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Health Secretary accepts need for more evidence on assisted dying, as lockdown removes Dignitas option for many dying Brits

  • Speaking in House of Commons today, Hancock said there is a role for Government in gathering evidence on impact of UK’s blanket ban on assisted dying and said “we should make sure that this conversation and discussion happens”
  • Majority of cross-party MPs speaking this morning were in favour of review into current assisted dying law
  • Hancock confirms terminally ill Brits can travel to Dignitas under lockdown
  • But fewer flights, huge cost and risk of prosecution for loved ones make this option impossible for most terminally ill Brits, warns Dignity in Dying

The Secretary of State for Health and Social Care, the Rt Hon Matt Hancock MP, has today (Thursday 5 November 2020) accepted the need for more evidence on the impact of the UK’s blanket ban on assisted dying, welcomed a conversation about this issue and suggested the Government has a role to play in gathering evidence on the scale of the problem. Mr Hancock was responding to an urgent question from the Rt Hon Andrew Mitchell MP on the devastating impact of new lockdown restrictions, which have made travel to Dignitas in Switzerland impossible for many terminally ill Brits.

Speaking in the House of Commons this morning, Matt Hancock said: “we should make sure that this conversation and discussion happens, that there is rightly a debate about this topic” and acknowledged “the changing views of many, including many in the medical profession, and of course we observe the changes and the international debate that is taking place.” Mr Hancock added that “it is right that we locate this question within a broader discussion about how we care for people at the end of their lives, which has become, sadly, due to the coronavirus pandemic, a central issue of public debate in this country”. Mr Hancock also said that “high-quality palliative care and the question, directly, of assisted dying before the House today are not separate questions; they are intimately tied together.”

Mr Hancock said the Government “would consider collecting data on assisted dying if it was felt that that would improve and contribute to a sensitive debate in Parliament on this subject” – including the number of Brits travelling to Switzerland for an assisted death – and recognised that “it is important that any debate is conducted based on the evidence”.

The Health Secretary also confirmed that travelling abroad for an assisted death would be permitted under the latest lockdown restrictions.

However, this does not change the current law, under which anyone assisting a terminally ill person in making arrangements for an assisted death overseas or accompanying a loved one on their journey risks prosecution, with a maximum sentence of 14 years. In addition, fewer flights to Switzerland, the significant cost (on average £10,000) and the difficulty of openly procuring the necessary documentation to prove terminal prognosis and mental capacity mean that Dignitas is still virtually impossible for most terminally ill Brits, warns Dignity in Dying. The organisation, which campaigns for a change in the law on assisted dying in the UK, is already aware of terminally ill people who have resorted to ending their own lives at home because they have been unable to secure an assisted death overseas in recent months.

Mr Hancock also agreed to meet with Dignity in Dying campaigner Noel Conway, who has terminal motor neurone disease and brought a judicial review challenging the UK’s ban on assisted dying in 2017-2018. The suggestion was made by Daniel Kawczynski MP, who said that meeting Mr Conway, his constituent, had profoundly changed his views on assisted dying.

Mr Hancock’s statements come amid growing calls from across society for a review of the UK’s blanket ban on assisted dying, most recently at a cross-party parliamentary meeting on Tuesday 3 November 2020. Co-chairs of the All Party Parliamentary Group on Choice at the End of Life, Andrew Mitchell MP and Karin Smyth MP, spoke alongside former Lord Chancellor David Gauke and Emeritus Medical Director of Public Health England, days after 50 senior healthcare professionals called publicly for an inquiry into current laws.

In the House of Commons this morning, cross-party MPs highlighted the devastating impact of the UK’s current laws on assisted dying, now compounded further by coronavirus restrictions. Mr Mitchell raised the recent coverage of a terminally ill frontline NHS professional who was forced to travel to Dignitas this week prematurely and alone, for fear of the lockdown jeopardising her plans and family members being prosecuted for accompanying her. Ms Smyth spoke of a terminally ill person who resorted to drastic means to end their life earlier this year because they were unable to get to Switzerland.

MPs also spoke of the progress being made around the world on assisted dying. Last week New Zealand became the latest country to approve legislation after preliminary results last week found 65.2% voted in support of its historic referendum on the End of Life Choice Act. Within a year New Zealand will join the Australian states of Victoria and Western Australia, plus 10 jurisdictions across the US, including California, Washington, and New Jersey, in providing safeguarded choice at the end of life for its dying citizens. In October members of Ireland’s Dáil voted to progress a Dying with Dignity bill to committee stage, meaning it will now undergo pre-legislative scrutiny by one of the select committees.

International developments come amid a dramatic shift in views among UK medics. Last month the results of the largest ever survey of British doctors’ views on assisted dying found that half of doctors personally support a change in the law (50%), in addition to overwhelming support for a change to the British Medical Association’s current stance of opposition to an assisted dying law (61%).

Andrew Mitchell MP said:

“The Health Secretary has today shown leadership on the vitally important issue of assisted dying, which has taken on a new urgency since the pandemic. Coronavirus has exacerbated even further the suffering of terminally ill Brits and their families under the UK’s ban on assisted dying, making it more pressing than ever that we re-examine these laws. It is vital that Parliament has an accurate and up-to-date understanding of the functioning and impact of our assisted dying legislation and I commend the Health Secretary for highlighting the importance of evidence; something which colleagues on all sides of this debate can surely agree upon.”

Karin Smyth MP said:

“I thank the Health Secretary for welcoming an open, evidence-based discussion on end of life choice in the UK, including the current ban on assisted dying. Our current law has created a two-tier system, where those with the resources can access a dignified death overseas and those who cannot afford it must either suffer against their wishes or take drastic actions to control their deaths. Now, even this limited choice to travel abroad has been removed. I hope this acknowledgement of the need to listen to dying people and their loved ones will enable us to work together as a Parliament to create a law that works for society as a whole.”

Jane Parker, a 69-year-old woman from Devon who was diagnosed with terminal motor neurone disease last year, reacted to the announcement:

“I thank the Health Secretary for acknowledging those of us who have felt the effects of the UK’s ban on assisted dying most keenly. I hope we will soon have the opportunity to have our voices heard.

“Motor neurone disease is killing me and has already taken my speech, my ability to swallow and is now robbing me of my breathing. I have only months left and I want to be able to choose how and when I die. Before lockdown, I could have travelled to Switzerland with suitable advance preparations and cash, accompanied by brave family members who are prepared to risk a police interview and possible arrest. But now this is virtually impossible, so I must contemplate letting nature take its course or refusing food through my PEG tube and effectively starving to death. The time has come to review these cruel laws.”

Sarah Wootton, Chief Executive of Dignity in Dying, said:

“The Health Secretary and MPs across the House have today recognised that there are significant issues with the UK’s current laws on assisted dying and acknowledged the need to gather evidence on the full impact of present legislation. MPs views are shifting more in line with the vast majority of the British public, who recognise that the current law is not working and that reform is urgently needed. The Secretary of State’s recognition that assisted dying should be part of a discussion about end-of-life care is very significant and in line with what the public want and need.

“The pandemic has proven what we have long known, that banning assisted dying does not protect people; it merely drives the practice overseas and underground and criminalises acts of genuine compassion. Dignity in Dying’s calls for a review of the current law have been gaining support from across society, with a growing number of cross-party parliamentarians, police and crime commissioners, senior healthcare professionals and interfaith leaders recognising the urgent need to look again at whether the status quo is fit for purpose.

“Parliamentarians must step up and grasp this nettle. Gathering evidence on what is really going on under the ban on assisted dying can only help them in that task, and a review of the functioning and impact of our current law would give terminally ill Brits and their loved ones a much-needed voice in this debate.”

***ENDS***

For more information or interview requests with Dignity in Dying, members of the All Party Parliamentary Group on Choice at the End of Life, healthcare professionals or people with personal experiences, please call 07725 433 025 or email ellie.ball@dignityindying.org.uk or thomas.davies@dignityindying.org.uk.

Notes to Editor:

Dignity in Dying campaigns for greater choice, control and access to services at the end of life. It campaigns within the law to change the law, to allow assisted dying as an option for terminally ill, mentally competent adults with six months or less to live – something supported by 84% of the public (Populus, 2019).

The UK’s laws on assisted dying

Assisted dying is prohibited in England and Wales under the Suicide Act (1961), and in Northern Ireland under the Criminal Justice Act (1966) which states that anyone who “encourages or assists a suicide” is liable to up to 14 years in prison. There is no specific crime of assisting a suicide in Scotland, but it is possible that helping a person to die could lead to prosecution for culpable homicide.

Before the coronavirus pandemic, on average 1 Briton every week travelled to Switzerland for a legal assisted death – a process which costs £10,000 on average and often causes people to die prematurely because of the need to retain the physical strength to make the journey. Anyone who assists in the arrangement of an assisted death overseas or accompanies someone to Switzerland for this purpose could be prosecuted for ‘assisting a suicide’. Polling has found that over half (53%) of Brits would consider travelling abroad for an assisted death if terminally ill and two-thirds (66%) would consider breaking the law to help a loved one do so, yet only a quarter (25%) would be able to afford it.

A further 300 terminally ill people end their own life in England every year on average, and 17 people every day suffer as they die even with access to the best end of life care.

International developments

New Zealand is set to legalise assisted dying as a choice for terminally ill, mentally competent citizens within a year, following a public referendum on the End of Life Choice Act last month. Preliminary results released last week found 65.2% support, with final results due Friday 6 November 2020.

On Wednesday 7 October 2020 TDs in Ireland’s Dáil voted 81 to 71 to allow the Dying with Dignity 2020 Bill to proceed to committee stage for pre-legislative scrutiny. An amendment tabled by the coalition government to establish a new special Oireachtas committee to examine the issue and report back in a year’s time was defeated.

Assisted dying as an option for terminally ill, mentally competent adults in their final months of life is legal in ten US jurisdictions: Oregon (1997), Washington, Vermont, Montana, the District of Columbia, California, Colorado, Hawaii, New Jersey and Maine (June 2019).

Victoria became the first Australian state to legalise assisted dying for terminally ill people in June 2019. Western Australia voted to legalise a similar bill in December 2019. The health committee of the Government of Queensland published a report in March 2020 recommending that legislation enabling terminally ill citizens the option of assisted dying be introduced, the result of a year-long investigation.

Healthcare professionals

Last month the British Medical Association released the results of its membership survey on assisted dying – the largest ever poll of British doctors on the issue. It found overwhelming support for a change to the BMA’s current stance of opposition to an assisted dying law (61%), and half of doctors personally supporting a change in the law (50%). The BMA’s current position is due to de debated at their next Annual Representative Meeting in 2021.

Eminent GPs Prof Aneez Esmail and Sir Sam Everington recently launched a legal challenge to the Royal College of GPs alongside the Good Law Project and Dignity in Dying over RCGP Council’s decision to maintain opposition to assisted dying despite its own survey showing a dramatic shift in GP opinion. The RCGP has committed to respond to the concerns raised in the legal challenge by the 6th November.

In March 2019, the Royal College of Physicians dropped its longstanding opposition to assisted dying in favour of neutrality following a member survey.

Assisted dying proposals in the UK and Crown Dependencies

A Westminster Hall debate on assisted dying took place on 23 January 2020, in which a majority of speakers backed growing calls from across society for an inquiry into the UK’s current laws on assisted dying. The functioning and impact of the current law was debated at a backbench business committee debate in July 2019. Proposals for assisted dying legislation were last debated in the Commons in September 2015.

The Government of Jersey announced in February 2020 that it would launch a Citizen’s Jury on assisted dying, which will give recommendations to the States Assembly ahead of a debate at the end of this year. In 2019 the Government of Jersey announced that it would undertake detailed research into the views of residents, overseas developments and potential legislation.

The Isle of Man’s Parliament, Tynwald, debated assisted dying at its January sitting on 22 January 2020. It last debated legislation in 2015.

The Legislative Assembly of the Falkland Islands voted in favour of two motions on assisted dying in July 2018 (that terminally ill residents should have the right to die at a time and place of their choosing, and that should legislation be introduced in the UK, the Falkland Islands would consider adopting it).

The States of Guernsey last debated assisted dying proposals in May 2018.