A consummation devoutly to be wished

The Terminally Ill Adults (End of Life) Bill 2024 gets its second reading in the House of Commons next Friday.

This Private Member's Bill, commonly referred to as the assisted dying bill, was tabled by Labour MP, Kim Leadbeater, sister of the murdered MP, Jo Cox. It is the first opportunity for MPs to debate this controversial issue since 2015, when Rob Marris MP's Private Member's Bill failed to make it onto the statute book. I sincerely hope Ms Leadbeater's attempt will fare better.

Having read through the explanatory notes prepared by her to accompany her Bill, they seem to me, as a layman, to be thorough, reasonable and practicable and I urge anyone interested in this subject to read them. My only doubt was over the clause allowing a proxy to sign the consent form if the patient is unable to do so. This was not a concern over fraudulent signing, rather over how a patient unable to write his or her signature would be able to self-administer the fatal substance.  

But I am not an MP, a lawyer or a medic and the arguments from those who are will doubtless be learned and powerful, which is why I hope MPs will reserve judgment until having heard all the arguments, pro and con, advanced during next Friday's four-hour debate, putting their pre-conceived notions aside. Unfortunately, some MPs have already voiced their reservations and objections publicly where it might have been wiser to keep their counsel until listening to and speaking in the debate. 

It was particularly surprising that the Secretary of State for Health, Wes Streeting MP,  chose to preempt the debate by talking about "the chilling slippery slope argument" and raising doubts about the cost implications for the NHS. However, it will be a free vote, not subject to a government whip, and in its first reading he voted in favour of the Bill. Now he says the state of palliative care has led him to change his mind. Maybe he will change it again having listened to the second reading debate.

Doubts have also been voiced by two senior MPs on opposite sides of the House, the Mother and Father of the House, Diane Abbott (Labour) and Sir Edward Leigh (Conservative). Despite their polar opposite political views on most issues they released a joint statement to The Guardian expressing concern about putting "vulnerable minorities" at risk, arguing that the process for bringing the bill to Parliament had been "rushed", with scrutiny of its contents "being limited". 

And it is arcane Parliamentary procedure that could ultimately lead to this well-intentioned Bill's downfall. If it is felt that the government has allotted insufficient time for proper scrutiny and debate and is unwilling to sacrifice any of its own time to the process then, as I understand it, being a Private Members Bill, only one MP at the close of the session has to shout "object" for it to fall (Sir Christopher Chope MP (Con) - he of the 'up-skirting' debate furore and a known opponent of assisted dying - springs to mind).

Although the Greek Hippocratic Oath is no longer taken by doctors its 'First, do no harm' principle still informs modern medical ethics. The question in relation to assisted dying must surely be whether more harm is done to a terminally ill patient suffering excruciating pain and distress by denying death at their informed request or by enabling it. The "slippery slope" argument (alluded to by Wes Streeting) is often cited by opponents and yet it is clear that robust oversight and scrutiny needs to be put in place, which Kim Leadbeater's Bill envisages. 

The fact that current safeguards are failing the vulnerable in the health and care systems, as witness the shocking Lucy Letby case and others where whistle-blowers were consistently ignored or side-lined over a long period of time, is not a good enough excuse for not introducing cautious legislation to enable assisted dying.

Another nine-year hiatus would be unforgivable.

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