An Open Letter to Welsh MPs

We are writing on behalf of a group of health care professionals, about the specific needs of Welsh speakers relating to the Terminally Ill Adults (End of Life) Bill.

This Bill, as currently proposed, requires the coordinating doctor and the independent doctor to assess the decision-making capacity of any adult requesting assisted suicide, and to assess that the person’s decision to end their life is voluntary (free from coercion).

There is no requirement to enquire or record whether the person is a Welsh Speaker, nor a requirement to undertake the necessary assessments in Welsh.

In all cases, the coordinating doctor and the independent doctor (and any other healthcare professional involved) should be required to enquire about the person’s language preferences; English speaking healthcare professionals are often unaware of the challenges that Welsh speakers face when accessing healthcare in English.

Frequent experience demonstrates that it is not possible to confidently assess decision making capacity of a Welsh speaker in their second language (i.e. in English). Superficial conversations in English often fail to demonstrate that a Welsh speaker with significant health problems is confused or does not have a good understanding of their health condition and treatment options. The presence of confusion or lack of information may only become apparent during detailed conversation with a Welsh speaking healthcare professional.

It can be extremely challenging to detect the presence of coercion, and the nuances of family dynamics will not be apparent to a non-Welsh speaking professional, when the language spoken in the family is Welsh. Thus, it will not be possible to make any assessment of the presence or absence of coercion if the coordinating and independent doctors (and any other healthcare professionals involved in the process) have the necessary conversations in English with a Welsh speaker.

It should be apparent that these arguments apply to anyone whose first language is not English.

Thank you for taking the factors detailed above into account when debating the Terminally Ill Adults (End of Life) Bill, and when voting.

We would welcome the opportunity to discuss this with you in more detail. Please do let me know when we could meet with you in the coming weeks.

Yours sincerely,