I have to admit that Diane Abbott and I do not normally share the same politics. She is of the left and I am of the right. But despite whatever disagreements we might have about the way we see the world, it is important to come together when vulnerable people are at risk.
We came together again as Mother and Father of the House of Commons to write a joint opinion piece for The Times about the dangers presented by the assisted suicide bill that comes up for third reading soon.
In 1946, the Clement Attlee government introduced probably the most significant piece of legislation ever passed by a UK government — the National Health Service Act, 1946.
Section 1 put a duty on the minister to establish a comprehensive health service designed to “secure improvement in the physical and mental health of the people of England and Wales and in the prevention, diagnosis and treatment of physical and mental illness”. That provision would be radically changed by Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill.
We should only cross that Rubicon of assisted dying with the toughest of safeguards. We would wager that at second reading a majority of MPs were not satisfied that the bill had adequate safeguards but were prepared to let it go to committee in the hope that it would become safer. Unfortunately, the opposite has happened. The bill is even weaker now than it was.
The final oversight of the High Court is being replaced by a panel that is neither a court nor a tribunal. It cannot summon witnesses, cannot hear evidence on oath and, unlike judges, the members of the panel do not take a judicial oath to act impartially. Family members of those applying for assisted death would not need to be informed until after the death had occurred.
Doctors remain free to proactively suggest assisted suicide as one possible option. We are all naturally trusting of our doctors and when told by them that something is an option, this carries with it the understanding that the doctor thinks it would be in our interest to take it.
And the committee that examined the bill refused to protect those terminally ill persons whose mental health is causing or contributing to their wish to die. For example, young women with anorexia. None of the amendments supported by anorexia charities have been accepted.
On this, and a wide range of other issues, putting safeguards on the face of the bill was rejected on the ground it was “embroidery”. Instead, the promoters of the legislation have put a great deal of faith on regulations, guidance, codes of conduct and training. As longstanding parliamentarians, we can see four major difficulties with this approach.
First, even with all the best intentions in the world, the implementation of the legislation is never as robust as it is intended. The Mental Capacity Act 2005 is a good illustration of that. A House of Lords report found that it had been poorly implemented and that “health and social care professionals continue to struggle with how to apply the core principles in practice”.
Second, the regulations, guidance, codes of practice and training provided will receive no or very little parliamentary scrutiny. There is no guarantee that these will meet the high expectations that MPs will have. While it is good that training on domestic abuse will be provided, we do not know how stringent that training will be.
The experience of other jurisdictions is not reassuring. In Australia, training on domestic abuse in this context “makes up a part of a single module of c.40 – 60 minutes of self-guided e-learning”. Under Leadbeater’s legislation the training could be even less.
Third, guidance and training cannot override the words of the statute. The case law under the Mental Capacity Act is clear that having an impaired judgment due to a mental health condition does not mean that one does not have capacity. No amount of guidance or training can change that fact.
Fourth, and most concerning of all, in England but not in Wales the whole scheme will come into force automatically after four years. There is no possibility of extension if all the relevant guidance has not been issued or if the training has not been adequately completed. Given the delay, the House of Lords is unlikely to have time to scrutinise the Bill in very much detail. MPs must therefore assume that the Bill we vote on at third reading would become law.
This bill is literally a matter of life or death, and in our opinion there is only one proper course of action for MPs. We must vote it down. Whatever we think of “assisted dying” at a personal level, the bill before parliament is not fit for purpose.
