Laws allowing assisted dying could be passed in Scotland, Jersey and the Isle of Man in coming years, creating a divergence between different parts of Britain and the British Isles, MPs have warned.
The government must take the consequences of this into account, according to a parliamentary inquiry into assisted death.
Jersey, the Isle of Man and Scotland are all considering legalizing assisted death, although in both cases only permanent residents would be eligible.
“It seems increasingly likely that at least one jurisdiction among the UK and Crown dependencies will allow (assisted dying) in the near future and ministers should be actively involved in discussions about how to address the differences in legislation,” it says a report from the health department. and Social Care Commission.
It also recommends that doctors be given clear guidance on how to respond to requests for medical reports from terminally ill patients considering traveling abroad for assisted dying.
While it is not illegal to provide medical reports to facilitate assisted death abroad, the British Medical Association (BMA) advises doctors not to do so, while the General Medical Council (GMC) says that providing access to the patient’s records should not be taken as encouragement or encouragement. assistance.
“It does not appear to be entirely clear to doctors what they are allowed to do,” the report says, adding that revised guidance from the GMC and BMA is needed.
The report urges the government to commit to greater financial support for hospices and “ensure universal coverage of palliative and end-of-life services”.
The study took into account more than 68,000 citizen responses and 380 pieces of written evidence during the assisted death investigation.
The report, published on Thursday, does not address one side or the other of what it describes as a “difficult, sensitive and yet crucial subject”. Rather, it is intended as a tool for continued debate, including the possibility of a parliamentary vote in the coming years.
The committee heard from proponents of a change in the law, who argued that too many people suffer painful and undignified deaths. Legislation would offer terminally ill people no choice between life and death, but some control over the manner and time of their death.
Opponents of assisted dying told the committee that legislation is a “slippery slope” and could increase pressure on old and sick people. Instead of legalizing assisted dying, more resources should be allocated to palliative care.
Steve Brine, chairman of the committee, said the inquiry “raised the most complex issues we have faced as a committee, with strong feelings and opinions expressed in the evidence we heard. It is our intention that the information and testimony we present in our report today … will be an important and useful resource for future debates on this issue.” He thanked those who had shared “very difficult personal stories.”
The report was completed amid mounting pressure for change after broadcaster Esther Rantzen revealed in December that she was considering assisted death after being diagnosed with an incurable cancer.
Keir Starmer, the Labor leader, backed a call for law change and Education Secretary Gillian Keegan said the issue “It needs to be debated”. The last parliamentary vote on legalizing assisted dying, in 2015, was defeated by 330 votes to 118, but many more MPs are now believed to be in favour.
Polls have shown that between 73% and 84% of the public support legalization within strict guidelines. Between 1998 and 2022, 531 Britons traveled to Dignitas in Switzerland for assisted death, the report said.
It is not illegal for a British citizen to travel abroad for an assisted death, but anyone who accompanies or assists the person may be subject to investigation and prosecution.
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A woman who accompanied her mother to Dignitas said she was investigated by police for two years before the Crown Prosecution Service (CPS) said there was no public interest in proceedings.
“In the meantime, they had looked at my bank account, they had taken witness statements from people we loved, who loved my mother, they had taken equipment from me,” the woman said. ‘I felt like my reputation was in serious jeopardy. It almost brought my sister to the brink of suicide… It cost us thousands and thousands of pounds in legal fees to defend ourselves.”
CPS guidance from 2014 states that any prosecution must be in the public interest. Starmer, then head of the CPS, said he is “unlikely to prosecute those who are motivated by compassion and who help a family member or close friend” with a “clear, firm and informed” wish to die.
Of the 182 cases referred to the CPS between April 2009 and March 2023, 125 were not pursued and 35 were withdrawn by police, the report said.
The government said it had a “neutral position on whether legislation should be introduced” to allow assisted dying. Helen Whately, the social care minister, told the committee: “Should the will of Parliament change, the Government will not stand in its way, but Parliament must take that step.”
Jersey is expected to move forward with a bill after a citizens’ jury overwhelmingly supported assisted dying for adult residents with a terminal illness or experiencing unbearable suffering. The process would take twelve to eighteen months, with another eighteen months before the law could come into effect.
The Isle of Man Parliament backed a proposal in October to allow terminally ill, mentally competent adult residents to choose an assisted death option. The bill is in the committee stage.
In Scotland, a bill to legalize assisted dying is expected to be introduced for debate in the devolved parliament this year.
The committee examined data from seventeen jurisdictions around the world where assisted death is legal for someone who is terminally ill. This includes a number of American and Australian states, Canada and several European countries. It found that the number of assisted dying cases had “increased in every jurisdiction”, but this “need not be seen as negative but can instead be seen as a sign of increased access”.
The report says: “Britain has long been the world leader in palliative and end-of-life care, but access to and provision of palliative and end-of-life care is patchy. The government should ensure universal coverage of palliative and end-of-life services, including hospice care at home.
“It is important that everyone can choose the type of support they need at the end of life and that their advanced care plan is respected where possible.”