😐 Terminally Ill Adults (End of Life) Bill (Eighth sitting)

• The session focused on the Terminally Ill Adults (End of Life) Bill, discussing amendments and clauses related to assisted dying.
• Concerns were raised about the volume of written evidence and correspondence received by the Committee, with some members feeling overwhelmed and suggesting an adjournment to digest the information.
• Amendments were proposed to ensure that assistance under the Bill is only provided to individuals physically present in England and Wales, aiming to prevent medical tourism.
• A significant debate centered around the use of the Mental Capacity Act 2005 for assessing a person’s ability to make a decision about assisted dying. Some members argued that the Act’s criteria are too low for such a grave decision.
• An amendment was proposed to replace “capacity” with “ability” in the Bill, suggesting that individuals should “fully understand, use and weigh the relevant information” to be eligible for assisted dying.
• Concerns were voiced that the Mental Capacity Act might not adequately protect terminally ill individuals with co-occurring mental health issues, such as depression, from making decisions influenced by their condition.
• The discussion included the possibility of referring individuals to a psychiatrist if there is doubt about their capacity, with an amendment potentially changing “may” to “must” in the referral process.
• Some members defended the Mental Capacity Act, citing its use and familiarity among medical practitioners and its established legal precedent over 20 years.
• The session ended without a vote on the amendments, as the Chair adjourned the Committee to reconvene later.

The disagreement displayed in the session falls into the moderate category. While there is disagreement and debate among the members, it is centered around specific amendments and expressed constructively, with the aim of improving the legislation rather than outright opposition. The session focuses on the nuances of the ‘capacity’ versus ‘ability’ amendments, which indicates a detailed and technical discussion rather than a deeply fractious debate. Here are the key points that lead to this rating:

1. Nature of Disagreement: The main disagreements revolve around the suitability of the Mental Capacity Act for assessing a person’s competence in requesting assistance with dying. The discussions are technical and focused on the legislative language and its implications, rather than personal or ideological clashes.

2. Examples of Disagreements:
   • Sarah Olney argues for replacing ‘capacity’ with ‘ability’ in the Bill, citing concerns that the Mental Capacity Act may not be sufficient for the purposes of this legislation. She presents evidence from the Royal College of Psychiatrists to support her amendments.
   • Dr. Marie Tidball and Dr. Neil Shastri-Hurst oppose Olney’s amendment, defending the Mental Capacity Act’s suitability and warning against the potential complexity and lack of clarity of introducing a new term. They reference the established use and court-tested nature of the Act.
   • Danny Kruger supports Olney’s amendment, arguing that the Mental Capacity Act may allow for impaired judgment, which he believes should not be the case for assisted dying decisions.

3. Tone and Constructiveness: The debate, while showing clear differences in opinion, remains respectful and focused on the objective of refining the legislation. Members articulate their positions with references to legal precedents, expert opinions, and personal experiences, aiming to enhance the safeguards within the Bill.

4. Level of Consensus and Compromise: There are signs of compromise and potential for further agreement, as seen in the discussions about additional amendments that would require mandatory psychiatric assessments if there is doubt about capacity. This suggests a willingness to address concerns and move forward with the legislation.

Overall, the session exhibits a moderate level of disagreement, characterized by constructive debate aimed at legislative improvement rather than entrenched opposition.