Assisted Dying Bill moves to House of Lords

MPs vote in favour of progressing assisted dying legislation
Westminster

In what was a seismic moment in British politics on Friday, the House of Commons agreed to support Kim Leadbeater’s Private Member’s Bill to legalise assisted dying services in England and Wales.

Specifically, the Bill will enable patients who are terminally ill and with fewer than six months to live to apply for an assisted death. MPs were again given a ‘free vote’ on the issue, meaning that they were not instructed to vote along party lines. The result was 341 votes in support, with 291 against. 

It is the first time that a Bill of this nature has progressed this far in Westminster’s parliamentary process. Since its introduction in November, MPs have poured over its detail through several debates, including the consideration of amendments. It will now move to the House of Lords, where Peers will similarly scrutinise and contest the proposals.

Traditionally, the Lords do not reject government bills, given that it is an unelected chamber. However, they do possess the constitutional power to do so and, given that this is not a government bill, there is no guarantee that they wouldn’t, should they believe that the final version is unworkable. Before then though, Peers will have the opportunity to propose and vote on changes.

What is in the Bill?

When the Bill was introduced, we produced a summary of what it contained, which you can read here. MPs have also agreed several changes and additions since then, outlined below.

  • An expert, multi-disciplinary panel comprising of a social worker, a psychiatrist and a legal professional will assess applications for an assisted death following sign off from two independent doctors, rather than a High Court Judge.
  • All professionals, including social workers, will now be able to legally opt-out of the process under the ‘conscience clause.’ Previously, only healthcare professionals had this option.
  • If either of the assessing doctors have doubt about the patient’s capacity, they must be referred for a mental capacity assessment.
  • The assessing doctors and all members of the panel will receive mandatory training in coercive control, financial abuse and domestic abuse.
  • Independent advocates will provide assistance to qualifying persons (people with learning disabilities, autism, a diagnosed mental disorder). The role of independent advocates will be to provide support and advocacy to a qualifying person who is seeking to understand options around end-of-life care.
  • The implementation period for the Bill has been extended from two years to four years, meaning that the earliest it could come into force is 2029.
  • The introduction of a Disability Advisory Board to specifically address and advise on the implementation and potential impact of the legislation on disabled people.
  • Information through any service, report, declaration or certificate of eligibility provided under the Act must be available in the person’s first language, if that language is either English or Welsh. Where a patient wishes to communicate in Welsh, the Commissioner must ensure that all panel members speak Welsh.
  • A ban on adverts promoting assisted dying services.
  • No health professional shall first raise the option of assisted dying with a patient under the age of 18.
  • Someone who is not terminally ill cannot bring themselves within that definition by voluntarily stopping eating or drinking or both.

BASW’s Position

BASW does not have an ‘in principle’ position on assisted dying but, given that a change in the law would have a significant impact on social work and on people who use social work services, we have sought to engage extensively with MPs at every stage of the process. In addition to submitting written evidence, we met with Kim Leadbeater MP alongside the Association of Palliative Care Social Workers in January.

Our approach has been to raise concerns where we identify them and to suggest possible solutions. We’re pleased that this has already led to important changes in the face of the Bill, including the introduction of a multi-disciplinary framework for assessing assisted dying applications and securing vital legal protections for social workers who choose to opt-out of the process.

We will adopt this same constructive approach with Peers. It is important that the legislators responsible for shaping these proposals continue to hear and take into consideration social work’s voice. Meantime, you can read our publicly available evidence to MPs here.

Next Steps

As the Bill stands, social workers will have a key role in assessing mental capacity for those eligible and opting for an assisted death. However, while the principle of the importance of mental capacity has been established, very little is known around how it will work. For example, how will an assessment be carried out when someone is in great pain, or on heavy medication?

A critical element of BASW's engagement with legislators will be to inform them around how we, as a profession, believe it should work. 

To achieve this, we are organising an online event on Monday, 7 July (17.00-18.30) for social workers to pool expertise and share ideas. Register here.

The event is likely to be of particular interest to Best Interests Assessors in England and Wales, although we would also welcome contributions from Mental Health Officers in Scotland. There is a separate Bill currently making its way through the Scottish Parliament, albeit at an earlier stage.

In addition to the above, we will also be lobbying Peers to include in the Bill a robust, independent inspection of assisted dying services, to be delivered by an appropriate agency. Currently, it is proposed that this is carried out by a “Voluntary Assisted Dying Commissioner”, which we do not believe is sufficiently independent. We also want patients and their families to be able to access advice and support from a suitably experienced social worker up to two years before a potential assisted death. We argued for these additions at Report Stage in the Commons, which you can read here.

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If you cannot make the above event but would still like to share your views with us, please contact policyadmin@basw.co.uk