Committee says no

The consistent rejection of sensible safeguard amendments by Kim Leadbeater’s Bill Committee feels like a uniquely bleak Little Britain sketch.

Protect people who feel they are a burden on others from accessing assisted suicide?

Committee says no.

Assessment of a patient’s capacity to choose assisted suicide must be beyond reasonable doubt?

Committee says no.

Explicitly prevent patients with anorexia from qualifying for assisted suicide?

Committee says no.

And how about we require all patients requesting assisted suicide to first meet with a palliative care doctor so they understand all the alternatives?

No. No. No.

With a single exception in which there was a one vote difference, every vote against a meaningful safeguard has been fifteen noes to eight ayes, indicating just how stacked with ideological supporters of assisted suicide the Committee was from the beginning. The Bill supporters’ contributions and votes give every indication that they are not overly concerned that some vulnerable people who have not received all the facts may slip through the net and die early, just as long as the Dame Esthers get their boutique deaths.

They think medically assisted suicide should have similar thresholds of understanding to an appendix being removed

The rejection of the need for a consultation with a palliative care specialist particularly irks me as a doctor who provides palliative care, as this whole debate has shown how many misconceptions our MPs and the public have about the symptoms people typically experience at the end of their lives and our ability to control them. At Second Reading, MPs were told how assisted deaths would primarily be for patients dying in uncontrollable pain, giving the impression that pain is the norm at the end of life. The reality is that most deaths do not involve significant pain and for those that do, all but a small number of patients respond very well to good quality palliative pain management.

MPs such as Kit Malthouse and Richard Tice have described patients “drowning in their faecal vomit” whose only way out of suffering and indignity would be state-assisted suicide. But any palliative care doctor could have told them that with the right resources, any prospect of such a death could be prevented with relatively simple hospice interventions.

I have noticed a lot more anxiety amongst my patients about whether they will suffer when they die since this debate started.

The fact that those fifteen “Committee says no” MPs, including Malthouse and, incredibly, the Palliative Care minister Stephen Kinnock, rejected this amendment, demonstrates they have very little insight into how patients under the stress of a terminal diagnosis could make an extremely grave decision based on an incomplete picture of their future.

It is a maxim in medicine that the more information and understanding we arm our patients with, the better decisions they make for themselves. So, why not bake that maximum patient education into this bill?

From what I can understand from Danny Kruger’s questioning of the “Committee says-no” brigade, they don’t think that assisted suicide should be treated particularly differently from any other “medical” decision a patient might make. In other words, medically assisted suicide should have broadly similar thresholds of understanding and capacity to an appendix or even an ingrown toenail being removed.

If this is how the drafters of the Bill see assisted suicide — as a therapy option like any other — and if the Bill remains as it is reflecting a broad approach, then the NHS will likely oversee a Pandora’s box of horrors such as those that have taken place in Canada.

If the Committee keeps saying no to sensible safeguarding amendments, then MPs should in turn say no to the Bill at Third Reading.