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The Terminally Ill Adults (End of Life) Bill Committee has voted to remove the required High Court approval for assisted deaths, which will be replaced with oversight from a panel of legal, medical, and social care experts. Under previous provisions, all assisted deaths had to be approved by a High Court judge. Amendments put forward by Kim Leadbeater MP, the sponsor of the Bill, will replace the role of the High Court in the Bill with a Voluntary Assisted Dying Commission and expert panels. Humanists UK and My Death, My Decision have welcomed the votes.

15 MPs on the committee voted in favour of removing Clause 12, 7 against. Clause 12 outlined the steps required for court approval of an assisted death. New clauses to set up the Voluntary Assisted Dying Commission and expert panels have been debated as part of this group; however, voting on them will happen at the end of the committee stage. Amendments NC14 to NC17, NS1 and NS2 outline the new process.

Claire Macdonald, Director of My Death, My Decision, said:

“Removing the High Court approval, to replace it with a dedicated Commission and expert panels, is a welcome step forward. We support the move towards a specialist panel that can provide expertise and fairness in assisted dying decisions. 

“Spain is the only country in the world that requires a panel to assess every single assisted death while none require the High Court. Most jurisdictions trust two independent doctors to assess the patient, with no third tier of oversight. We hope MPs on the committee remain dedicated to ensuring the process is safe, without being too complex or burdensome for those in need.”

Andrew Copson, Chief Executive of Humanists UK, said:

“Replacing the High Court judge with a multidisciplinary panel is a welcome improvement. It has the potential to make assisted dying decisions more efficient and accessible while strengthening already rigorous safeguards. However, it is crucial that this new process as implemented is practical and does not create unnecessary bureaucracy that could delay compassionate end-of-life choices.”

Tom Gordon, MP and committee member, said:

“T​oday’s vote is a step in the right direction​. Replacing the High Court with a multidisciplinary panel will ensure decisions are made with the right expertise, rather than adding unnecessary legal delays. We must ensure that our assisted dying process remains clear, accessible, and does not create obstacles for those already dying and facing immense suffering.”

Polling commissioned by Humanists UK shows that more than two-thirds (67 per cent) of the British public support the amendments to replace High Court approval with a panel of legal, medical, and social care professionals. The High Court requirement had been criticised as costly and time-consuming, while a specialist panel should provide faster and more practical decision-making to make end-of-life care more accessible while maintaining safeguards.

The role of the High Court in the Bill has been replaced with a Voluntary Assisted Dying Commission and expert panels.  The role of the High Court and its workability has been challenged on the basis that the Court doesn’t have the capacity and that it wouldn’t provide additional safety. The Voluntary Assisted Dying Commission will be led by a High Court judge or senior former judge. It will oversee all cases and report each year on the number of applications and how many were approved or rejected.

It will also appoint expert panels, with each applicant for assisted dying going to a panel for a decision after sign-off by two doctors. The panel will be chaired by a senior lawyer or retired judge and also feature a psychiatrist and a social worker.

Spain is the only country in the world that requires a panel to assess every single assisted death while none require the High Court. Jake Richards MP cited in the debate that 20% of people who apply for an assisted death in Spain die before they can finish the process. Most jurisdictions trust two independent doctors to assess the patient, with no third tier of oversight.

During her speech, Kim Leadbeater MP highlighted the uniqueness of this clause:

“I appreciate this is very unusual if we compare this Bill to the many other models of assisted dying around the world. Most jurisdictions have a process which involves two doctors as this Bill does, but there is no additional stage in those processes, and I know there are different views as to whether this third layer is necessary as many of the jurisdictions have processes which provide a very compassionate, patient-centered, and well safeguarded approach to assisted dying without it.

“Indeed, some of the most difficult emails I receive are from terminally ill people who are very concerned about the complexity of the process as laid out in the Bill, who feel that it is overcomplicated and too bureaucratic for people who are in their dying weeks and days to navigate, and I am very sensitive to this.

I’m also aware that the thorough process as set out in the Bill will take time, and there will be people who embark upon it who will die before they can complete it, as happens in other jurisdictions, which is of course extremely sad. But I also know that certainly in this country people feel strongly that oversight and scrutiny of what we might call the medical initial stages of the assisted dying process is important.”

Supporting the panels, Kit Malthouse, MP and committee member, said during the debate:

‘We need to take care to tread lightly on people’s final moments. We have to have at our at the heart of our thinking, the notion that we are filling these people’s final days and hours with possibly stress, with bureaucracy, with a sense of jeopardy. About whether they’re going to get permission for what they want. For what they’ve declared to two doctors, for the forms that they filled in, and at the back of their mind that they don’t have long left.

‘And so, while I understand the motivation of those who are trying to amend and restrict accessibility and elongate the time, I do ask them to to bear that in mind and help us to strike a balance. Between, yes, having a system that gets to the robust answer, but, as I say, treads as lightly as possible on the lives of remaining lives of these people are facing their end.’

“We must tread lightly on people’s final moments.” Powerful words from @kitmalthouse on why assisted dying must be accessible, compassionate & free from unnecessary stress. A choice, not an ordeal. Watch his speech 👇 #AssistedDying pic.twitter.com/Te61JYsf8A

— MyDeath, MyDecision (@MDMDmydecision) March 12, 2025

Notes:

For further comment or information, media should contact Humanists UK Assisted Dying Campaigner Nathan Stilwell at nathan@humanists.uk or phone 07456200033.

Humanists UK and My Death, My Decision have people and their loved ones who would be affected by this change available for the press.

If you have been affected by the current assisted dying legislation, and want to use your story to support a change in the law, please email campaigns@humanists.uk.

Amendments NC14 to NC17, NS1 and NS2 in detail:

• NC14 establishes the ‘Voluntary Assisted Dying Commissioner’ appointed by the Prime Minister. The appointee must be a current or former judge of the Supreme Court, Court of Appeal, or High Court, and will not become a civil servant upon appointment
• NC15 sets out how, after two doctors have approved an application for an assisted death, the Voluntary Assisted Dying Commissioner is to refer the case to a multidisciplinary panel, to be called an Assisted Dying Review Panel
• NC16 is called ‘Determination by panel of eligibility for assistance’. The panel must do this by determining that all the decision-making up to that point has been correct, including that all the eligibility criteria are met. The panel is required to question one of the two approving doctors and may question both. The panel may also question the patient themself, as well as others including other experts. Such questioning can be in-person or by video or audio link. If someone is deemed eligible, then a certificate to that effect will be issued
• NC17 is called ‘Reconsideration of panel decisions refusing certificate of eligibility’. It allows for an appeal by an unsuccessful applicant to the Commissioner, which happens without a hearing, and if the appeal is successful the case is remitted to a new Review Panel
• NS1 contains various consequential provisions related to the Commissioner role, including that there is also a Deputy Commissioner, and tenure is up to five years for both roles, although the Secretary of State may dismiss them. It provides for staffing and funding for the Commission
• NS2 outlines the make-up of the panel, consisting of a legal member, a psychiatrist, and a social worker. Again there is a five-year tenure. The legal member will be the chair and must be a current or former judge of the High Court, Court of Appeal, or Supreme Court, or be a KC. There is majority voting except to approve an assisted death, where it has to be unanimous.

Humanists defend the right of each individual to live by their own personal values, and the freedom to make decisions about their own life so long as this does not result in harm to others. Humanists do not share the attitudes to death and dying held by some religious believers, in particular that the manner and time of death are for a deity to decide, and that interference in the course of nature is unacceptable. We firmly uphold the right to life but we recognise that this right carries with it the right of each individual to make their own judgement about whether their life should be prolonged in the face of pointless suffering.

We recognise that any assisted dying law must contain strong safeguards and the international evidence from countries where assisted dying is legal shows that safeguards can be effective. We also believe that the choice of assisted dying should not be considered an alternative to palliative care, but should be offered together as in many other countries.

Humanists UK is the national charity working on behalf of non-religious people. Powered by over 130,000 members and supporters, we advance free thinking and promote humanism to create a tolerant society where rational thinking and kindness prevail. We provide ceremonies, pastoral care, education, and support services benefitting over a million people every year and our campaigns advance humanist thinking on ethical issues, human rights, and equal treatment for all.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

Humanists UK and My Death, My Decision are both members of the Assisted Dying Coalition, along with Friends at the End, Humanist Society Scotland, and End of Life Choices Jersey.

MPs scrutinising the Terminally Ill Adults (End of Life Choices) Bill have debated an amendment that would have allowed those with neurodegenerative illnesses to access assisted dying when they have twelve months or fewer to live, rather than six. Following the debate, the amendment was withdrawn due to lack of support. Campaigners have expressed their disappointment at the outcome.

The amendment was proposed by MPs from the Labour Party, Conservatives, Liberal Democrats, and Green Party, and supported by Humanists UK and My Death, My Decision as well as the public. 

The amendment’s primary sponsor was Tom Gordon MP, who withdrew the amendment after the debate over fears that the amendment could negatively impact the chances of the Bill passing in later stages. 

Tom Gordon, MP for Harrogate & Knaresborough, who proposed the amendment said:

‘Extending the eligibility period to 12 months for those with neurodegenerative conditions remains a compassionate approach, however, I decided to withdraw the amendment. My priority is ensuring that we make progress on assisted dying legislation, and I do not want to risk delaying or jeopardising the Bill’s success by pushing for changes that might divide support at this crucial stage. I remain committed to advocating for those with neurodegenerative conditions and will continue working towards a law that is as fair and inclusive as possible.’

Fellow committee member Rachel Hopkins MP spoke in support of it. She mentioned:

‘Diane Pretty was from Luton… 25 years ago she was diagnosed with motor neurone disease and tried to change the law then, so she could access assisted dying because of the pain and suffering she endured because of her terminal illness.  

She said, which is fundamental and at the heart of what we are trying to do here 25 years later: “I want to have a quick death, without suffering, at home and surrounded by my family”. In the end Diane Pretty was not successful, she died aged 53… She didn’t have a choice, she could not choose the death she wanted. Much has been said about rushing the Bill, but that was 20+ years ago.’

My Death, My Decision Chair Aleisha Murray commented:

‘We know that many people living with neurodegenerative conditions are dismayed that MPs have decided not to give them the choice offered by this Bill, leaving them to face prolonged and unbearable suffering that could be avoided. The six-month limit fails to account for the realities of diseases like motor neurone disease, where prognosis is uncertain and many may lose mental capacity before they become eligible. 

‘While we regret this missed opportunity for a more compassionate law, we remain steadfast in our support for the Bill as a crucial step toward giving people the dignity and autonomy they deserve at the end of life.’

Humanists UK Chief Executive Andrew Copson commented:

‘It is disappointing that this amendment was not taken up. It would have extended the hope offered by this Bill to the large number of terminally ill people who are not covered by a six-month limit. All terminally ill people deserve the dignity of choice that legal assisted dying will afford. 

‘While we regret this outcome, we continue to support the unamended Bill, as a once-in-a-generation opportunity to bring choice at the end of life to those many people that it will help.’

Why the amendment was proposed

The amendment would have aligned England and Wales’s assisted dying law with that found in most of Australia and would be particularly important for people with Motor Neurone Disease (MND), Huntington’s, Multiple System Atrophy (MSA), Progressive Supranuclear Palsy (PSP), and Corticobasal Degeneration (CBD), as well as some people with Parkinson’s. Under the Bill, some people with these conditions who meet the eligibility criteria of terminal illness would be excluded as the six-month limit is frequently past the point at which they need an assisted death – and sometimes it is past the point they can even be granted one.

Every UK resident who travels to Switzerland for an assisted death has a debilitating condition meaning they need an assisted death. But most do not have six months or fewer to live and so would not fit the criteria of the current Bill. The ‘six-month’ definition of terminal illness currently exists in law only in parts of the United States and in New Zealand. But even in New Zealand, yearly reports on assisted dying indicate that being unable to confirm a six-month prognosis is the primary barrier for eligibility. There are now proposals to extend it.

Motor Neurone Disease kills six people per day in the UK. 45% of people living with MND say they’d consider assisted dying if the law changed. The MND Association highlighted in its evidence to the committee that the six-month criteria is problematic as prognosis is incredibly difficult and for many the suffering is too great to mean that they can wait that long. Some will also lose mental capacity if forced to wait.

The Multiple System Atrophy Trust similarly said in its evidence that the six-month criteria is problematic, stating that 85% of people living with Multiple System Atrophy who have a view support a change to the law. The amendment will also extend choice at the end of life to the almost 8,000 people living with Huntington’s in the UK, many of whom would otherwise be excluded from the Bill for similar reasons as described above.

And the PSP Association similarly highlighted in its evidence to the committee that the six-month criterion is problematic for people with Progressive Supranuclear Palsy and Corticobasal Degeneration. And during oral evidence, several witnesses made similar points, such as Sir Nicholas Mostyn and experts from Australia.

Text of the amendment (No 234):

Clause 2, page 2, line 2, leave out “within 6 months” and insert— 

1. 1. in the case of a neurodegenerative illness, disease, or medical condition, within 12 months; or

1. 1. in the case of any other illness, disease, or medical condition, within 6 months.”

Member’s explanatory statement

This amendment changes the definition of a terminal illness for the purposes of the Act to include neurodegenerative illnesses, diseases or medical conditions where a person’s death in consequence of such an illness can reasonably be expected within 12 months.

The amendment would not have affected the ability of those who lack mental capacity to access assisted dying under the terms of the Bill. They remain, and would have remained, precluded from being able to access it under clause 1(a).

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

The Assisted Dying Bill on the Isle of Man has passed a key hurdle, with a majority of amendments to the Bill being accepted. My Death, My Decision, whose local Isle of Man branch has been campaigning strongly for a law, welcomes this compassionate move.

Today, Members of the House of Keys, the Isle of Man’s lower house, voted on changes to the Bill made by the Legislative Council, the upper chamber. They chose to support changes including:

• A mandatory referral to a psychiatrist if there are doubts about the patient’s mental capacity.
• Specific training for healthcare professionals to identify coercion, duress or pressure.
• A person must be registered as a patient with a GP practice on the island

However, they rejected an amendment to cut the residency criteria from five years to 12 months before a patient can access the scheme.

The Bill will go back to the upper chamber on the 11th March, if they accept the final changes the Bill will go to Royal Assent and the Isle of Man will be the first part of the British Isles to legalise assisted dying with the choice of assisted dying potentially available to terminally ill residents from 2027.

The Bill would give terminally ill Manx residents with fewer than twelve months to live the choice of receiving help to end their own life. The Bill proposed in Westminster is limited to people with six months’ life expectancy or less. 

Our former chair, Trevor Moore, visited Tynwald in June 2023, to make the case for parliamentarians to vote for a compassionate assisted dying law that will help end unnecessary suffering for those who so choose.

Trevor Moore, Board Member of My Death, My Decision said:

“The members of the House of Keys are to be applauded for taking this historic step. They have engaged positively with the debate, with arguments put forward from all sides in good faith. We hope that Westminster will pay attention to this, and follow in their footsteps.

We would like to thank our passionate campaigners on the island, like Vicky Christian who chairs our local group there. They have done extraordinary work to ensure that the voices of people who have been deeply affected by the current unjust assisted dying laws are heard.”

Vicky Christian, Chair of My Death, My Decision Isle of Man said:

“This is a historic step, and is likely the last time the Bill will be debated in the lower chamber. This Bill will ensure people on the Isle of Man will finally have choice and dignity at the end of their lives. I am incredibly proud of our island for not only listening to its people but, more importantly, listening to those facing the end of life. In this debate, compassion and evidence have prevailed.

I want to thank the members of the House of Keys for their dedication to this cause. But above all, I want to thank the individuals who shared their personal stories and stood with us throughout this journey—this has truly been a campaign led by the people.”

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

In 2017 Victoria became the first state in Australia to pass an Assisted Dying Act. The Act came into force in 2019. Today a review of the Act has prompted the Victorian Government to propose changes to the law to improve access – in ways that should be instructive to UK politicians as to how our proposed laws can best be constructed. Here’s everything Humanists UK and My Death, My Decision think UK politicians could learn from Australia:

A six-month eligibility clause is too narrow

The Victorian law requires that the patient accessing assisted dying must have six months left to live or less, or twelve months left to live if they have a neuro-degenerative condition. The proposed law in England and Wales is six months for everyone, although an amendment has been put forward to change that to the same system as Victoria. 

In New Zealand (a six-month limit), many people lost their decision-making capacity before they could proceed. In contrast, in Victoria, only 7% lost competence during the process.

However, as the 12-month limit has proven more compassionate for people with neuro-degenerative conditions, the Victorian Government is now proposing extending it to all conditions. They argue this will also help doctors who have difficulty determining how long a patient has left to live.

There will be a consultation on this proposal, and politicians in Australia will have a free vote on it.

Assisted dying is safe and compassionate

The independent review, which was a result of extensive research and community consultations, found that assisted dying ‘is a safe and compassionate end-of-life choice available to eligible Victorians.’

The review found that families overwhelmingly valued the care and support provided by assisted dying medical practitioners. 93% of families reported that the process was compassionate.

‘The application was as good as it possibly could be… handled compassionately and efficiently.’ (Family member)

‘Just knowing that he had the option to access [assisted dying] was huge for him, even if he never ended up needing to use it.’ (Family member)

Don’t stop doctors from having frank and open conversations

Currently, doctors are essentially banned from talking about assisted dying unless the patient specifically asks for it, known as the ‘Gag Clause’. 

Nick Carr, a doctor in Victoria, has said that one of the hardest things to witness as a doctor is seeing terminally ill patients in unbearable pain, knowing that there is an option to end their suffering – but being unable to mention it. He said:

‘There’s been times where I’ve been sitting there, having to sit on my hands, having to shut my mouth because I want to say to them, ‘Do you know there is the option of voluntary assisted dying?’ and I can’t.’

Politicians in the UK have argued extensively about whether doctors can raise assisted dying. The BMA and other organisations have argued that doctors should not be ‘gagged’ and should always be able to have free and open conversations with patients. Thankfully, such a gag clause is not currently in the England and Wales bill. Proposals to add it should be resisted.

Accessibility is important

The review goes into depth about how assisted dying should be accessible. Currently, there is a ban on non-Australian citizens from being able to access it. 

There have been a number of high-profile cases of suicides from people found not to be eligible, including a British national who had lived in Australia for 42 years but who had never become a citizen. That man, who was eligible to vote and paid local taxes, was only rejected because of his lack of citizenship – despite receiving a terminal pancreatic cancer diagnosis and enduring immense pain, according to his doctor.

Politicians have also proposed reducing the time to obtain an assisted permit from 28 days to 21 days, making access quicker and reducing suffering. The Committee in the UK received a lot of evidence not to make the process too difficult for patients, to avoid them dying while waiting for access.

Assisted dying works in line with palliative care

The report also outlines that the overwhelming majority (83% in some areas) of applicants were also receiving palliative care, showing that assisted dying is used as a complementary option rather than a replacement.

There is a growing sense of approval in the palliative care community in Australia. The report outlines that medical practitioners and families support the process, and the medical community acknowledges that even the best palliative care cannot always alleviate suffering.

91% of people seeking assisted dying in Victoria were satisfied with the support from medical practitioners.

Aleisha Murray, Chair of My Death, My Decision, said:

‘On assisted dying, the UK isn’t leading the way – we’re lagging behind. We absolutely must learn from places like Victoria, which share our core values and now have years of experience. Crucially, we should take lessons from Victoria’s comprehensive review of assisted dying to ensure we introduce the best possible law from the outset.

‘It’s unjust that a dying person in Australia can choose a compassionate, dignified death, whilst in the UK, that same person would be forced to suffer. Compassion shouldn’t depend on geography. Everyone deserves a choice, and now is the time to introduce a compassionate law.’

Richy Thompson, Director of Public Affairs and Policy at Humanists UK, said:

‘We hope MPs take note of how assisted dying is evolving in Victoria. We must take into account all the international evidence and, where possible, learn from other countries about how to construct the most compassionate law possible, rather than seeing the same issues arise.

‘Adults in the UK deserve the right to a compassionate and dignified assisted death. 20 people a day die in pain, even with the best care, and for those people, they should have a choice at the end of their lives. No-one should be forced to die in pain when internationally more compassionate options are available.’ 

Notes

For further comment or information, media should contact Nathan Stilwell at nathan@humanists.uk or phone 07456200033.

Humanists UK and My Death, My Decision have people and their loved ones who would be affected by this change available for the press.

If you have been affected by the current assisted dying legislation, and want to use your story to support a change in the law, please email campaigns@humanists.uk.

Media can use the following press images and videos, as long as they are attributed to ‘Humanists UK’.

Humanists defend the right of each individual to live by their own personal values, and the freedom to make decisions about their own life so long as this does not result in harm to others. Humanists do not share the attitudes to death and dying held by some religious believers, in particular that the manner and time of death are for a deity to decide, and that interference in the course of nature is unacceptable. We firmly uphold the right to life but we recognise that this right carries with it the right of each individual to make their own judgement about whether their life should be prolonged in the face of pointless suffering.

We recognise that any assisted dying law must contain strong safeguards, but the international evidence from countries where assisted dying is legal shows that safeguards can be effective. We also believe that the choice of assisted dying should not be considered an alternative to palliative care, but should be offered together as in many other countries.

Read more about Humanists UK’s campaign to legalise assisted dying in the UK.

Humanists UK is the national charity working on behalf of non-religious people. Powered by over 130,000 members and supporters, we advance free thinking and promote humanism to create a tolerant society where rational thinking and kindness prevail. We provide ceremonies, pastoral care, education, and support services benefitting over a million people every year and our campaigns advance humanist thinking on ethical issues, human rights, and equal treatment for all.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

Humanists UK and My Death, My Decision are both members of the Assisted Dying Coalition, along with Friends at the End, Humanist Society Scotland, and End of Life Choices Jersey.

A new amendment to the Terminally Ill Adults (End of Life) Bill aims to allow those with neurodegenerative illnesses to access assisted dying when they have twelve months or fewer to live, rather than six, as currently stipulated in the Bill.

Text of the amendment (No 234):

Clause 2, page 2, line 2, leave out “within 6 months” and insert— 

1. 1. in the case of a neurodegenerative illness, disease, or medical condition, within 12 months; or
   2. in the case of any other illness, disease, or medical condition, within 6 months.”

Member’s explanatory statement

This amendment changes the definition of a terminal illness for the purposes of the Act to include neurodegenerative illnesses, diseases or medical conditions where a person’s death in consequence of such an illness can reasonably be expected within 12 months.

The amendment does not affect the ability of those who lack mental capacity to access assisted dying under the terms of the Bill. They cannot access an assisted death under clause 1(a).

The amendment would align England and Wales’s assisted dying law with that found in most of Australia and would be particularly important for people with Motor Neurone Disease (MND), Huntington’s, and Multiple System Atrophy (MSA), as well as some people with Parkinson’s. Under the Bill as introduced, some people with these conditions who meet the eligibility criteria of terminal illness would be excluded as the six-month limit is frequently past the point at which they need an assisted death – and sometimes it is past the point they can even be granted one.

Proposing the amendment, Tom Gordon MP, who is on the Bill Committee, said:

 

‘This Bill is about ensuring people facing painful deaths from terminal conditions can have the choice of how they die. For those with neurodegenerative conditions, in their last six months, it may be too late for them to engage in the bureaucracy of applying. The amendment I have put forward, supported by colleagues across the house, will ensure more people with neurodegenerative conditions will be able to access an assisted death if that is their choice.’

 

Claire Macdonald, Director of My Death, My Decision, said:

‘MPs have heard evidence in the Terminally Ill Adults Bill Committee sessions from doctors in Australia and New Zealand why it would be sensible to permit a 12-month eligibility limit for people with neurodegenerative conditions like Motor Neurone Disease and Parkinson’s. We have a great opportunity in England and Wales to learn from doctors how assisted dying is working in their countries. My Death, My Decision really welcomes the amendment being put forward by these MPs – it is both evidence-based and compassionate.’

Why the amendment is being proposed

Most UK residents who travel to Switzerland for an assisted death do not have six months or fewer to live and so would not fit the criteria of the current Bill. The ‘six-month’ definition of terminal illness currently exists in law only in parts of the United States and in New Zealand. But even in New Zealand, yearly reports on assisted dying indicate that being unable to confirm a six-month prognosis is the primary barrier for eligibility. There are now proposals to extend it.

Motor Neurone Disease kills six people per day in the UK. 45% of people living with MND say they’d consider assisted dying if the law changed. The MND Association highlighted in its evidence to the committee that the six-month criteria is problematic as prognosis is incredibly difficult and for many the suffering is too great to mean that they can wait that long. Some will also lose mental capacity if forced to wait.

During oral evidence, several witnesses highlighted a problem with the six-month limit, such as Sir Nicholas Mostyn.

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

My Death, My Decision has told the committee examining the Terminally Ill Adults Bill that the assisted dying process must be compassionate. In our recently published evidence to the committee, we said:

“At the heart of the legislation must be the journey of the terminally ill patient, and ensuring a compassionate process that is as straightforward, swift, and inexpensive as possible for applicants, whilst offering adequate safeguards to protect the most vulnerable.” 

This evidence was submitted to a committee of 21 MPs who are looking into the details of the Terminally Ill Adults Bill, and will soon be debating amendments to the Bill line by line.

In our submission, we outlined how My Death, My Decision supports the Terminally Ill Adults (End of Life) Bill. We explained that the current legislation that prohibits assisted dying in any form is unsafe, unworkable, and severely lacking in compassion. The prohibition of assisted dying is directly causing thousands of individuals at the end of their lives to suffer undignified, prolonged and often painful deaths, in many cases taking their own lives using dangerous and unregulated methods.

We also outlined:

• Doctors should be free to raise assisted dying with their patients (as already provided in the Bill)
• The High Court as a third tier of protection may lengthen the process for dying applicants excessively, so alternatives such as tribunals should be explored
• The Bill should explicitly remove both criminal and civil consequences from those providing help to assisted dying applicants out of compassion.

Claire McDonald, Director of My Death, My Decision, said:

“20 people a day die with no effective pain relief in the last 3 months of their life, even if the highest levels of hospice-level care are available to patients. That’s absolutely wrong and terminally ill people deserve better.

While we’re absolutely committed to passing this legislation, we outlined a number of areas that the committee should examine and where the Bill could be amended. We’re dedicated to creating a kind, compassionate and dignified assisted dying law.”

Committee members have recently heard evidence from nearly 50 witnesses, including Chris Whitty, the Chief Medical Officer, who similarly outlined that the law should not be too burdensome on the patient. 

Introduced by the Labour MP Kim Leadbeater MBE, the Bill will allow adults who are terminally ill with six months or fewer left to live to ask for help to end their own lives. In November, MPs voted on the principle of this legislation, passing the second reading 330 votes to 275. The Bill is currently in the Committee Stage, where it will remain for several months of scrutiny before a final vote in the House of Commons next year. 

The Bill applies to England and Wales only. A private member’s bill in Scotland by Liam McArthur MSP has been introduced in the Scottish Parliament.

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

Thursday 30 January was the last day of oral evidence for The Terminally Ill Adults Bill Committee. MPs heard evidence from international experts, medical professionals and people with lived experience.

The testimony from people with lived experience was incredibly powerful, and we will make sure these testimonials are highlighted throughout our work.

Make sure to catch up on the summary of evidence from the previous sessions:

• Day 1 Session 1: Senior Medical Leadership 
• Day 1 Session 2: Palliative care, and legal and international experts.
• Day 2 Session 1: Australia and disability experts.
• Day 2 Session 2: Palliative care and disability considerations

Session 1:

• Dr Chloe Furst, Geriatrician and Palliative Care Physician, Adelaide,
• Alex Greenwich, MP for Sydney, Parliament of New South Wales,
• Professor Meredith Blake, University of Western Australia

Dr Furst explained that the end-of-life medication is working, compassionate and safe, with 95% of cases seeing death within minutes. When asked about how the palliative care community reacted to a change in the law in Australia, Dr Furst said:

“I would be lying if I said the palliative care community were completely on board with it.. new consultants, new doctors that are coming through are really seeing assisted dying as something they want to do. There is no animosity any more from those who want to work in this space and those who don’t.”

In some states in Australia, people can choose to have an assisted death if two doctors signs off that they are terminally ill and have six months left to live, but that extends to twelve months for neuro-degenerative conditions. Professor Blake told MPs:

“As a clinician, I think that 12 months for neurodegenerative conditions is really helpful. If you’re looking at prognosis and trajectory, if you look at things like cancer, that six-month prognosis is quite noticeable, but if you look at motorneurone disease that process can be quite slow and very distressing for them.”

In Queensland, the criteria is set as people with twelve months left to live, no matter the condition.

When asked about the experience of politicians in Australia, and why New South Wales felt it needed to introduce a law, Alex Greenwich MP said: 

“We decided we can do better and we can regulate in this space. Voluntary Assisted Dying in New South Wales is an important form of suicide prevention. What voluntary assisted dying does is ensures a person who has a terminal illness who knows it is going to be a cruel and painful end to their life is instead directed to a doctor who will be able to take them through all their options, including palliative care.”

Session 2:

• Dr Amanda Ward, PhD in law reform on Voluntary Assisted Dying.
• Professor Gareth Owen, Kings College London and South London and Maudsley NHS Trust
• Professor Laura Hoyano, Professor of Law, Oxford University 

Dr Ward contributed significantly to the legislation that is currently going through the Scottish parliament. The Assisted Dying for Terminally Ill Adults (Scotland) Bill is very similar to the Terminal Ill Adults (End of Life) Bill for England and Wales. The two key differences between the proposals are:

• In England and Wales, a person must have six months left to live or fewer, but in Scotland the person must have a terminal illness, but there is no time limit set.
• In Scotland, there is no requirement for a High Court judge to sign off on each case.

Dr Ward told MPs:

“So that has been a four-year process and I understand that there have been concerns voiced and this committee that this has proceeded at pace. However, I would argue that you are not pioneers. There’s 20 to 30 years of data that we have drawn on in Scotland and there are four years of working in Scotland that this committee in this Parliament could look to.

I would make the point that the data is peer reviewed and evidence-based and you really have to trust your international colleagues because the data is from government bodies, it’s from health departments, it’s from independent academic peer reviews”

Drawing from her experience of medical law, Professor Laura Hoyano told MPs:

“There is considered to be a fundamental right at the heart of medical law that the patient has autonomy to decide what to do with his or her body and to refuse medical treatment, providing they have the capacity to do so and are acting without coercion from external sources.

Doctors have to make those assessments all the time, it’s a convenient fallacy to say there’s a difference between pulling the plug on a respirator as a positive act, whereas giving a patient a syringe to end their own life is a negative act.”

Professor Gareth Owen disagreed with Professor Hoyano, arguing there was a clear difference between withdrawing treatment and assisted dying. When asked about whether a psychologist was needed in every case, he said:  “I think the answer to that is probably not, given the current workforce. “

Session 3:

• Professor Nancy Preston, Professor of Palliative Care, Lancaster University
• Dr Naomi Richards, Director of End of Life Studies, University of Glasgow
• Claire Williams, Head of Pharmacovigilance and Regulatory Services

There was a strong emphasis on why people choose assisted dying in this session. Dr Richard told MPs:

“It’s individually specific which won’t come as a shock to you. The evidence shows that people who request assisted dying are people who perhaps have a particular preference for control in their life and they have had this preference across their life. It’s part of their identity. In that sense, it is a personal preference as opposed to a deficit in palliative care, which is what we hear a lot about. “

Professor Preston agreed, saying:

“We’ve done interviews with bereaved families and healthcare workers in the United States and the Netherlands, as well as in Switzerland and also British families who access to Dignitas. It often comes there’s something they’ve really thought about for a long time, this is what we hear from the family members, and it might come to a crunch point where they know they’re potentially going to lose capacity and they are potentially going to lose the abilities”

Claire Williams advocated strongly for the Bill to move away from a High Court judge, arguing: 

“I absolutely agree that a panel/committee approach would have better safeguarding for patients, because the decision is being made collectively with legal expertise and with other healthcare professionals—that might be palliative—or ethicists like myself. It is having that collective view, ensuring that everybody is happy and that that is exactly what the patient wants. I believe it should be a committee/panel-based approach for the final decision.”

Session 4: 

The fourth session focused on families with relevant experience – which we highly recommend you watch, as one of the most moving and heart-felt evidence sessions this parliament has seen. 

Pat Malone: Three members of Pat’s family died in dreadful circumstances, two of them by suicide after suffering from cancer, the third with Motor Neurone Disease travelled to Dignitas to have control over her own death. Their pain and suffering could have been avoided by a compassionate assisted dying law

Liz Reed: Liz’s brother had an assisted death in a hospice in Queensland, Australia aged 39. Their law is very similar to the England and Wales Bill. She explained how the law works in practice for a dying person and their family.

Julie Thienpont: Julie and her husband were living in Spain when he was diagnosed with mesothelioma and given three months left to live, so he opted for assisted dying.

Pat told the committee:

“My sister’s death, having seen those two deaths, was much easier. She got motor neurone disease and was not really suffering in the way that my father and brother had been. She knew that her end was going to be as a live brain in a dead body, and that was the horror that she faced. From the beginning, she was fixed on going to Dignitas, which she did… When she was accepted by Dignitas, she said that it was the greatest relief of her life. She said, “I know I am not going to get cancer or dementia. I’m going to die painlessly at a time and place of my choosing.”

That is exactly what she did, but she died 1,000 miles from home. She should have died in her house with her family, and her dogs on the bed. She should not have been denied that.”

Julie told the committee:

“It was a very peaceful, serene and beautiful death, as opposed to what it would have been like. He was able to speak to his relatives in Australia, his brothers in Belgium and other family members, and I was able to hold his hand. Guy had always been a bit of an old cowboy, and he always said that he wanted to die with his boots on. I am proud to say that that is what he did. At the end, we were holding hands, and I said to him, “Don’t be afraid.” He said, “I’m not afraid,” and he winked at me just before he closed his eyes.”

Liz told the committee:

“The day my brother died we sat outside in the courtyard and had a glass of champagne. He chose a Bob Dylan song that he wanted to die to. It was extremely peaceful. It was seconds. And he got to say all the things, have all the conversations, speak to our parents—that sort of real American “closure”. That is what he got, and we were not sitting around thinking, “I wish I’d said this. I missed it,” or, “I was off doing something with the kids.” We were all there: my mum, my dad, me, his wife. We sat there and held his hand—and what a gift.”

Session 5:

• Professor Emyr Lewis, Emeritus Professor, Department of Law and Criminology, University of Aberystwyth
• Dan Scorer, Head of Policy and Information and Advice at Mencap
• Dr Annabel Price, Member of the Faculty of Liaison Psychiatry at the Royal College of Psychiatrists and past Chair of RCP
• Dr Michael Mulholland, Honorary Secretary at Royal College of General Practitioners

The final session of the oral evidence ended with a focus on Wales and devolution. Professor Lewis explained that due to the potential changes on the Welsh healthcare system, that a legislative consent motion may be required, where Westminster asks Welsh ministers or the Senedd, the Welsh parliament, for permission around certain powers.

Sarah Sackman MP, The Minister of State, Ministry of Justice, replied that she will work closely with the Welsh Government to assess the legalities and practicalities of any potential changes to the law.

When asked about a potential ‘gag clause’ that would prevent doctors from talking about assisted dying to patients, Dr Mulholland said:“We are very protective of our relationship as GPs, and want to give patients the options that they might want to choose for themselves. We are not usually pushing anyone to any decision, but supporting them through their end-of-life journey. We would want to protect that in whatever way, so we therefore feel that a service we can signpost to would be the most appropriate thing as the next step.”

Dan Scorer raised many issues that he recommended that the committee take into account to be inclusive of people with learning disabilities. He also urged the committee to bring the review that is due to take place after five years of legislation working, to be much earlier.

A considerable amount of Dr Price’s evidence centred around the Mental Capacity Act and if it was sufficient for a Bill of this kind. When questioned about how mental capacity works with the refusal of treatment, Dr Price replied:

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

Subject: Oral Evidence Sessions: Day 2 Session 1 Australia and Disability

This morning was the second day of oral evidence, where the Committee which is examining the Terminally Ill Adults Bill, questioned experts from Australia and experts in disability.

Make sure to read our summary of yesterday’s morning session and afternoon session.

The first session included three experts from Australia:

• Dr Cam McLaren, a Medical Oncologist from southeast Melbourne, an early adopter of Assisted Dying when it became legal in Victoria
• Dr Greg Mewett, a Specialist Palliative Care Physician from Victoria
• Dr Clare Fellingham, Deputy Director of Medical Services, Royal Perth Hospital

All three experts told the Committee how the Australian states have safe, compassionate and working assisted dying laws. Dr Mewett told the committee:

“I see [assisted dying] as an end-of-life choice amongst a number of end-of-life choices people may or may not make…. They require excellent palliative care up until the point they die. Despite the best palliative care in the world, there are still patients who suffer uncontrollably and intolerably and it’s that small minority of patients who should have a legal option to take control of that stage where it’s irreparable” 

Dr Clare Fellingham, Deputy Director of Medical Services, Royal Perth Hospital, highlighted how the Terminally Ill Adults Bill is very similar to the Australian legislation and there are many similarities between the countries and their healthcare systems. She told MPs:

“You have a golden opportunity to look, as you are, across every jurisdiction that already has laws in operation and cherry-pick the very best bits of what is working well in those jurisdictions to create the very best, most robust but also most patient-centred legislation you can.”

Dr Cam McLaren recommended to MPs that they should increase the eligibility criteria for an assisted death from six months to twelve, and remove unnecessary waiting periods. He told MPs:

“I always say to people, we do not know they have six months left to live until they have six weeks left to live. And we as oncologists know that in the matter of one CT scan, we can change a person’s prognosis from 18 months to three months and all of a sudden they see their life ending and then they begin an application that takes a month to apply.”

“My recommendation has always been to increase the prognostic eligibility criteria from 6 to 12 months, and to reduce the waiting periods that patients will place on themselves regardless of the legislative requirements”

Dr Greg Mewett supported this point, saying:

“We all know patients with all sorts of diseases can lose their cognitive abilities. We don’t see that as logical or reasonable. One of the things we are considering is recommending that the prognosis is changed to 12 months for all, which is in fact what Queensland legislation for, that a 12 month prognosis is reasonable for a range of reasons.”

Session 2:

The second session saw a range of experts with different specialities around disability. 

• Professor Tom Shakespeare CBE FBA (London School of Hygiene and Tropical Medicine),
• Dr Miro Griffiths (University of Leeds),
• Yogi Amin, National Head of Public Law and Human Rights, Irwin Mitchell
• Chelsea Roff (Eat Breathe Thrive)

Citing his quality research with disabled people, Professor Tom Shakespeare, told the Committee:

“I’m here to say that most disabled people support the Bill. There are some very vocal people who oppose it and they have every right to do so.

This Bill is restricted to terminal illness which is a very good thing. This is relevant to people who are dying already, it defines terminal illness very clearly. Mental illness cannot be the sole criterion so that would rule out people with eating disorders.

I would like to see better palliative care, more hospices, and more options for terminally ill people. This should be a tool in the toolbox for people who have terminal illness. They may not select it but knowing it’s there will give them a sort of insurance, knowing if they are facing death they have a way out that’s a quicker, better death if they choose that.”

Citing his 20 years of human rights work, Yogi Amin told the committee: 

“Professionals, doctors who are meeting individuals, understand what it means to identify safeguarding triggers and where referrals are required. That makes it quite strong in this particular Act.

The wording you have got in the Act I’m comfortable with. I say that as someone who has worked in the area for many years and lawyers will go into courts and pick over words but I think the way it’s drafted it is understood that there is voluntariness as drafted within the Bill.

And coercion, I don’t think additional words are necessary to describe what is required here. A doctor trying to understand that and then a court interpreting it, its pretty clear.”

Dr Miro Griffiths opposes the Bill. He disagreed with many of the safeguards and urged the committee to make it tighter. Raising issues with prognosis, Dr Griffiths said:

“[The Bill] relies on a doctor’s interpretation of prognosis, as the doctor assumes you have six months left to live the doctor may then raise assisted suicide, particularly when we have evidence of certain interventions of mishaps when it comes to prognosis when the individual can live for months or years.”

Chelsea Roff raised concerns about ensuring people with conditions like anorexia will not be able to access assisted dying. Roff made an impassioned plea to ensure those with reversible conditions like anorexia should not be included:

“You really have to get this right because those [vulnerable] people are depending on you.”

Kim Leadbeater MP confirmed this will not be the case, but asked for suggestions of amendments that could be made to provide further reassurance. Amin backed up the claim, saying:

“It will be clear. Anorexia, I don’t consider it to be coming into a terminal illness unless it is right at the end of life, and that doesn’t fit within the parameters of this act. And then you’ve got the Mental Health Act.”

Claire Macdonald, Director of My Death, My Decision says:

“MPs must listen to the international evidence, that is overwhelmingly in support of compassionate assisted dying laws. In every jurisdiction that has an assisted dying law, the public supports it disabled people support it,, it’s safe and it’s working.

We must use this golden opportunity to learn from international experience to make laws more compassionate. People who are dying and people who are suffering want that choice and dignity”

Introduced by the Labour MP Kim Leadbeater MBE, the Bill will allow adults who are terminally ill with six months or fewer left to live to ask for help to end their own lives. In November, MPs voted on the principle of this legislation, passing the second reading 330 votes to 275. The Bill is currently in the Committee Stage, where it will remain for several months of scrutiny before a final vote in the House of Commons next year. 

The Bill applies to England and Wales only. A private member’s bill in Scotland by Liam McArthur MSP has been introduced in the Scottish Parliament.

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.

 

This afternoon, the Committee which is examining the Terminally Ill Adults Bill, heard evidence from palliative care, and legal and international experts.

Our summary of the morning session is available here, but here is our summary of the afternoon session:

Session 1:

• Dr Rachel Clark, Palliative Care doctor 
• Dr Sam Ahmedzai, Emeritus Professor at the University of Sheffield
• James Sanderson, CEO of Sue Ryder, 
• Dr Sarah Cox, President of Association of Palliative Medicine

This session saw a range of reviews looking at the state of palliative care in the UK and whether individuals can make an informed decision about assisted dying if there’s not currently uniform equality of access. 

Dr Sam Ahmedzai said:

“British people have had that option for many years since Switzerland offered it. It’s clear, it’s selecting our people who are better off, and more functionally capable. They can do that, so it discriminates against disabled people who go long before they need to. They need to because they mostly want to go on their own without dragging relatives along so it’s doubly damaging for families because they have to say goodbye long before they have to do that.”

Dr Rachel Clark told MPs:

“If there is one thing that I would say to the Committee about making the bill as robust and strong and safe as possible. Please consider seriously the matter of education and training from day one of medical school and onwards. Death is at the periphery of a medical school curriculum, you might get a week of palliative care in five years”

James Sanderson said:

“Increasingly hospices are reading beyond the walls of the hospice into the community, people want to die at home, supporting people at home enables us to go out into the community.”

Dr Sarah Cox said:

“I accept there will be people even with a very good palliative care system who will still choose assisted dying. We currently don’t have the palliative care system that we need and that’s what concerns me.” 

Session 2: 

• Sir Max Hill KC,
• Alex Ruck Keene KC (Hon),
• Sir Nicholas Mostyn

Sir Max Hill told MPs that in his experience of working as Director of Public Prosecutions, he oversaw a number of cases to do with people travelling to Dignitas. He told MPs

“In each of the 27 cases I considered the deceased individual was already dead and that is when the scrutiny started. A major advantage of this Bill is that would be reversed and scrutiny would be before death.”

Sir Nicholas Mostyn told MPs that he may still have to go to Dignitas, even if the Bill passes. He told MPs:

“I fear that I am one of the people who has to go to Dignitas, and frankly I can afford to do that, because this bill is never going to provide an assisted death for me. 

I’m not going to be graphic about what the advanced stages of Parkinson’s are like, but the medical members amongst you will be able to describe what is likely, not definitely, but likely to await me. It is either going to be a poor death here, or to go somewhere like Dignitas. I would be very surprised, if my children drove me to Calais, and then drove me onto Zurich, I would be very surprised if any prosecution ensued…” 

A large part of the session focused on the legal aspects of the Bill, including if it could be challenged in the courts.

Alex Ruck Keene KC said: 

“We get into this enormous argument about “is it inevitably discriminatory?”, and courts today have been very clear we are not going to get into it, it’s for parliament to decide whether or not to make assisted dying legal.”

“Once it has been made legal for some but not others, there’s a difference in treatment. Whether it is discriminatory, and contrary to an article in the ECHR, depends on whether that difference is justified.

Parliament needs to be very very clear why, if you’re going to limit this, why it could be explained to somebody that you are not eligible and that it is a difference in treatment but it is perfectly justified.”

The session also went into depth about the current clause in the Bill that mandates the patient seek approval from the High Court. Committee members pressed the experts on whether other potential systems were workable, such as panels and tribunals. 

Session 3:

• Dr Ryan Spielvogal (Senior Medical Director for Aid in Dying Services, Sutter Health, USA),
• Dr Jessica Kaan (Medical Director, End of Life Washington)

On concerns about coercion, Dr Ryan Spielvogal, Senior Medical Director for Aid in Dying Services in California, told MPs:

“I’ll tell you in practice it just doesn’t happen. So I’ve seen assisted dying laws go into practice across numerous states. I have helped many many people through this process, I have never seen a case of even suspected coercion.

People are just not that good as actors. We get the family out of the room, we dig deep into their concerns and their justifications and reasoning behind their choices. It is often extremely crystal clear. They are focused on their quality of life, they are focused on their suffering.

‘I don’t ever get the sense from them, the family, or doctors, or anyone are coercing them into a decision. If anything, I’ve seen it many times the other way around. The patient is ready to let go but the family is not ready to let go, and they put various degrees of roadblocks to the patient accessing it.”

Dr Jessica Kaan, Medical Director of End of Life Washington, reinforced these claims. She told MPs:

“I would echo those comments. We are trained to assess capacity in big ways and small ways, throughout our medical training. 

‘Virtually all of the time it is the opposite way around, where the family are trying to coerce or convince someone not to make this choice… I have also never come across a case where I felt a patient was being coerced into this decision by a family member.”

Claire Macdonald, Director of My Death, My Decision says:

“It was very reassuring to hear from the American doctors who work extensively on assisted dying that the work they do is rewarding – and that they have no concerns over coercion. They also stressed that doctors should freely be able to discuss assisted dying with patients and their families”.

What’s Next:

This was the second oral evidence session of the day. These evidence sessions will continue throughout Wednesday and Thursday, then followed by line-by-line scrutiny of the Bill, where a committee of MPs will look at the details and suggest changes. 

Introduced by the Labour MP Kim Leadbeater MBE, the Bill will allow adults who are terminally ill with six months or fewer left to live to ask for help to end their own lives. In November, MPs voted on the principle of this legislation, passing the second reaching 330 votes to 275. 

The Bill applies to England and Wales only. A private member’s bill in Scotland by Liam McArthur MSP has been introduced in the Scottish Parliament.

Notes:

Members of the MDMD team, as well as individuals affected by the current law on assisted dying, are available for interview upon request

For further comment or information, media should contact Nathan Stilwell at nathan.stilwell@mydeath-mydecision.org.uk or phone 07456200033.

Media can use the following press images and videos, as long as they are attributed to “My Death, My Decision”.

My Death, My Decision is a grassroots campaign group that wants the law in England and Wales to allow mentally competent adults who are terminally ill or intolerably suffering from an incurable condition the option of a legal, safe, and compassionate assisted death. With the support of over 3,000 members and supporters, we advocate for an evidence-based law that would balance individual choice alongside robust safeguards and finally give the people of England and Wales choice at the end of their lives.