In June, the House of Commons voted to pass the Terminally Ill Adults (End of Life) Bill (known as the assisted dying bill). The bill has now moved to the House of Lords for further scrutiny and debate, with the second reading taking place on 12 and 19 September. Similarly, in May, the Scottish Parliament voted to progress the Terminally Ill Adults (Scotland) Bill, with further consideration scheduled for November. In part four of our assisted dying blog series, we update you on what is happening with the assisted dying bills in the UK, what happens next, and what the BGS is doing.
What is happening in England and Wales?
The House of Commons narrowly voted to pass the Terminally Ill Adults (End of Life) Bill at its third reading, with 314 votes in favour and 291 votes against. The Bill has now been introduced in the House of Lords, with Lord Falconer its sponsor in the upper house. The second reading in the Lords was held on 12 September with a further session on 19 September. This provides the opportunity for peers to debate the general principles of the bill, and to flag any concerns. The bill has drawn significant attention, with nearly 200 peers registering to speak - one of the largest speaking lists in recent years. Typically, there isn’t a vote at this stage unless a member formally opposes the bill. This is rare and most private members bills move onto the next stage (committee). However, considering the controversial nature of the bill, it is possible that a peer may choose to trigger a vote.
Committee stage generally starts at least two weeks after the second reading of the bill. Peers can table amendments to the bill, which are debated and voted on at committee stage, alongside line-by-line scrutiny of the bill. A new version of the bill is then published for further scrutiny at report stage and third reading, where further amendments can be considered. Third reading is the opportunity for peers to ‘tidy up’ the bill, concentrating on loopholes and making the bill workable. A vote may happen at Third Reading if a peer tables a motion not to give the Bill a Third Reading. Again, this is rare but possible, considering the nature of the bill.
If the bill passes Third Reading, the bill will go back to the House of Commons for the Lords’ amendments to be considered. If they do not agree, and propose alternative wording, then the bill may go back to the Lords again. The bill may ‘ping pong’ between each House until an agreement is reached. In rare cases they do not agree, in which case the bill falls. However, if it is agreed, the bill can receive Royal Assent and become an Act of Parliament, therefore passing into law.
What is happening in Scotland?
The Assisted Dying for Terminally Ill Adults (Scotland) Bill is currently at stage two of the process to decide if it should become law. Stage two involves MSPs proposing amendments to the bill, which are then considered by MSPs sitting on the Health, Social Care and Sport Committee. The Stage Two committee meeting is expected to take place on 4 November. A new version of the bill is then considered by the Scottish Parliament, who can vote on further amendments. This is followed by a debate and a vote on whether to pass the bill. If the bill passes at this stage, it will become law.
What has the BGS been doing?
The BGS is currently opposed to the legalisation of assisted dying because we believe that palliative and end of life care needs are not adequately met at present and such care should be improved before a change in the law is considered. We are also worried that effective safeguards cannot be developed to protect older people from harm. This is reflected in our position statement published last year.
The BGS has actively engaged with the parliamentary process of the UK assisted dying bills. We wrote to the Chairs and the Sponsor of the Public Bill Committee requesting to give oral evidence and, despite two separate amendments suggesting the BGS give evidence, we were not invited, as outlined in our public statement.
However, we did submit written evidence to the committee. This was developed with input from BGS members who spent time analysing the bill. As a direct result of the BGS’s written evidence, Danny Kruger MP tabled an amendment to remove ‘medical condition’ from the definition of terminal illness. This was prompted by concerns that the term is vague and left open to misinterpretation, potentially including those with treatable clinical frailty. The BGS provided the committee with a briefing document on frailty, which was referred to in the committee meeting, and this was circulated to the whole committee. The committee was unanimous in its decision to pass the amendment.
In June, we published a statement and news story outlining our concerns with the Terminally Ill Adults (End of Life) Bill. We are concerned that the current provisions in the bill do not support the complex needs of older people with multiple health conditions and frailty. Additionally, it does not include adequate safeguards to protect the interests and autonomous choices of older people. Most people reaching the end of life are older people who require holistic person-centred assessment of needs. We are deeply concerned that the bill does not require such an assessment, which may identify treatable needs that would, if unmet, otherwise result in an assisted death. This statement was sent to all MPs, and we were mentioned in the report and third reading debates. Following the bill being passed in parliament, we put out a statement. Professor Martin Vernon, Chair of BGS Ethics and Law Special Interest Group, was also interviewed live on Sky News outlining concerns (a second interview with the news outlet).
Ahead of the second reading in the House of Lords, we have written to peers in the House of Lords outlining some of our concerns. We will be continuing our influencing activities as the bill progresses, and we will look to formally review our position statement if there is a change in the law. If the bill becomes law, we will work constructively to help ensure that the impact of its implementation on older people and on the healthcare professionals who look after them is carefully considered and managed.
