Few recent pieces of British legislation have proved as controversial as the Terminally Ill Adults (End of Life) Bill, introduced by Labour MP Kim Leadbeater. Despite assisted suicide being decisively rejected by parliament multiple times in past years (including by 330-118 votes in 2015), Leadbeater has pushed on with her bill in the face of mounting opposition.
The bill was published only days before its second reading and one of its supposedly “robust” safeguards was a requirement for sign-off from a High Court judge for each individual case. For many MPs, who were denied the chance to take more time over this life-and-death issue, this so-called ‘safeguard’ was central to its appeal, and they saw judicial oversight as a vital check.
Now, in a remarkable turn of events, Ms. Leadbeater has proposed removing this requirement—one she once considered a unique protection. Instead, a three-member panel, chaired by a senior lawyer or retired judge and including a social worker and a psychiatrist, would approve each case.
The broader concerns with the bill are well known: the impossibility of accurately detecting coercion, the disproportionate impact on the vulnerable, the problems with predicting life expectancy, the one-sided approach to hearing real concerns from parliamentarians during the committee stage, and the dramatic escalation of assisted deaths we have seen in other countries with similar regimes. Its critics, including cabinet ministers, a former Chief Coroner, a former President of the Family Division of the High Court, palliative care professionals, and disability rights groups all spoke out.
The new approach signals the bill’s ‘direction of travel.’ Even Leadbeater seems to tacitly admit this in the rhetorical flourish of calling this new model ‘Judge Plus.’ With this amendment, there would be no requirement for a judge to play any role. Just a few months ago, the necessity of a High Court judge’s involvement was touted as the key factor that differentiated this bill from other assisted dying frameworks. Those promoting it on television and in Parliament assured the public that this safeguard was critical for protecting the vulnerable. Now, that very safeguard is being scrapped.
If the supposed “most robust” protection can be thrown out so easily, what will be next to go? Indeed, this continual expansion of the criteria and relaxation of the rules is exactly what the bill’s opponents have warned of.To those of us who have spent time looking at similar laws overseas, this isn’t surprising. It’s the direction of travel of every single jurisdiction that has legalized the intentional ending of life. And the laws in those countries now look strikingly similar to the British bill.
This is not my first interaction with a death approval panel. I represented Tom Mortier at the European Court of Human Rights after his physically healthy 64-year-old mother was euthanized in Belgium for what doctors deemed “incurable depression.” In that case, the Court ruled that Belgium had violated her right to life, specifically because of concerns about the panel and process through which her euthanasia was deemed lawful. The court cited a lack of robust accountability and conflicts of interest. The committee set up to vet euthanasia requests, composed almost entirely of pro-euthanasia figures, functioned more like a rubber stamp than a meaningful safeguard.
This should not be surprising. In Belgium—as in the UK—only those inclined to support assisted suicide are likely to volunteer or be appointed, leading to a small echo chamber. Moreover, the opportunity for a small panel, sitting alone in a room, with a stack of paperwork to understand someone’s motivations, the assumptions of their treating doctor, and the coercion they may be experiencing is—at best—very limited.
Or take it from those who have served on these panels.
Professor Theo Boer sat on a Dutch euthanasia review panel, reviewing 4,000 cases. In his 2023 evidence to Parliament, he concluded:
Like those currently arguing for a change in the law in Great Britain, I once believed it was possible to regulate and restrict killing to terminally ill mentally competent adults with less than six months [to live]. … Moreover, by taking this bold step I believed we could regulate suicide and death in this way that would curtail those all too familiar cases where someone ends their own life. I was wrong.
Meanwhile, in Belgium, Dr Ludo Vanopdenbosch, a neurologist who was a member of the euthanasia commission for several years, resigned with a scathing letter. He highlighted a case in which he considered other members not ‘stretching’ the law but ‘breaking’ it before charging the rest of the panel to secrecy. He ultimately concluded that the panel was “neither independent nor objective.”
How many more examples do we need before concluding these are not isolated cases but inherent to this approach?
The real task of these panels is not in comprehensively reviewing requests and safeguarding the vulnerable, but giving an air of legitimacy to the kind of paper review a former senior High Court judge has already told us is essentially impossible.
The bill basically now looks like every other euthanasia bill around the world. Leadbeater was quick to try and differentiate her bill because of the stories coming out of places like Canada – where a 27-year-old with Autism and ADHD was approved for ‘MAID’, and Belgium where the youngest person to be euthanized was just 9 years old, and Oregon where more than 43% of people seeking lethal drugs expressed the concern that they were “a burden on family, friends/caregivers.”
At a societal level, the ‘right to die’ quickly becomes a ‘duty to die’. And countless people are left in its wake. Apart from the immediate victims, including the elderly and the vulnerable, there are family members and friends left behind; medical professionals required to play some role; and now social workers, too, are being implicated.
To the extent this bill occupied any high ground, it has ceded it. It now joins the ranks of other bills that have delivered the outcomes from which Leadbeater was so keen to put some distance.
Her amendment indicates that the bill is floundering. Itl is not as thought-through as Dignity in Dying’s marketing push would have us believe. If something so central to the bill’s promise of “robust checks” can be dropped at this stage, it underscores just how fragile the entire framework really is.
And that should give those concerned about protecting the vulnerable hope. This bill can and should be stopped. Rather than forcing this defective bill through, Parliament must recognize the legitimate concerns, lament the defective process through which its proponents are rushing to try to address them, and reject the text. The warning signs could not be clearer. And the stakes could not be higher.
From ‘Right To Die’ to ‘Duty To Die?’
Wikimedia Commons
Few recent pieces of British legislation have proved as controversial as the Terminally Ill Adults (End of Life) Bill, introduced by Labour MP Kim Leadbeater. Despite assisted suicide being decisively rejected by parliament multiple times in past years (including by 330-118 votes in 2015), Leadbeater has pushed on with her bill in the face of mounting opposition.
The bill was published only days before its second reading and one of its supposedly “robust” safeguards was a requirement for sign-off from a High Court judge for each individual case. For many MPs, who were denied the chance to take more time over this life-and-death issue, this so-called ‘safeguard’ was central to its appeal, and they saw judicial oversight as a vital check.
Now, in a remarkable turn of events, Ms. Leadbeater has proposed removing this requirement—one she once considered a unique protection. Instead, a three-member panel, chaired by a senior lawyer or retired judge and including a social worker and a psychiatrist, would approve each case.
The broader concerns with the bill are well known: the impossibility of accurately detecting coercion, the disproportionate impact on the vulnerable, the problems with predicting life expectancy, the one-sided approach to hearing real concerns from parliamentarians during the committee stage, and the dramatic escalation of assisted deaths we have seen in other countries with similar regimes. Its critics, including cabinet ministers, a former Chief Coroner, a former President of the Family Division of the High Court, palliative care professionals, and disability rights groups all spoke out.
The new approach signals the bill’s ‘direction of travel.’ Even Leadbeater seems to tacitly admit this in the rhetorical flourish of calling this new model ‘Judge Plus.’ With this amendment, there would be no requirement for a judge to play any role. Just a few months ago, the necessity of a High Court judge’s involvement was touted as the key factor that differentiated this bill from other assisted dying frameworks. Those promoting it on television and in Parliament assured the public that this safeguard was critical for protecting the vulnerable. Now, that very safeguard is being scrapped.
If the supposed “most robust” protection can be thrown out so easily, what will be next to go? Indeed, this continual expansion of the criteria and relaxation of the rules is exactly what the bill’s opponents have warned of.To those of us who have spent time looking at similar laws overseas, this isn’t surprising. It’s the direction of travel of every single jurisdiction that has legalized the intentional ending of life. And the laws in those countries now look strikingly similar to the British bill.
This is not my first interaction with a death approval panel. I represented Tom Mortier at the European Court of Human Rights after his physically healthy 64-year-old mother was euthanized in Belgium for what doctors deemed “incurable depression.” In that case, the Court ruled that Belgium had violated her right to life, specifically because of concerns about the panel and process through which her euthanasia was deemed lawful. The court cited a lack of robust accountability and conflicts of interest. The committee set up to vet euthanasia requests, composed almost entirely of pro-euthanasia figures, functioned more like a rubber stamp than a meaningful safeguard.
This should not be surprising. In Belgium—as in the UK—only those inclined to support assisted suicide are likely to volunteer or be appointed, leading to a small echo chamber. Moreover, the opportunity for a small panel, sitting alone in a room, with a stack of paperwork to understand someone’s motivations, the assumptions of their treating doctor, and the coercion they may be experiencing is—at best—very limited.
Or take it from those who have served on these panels.
Professor Theo Boer sat on a Dutch euthanasia review panel, reviewing 4,000 cases. In his 2023 evidence to Parliament, he concluded:
Meanwhile, in Belgium, Dr Ludo Vanopdenbosch, a neurologist who was a member of the euthanasia commission for several years, resigned with a scathing letter. He highlighted a case in which he considered other members not ‘stretching’ the law but ‘breaking’ it before charging the rest of the panel to secrecy. He ultimately concluded that the panel was “neither independent nor objective.”
How many more examples do we need before concluding these are not isolated cases but inherent to this approach?
The real task of these panels is not in comprehensively reviewing requests and safeguarding the vulnerable, but giving an air of legitimacy to the kind of paper review a former senior High Court judge has already told us is essentially impossible.
At a societal level, the ‘right to die’ quickly becomes a ‘duty to die’. And countless people are left in its wake. Apart from the immediate victims, including the elderly and the vulnerable, there are family members and friends left behind; medical professionals required to play some role; and now social workers, too, are being implicated.
To the extent this bill occupied any high ground, it has ceded it. It now joins the ranks of other bills that have delivered the outcomes from which Leadbeater was so keen to put some distance.
Her amendment indicates that the bill is floundering. Itl is not as thought-through as Dignity in Dying’s marketing push would have us believe. If something so central to the bill’s promise of “robust checks” can be dropped at this stage, it underscores just how fragile the entire framework really is.
And that should give those concerned about protecting the vulnerable hope. This bill can and should be stopped. Rather than forcing this defective bill through, Parliament must recognize the legitimate concerns, lament the defective process through which its proponents are rushing to try to address them, and reject the text. The warning signs could not be clearer. And the stakes could not be higher.
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