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
12pm
There’s a lot of worry in the committee about embroidery, and it is a big dividing line. Not about the MPs’ attitude to sequins or back stitches. It’s their jargon for over-ladening a bill with unnecessarily protection that actually makes it worse in practice. Labour, pro-bill MP Dr Simon Opher put the argument very clearly.
“As the bill is drafted, it’s simple but very, very effective,” he began. “I would also say something about ending treatment and its effects. These are the discussions we have with patients. We say, for example, ‘You can go for further chemotherapy, but it may cause you to lose your hair, it has other side effects, and it might only give you another couple of months.’ These are the sorts of discussions we have as medical practitioners.
“What guides us as doctors is the General Medical Council (GMC), which sets standards for the profession. If we are hemmed in by legal parameters, we risk breaking the law without realising it. If we set too many legal constraints around medical consultations, patient care will suffer because doctors won’t have the freedom to offer the best advice.”
He added: “I think that if we add too much embroidery to this, it will not be a safe bill. That has been the case throughout its drafting.
“Good medical care is based on explaining treatment availability, its likely effects, prognosis and the chance that it may be either longer or shorter than expected. All of this is based on good clinical care.”
11.30am
There has already been a series of rapid-fire votes on various amendments—all of which went the expected way: eight for tighter guidelines to 13 against stricter rules. One MP, Conservative Kit Malthouse, asked if there was any way of stopping people misrepresenting what the committee had decided, for instance if they said the committee had rejected the views of those representing people with Down’s syndrome.
Leading bill opponent Danny Kruger, and the probable target of the remarks, replied: “We must accurately reflect the debates that take place in this House. For my part, I will not be commenting externally that the House has disregarded people with Down’s syndrome, and I respect the point made by the minister and the honourable lady that there will be an effort to engage with the Down’s syndrome community in the drafting of further consultation and guidance. I appreciate that point.
“Nevertheless, the committee did choose to exclude an amendment that would have required the government to put specific protections for the Down’s syndrome community into the bill, as my right honourable friend, the member for Hampshire, has specified. I will be making that point, but I also understand the importance of accurately and fairly reflecting the amendments in this group.”
No gagging clause for MPs then.
11am
This morning the committee is looking at various plans to impose gagging clauses on doctors, limiting how they raise the subject of assisted dying with patients, and with which patients. The minister for social care Stephen Kinnock opened up, setting out the government’s basic provision that existing rules and regulations worked well and should be tinkered with as little as possible.
Conservative MP Rebecca Paul began to make a broad point: “During these proceedings, there has been a tendency among some speakers to describe assisted dying as another type of treatment or healthcare option offered by medical practitioners rather than as a completely separate and distinct matter. I have grave concerns about this. The legal norm and guidance are that patients should be offered all reasonable medical treatments. A medical treatment is defined as something that combats disease or disorder. It is fundamentally about healing, symptom relief, recovery and cure. Straight away, we have a conflict. Assisted dying ends the life of the person; it is not a treatment in the usual sense of the word.”
But the chair interrupted, saying she had to talk about the specific amendments rather than make general points. Looking somewhat frustrated and bewildered she sat down.
Kim Leadbeater quoted the British Medical Association (BMA) at length. “Doctors and healthcare professionals, like any other group of people, hold a range of views on assisted dying. We only have to reflect on the oral and written evidence presented to the committee to see that. The BMA holds a neutral position on assisted dying, and in their oral evidence to the committee they made it clear that they wanted an opt-in model for doctors, allowing them the right to decline participation in assisted dying for any reason. These requests have been incorporated into the bill.
“It is also worth noting that in their submission the BMA are very clear in opposing amendments, including 342, which we will come to later. They argue that adding prohibitions or limitations in the bill would create uncertainty and legal risks for doctors, potentially inhibiting effective doctor-patient communication. The BMA welcomes the bill’s provision that a doctor is not under a duty to raise assisted dying, which they see as necessary to avoid any suggestion that doctors have a legal obligation to do so. They are concerned that these amendments will remove that provision, leaving doctors in a position of legal uncertainty.”
4th March
10am
The third week of detailed scrutiny of the bill gets underway this morning. The first two weeks were gruelling line-by-line trench warfare, with opponents in a losing battle to amend the bill. Today and tomorrow are unlikely to be any different.
The bill’s sponsor Kim Leadbeater has reacted with this appeal to MPs: “Dying people and their families must be at the heart of this process. It is for them that I and the committee as a whole are putting in so much time and effort into making sure the bill is workable. It is essential we keep in mind the harm inflicted on terminally ill people and bereaved families by the law as it stands, so we can work together to produce a better, safer and more compassionate law than we have at present.”
You can watch proceedings here—but don’t worry, I’ll do it for you and will report back soon.
