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Assisted suicide Bill: Key moments in week 3

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Kim Leadbeater’s Committee has again made headlines for the way in which it has rejected safeguards. Here are some of the key moments from the proceedings this week:

Tuesday 4 March

Reasonable amendments voted down

Discussion continued from the previous session about protections for people with Down’s syndrome. Danny Kruger and others pushed for the Bill to include a requirement for statutory guidance to make sure those with Down’s syndrome are treated properly. The amendment was rejected by 13 votes to 8. The Committee also voted down proposals to ensure doctors do not raise the issue of assisted suicide with patients, including children.

Clamping down on criticism of the Bill

This vote against adding protections for people with Down’s syndrome prompted an unusual point of order from Kit Malthouse, one of the most ardent supporters of the Bill. He called on the Committee to consider ways to “correct” those who criticise the Committee’s votes and deliberations on social media.

Doctors are ‘obliged’ to raise assisted suicide with terminally ill people

Kim Leadbeater said doctors have an “obligation” to raise assisted suicide when a patient meets the criteria. This is a logical position to take if, as the Bill’s supporters maintain, assisted suicide is simply another treatment option.

An amendment was discussed to require a doctor, when asked by a patient about assisted suicide, to hold a preliminary discussion about it with them. Several committee members, including Government Minister Stephen Kinnock, raised concerns that this would cut across conscience protections for doctors, and this amendment has now been withdrawn.

Protections for doctors opposed to assisted suicide have been improved as the ‘duty to refer’ was dropped for a duty to signpost patients to information. Rebecca Paul MP made the point that under the Abortion Act, there is no statutory duty on doctors to refer or signpost information about abortions.

Vulnerability of ethnic minorities
An amendment to ensure interpreters are available for people who don’t speak English as a first language was also approved by the Committee.

But Naz Shah, who was previously a healthcare interpreter, explained further complexities: “In Urdu there isn’t a word for depression… the words literally don’t exist that would need to be translated. People don’t understand what assisted death is.”

Rebecca Paul also pointed out that a large proportion of people think that ‘assisted dying’ means withdrawing life support.

Committee accepts referrals for palliative care
Shaun Woodhouse, another critic of the Bill, proposed an amendment that those requesting assisted suicide must be offered a referral to a palliative care specialist. This was passed unanimously by the Committee.

Whilst a welcome development, it doesn’t go as far as amendments that were rejected that would have given greater protections to suicidal patients. There could be situations where patients might refuse help from palliative care specialists, even where it could significantly improve their lives, in order to pursue an assisted suicide.

Psychiatrists recommendations rejected

Separate amendments on suicide prevention within the assisted suicide process were put forward by Sarah Olney, Danny Kruger and Naz Shah – attempting to divert as many people who are suicidal towards help. These amendments were based on evidence presented to the Committee from leading psychiatrists. All were rejected.

When arguing against providing psycho-social support for everyone seeking an assisted suicide within six months of receiving a terminal diagnosis, where a patient may be particularly vulnerable to suicidal thoughts, pro-Bill MP Lewis Atkinson came unstuck. He tried to assert that it was both a terrible tragedy when someone is suicidal, as well as it being somehow wrong to persuade people against choosing an assisted suicide.

We must pray that MPs have clarity that legalising assisted suicide is wrong as it is actually an endorsement of suicide – something we must always stand against. Every life is worth living.

Wednesday 5 March

Confusion in the pro-Bill ranks
There was significant confusion yesterday over the question of how assisted suicide would be delivered, which even the Bill’s greatest cheerleaders could not answer. Kim Leadbeater and her co-sponsor Kit Malthouse appeared to contradict each other.

One moment Leadbeater seemed to rule out private provision: “To be very clear, there is no anticipation that assisted dying would be set up as a private enterprise or a private service. It would be delivered within the provision of the NHS.”

The next moment, following a suggestion from Malthouse that it would also be available privately, she backtracked. She said it would be delivered “through a range of providers”, re-opening the door to it being administered by private companies for profit.

Senedd opposition ignored
Plaid Cymru MP Liz Saville Roberts expressed concern that the Bill fails to take account of Welsh devolution. Danny Kruger said it is “regrettable” that the Bill fails to acknowledge that the Senedd rejected a motion in October last year calling for assisted suicide.

Domestic abuse amendment
An amendment to ensure coordinating doctors undertake training to spot domestic abuse was passed. But Naz Shah MP argued that the amendment doesn’t go nearly far enough. She pointed out that there’s no requirement to ensure there is a longstanding relationship between the doctor and the patient, and no requirement for the assessment panel to even speak to the patient.

She said: “… it is unreasonable to assume that someone in an abusive relationship or [who] experiences coercive and controlling behaviour on top of their terminal illness would be willing and able to disclose this to a stranger”.

Shah also cited a 2024 review carried out by think tank the Other Half, which refutes claims that so-called mercy killings show the need for assisted suicide. The review found that of the more than 100 UK cases of mercy killings, they were not the wanted, hastened deaths that people claim, but “overwhelmingly violent domestic homicides of women”.

More missing documents
In addition to the long-awaited and still missing Impact Assessment, concerns were raised that a Delegated Powers Memorandum – which would examine the Secretary of State’s powers to specify the detail of the regime – has not been published. According to the Hansard Society, this would normally be published ahead of Second Reading for a Private Member’s Bill like this. Given that so many of the important details will be left to the Secretary of State, why has it not been published?

Safeguards are barriers
On more than one occasion, proposed safeguards were described as ‘barriers’ by Kim Leadbeater. This included a requirement for all patients to see a psychiatrist before approval – something that is commonplace for those considering live organ donation.

Photo ID
Despite the seriousness of the decision, there is no requirement on the face of the Bill that photo ID is provided to the coordinating doctor before documents are signed. But as Naz Shah pointed out, if it’s required for getting a bus pass, why not assisted suicide?

Matter of priorities
Concerns were raised that the time-consuming nature of the assisted suicide process, combined with the tight time pressures linked to end of life, would put an additional burden on an already-stretched health service. Pro-assisted suicide MP Dr Simon Opher was reminded of his words from last November: “I have watched with horror as our NHS has gone from being the best health service in the world—as it was in 2010—to being a service on its knees.” An amendment to make clear that the potentially extensive resource implications of assisted suicide should not impact other patients was rejected.

Papering over the cracks
Kim Leadbeater indicated her support for an amendment to require referral to a psychiatrist if there is any doubt that a person may lack capacity. But this only papers over the cracks. It doesn’t address the situation where the person has capacity but an underlying mental illness that may be affecting their judgement. The tragedy is that a person could choose death when underlying mental health conditions could be treated. Strengthening amendments on this and other issues were rejected.

Cooling off periods
The Committee also debated amendments to extend the reflection periods for the patient to consider their position. As Naz Shah pointed out, currently industry standards for returning something bought from a shop far outstretch the reflection periods in the Bill.

She explained that because “there will be intensity, intrinsic stress and many complex layers of decision making”, it is essential “the patient is properly able to breathe, reflect and even change their mind”. She expressed psychiatrists’ concerns that time is needed to process new information provided around palliative care and potential psychiatric interventions to address mental health issues preceding or triggered by a terminal diagnosis. The reflection periods should not be “a micropause for an inevitable death”.

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