7 problems with the Assisted Suicide Bill

Kim Leadbeater MP has finally published the full text of her Terminally Ill Adults (End of Life) Bill.

MPs had been growing alarmed by the lack of time available before Second Reading of the legislation on 29 November to properly read and scrutinise the proposals. Whilst 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?

Some might argue that MPs should pass the Bill at 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.

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.

Firstly, 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 report indicated doctors wrongly predicted how long terminally ill patients would live in half of cases.

Secondly, there are just three weeks from asking for assisted suicide to being dead. This might be dressed up as a safeguard, but that is still a really short period of time. Does this properly allow for due diligence? Are we confident the courts will have time to consider all the requests that will come their way? The courts are still dealing with huge backlogs. This could see requests rubber stamped rather than properly considered.

Thirdly, complications can and do occur when taking the lethal drugs that end your life. The legislation acknowledges this when it says the doctors involved must discuss with the patient their wishes in event of complications. But the mere fact it makes 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?

Fourthly, 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. It is the product of our culture’s obsession with autonomy. But no one is an island. All our decisions have an impact on our nearest and dearest. This legislation does not do justice to the role of the family.

Fifthly, 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. In other words, to a degree, you can ‘shop for a doctor’ who will approve your desire.

Sixthly, 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?

Seventhly, patients can give their consent to assisted suicide by proxy ‘by reason of physical impairment, being unable to read or for any other reason.’ Just let that sink in. ‘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 we should conclude that this Bill is unworkable. It will cause chaos in our healthcare, in our justice system and will also create a pressure on some of the frailest in our society. People across the philosophical and political spectrum can 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, it 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.