Lord Falconer has pushed the idea of assisted suicide in Westminster eight times over the last decade and a half, believing that the right safeguards can enable doctors to prescribe death without unintended consequences. The opening session of the Select Committee receiving evidence on the Terminally Ill Adults (End of Life) Bill exposed just how false that illusion is. Members of the select committee and representatives from the (neutral on the principle) Royal Colleges tore apart his Bill.
The Select Committee on the Terminally Ill Adults (End of Life) Bill was never going to be easy for Falconer. The committee was formed due to an amendment that postponed the Bill’s formal Committee Stage until a select committee reported. This was branded by supporters of the Bill as a “wrecking amendment” and dismissed by Falconer as not “workable”. He was forced to concede and was called to give evidence to the 13 members in the House of Lords.
The initial session revisited significant flaws, leaving sponsors Falconer and Leadbeater on the back foot after enduring a tough grilling. Both appeared rattled as Peers pressed them on flaws which have been raised repeatedly since the Bill’s publication. Lord Falconer’s assurance gave way to agitation as the assisted suicide Bill unravelled under questioning. Leadbeater, too, struggled to reconcile the Bill’s contradictions: that it promises “robust” protection while offering few safeguards for enforcing it. Peers from across the House challenged them over misleading statements made in previous debates, shadows that have followed Leadbeater and her Bill from House to House.
Then the second session began, and control of the narrative shifted. At one end of the room sat representatives from professional bodies: Professor Mumtaz Patel of the Royal College of Physicians, Dr Michael Mulholland of the Royal College of General Practitioners, and Professor Nicola Ranger of the Royal College of Nursing. At the other end, members of the Lords were well prepared to test whether this Bill is fit for law.
It became clear that the professionals were not there to help the Bill’s sponsors justify their case.
Each witness raised serious concerns about how the Bill would function in medical practice. Dr Mulholland, Honorary Secretary at Royal College of General Practitioners, made perhaps the most profound statement of the day, that decisions of life and death “go against everything [he’s] been trained in and [he’s] practised for 30+ years.” People do not become GPs to end lives.
Professor Nicola Ranger, representing nurses, was equally bold. Investment in end-of-life care, not assisted suicide, she said, is the real answer to suffering. She cautioned that no bill, no matter how detailed, can cover every risk, undermining Leadbeater’s frequent assertion that her Bill is the “safest in the world.”
If day one was bruising, day two was downright bloodied
From the physicians, the critique was more technical. Professor Patel criticised the use of the Mental Capacity Act in such untested and irregular circumstances, suggesting it is inadequate for determining a person’s capability in choosing assisted suicide. Her comments echoed a warning earlier this year from the Royal College of Psychiatrists, which announced it “cannot support the Terminally Ill Adults (End of Life) Bill” due to its implications for the Mental Capacity Act and several other reasons. Read on to hear more from the RCPsych following their appearance on day two (spoiler: it doesn’t make for happy news if you are a Bill supporter).
Lord Falconer and Kim Leadbeater appeared as weary activists desperate to push their Bill forward. The Royal Colleges presented themselves as experts ready to provide honest and practical evidence to those who will vote on the Bill. For a Bill already struggling to convince Parliament that its safeguards can withstand today’s real-world pressures, the select committee could prove fatal.
If day one was bruising, day two was downright bloodied.
More Royal Colleges joined social workers, coroners and NHS representatives at the witness table to discuss the Bill. What followed was a cross-examination which left the distinct impression that the Bill sponsors had not thought through the real-world consequences of their proposals at all.
Dr Annabel Price, representing the Royal College of Psychiatrists, reaffirmed that assisted suicide is “not a treatment”. Dr Luke Geoghegan from the British Association of Social Workers warned that Britain’s collapsing social care system could push vulnerable people toward assisted suicide. Pro-Bill Peers Lord Markham and Baroness Hayter became defensive, attempting to discredit experts by focusing on their assumed “personal views” instead of engaging with their evidence.
When pressed by Lord Markham, Dr Price corrected his misleading claim that the College was “split” on the Mental Capacity Act’s suitability for assisted suicide. The division among psychiatrists lies in the principle of assisted suicide itself, not in support for this specific Bill, which the College “cannot support”. Her evidence grew more damning by the minute. The Bill lacks a clear mechanism for identifying depression or coercion in the terminally ill, and the Mental Capacity Act is new territory, untested in court.
The revelations grew when the second panel of witnesses took their seats. Dr Suzy Lishman, of the Royal College of Pathologists, warned that under the Bill’s framework, “One could argue [Harold Shipman] would be on the assisted dying panel.” There we have it. “Death panels” could enable the very abuses our health service swore never to repeat.
Former Chief Coroner Thomas Teague KC was no less blunt. Assisted suicides, he reminded the Committee, are unnatural deaths, and if coroners were excluded from their investigation, abuses would “slip through” the cracks. He called the Bill’s omission of coroners’ oversight “frankly absurd”. NHS England’s National Director of Patient Safety, Professor Aidan Fowler, agreed, expressing concern that medical examiners would be unable to spot coercion if the assisted suicide Bill were to become law.
By the close of day two, the verdict was in. The Bill’s supporters were cornered. Their arguments were ground down by the weight of expert evidence. What began as a campaign “for compassion” has collapsed into a bitter struggle to push through inadequate legislation, whatever the cost.
Those tasked with the process of assisted suicide — psychiatrists, doctors, nurses, social workers, coroners — warned starkly and firmly that this Bill is unsafe and unworkable.
Campaigning, it would seem, can only take you so far. Laws are dependent on attention to detail, as it is through the gaps in the details that people fall. On the basis of the first two days of scrutiny, experts are clear that the detail in this Bill is fatally lacking: the Lords must heed these warnings.
