When the Terminally Ill Adults (End of Life) Bill was debated in the
House of Lords last month, the Bill’s sponsor, Lord Falconer, argued
that it would improve palliative care.
That view isn’t shared by
Toby Porter, the CEO of Hospice Care UK. He testified before the
Terminally Ill Adults Bill select committee in the House of Lords last
week and warned that hospices are facing “significant cuts”. The last
thing they need is for NHS funds to be diverted to an assisted dying
service.
The NHS already struggles to provide enough GPs,
consultants, nurses and psychiatrists to meet demand. Yet the Bill
assumes there will always be qualified professionals on hand to assess
patients, confirm mental capacity, and prescribe life-ending medication.
In reality, those resources are already stretched to breaking point.
The
Royal College of Psychiatrists has stated repeatedly, including last
week in the special committee set up in the Lords, that it also doesn’t support the Bill.
It doesn’t feel psychiatrists will be able to properly assess mental
capacity and consent in their proposed roles on the panels.
Wes
Streeting has repeatedly emphasised that the budget for the assisted
dying service – the Bill’s name for the proposed suicide unit – would come out of the NHS budget, meaning other services would have to be cut to fund it, at least in the short term.
There
are also practical questions that no one seems to have answers to. The
Bill insists patients must self-administer the life-ending drugs – one
of the so-called “safeguards”. But many patients in palliative care –
those with Motor Neurone Disease, Parkinson’s, or simply very advanced
illnesses – can’t even self-administer their regular painkillers. Nor
can they walk to a pharmacy to pick up a prescription. Would the
life-ending drugs be delivered by post? If relatives collect them and
hand them to their loved ones, would they risk prosecution? Or would
they need to be handed to patients by doctors who would then be required
to stand over them while they swallow the lethal pills?
That
last method is the one suggested by the Bill, with doctors being allowed
to “assist [the patient] to ingest or otherwise self-administer the
substance”, i.e., they could spoon the poison into their mouth. They
will also be permitted to prepare “a device which will enable [the
patient] to self-administer the substance“ i.e., set up an intravenous
line with an infusion which the patient would then have to activate.
In practice, this would create a system very similar to how euthanasia works in Canada where the majority of deaths are by IV infusion, with the only
difference being that in the UK the patient presses the button. Doctors
who administer or help administer the lethal drugs in this way are also
required by the Bill to stay with the patient until they die and it’s
worth bearing in mind that in Oregon deaths have taken up to 137 hours
to occur after the suicide pills have been taken. Needless to say, this
would eat into other clinical commitments....<<<
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