An update on the push for assisted suicide in Westminster and Scotland

Ultimately, only one amendment was put to a vote – Rebecca Paul’s proposal to allow hospices to opt out of providing assisted suicide. Despite all the talk of freedom, this amendment designed to give hospices a choice was voted down.

It has become increasingly clear that this bill is not only flawed in principle – it is deeply problematic in practice. The same is also true of Scotland’s Assisted Dying Bill, and my colleague, Chris Ringland, provides an update on Tuesday’s vote below.

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Despite repeated claims that this is ​“the most robust piece of legislation in the world”, Kim Leadbeater, the bill’s sponsor, tabled a number of significant amendments. It is rare – and telling – for the sponsor of a bill to show such a lack of confidence in their own legislation.

But the fault doesn’t lie solely with her. A Private Member’s bill is a completely inadequate vehicle for such serious legislation. Just five hours were allocated for Friday’s debate, the same as for the bill’s initial reading. Committee stages were similarly rushed, stretching late into the night. Many MPs rightly pointed out that this is no way to legislate on life and death.

The debate was also shaped by Dame Esther Rantzen, who, in a letter on Friday morning, accused some bill opponents of being motivated by ​“undeclared personal religious beliefs”. Many MPs expressed frustration with this claim, highlighting how the demand for faith-free politics is wearing thin. 

Most troubling is the bill’s failure to protect the vulnerable – those with disabilities, mental illness, eating disorders, learning difficulties or suicidal despair. The bill’s proposed safeguards are completely insufficient for these groups.

The church still has a crucial role to play. MPs can change their minds before the third reading on 13 June. One previous proponent, Karl Turner MP, announced he will now abstain, saying, ​“I just don’t think I should be God.” Sometimes, one conversation or overlooked piece of evidence can shift an MP’s vote.

Here are four key concerns that emerged from the debate: 

MPs raised alarms about the potential for coercive control. The bill criminalises direct coercion but does nothing to address the subtler, societal pressure patients face during terminal illness. 

As Iqbal Mohamed MP put it: 

“It is not just about coercion from family members or friends, but about societal coercion and circumstances. The current state of palliative care in our country is among the worst in the developed world. Without adequate palliative care, patients might feel pressure to go down the assisted dying route instead.”

Mental capacity was another major issue. The bill presumes capacity under the Mental Capacity Act 2005, presuming that capacity exists in the first instance, even if a patient appears confused or illogical. 

There is also nothing in the bill that precludes patients from entering into assisted suicide because they feel like they are a burden to their families. 

Rebecca Paul MP said the following:

“There are such problems with the current approach to determining capacity that I barely know where to start…Under the Bill, a person is assumed to have capacity in the first instance. A clinician only needs to be over 50% sure that a person has capacity.”

Evidence strongly suggests that palliative care declines where assisted suicide is introduced. There is a real risk that patients could be pressured into assisted suicide due to limited palliative care provision and competition for resources.

Rachael Maskell MP emphasised this point, saying:

“The palliative care commission reported on Tuesday and I urge hon. Members to read its evidence-rich report, which draws on best practice. We reported that excellence in end-of-life provision is achievable, but that too many people are not getting access to it. Without that, I fear that the Bill only leads the patient down one route – to die. This is not a choice at all, but a path to an assisted death.”

The flagship safeguard for the bill was the involvement of a High Court judge, which was subsequently scrapped. This was replaced by a multi-disciplinary panel, which has now proven unworkable. 

Last Wednesday, the Royal College of Psychiatrists announced that it has withdrawn its support of the assisted suicide bill over ​“many, many factors”. They claimed a multi-disciplinary panel would not be possible because there were not enough psychiatrists in the country to do what the bill requires. The college said:

“We have spent decades focused on preventing people from dying by suicide. A significant part of our engagement on this bill to date has been to point out that people with terminal physical illnesses are more likely to have depression.”

My colleague Chris Ringland, our Public Policy Officer for Scotland, has given the following update:

“On Tuesday 13 May, the Scottish Parliament voted in favour (70 votes for, 56 against, 1 abstention) to progress the Assisted Dying for Terminally Ill Adults (Scotland) Bill to stage 2 of the legislative process.

“The bill will therefore now move to Stage 2 and we await to see when it will be scheduled for. A significant amount of MSPs have indicated that they voted at stage 1 to continue discussion and debate on the bill, with no guarantees that they will support it to become law at stage 3. Ultimately, we will be advocating for MSPs to vote against the bill at stage 3.

“We will continue to engage with the bill going forward on your behalf and keep you informed on developments.”