UK MPs Vote in Support of Assisted Dying
On November 29 2024, MPs in the UK voted on the Terminally Ill Adults (End of Life) Bill. Currently, the law in the UK is that assisted dying is illegal. Those who aid someone who wishes to end their life may face prosecution. The Bill would mark a move away from the current stance and allow those who wish to end their lives to do so if they fulfil certain steps. Introduced by Labour MP Kim Leadbeater, the Bill includes conditions such as being over 18, being registered with a GP for at least 12 months, having the mental capacity to make the choice, and having two doctors assess the patient’s eligibility. Furthermore, the High Court would have to rule when a person chooses to end their life. The free vote led to 330 MPs voting in favour of assisted dying, while 275 MPs voted against it. The Bill came at a time when “⅔ of Britons support assisted dying”, according to an IPSOS survey in July 2023.
During the five hours of debate, several arguments were for and against assisted dying. The ‘against’ camp was of the view that older individuals might feel pressured into agreeing to assisted dying. As a result of the cost-of-living crisis, there could be more pressure on older individuals who do not want to rely on or “burden” their families. Moreover, MP Meg Hillier argued that the Bill would ‘cross a Rubicon’ and fundamentally alter the patient-doctor relationship. The Bill could lead to the perception that doctors are arbiters of death instead of protectors of life. This perception would be damaging to the medical profession as this could erode public trust in the patient-doctor relationship.
The current health secretary, Wes Streeting, spoke in opposition to the Bill in fear of the costs that assisted dying would bring. Furthermore, he highlighted that there is a disparity in palliative care, and some patients who could not afford it would feel like it was easier for them and their families to choose assisted death. The BMA has highlighted this same view, “high-quality palliative care can effectively alleviate distressing symptoms associated with the dying process.” In times when wealth inequality is drastic and increasing, patients from lower-income households may feel more pressured to opt for assisted dying.
There were also important discussions on coercion. Labour MP Rachel Maskell indicated that coercion can sometimes be recognised long after a patient has died, but then the act has already occurred. There are steps to prevent coercion, such as having the High Court judge be satisfied that none exists. Then, the court can ensure they have the mental capacity, and the patient has to declare their informed wish. Coercion manifests itself in various, nuanced ways. It would only be evident that a patient was manipulated or coerced after the patient had passed away and it would be too late to intervene. Thus, the extent to which these provisions in the Bill prevent coercion is questionable.
The bill’s future is not yet set in stone. The Bill now has to be scrutinised by MPs in committee. Then, there will be a report stage, which allows MPs to propose amendments after the Commons Speaker will allow some of these amendments to be debated and voted on. After this, the third reading will occur, and MPs will vote on the bill for the last time. These stages will then be repeated in the House of Lords. At some point during the process, there will need to be a money resolution to authorise the proposed spending for the bill. The bill will then be sent to the House of Lords for Royal Assent. So far, the Terminally Ill Adults (End of Life) Bill could be altered by Parliament and could fall short.
As for the content of the Bill, there could be some changes based on recommendations from the British Medical Association. For instance, the BMA has suggested there should be “an ‘opt-in’ model for doctors to provide assisted dying”, “no duty to raise the issue of assisted dying with patients”, and “a review of all assisted deaths.” These elements could be incorporated into the Bill to show respect for both patients and doctors and to ensure there’s oversight of the assisted dying process.
The UK seems to be moving in the direction several countries in Europe have. The Terminally Ill Adults (End of Life) Bill allows terminally ill people to end their lives with dignity and on their own terms. Although the Bill requires more explicit measures to prevent coercion and ‘pressuring’ elderly people to terminate their lives early, it is a step in the right direction. This Bill also highlights the importance of improving palliative care for all who need it in the United Kingdom and Wales.
By Serena Ogara
