Assisted Dying – Lack Of Safeguards To Protect Vulnerable People Is A Valid Concern…

Donna Moore is from Belfast, and works as an administrator.

Northern Ireland remains an outlier in the field of assisted dying – while the Republic of Ireland, Scotland, Wales, and England have all made moves towards legalising the practice, none of the major political parties in the six counties have any plans to introduce legislation on the issue. And that might be for the best.

Before continuing, it is likely helpful to clarify the terms used in this issue (with credit to the BBC).

Assisted dying: Refers to someone who is terminally ill receiving lethal drugs from a medical practicioner – the terminally ill person self-administers the drugs.

Assisted suicide: Intentionally helping someone to end their life, even if they aren’t terminally ill. This can involve providing lethal drugs, but also covers helping someone travel to a jurisdiction where this practice is legal.

Euthanasia: Deliberately ending someone’s life to relieve suffering by administering lethal drugs. This can be voluntary (where a patient consents) or non-voluntary (where a patient cannot consent – if, for example, they were in a coma).

Much of the reportage has employed the term ‘assisted dying.’ Among those using this term is the MP for Spen Valley, Kim Leadbeater, who is responsible for proposing this legislation through the Terminally Ill Adults (End of Life) Bill. In an October 2024 article which she wrote for the Guardian, Leadbeater made her case:

“One of the reasons I’m in politics is because I believe everybody should be given the chance and opportunity to live their best possible life for as long as they can. But I also strongly believe that we should give people facing the most unbearable end to their life a choice about what that end is like.”

A month later, MPs voted on the proposal to legalise assisted dying in England and Wales, with 330 in favour and 275 against on the second reading. In Northern Ireland, the issue is a devolved matter, and while none of the major parties have plans to introduce similar legislation, how things are unfolding in England and Wales should give pause to many here.

While Leadbeater gives the appearance of nuance in her Guardian piece, she has also claimed that her proposals include “the strictest safeguards anywhere in the world.” However, this claim has been undermined by an amendment to the original proposal – an amendment made by Leadbeater herself, and approved by the MPs reviewing the bill.

Under the original proposal, a High Court judge would have to approve requests for an end-of-life solution. Leadbeater’s amendment would permit a three-person panel comprising a senior legal figure, a psychiatrist, and a social worker should have oversight instead.

Leadbeater’s justification for the amendment was that there were concerns that the High Court would not have the resource to render a judgment on each individual case. Worryingly, she also stated that there were concerns that the bill had “too many safeguards.”

“I’ve had e-mails saying why are you making this so difficult? Because we must remember at the heart of this is a terminally ill person who wants choice.”

However, while more experts being involved is a good thing, the lack of judicial impartiality that can result from this, coupled with the lack of judicial safeguards, is a concern.

It must also be remembered that even before Leadbeater’s proposal was put forward, most experts had grave misgivings about assisted dying. A Doctors.net.uk survey carried out in November 2023 found that a majority of respondents felt that “a physician assisted dying (PAD) law would negatively impact the medical profession.” And in the wake of the November vote on Leadbeater’s bill, the Royal College of Psychiatrists issued a statement which stated the following:

“There are a number of unanswered questions about whether it is possible to provide adequate protections and safeguards for all individuals and, if so, what these measures would be. The College believes these details must not be left to the relevant professions to be dealt with through amendments to existing or new codes of practice.

“As the Bill progresses to the next stage, RCPsych is urging parliamentarians to carefully consider outstanding questions about whether a person’s capacity to decide to end their own life can be reliably assessed and the adequacy of consent as a safeguard against coercion in this context.

“It is also important to consider the potential implications for those with mental disorders, intellectual disabilities and neurodevelopmental conditions (who do not always have good access to palliative care), as well as on suicide prevention efforts, palliative care and the NHS.”

Small wonder that Michaela Hollywood, a NI citizen with spinal muscular atrophy, is opposed to the bill. She is concerned that the bill is being introduced “without the proper scrutiny and the proper time to have a proper discourse about it.” She adds that the “protections for disabled people just are not enough.”

“What we need to be focussing on first is proper care, resourcing the NHS appropriately, and then we can have the discussion about what the right way is to provide choice, because there’s no choice without care, and at the minute we’re trying to do choice without care.”

Unfortunately, activist groups such as CARE (Christian Action, Research and Education), who oppose the bill, and My Death, My Decision, who support it, have taken up space on this issue across the UK, and have been promoting themselves actively in Northern Ireland in the service of their respective agendas.

Policy makers are often ill-served listening to agenda-driven activists, and would be better off paying heed to experts such as doctors, psychiatrists, and those directly affected by such proposals instead. If the major parties do elect to introduce legislation on this matter, let us hope they ignore the activists and listen to those people who know what they are talking about.