatrists has stated that it “cannot support” the legislation, owing to the “too many unanswered questions about the safeguarding of people” in the Bill. The British Medical Association, which represents all doctors in Britain, has also criticised the proposals which would require doctors to assist in ending lives, affirming that assisted suicide is “not a medical treatment” and that parliamentarians “must not alter the fundamental principles of the NHS” by passing an assisted dying law.

It is also of significant concern that despite the Lords’ sponsor of the Bill in the previous session conceding the myriad ways in which the Bill remains flawed, by tabling more than 70 amendments, the intention of the Bill sponsor in the current session is that MPs should not address these matters and allow the Bill to complete its Commons stages unamended, to leave open the possibility of utilising the Parliament Acts to force the Bill into law. This would be an unconscionable derogation of our responsibility as elected representatives. If legislation is inadequate, we must take action to address it instead of leaving gaps for others to possibly fill. Otherwise, we risk vulnerable people being gravely endangered.

Marie Curie warns that almost one in three people who die in England do so with an unmet need for palliative care. Collectively, hospices in the country faced a deficit of more than £70 million at the end of the last financial year, more than double that of the previous year.

The budget for assisted suicide would largely come from the reallocation of existing health and social care funding, meaning that these essential yet underfunded services would receive even less money. This speaks to a previously known, yet now increasingly unavoidable reality which MPs must consider before voting on 11 September: the “choice” and “autonomy” espoused by many advocates for this Bill is currently illusory. Nor is this a quick fix - reforming palliative and social care is a generational project. The prospect of an established state-funded assisted dying service accessible to all, set alongside a patchy palliative and social care service, ought to give serious pause for thought.

As we say, in light of what we know - from expert judgement, public opinion, and drafting concerns - there must be only one result on 11 September. MPs cannot look past the dangers inherent in this Bill simply to get it over the line. The Bill is fundamentally deficient. It is the wrong answer to the question the Prime Minister is seeking to address in prioritising fixing palliative and social care. MPs - of all parties - should unite behind this laudable and necessary aim, and leave this divisive debate behind. Too much is at stake just to plough on and naively hope for the best.