This is Prospect’s rolling coverage of the assisted dying debate. This page will be updated with the latest from our correspondent, Mark Mardell. Read the rest of our coverage here
11th February
Kim Leadbeater is taking a scalpel to her own bill to remove one of its most widely criticised proposals: that a High Court judge should be in charge of reviewing each and every application for an assisted death. Friend and foe of the bill alike all seemed to agree that it was wildly impractical, given the current stresses and strains on the judiciary and the legal system. As I predicted, after listening to the legal evidence, the High Court judge will be replaced by a panel of experts. Chaired by, yes you guessed it, an ex High Court judge.
Just hours before the committee is due to meet for the first time to go through the bill line by line, her office announced the new plan for a “judge-led Voluntary Assisted Dying Commission that would give a greater role for experts such as psychiatrists and social workers in overseeing applications”.
“Under an amendment expected to be tabled later this week, the Commission would be chaired by a High Court judge or a senior former judge. It would appoint a multi-disciplinary panel of experts to examine every request for assistance. Permission would only be granted if the panel agreed.
“The chair of each panel would be a retired High Court judge, King’s Counsel or a person with similar qualifications. The panel’s decision could, if required, be reviewed by the High Court itself.”
Leadbeater is quoted as saying: “Many of those who gave evidence to the committee, either in person or in writing, recommended an enhanced role for professionals such as psychiatrists and social workers. I agree that their expertise in assessing that a person is able to make a voluntary decision free from coercion or pressure, in addition to the necessary legal checks, will make the system even more robust.”
The release gives further detail. “Each panel would consist of three members, chaired by a senior legal figure. It would be a wholly independent public body responsible for checking that all the requirements specified by law had been met. In particular it would need to be satisfied that the decision to request assistance was voluntary and not the result of pressure or coercion, and that the person had the capacity to make that decision.
“The two independent doctors would be required to submit reports on each applicant to the Commission along with copies of all supporting documentation. These would enable the panel to decide whether to carry out further enquiries, including hearing from the applicant, one or both doctors and anybody else they believed could help determine whether the person had a ‘clear, settled and informed wish to end their own life’ made voluntarily without coercion or pressure by any other person, under the terms of the legislation.
“The Commission would report annually on the number and nature of all applications referred to it, whether they were approved or rejected.”
It is doubtful that this will satisfy the bill’s most passionate opponents but it does show Leadbeater’s willingness, indeed enthusiasm, for making the bill as bomb-proof as possible, ensuring that it won’t fall victim to friendly fire.
10th February
A piece of smart detective work by an Australian coroner following a particularly sad suicide has led to a review of the laws in Victoria state governing assisted dying—and might lead to the sort of changes some campaigners here would like to see to the Leadbeater bill.
Simon McGregor, a coroner in Victoria state, was examining the grisly case of an 82-year-old man who’d suffered a serious stroke but was turned down for voluntary assisted dying (VAD). He stabbed himself in the leg and bled to death.
Mr McGregor said the man would not have been eligible for VAD in Victoria, which reserves the procedure for people suffering from an incurable, advanced and progressive disease expected to cause death within six months. This led the coroner to order an investigation into other similar deaths.
They found nine cases of people who had tried to access VAD but were refused because they did not meet all the relevant criteria. Eight subsequently took their own lives—the ninth possibly killed themselves but the coroner could not be sure (which may be why the number is widely reported as eight, rather than nine).
Mr McGregor said: “A recurring theme throughout many of these deaths was the impact that voluntary assisted dying refusal had on the deceased.
“Family members often reported that when people believed they would have access to voluntary assisted dying they maintained hope that they would be able to exercise control over how they died.
“When their access to voluntary assisted dying was refused, their consequent despair and frustration contributed to their decision to take their own life.”
He concluded: “I understand the Voluntary Assisted Dying Act was the result of a thorough process through which the executive and legislative arms of government debated conflicting legal, ethical and clinical considerations. The circumstance of an individual suicide, or even 10 suicides, may not carry much weight in comparison. However, I’d ask the Voluntary Assisted Dying Review Board to remain open to considering this finding as part of a developing body of evidence about whether there may be opportunities to improve the operation of voluntary assisted dying in the state.” It has been reported the board is now doing that, but the process is lengthy and subject to political whims.
There are campaigners here who’d like the Leadbeater bill to drop the six-month requirement or, at the very least, allow exceptions in certain cases. After all, the Scottish assisted dying bill has no time restriction at all, but simply states that the condition must be an unrecoverable one that can reasonably be expected to cause premature death.
There’s been much debate about how difficult it is to predict death with precision, and the looser criteria seem to make sense to me—but it’s not going to happen for the Leadbeater bill. Chief medical officer Chris Whitty has supported the six-month limit, and I’m told campaigners believe Leadbeater has no interest in widening the bill or doing anything at the moment that might attract even more opposition. It already faces plenty.
