Assisted Dying Bill: Doctors required to discuss other options with patients

Doctors would be required to set out a range of other options available to a patient if they discuss assisted dying, the MP behind the Bill has proposed, in an effort to ensure “the most rigorous safeguards” for any new law.

Kim Leadbeater has written to MPs, stressing that it is important to “enhance” the proposed legislation where necessary.

It follows three days of evidence from various experts including England’s chief medical officer Professor Sir Chris Whitty, as well as other medical and legal professionals.

Among some 50 witnesses appearing before a committee last week, learning disability charity Mencap warned of their fears around how the subject of assisted dying would be broached with people.

Ms Leadbeater has now proposed a number of amendments around the role of doctors and the training for those who would provide the service.

Under the changes, she proposed a requirement that doctors, in their initial discussion with a patient, could not raise the provision of assisted dying on its own.

They would have to set out any treatment and palliative, hospice or other care available, including symptom management and psychological support.

Ms Leadbeater said the Bill gives “an opportunity to develop the very best end of life care, conversations and choice with ‘gold standard’ training”.

As part of her amendments, medics would be required to produce a detailed report into every person who applied for assisted dying, including an assessment of both mental capacity and coercion, and those willing to provide assisted dying would need training in assessing capacity and identifying coercion.

Ms Leadbeater has also proposed that experts in capacity and coercion, as well as the human rights watchdog the Equality and Human Rights Commission (EHRC) would have to be consulted before training and other regulations were put in place.

The committee of MPs set to scrutinise formally the Terminally Ill Adults (End of Life) Bill last week heard concerns from the EHRC around how different people’s rights might be affected by a new law.

Dan Scorer, head of policy and public affairs at Mencap, told MPs: “How that initial conversation, how it’s initiated, is potentially an extremely risky and dangerous moment for people with a learning disability who are terminally ill.”

He said there are concerns it could be “highly suggestive and push people in a course that they don’t, they may not want to go down” and that Mencap believes initial conversations would have to be “incredibly well supported and structured” with an advocate present.

In her letter to all MPs, Ms Leadbeater said the Bill must be “workable and legally sound in all respects”.

She wrote: “It is extremely important to get the details of the legislation right, and enhance it where necessary, particularly with regard to safeguards, but we must also not lose sight of the fact that the current legal situation is unacceptable and deeply problematic, inflicting terrible injustices on terminally ill people and their families at their most vulnerable time.”

She repeated her desire “to give terminally ill people choice, autonomy and dignity whilst ensuring the most rigorous safeguards are embedded in the legislation”.

The Bill could see terminally ill adults in England and Wales with under six months to live legally allowed to end their lives, subject to approval by two doctors and a High Court judge.

The committee is expected to start line-by-line scrutiny of the Bill on February 11.

No date has been given yet for the Bill to return to the Commons for further debate by all MPs at report stage but it is likely to be towards the end of April.

It will face further scrutiny and votes in the House of Commons and the House of Lords, meaning any change in the law would not be agreed until later this year at the earliest.

After that it would likely be at least another two years before an assisted dying service was in place.