Four groups negatively affected by the assisted dying bill

Ineffective scrutiny of the bill can be explained by two reasons. Firstly, the committee membership is skewed 18 to 5 in support of the bill, including from both the justice and health ministers attending the committee. Secondly, the bill sponsor along with the 17 other supportive MPs have dismissed the many concerns raised by palliative care, legal or health specialists as obstacles to individuals exercising personal autonomy. 

As a result, committee members in support have designed a broad bill that provides inadequate safeguards and therefore compromises future medical care and practice for four groups of people. 

As the Evangelical Alliance we are vehemently opposed to this bill and communicated as such, whether speaking with MPs or in our written submission to the committee. We continue to set out our theological convictions in the sanctity and value of every life and to demonstrate the risks through sharing examples from countries like Canada, where promises of safeguards and restrictions in the beginning have progressively weakened over time.

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Below is an overview of how the bill fails to provide adequate safeguards to four groups with complex health needs.

1. The elderly are at an increased risk of being coerced into an assisted death

In the early sessions of the committee, several amendments were tabled to strengthen the wording around detecting coercion amongst different vulnerable groups, particularly the elderly. A conservative estimate in the UK is that half a million people over the age of 65 experience abuse. All proposed amendments seeking to protect the elderly were rejected.

The committee rejected an amendment for hospices and care homes to be exempt from facilitating an assisted death.

2. Women with an eating disorder or in an abusive relationship are left vulnerable

In January, several witnesses gave evidence to the committee outlining an international precedent where women with anorexia or with an eating disorder were considered for an assisted death pathway. 

The Eat Breathe Thrive research report found sixty women with an eating disorder died by assisted dying in Colorado, California and Oregon because they refused food and drink and were considered ​“terminally ill”. Proposed amendments for an exemption for individuals with living with anorexia or an eating disorder were rejected.

Similarly, domestic abuse services – led by women of faith and none – have written to the committee to expressing deep concern that the bill in its current form does not account for coercive control in abusive relationships and fails to protect women from being unduly influenced or pressured into an assisted death. 

Several amendments were tabled to strengthen wording on coercion and control but the only concession from Ms Leadbeater was that a co-ordinating doctor would receive (unspecified) training in coercion and control.

3. For those living with a disability, access to care and support is squeezed

Damian Hinds, Conservative MP for East Hampshire, tabled an amendment for the safeguard and protection of people with Down’s syndrome from an assisted death. This was voted against 13 – 8.

Paralympian medallist Baroness Tani Grey-Thompson spoke in The Times about how the government’s welfare reforms could leave ​“disabled people feeling forced to end their lives under a new assisted dying law”. This would be an absolute stain on our society if such a bill were to pass at a time when the health, social care and welfare system are deeply broken. 

3.Ethnic minorities are deeply concerned by proposals to legalise assisted dying

NHS England, health charities and the government are all in agreement on the deep health inequalities amongst minority ethnic communities across different diseases and treatment pathways. 

Dr Jamilla Hussain gave oral evidence on the Terminally Ill Adults (End of Life) Bill in February and has also fed into the Palliative and End of Life Care Commission inquiry. She described from her research how patients living in socially deprived and racialised communities tend not to access end-of-life care support, are less likely to be happy with the care they received and tend to have worse health outcomes.

The introduction and embedding of an assisted death provision within public and private health and social care settings complicates this further.

By the time you read this briefing, it is probable Ms Leadbeater would have presented her amendment ​“voluntary assisted dying service: England” to the committee and feature in the report stage version of the bill for wider MPs to discuss in April. 

This amendment is the most explicit in what is required to embed an assisted death pathway into the NHS and social care sector. In short, it replaces founding principles in the 1946 National Health Service Act for the government ​“to improve physical and mental wellbeing in England and Wales” through prevention, diagnosis and treatment of illness, ie, a duty to protect life. Instead, this amendment would compel the health secretary to make ​‘regulations’, ​‘provisions’ and ​‘arrangements’ for assisted dying across private and public health. 

The current health secretary Wes Streeting has expressed his opposition and voted against the bill at second reading. Such an amendment undermines his department’s long-term strategy to reform the NHS and social care and wrongly legitimatises ​‘choosing death’ as a treatment option. If the bill becomes law, it will entrench inequalities and reduce health outcomes for these four groups for decades to come.

The committee stage concludes this week, when a revised version of the bill, along with a government impact assessment, will be published in time for the third reading debate on Friday 25 April. We expect a vote will be early May. Let’s continue to pray that the will of the Lord will prevail.