⚖️ Terminally Ill Adults (End of Life) Bill (Twenty-sixth sitting)

• The Terminally Ill Adults (End of Life) Bill Committee reviewed amendments to clause 23, which deals with the obligation to provide assistance in assisted dying.
• Amendment 480 proposed by Danny Kruger aimed to extend the protection from obligation to all individuals, not just registered medical practitioners, nurses, and pharmacists. The amendment also specified activities where individuals are not obligated to participate.
• Lewis Atkinson expressed support for expanding protections but raised concerns about the amendment’s clarity and potential impacts on continuity of care.
• Amendments 483 and 484 aimed to widen the activities that healthcare providers are not obligated to participate in, but their vague language caused uncertainty.
• Other amendments, like amendment 441, sought to ensure care homes and hospices are not obligated to allow assisted dying on their premises, potentially affecting residents’ access to the service.
• New clause 22 addressed the right of premises’ occupiers to refuse assisted dying on their property, raising questions about the scope and potential impact on residents’ rights.
• New clause 23 aimed to prevent care homes and hospices from facing detriment for not providing or permitting assisted dying, which could conflict with residents’ rights under the European Convention on Human Rights (ECHR).
• Minister Stephen Kinnock expressed concerns that the proposed amendments could create legal uncertainty and potentially limit access to assisted dying for residents of care homes and hospices.
• Kim Leadbeater supported the principle of not forcing individuals to participate in assisted dying but was concerned about institutional opt-outs and their impact on terminally ill patients’ choice.
• The debate highlighted the complexity of balancing individual and institutional rights with the autonomy of terminally ill individuals seeking assisted dying.
• Danny Kruger defended the amendments, arguing for the protection of individuals and institutions’ rights to opt out of assisted dying, even if it conflicts with ECHR rights.
• The session underscored ongoing discussions about the practical and ethical implications of assisted dying legislation, with further amendments and considerations expected on Report.

The session shows a moderate level of disagreement among the Members of Parliament. This rating reflects the nuanced debate where there were clear differences in opinion, especially regarding institutional opt-outs and the rights of individuals and organizations in relation to assisted dying, but the discussions were respectful and aimed at improving the Bill. Key areas of disagreement include the following points, supported by specific examples from the transcript:

1. Institutional Opt-Outs: There was significant debate around amendments that would allow care homes and hospices to opt out of facilitating assisted dying on their premises. For instance, Naz Shah supported amendments that would permit care homes and hospices to opt out, emphasizing the need to protect the rights of these institutions and their staff. In contrast, Kim Leadbeater expressed concerns about these amendments, stating they might limit patient access to assisted dying and could lead to distress, particularly for those who consider a care home their home. The argument was highlighted by Leadbeater’s statement about a care home being someone’s ‘home’, indicating a disagreement on the balance between institutional autonomy and patient rights.

   • Example: Naz Shah states, “There are clear moral and practical arguments for saying that hospices and care homes should be able not to allow people to take lethal drugs on their premises,” while Kim Leadbeater counters, “Can it be right to ask them to leave their home if they choose to have an assisted death?”

2. Employee Rights and Conscience Clauses: There was disagreement on how far protections for individual conscience should extend in the workplace. Lewis Atkinson argued that amendments designed to protect employees if they refuse to provide assisted dying services were unnecessary, as existing healthcare regulations already serve this purpose. Conversely, Rebecca Paul proposed amendments to clarify that employers should not be forced to allow employees to provide such services against the employer’s policy.

   • Example: Lewis Atkinson argues, “Amendment 481 would insert a new subsection… That is moot: it is not necessary,” whereas Rebecca Paul defends her amendment by saying, “The amendment is simply to prevent a discrimination case.”

3. Legal and Ethical Considerations: The debate also included discussions on how the proposed amendments could affect legal rights under the European Convention on Human Rights (ECHR). Danny Kruger expressed strong concerns about the Government’s apparent reluctance to challenge potential ECHR decisions, emphasizing the need for parliamentary sovereignty. This indicates a disagreement on the approach to legal challenges and the interpretation of international law’s impact on domestic legislation.

   • Example: Danny Kruger criticizes the Minister’s position by saying, “I am very concerned about that in terms of both parliamentary sovereignty and the Government’s position.”

4. Autonomy and Community Impact: There was disagreement on the impact of assisted dying on community environments, especially in care homes and hospices. Danny Kruger warned about the potential for communities to split based on views on assisted dying, suggesting that some institutions should have the right to protect their environment from the practice. This was contrasted by arguments, such as those from Kim Leadbeater, who suggested that institutions should evolve with societal values and laws.

   • Example: Danny Kruger notes, “I think many people will not want to live in communities in which that practice takes place,” while Kim Leadbeater counters, “Institutions do not function in the same way as individuals when it comes to conscience-influencing decisions.”

The high degree of engagement on these issues, combined with the expressed willingness to work across party lines to address concerns (e.g., Lewis Atkinson’s offer to work with Danny Kruger), suggests a level of underlying agreement and respect for differing views. The disagreements, while notable, did not result in heated conflict but rather a thoughtful exploration of the implications of the proposed amendments.