You can glean a lot from the way someone characterises their opponents in a debate. Do they engage with them constructively, assuming the best about their motives? Or imply they are acting out of bad faith? It’s telling that Kim Leadbeater, the MP who’s brought forward the bill to legalise assisted dying, seems to have gone for the latter approach.
There could not be more at stake: legalising the prescription of lethal drugs to terminally ill people raises the spectre of vulnerable people being wrongfully subjected to an assisted death with state assistance. It is critical that the bill’s proponents engage constructively with the doctors, psychiatrists, social workers, lawyers and domestic abuse experts who have this concern. Yet Leadbeater appears affronted by the opposition to her bill; she has characterised it as “noise”, described those who oppose her change in the law as unconstructive, and has complained about their “clear mobilisation”. (Yes, when people are worried that legislation could have tragic consequences, that’s what they do.) The implication seemingly being that, unless you agree with her on the principle, there’s no legitimate role for you in scrutinising her bill.
This attitude seems to be driving the way the bill’s proponents are approaching its scrutiny. Leadbeater picked the bill committee and on the opposition side left off seasoned MPs with relevant experience, such as the psychiatrist Ben Spencer, instead selecting a relatively inexperienced group. The committee heard just three days of oral evidence, heavily skewed to those in favour of the bill. It took no evidence from experts in domestic abuse, and had to be shamed into allowing the Royal College of Psychiatrists to give evidence. Almost 400 pieces of written evidence have been published just in the last couple of weeks; when are the MPs on the committee supposed to read and digest them? Meanwhile, the bill’s proponents appear to be cherrypicking evidence from those who agree with them while ignoring the medical experts pointing out the risks of their approach.
And now Leadbeater has abruptly proposed a big change to the bill that will almost certainly be rammed through, despite denying it was on the cards until the moment it was announced. Until last week the bill’s safeguards were talked up as the strongest in the world because assisted deaths would be signed off by a high court judge. This was criticised by legal experts both for and against the bill because the process was essentially a tick-box exercise, with the judge having no scope to hear cross-examination on whether the right decision has been made. For it to function as a safeguard, the judge’s role would have needed significant beefing up.
Leadbeater has watered it down by removing the judicial element altogether; instead, panels consisting of a senior lawyer or a judge, a social worker and a psychiatrist will sign off. They can sit in private; they don’t appear to have powers to compel witnesses to give evidence under oath; and not only is there no way for relatives to challenge approvals if they feel they have been given on the basis of incomplete evidence, there is also no obligation to let family members know, raising the possibility that someone’s adult child or parent might embark on an assisted death because they don’t want to be a burden, and the first their loved one hears of it is after they’ve killed themselves.
Her amendments also remove the role of the chief medical officer in monitoring assisted dying, replacing it with an assisted dying commissioner who has the dual job of appointing the panels and reporting on safety, marking their own homework. Neither panel members nor the commissioner will be acting in a judicial capacity, but this hasn’t stopped proponents dishonestly branding the proposal as “judge plus”.
Important opposition amendments that would strengthen the bill’s safeguards have already been rejected. There are more on the table, including requiring someone requesting assisted dying to have an independent psychiatric assessment, and opponents will try to remove the bill’s extraordinary provision that there should be no civil liability, including for negligence, for doctors prescribing lethal drugs to citizens. But unless something big shifts, the status quo will stand.
This approach appears to be underwritten by the prime minister. Keir Starmer has made no secret of the fact he supports this bill. Two ministers on the committee are voting with the bill’s proponents despite the government’s purported neutrality, rather than abstaining, as they ought. The government has said it will not publish an impact assessment, including cost estimates, until after committee stage, effectively handing its proponents a blank cheque, in sharp contrast to the frugality ministers are expected to exercise in other areas.
At the heart of this is a dispute about whether a neat line can be drawn around those making an autonomous, empowered decision to end their own life to relieve their suffering. The bill’s proponents believe against the evidence that this is relatively easy; its opponents believe people who are vulnerable through mental illness, abuse and poverty will inevitably be caught up in it. You can see this in the policing of language; proponents have tried to stop critics using the term “suicide”, with Kit Malthouse MP preposterously trying to redefine it as a “healthy person taking their own life”. Yet the government’s suicide prevention adviser is clear in his view that there is no clear line to be drawn between suicide and assisted dying.
If this bill passes, some people will be wrongly prescribed lethal drugs by the state. No state system of regulation is infallible: to take just one example, the Human Tissue Authority, with a considerably more independent assessment process than that proposed by this bill, has approved victims of organ trafficking for organ donation.
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The kindest reading is that the bill’s proponents feel so passionate about the rights of those whom it is designed to assist that they may have minimised its risks in their own heads. This would explain their flat-out denials that their bill is unsafe, and their failure to engage with genuine attempts to try to improve it by those who might oppose it but would rather its risks were reduced if it does become law.
If it continues, the hyper-partisanship this benevolent self-delusion has produced will mean people will suffer wrongful deaths, and the buck for that doesn’t stop with Kim Leadbeater, but with Keir Starmer himself.