Leadbeater’s euthanasia bill is the biggest threat we’ve faced since 2015; contact your MP and ask them to vote “No”
RHODA WILSON
UK Labour MP Kim Leadbeater’s euthanasia bill is “the biggest threat we’ve faced since the Marris Bill in 2015. We defeated it then, and we can do so now, but we need a huge effort to lobby MPs. Over half of MPs are new to Parliament and have not voted on this issue before,” the Society for the Protection of Unborn Children says.
In 2015, Labour MP Rob Marris introduced the Assisted Dying Bill, also known as the Marris Bill, to the House of Commons. The bill aimed to legalise assisted dying for terminally ill patients with less than six months to live. It was the eleventh attempt in twelve years to legalise assisted suicide through British Parliaments.
Now, the Terminally Ill Adults (End of Life) Bill, introduced by Kim Leadbeater, MP for Spen Valley, on 16 October 2024 and published on 11 November, will be debated by the House of Commons on 29 November 2024. The Bill seeks to amend the Suicide Act 1961 to allow doctors to supply adults with a “terminal illness” with lethal drugs to end their own lives.
The following is republished from a campaign email sent out by the Society for the Protection of Unborn Children (“SPUC”) on Thursday.
The text of Kim Leadbeater MP’s Terminally Ill Adults (End of Life) Bill was finally published on 11th November, less than three weeks ahead of the vote on 29th November.
Now that we have the details, it is even worse than we thought.
The definition of terminal illness in the Bill is broad and could include chronic conditions such as diabetes and even anorexia.
It allows doctors to raise the issue of assisted suicide unprompted – which could be highly influential on a vulnerable person.
The proposed safeguard of having cases approved by a High Court Judge has been heavily criticised by legal experts and appears to be unworkable.
We now have just over two weeks to persuade MPs to vote against this Bill.
SPUC has produced a full briefing, laying out the problems with the bill. We have summarised it below but you can read the full briefing HERE.
Please contact your MP, asking them to vote against this dangerous bill. You can use our easy online tool to do this. The tool contains template text with these key points and links to the briefing.
Write to your MP by following the link: Fight the Leadbeater Bill
A briefing on the private member’s bill introduced by Kim Leadbeater MP
The following are some excerpts from SPUC’s 8-page briefing on the Terminally Ill Adults (End of Life) Bill published on 11 November 2024. We have kept the subheadings the same as the briefing document for ease of reference. We have not included the references to supporting documentation that the briefing provides.
What Does The Bill Propose?
The Bill contains offences for using dishonesty, coercion or pressure to induce another person to complete any part of the process to request an assisted death, and for falsifying or destroying documentation (ss26-27). Interestingly, as much emphasis is placed on actions trying to prevent an assisted suicide. This could potentially serve to discourage the patients’ families from intervention and therefore prevent a familial safeguard against assisted suicide on grounds of depression.
Terminal Illness
There are some causes for concern around this definition of terminal illness:
1. Forecasting life expectancy: The scheme set out in the Bill is based on the assumption that doctors are able to predict the future of their patients. But even for experienced medical professionals, it can be extremely difficult to make an accurate forecast of life expectancy.
2. What is terminal?: Section (2) appears to discount medical treatment which would increase a person’s prognosis beyond six months. Conditions such as diabetes “cannot be reversed by treatment”. Treatment with insulin can prevent diabetes from becoming fatal. A patient who discontinues treatment with insulin, therefore threatening his or her life, would meet this definition. There are other examples of non-terminal conditions that fit this definition. [For example,] a recent study on physician-assisted suicide for eating disorders found cases where anorexia had been reported by name as a terminal illness.
3. Extending eligibility: A further concern is that there is already pressure to expand the criteria beyond a six-month terminal diagnosis. The campaign group My Death My Decision, on the day the Bill was published, expressed disappointment that it doesn’t include conditions that “can make life intolerable for the sufferer well before they can be described as terminal,” while campaigner Esther Rantzen said she regrets that the Bill would not apply to people with “chronic illnesses that can cause months of unbearable pain and distress.” Dame Esther said: “I understand that politics is the art of the possible, and having these narrow criteria makes it possible politically to get this reform through, which is so crucial.”
Proxies
Section 15 of the Bill allows for the person requesting assisted death to have the first or second declaration signed by a proxy if “they are unable to sign their own name (by reason of physical impairment, being unable to read or for any other reason).”
The proxy can either be well known to the person, or a stranger, as long as they are of “good standing in the community”, which is not defined. There also seems an inherent contradiction that someone who is not capable of signing their own name is expected to self-administer (section 18) the lethal substance to end their life.
The Role Of Doctors
The involvement of two doctors is proposed as a key safeguard in this Bill.
While it is welcome that doctors are not under a duty to raise the topic of assisted suicide, as in some jurisdictions, they are free to do so even if the patient doesn’t raise the issue first. This could result in some doctors routinely suggesting assisted suicide to anyone seen as eligible, potentially planting the idea into a patient’s head.8 Given the high level of trust commonly afforded to the medical profession, a physician suggesting assistance to die could be highly influential to a vulnerable person.
Other reasons why the involvement of two doctors may not constitute a sufficient safeguard include:
-
- Failure to recognise depression.
- Failure to recognise coercion.
Conscience Protections
It is known that many medical professionals are concerned about legalising assisted death. The majority of UK doctors, especially those working closely with dying patients, do not support assisted suicide. When last polled, 82% of members of the Association for Palliative Medicine of Great Britain & Ireland rejected the legalisation of assisted suicide,11 and the Royal College of General Practitioners12 and the British Geriatrics Society remain opposed.
Forced referral
Are the conscience protections in this Bill robust enough to alleviate some of these concerns? [No.]
[The wording in the Bill] would in fact require every doctor in the land to participate in some way in providing assisted death, through referring the patient to a colleague. This threatens to violate a doctor’s freedom of conscience protected by Article 9 of the European Convention on Human Rights (“ECHR”).
Assisted death specialists?
A further consideration is that if there were insufficient numbers of personnel to implement the scheme consistently, then the guarantee of conscience rights could face a challenge in the courts or be downgraded as part of the five-year review [as stipulated in the Bill].
In some jurisdictions, this situation has given rise to a small contingent of doctors taking on most of the workload … This means that the small number of willing participants are less likely to know the patient well.
Hospices and care homes
In addition, the Bill says nothing about the rights of institutions – hospices, care homes, etc – not to take part in assisted suicide procedures. However, subsection (2) not only prevents employers from subjecting an employee to any detriment for exercising their right not to participate in the provision of assisted suicide but also for participating in it. The management of an institution with a policy of not facilitating assisted suicide will not be able to discipline employees who violate that policy … This lack of explicit conscience protection will worry many in the UK hospice sector.
[The briefing also has a section on the role of the High Court not included here.]
Can Safeguards Be Maintained?
It is worth briefly noting the experience of other jurisdictions around safeguards. Once it is introduced, safeguards come to be seen as barriers, and the criteria for assisted suicide are invariably widened or removed.
Since arguments for assisted suicide and voluntary euthanasia are so similar, its legalisation in some places has led to vulnerable groups like disabled infants or dementia patients, who have not requested death, being euthanised.
The laws of Belgium and the Netherlands, now permit the non-voluntary euthanasia of children. Reports from Belgium and Holland up until 2010 show that between 7% and 9% of all infant deaths involved active euthanasia by lethal injection.
Human rights barristers and legal scholars have warned that the law could be dramatically widened by challenges to the European Court of Human Rights on discrimination grounds. Alex Ruck Keene KC, who argued a landmark 2017 Supreme Court case on behalf of Noel Conway, a motor neurone disease patient, said that, once the ban on assisted suicide is lifted, it is “entirely realistic” that a UK court or the European Court of Human Rights (“ECtHR”) “would find that any legislation which placed restrictions upon who could access assistance with dying breached the non-discrimination provisions of the ECHR.”
Approved Substance
It is worth examining the means by which assistance would be given to end life under this Bill.
The Bill [ ] leaves it to future regulations to decide what substances are to be used to end life. There is a popular perception that there exists an easily prescribed drug that consistently brings about death quickly and painlessly. However, evidence from jurisdictions where “assisted dying” is practised reveals that hastening patient death is not so simple.
As a paper in the British Medical Bulletin lays out, no single or combination of drugs is agreed to be most effective for ending a human life. Drugs used for medical purposes are required to undergo a stringent approval process in order to assess efficacy and safety. But the drugs being used for “assisted dying” have not undergone such process; the safety and effectiveness of previous and current combinations of lethal drugs is largely unknown. Canada’s MAiD protocol concedes this.
There are also concerns that an assisted death is not the peaceful and painless process of popular imagination. In 2021, Dr Joel Zivot, a practising anaesthesiologist and intensive care medicine specialist with more than 26 years of experience, gave expert testimony to the Canadian Senate regarding the effects of the lethal drugs used in the MAiD scheme, stating that:
“… when a person dies by lethal injection, they basically drown. Their lungs fill with fluid, and I would describe that the experience of dying under that circumstance is more akin to death by waterboarding, which we recognise to be cruel … it should be clear to the Canadian public that the kind of death that they will experience as a consequence of MAiD will be something other than the way it is represented. It could be exceedingly painful and more akin to drowning.”
The lack of any commonly agreed protocol for ending life with drugs, and the possibility of assisted deaths actually being painful and distressing, is something that should be considered by parliamentarians, and not left to regulations.
Conclusion
There are many factors for parliamentarians to take into account when voting on this Bill, including the impact on palliative care, the risk of a change in UK social perceptions towards the preservation of human life and towards suicide, and concerns from the disabled community. These are all vitally important, but could not be covered in this briefing, which focuses on the specific provisions of The Terminally Ill Adults (End of Life) Bill.
Kim Leadbeater has stated that her Bill is “the strongest most robust piece of legislation on this issue in the world.” However, an analysis of the safeguards contained within it leaves much room for concern. In particular, the involvement of two doctors and a high court judge in the process to approve an assisted death does not seem to guarantee that people will not be subject to coercion and abuse. Even the eligibility criteria are subject to broad interpretation, and risk being expanded. Some key points, such as the means used to end life, are left to future regulations. Medical professionals may also be concerned about the lack of conscience protection.
MPs will have to consider whether the time allotted to debate this Private Member’s Bill will be sufficient to rectify these concerns, and, indeed, if it is possible for the state to involve itself in the ending of human life without adverse consequences.
Featured image: Labour MP Kim Leadbeater who introduced the Private Members Bill to permit doctors to kill their patients (left). Broadcaster Dame Esther Rantzen, a campaigner who supports the bill to legalise death by doctor (right). Source: BBC
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