Doctors will not be allowed to discuss assisted dying with patients without first explaining available palliative care and other options, under an amendment tabled to the controversial bill.
The draft legislation, which would allow terminally ill adults to end their lives, was backed by MPs in a vote in November and is currently going through the ‘committee stage’, where it comes under detailed scrutiny.
Kim Leadbeater, Labour MP for Spen Valley and the bill’s sponsor, proposed an amendment last week which ’emphasises that the initial discussion’ by a doctor ‘may not be conducted without also explaining and discussing’ the person’s diagnosis and prognosis, any treatment available and any palliative or hospice care.
During the committee stage, MPs and experts raised concerns about the ‘capacity’ and potential ‘coercion’ of those requesting assistance to end their life.
Ms Leadbeater’s amendment, intended to strengthen the safeguards around the initial discussion on assisted dying, has not yet been voted on by MPs.
Meanwhile, the bill’s sponsor has this week proposed removing High Court sign-off for assisted dying, which was a key feature of her bill, in favour of an expert panel which would include a senior lawyer, a psychiatrist, and a social worker.
A vocal critic of the draft legislation, MP Danny Kruger, said High Court approval had been a ‘key safeguard’ in the original bill.
‘Instead we have a panel, NOT including a judge, of people committed to the process, sitting in private, without hearing arguments from the other side. A disgrace,’ he wrote on X.
Under the current bill, two doctors would first need to assess the person and provide sign-off, but it states that doctors are not under ‘any duty’ to raise assisted dying with patients or to ‘participate in the provision of assistance’ if they do not wish to do so.
Current bill wording and amendment
Proposed amendment highlighted
Initial discussions with registered medical practitioners
- No registered medical practitioner is under any duty to raise the subject of the provision of assistance in accordance with this Act with a person.
- But nothing in subsection (1) prevents a registered medical practitioner exercising their professional judgement to decide if, and when, it is appropriate to discuss the matter with a person.
- Where a person indicates to a registered medical practitioner their wish to seek assistance to end their own life in accordance with this Act, the registered medical practitioner may (but is not required to) conduct a preliminary discussion about the requirements that need to be met for such assistance to be provided.
- If a registered medical practitioner conducts such a preliminary discussion with a person, the practitioner must explain to and discuss with that person—
- the person’s diagnosis and prognosis;
- any treatment available and the likely effect of it;
- any available palliative, hospice or other care, including symptom management and psychological support (and, accordingly, such a preliminary discussion may not be conducted in isolation from an explanation of, and discussion about, the matters mentioned in paragraphs (a) to (c)).
- A registered medical practitioner who is unwilling or unable to conduct the preliminary discussion mentioned under subsection (3) must, if requested by the person to do so, refer them to another registered medical practitioner whom the first practitioner believes is willing and able to conduct that discussion.
Source: UK Parliament
The committee stage has also covered the potential role of GPs, with the RCGP telling MPs that ‘the GP should not be part of the assisted dying service’, and instead there should be a ‘standalone service’ to which GPs can signpost patients.
Honorary secretary at the college Dr Michael Mulholland said: ‘We would say that GPs need to have a space where they can step away from it: that is the key point that we want to get across.
‘For those who want to take part, it may be that they decide to do it, but it would have to sit outside the core general medical services that we provide at the moment.’
Currently, the college’s position is to oppose any change in the law on assisted dying, but it recently surveyed members on the topic in order to establish whether it should retain this stance of opposition.
Findings from the survey, which closed on Monday, will be discussed at the RCGP Council on 14 March.
While giving evidence to the committee stage, England’s chief medical officer Professor Chris Whitty told MPs that GPs will require additional training to be able to fully support patients should the assisted dying bill pass.
The assisted dying bill’s current committee stage, which will determine the inclusion of amendments tabled by Ms Leadbeater and others, is expected to conclude by 25 April with another vote.
A version of this story was first published on our sister title Pulse.
