MPs back assisted dying bill in final Commons reading

MPs have voted to support the assisted dying bill in its final reading in the House of Commons today, following hours of debate.

The draft legislation, which would allow terminally ill adults to end their lives, was initially backed by MPs in a vote in November and has gone through committee and report stages, with MPs debating amendments and voting on proposed changes at its third reading today.

After five hours of debate, 314 MPs voted in favour of progressing the bill, while 291 voted against it. This final vote in the House of Commons, meaning that the bill will now proceed to the House of Lords for further scrutiny.

Under the current bill, two doctors would first need to assess the person seeking assisted dying 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.

Primary care minister Stephen Kinnock told Parliament: ‘This bill has received more parliamentary time than most government and private members bills, and the debate has been respectful and well considered throughout.

‘The scheme set out in the bill now includes assisted dying review panels. Multidisciplinary panels would grant a certificate of eligibility if they are satisfied that all the relevant requirements have been met.

‘The panel would have to hear from the person seeking assistance, at least one of the doctors and any relevant other relevant persons, they would be responsible for monitoring and reporting on the operation of the Act, a role that was previously assigned to the chief medical officer.’

He also said that ‘specific training requirements’ for doctors ‘playing a formal assessing role’ under the bill have been added, and that a ‘dedicated board’ would be appointed to ‘advise on the impact of the bill on disabled people’.

‘Should it be the will of Parliament for this legislation to pass, then the Government will ensure the safe and effective implementation of this service,’ he added.

Changes to the bill which were passed at report stage included:

• New clauses 12 to 15, 20, and 21 – introducing new provisions, including: a prohibition on the advertisement of assisted dying; measures to regulate the substances and devices used in assisted dying; an exemption of assisted deaths from the definition of ‘unnatural deaths’ under the Coroners and Justice Act 2009
• New clause 2 – prohibiting any health professional from raising assisted dying with a person under the age of 18
• Amendment 14 – clarifying that a person cannot be considered terminally ill solely because they voluntarily stopped eating or drinking
• Amendment 21 – requiring the Government to publish an assessment of palliative and end of life care within one year of the Act’s passage.

Earlier this year, England’s chief medical officer has told MPs that GPs will require additional training to be able to fully support patients should the bill pass.

And last month, Pulse revealed that just under one in four GPs would be prepared to be involved in assisted dying to its completion.

During the committee stage, MPs and experts had raised concerns about the ‘capacity’ and potential ‘coercion’ of those requesting assistance to end their life.

In today’s debate, several MPs voiced similar concerns and argued that the bill was ‘not fit for purpose in its current form’, due to ‘a lack of scrutiny and rigour’.

MPs opposing the bill also raised concerns about how it would impact palliative care capacity and doctors’ relationships with patients, as well as how assisted dying would be funded.

The RCGP moved to a position of ‘neither supporting nor opposing’ assisted dying, after a vote of its council members in March, and the BMA has also previously reiterated its ‘neutral’ position on the issue.

BMA medical ethics committee chair Dr Andrew Green, a retired GP, said: ‘The BMA is neutral on the issue of assisted dying, which means we neither support or oppose it as a principle, nor in relation to any change in law.

‘We have always said this is a matter for parliamentarians, and not doctors, to decide, which is what we have seen play out over recent months, passing this important milestone today. 

‘If this law does come to pass, it would likely have a significant impact on the way doctors work and their relationship with patients, which is why, while being neutral on the central question, we have engaged with the bill and raised a number of key issues on behalf of our membership and the medical profession. 

‘One fundamental principle that we have been clear on, is that, if the law does change, doctors must have to actively opt-in, and no doctor should be forced to take part in any part of the process; they must be able to decline involvement in any part of the process and for any reason.  

‘We were therefore glad to see MPs pass an amendment at report stage, tabled by Ms Leadbeater as a direct result of our engagement, that strengthens the comprehensive protection for all healthcare workers to be able to decline to take part. ‘

In a briefing to MPs last week, the BMA warned that the Government would need to ensure additional funds are made available for a specialist assisted dying service, should the bill pass.

The union said: ‘If this bill is approved by Parliament, the Government would need to ensure that additional funds are made available so that the service is properly resourced, and that funding and workforce are not diverted from other, already overstretched, healthcare services.

‘They would also need to ensure that the service is available to all those who meet the eligibility criteria on an equitable basis.’