The Letter to the Lords

My Lords,

As health care professionals, we are deeply concerned about the Terminally Ill Adults (End of Life) Bill. We have worked across the nation with vulnerable patients, and in under-resourced health and social care services. Those who are distressed as they face a terminal illness deserve better. The inequity in provision of specialist palliative care and hospice beds was highlighted by the Commission on Palliative Care. We know that care provision currently fails too many, but this Bill is not the answer.

• The definition of terminal illness is too broad. It fails to recognise the risks from mistaken diagnosis or misinformation. Accurate prognostication is impossible.

• The Mental Capacity Act (MCA 2005) was not designed to assess suicidality. Assessment of mental capacity is not sufficient when considering a patient presenting with suicidal thoughts. A full psychosocial and mental health assessment  should be required for a person who presents with suicidal ideation, whether they are terminally ill or not.

• Patients will be eligible to access assistance to end their life under this Bill because they feel a burden or because of a lack of services. Coercion is often covert and difficult to detect, particularly when it comes from family or from a person with authority.

• The oversight within this Bill is inadequate. The panel does not need to see the patient. The MHRA does not need to regulate the drugs. The Coroner does not need to review the death. There is no mechanism for independent scrutiny of the assisted dying service, for appeal against panel approval or redress for distressed family members.

Will Parliament require that we give patients the means to take their own lives when we know they will not get a hospice bed or meaningful counselling? Should not Parliament require that we instead provide them with decent palliative care services and psychological support?

We urge you to speak against this Bill.

Yours sincerely,