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Citizens’ Jury set to increase understanding of public opinion on assisted dying

In its evidence to the Health and Social Care Select Committee’s inquiry on assisted dying, the independent National Centre for Social Research (NatCen) said there has been broad support for a medically-led option of assisted dying in this country for the last 20 years. This reflects NatCen’s own work, and also multiple other polls which have all found the public backs change. In its final report, the Committee referenced the high levels of public support indicated by these polls, but also said campaign groups opposed to assisted dying had expressed doubts about their reliability.

Shortly after the Committee’s report was published Dignity in Dying released findings from the biggest ever poll on assisted dying, conducted by Opinium Research. Consistent with previous polls, it found three-quarters of people support making it lawful for dying adults to access assisted dying in the UK, with only around one in eight people stating that they would oppose such a move. This groundbreaking research was also the first ‘MRP poll’ on the issue – a method of analysis that has accurately predicted the results of several recent elections – and it found that a majority of people support a change in the law on assisted dying in every single constituency in the country.

This research should leave MPs and prospective MPs in no doubt about the public’s views on assisted dying.

But given groups opposed to assisted dying still dispute the reliability of opinion polls, attempts to further measure and understand public opinion are valuable in informing the debate. This is why we are pleased that the Nuffield Council on Bioethics (NCOB) has started England’s first Citizens’ Jury on assisted dying.

Citizens’ Juries bring together a group of people representing a cross section of society to engage in the detail of topical policy questions, with the input of trusted experts. In contrast with polls – which provide a snapshot of public opinion – Citizens’ Juries are conducted over many weeks or months to allow jury members to examine evidence to help shape their views. The resulting recommendations can help decision-makers such as parliamentarians have a deeper understanding of public opinion on certain issues.

This is not the first time a Citizens’ Jury has been used to explore assisted dying. In recent years similar initiatives in Jersey and France have come out strongly in favour of law change, paving the way for proposals that have since been tabled in both jurisdictions.

We were pleased to have been able to share our thoughts on the NCOB’s project when it was in its initial stages and we are grateful to have since been invited to present directly to the jury members in the coming weeks, alongside a number of other campaign groups who hold differing views.

However, we are concerned about one aspect of the project. The NCOB set up a Content Group to ensure members of the Citizens’ Jury engage with material that is ‘balanced, accurate and accessible’. Unfortunately, we believe the Content Group itself lacks balance.

There are four members of the group and while one is publicly in favour of reform the others have spoken out against the need to change the law in line with proposals that are currently being considered across the British Isles. This Includes a Canadian academic who it has been reported by the Scottish Daily Mail ‘has travelled to the UK to warn against making right-to-die lawful’ as well as a retired palliative medicine doctor who has been described by media in the Isle of Man as ‘a leading opponent’ of law change and is the director of a campaign group that has the specific aim of trying to keep assisted dying out of healthcare.

As a speciality, palliative medicine does not have good form for contributing to the assisted dying debate in an evidence-based manner and we consider it an oversight to involve an individual campaigner as the sole representative of the medical profession on the Content Group; the last thing this debate needs is more doctors with extreme views trying to have a disproportionate say in how we die.

We have raised our concerns directly with the NCOB and have had reassurances that individual members of the Content Group will have limited influence on the overall process. So we remain hopeful that the perceived risk of bias created by the membership of the Content Group will not detract from what has the potential to be a valuable and informative project.

Given the balance of the Content Group weighs heavily against legalising assisted dying for terminally ill, mentally competent adults, there can also be no legitimate claim of undue influence by those in favour of assisted dying if the jury does, as we hope it will, reflect where polls suggest the public stands on assisted dying.

We are looking forward to seeing the initial findings of the Citizen’s Jury when the NCOB publishes them in the summer.