Anselm Eldergill, 'A time to live, a time to die?' (27/11/24)
Voluntary euthanasia In relation to the Terminally Ill Adults (End of Life) Bill 2024, this briefing note argues that "much more careful thought is required before we open this Pandora's Box" and that a more sensible approach, prior to legalising state- and physician-assisted death, would involve a Royal Commission or Law Commission report, or similar, with extensive consultation and reflection, accompanied by a government commitment to place a Bill drafted by the Commission before Parliament on a free vote. Problems mentioned include: (1) there is a risk that changing perceptions of doctors and nurses will undermine trust in them; (2) the 'six-month rule' suggests a degree of prognostic reliability that does not accord with reality; involves a social class bias; means the legislation would not cater for most of the test cases that have come before the courts; and would prolong the suffering of some while allowing others to die for reasons unrelated to life expectancy and even though they are not physically suffering and their death is likely to be painless; (3) a "slippery slope" of extensions may begin; some campaigners see the Bill as a Trojan Horse; the breaking of the taboo would make it less likely that people would oppose dangerous or ill-thought-out extensions; soon it would be sought to extend it to persons with constant and unbearable physical or mental suffering as the result of an incurable condition that cannot be appeased; over time that is likely to be flexibly interpreted by doctors sympathetic to euthanasia or engaged in the new medical speciality of physician-assisted death; it would next be argued that the law is discriminatory (including under the CRPD) because it excludes those who legally lack capacity to decide to die, and because children are excluded; (4) in relation to those with mental health disorders, many people "will wonder whether these out-patients were offered adequate, intensive assisted living ... before being assisted to die"; (5) the Bill is silent on Legal Aid and therefore on whether the new law would in reality be available only to the well-to-do; (6) the High Court judge is not obliged to hear from the person in question (only from a doctor, with the risk that contradictory evidence is not obtained) and there is no right of appeal; (7) no provision is made for the person, or family members, to be supported by a social worker or solicitor, which would be important to allow the person to mitigate potential significant consequences for others and reconsider their decision in the light of those; (8) the drafting is ambiguous in relation to the role of private clinics, but it seems likely that they will provide an independent doctor service including substitute decisions when the original doctor is of the opinion that the conditions for assisted suicide are not met, and the profit element may distort decision-making; (9) there does not appear to be a means by which a doctor who provided a statement that the conditions are met can rescind it; (10) the Bill only applies to England & Wales and so would divide the UK; (11) there appears to be no clear, close scrutiny of assisted suicides after the event, which is required to comply with Article 2.