The House of Commons, Health and Social Care Committee [H&SCC] has just released their 126-page report, summarizing their deliberations and 1 year of fact-finding about Assisted Suicide and/or Euthanasia. CA published the 3 pages of “Conclusions and Recommendations.”
This is a commentary on those recommendations. Most importantly:
The H&SCC made NO recommendation to change the law in the UK!
The Committee made few definitive statements, conclusions or recommendations. The conclusions & recommendations were commonly non-committal comments such as, “we heard”; “there is a pressing need”; “a view put forward” and that “we would welcome…” Still, there was NO recommendation to change the law in the UK!
DEFINITIVE RECOMMENDATIONS:
10. …a decision to participate should be freely taken by the individual healthcare professional and never imposed on them.
This is appropriate support for the freedom of conscience.
6. The UK Government must consider how to respond to another jurisdiction in the UK, or the Crown Dependencies, legislating to allow AD/AS, and how it may impact jurisdictions which do not allow it.
It is very appropriate to consider what would happen if say, Scotland introduces AS. [Clarification: The Isle of Man & Jersey are not part of the UK, being self-governing Crown Dependencies.]
13. The Government must ensure universal coverage of palliative and end of life services, including hospice care at home.
Absolutely! 24/7/365 country-wide.
13. It is important that everyone is able to choose what type of support they need at the end of their life, and that their advanced care plan is honoured where possible.
There should be a recommendation that — as much as possible — everyone with a serious illness, or advanced age, etc. should have a discussion and documentation of their Advanced Care Plan after being given a clear, factual prognosis. That decision/plan should be available to H.C. workers 24/7/365.
19. There is a pressing need to understand how to better provide mental health support, and guidance, for people who are living with a terminal diagnosis. We therefore recommend that the Government commission such research and report back to Parliament.
Reasonable & appropriate.
20. The Government must establish a national strategy for death literacy and support following a terminal diagnosis. This strategy will help healthcare professionals to better support someone and their loved ones, from the moment of a terminal diagnosis.
Good, though this is proper palliative care!
H&SCC COMMENTS & SUGGESTIONS (not definitive recommendations):
1. Our aim for this report is for it to serve as a basis for discussion and debate in future Parliaments...our report is not intended to provide a resolution to it.
Soft.
2. the pursuit of the very best end of life care…However, there is spectrum of views on how to best achieve this.
Inclusive type comment.
3. A view put forward by some who have provided evidence to us was that the current state of the law is unclear.
They seem to be referring to the question of people assisting the suicidal to go abroad for AS.
5. Although it is not illegal to provide medical reports in this circumstance, it does not seem to be entirely clear to doctors what they are allowed to do. We would welcome revised guidance from the GMC and the BMA enabling doctors to assist their patients.
This would be better as a firm recommendation.
7. In the evidence we received we did not see any indications of palliative and endof-life care deteriorating in quality or provision following the introduction of AD/AS; indeed the introduction of AD/AS has been linked with an improvement in palliative care in several jurisdictions.
Odd finding as there is evidence of decreased funding for PC in some jurisdictions & of increased regular (non-assisted) suicide in Australia, USA and the Netherlands.
8. …it to learn more about this difficult and sensitive subject.
This, after a year?
9. …there are two distinct models: one limiting its availability to those with a terminal illness and the other adding provision for unbearable suffering.
They did not comment on the slippage in what is considered to be “terminal.”
The overall trend is that numbers of AD/AS will increase from the time of introduction
Correct. Canada has had exponential growth & in 7 years is now the world leader.
11. We heard that any such assessment should be undertaken by professionals who have undertaken necessary training on capacity assessments, particularly in relation to vulnerable groups.
Absolutely — but NOT trained by the organization/doctors which will provide the AS/Euthanasia. (This happens in Canada: the Canadian Association of MAiD Assessors & Providers [CAMAP] writes the rules for the government… [MAiD: Medical Assistance in Dying.]
12. it is clear that there is hesitation around whether it is possible to accurately assess capacity, and safeguard the person, in every case.
Which begs the question as to what is the acceptable error rate in AS/Euthanasia? Is it ONE incorrect death per thousand? ONE per hundred??
With regard to the Death Penalty not one error is acceptable — so why is any error acceptable for innocent citizens?
14. …we agree that better data on the population within an ICB catchment area needs to be acquired by ICBs so that they can more fully understand the needs of the population.
Soft…”we agree” & we always need better data. [ICB Integrated Care Board. There are 42 ICB’s in England.]
15. …we call on the Government to commit to an uplift of funding to guarantee that support will be provided to any hospices which require funding assistance.
flimsy…would be better as a firm recommendation.
16. We were extremely saddened to read and hear about the experiences of people who had experienced a loved one taking their own life, and our thoughts and deepest sympathies remain with them.
Appropriate concern — but NOT in the recommendation section.
17. We are pleased that the ONS in now attempting to monitor the rates of suicide for people with a terminal diagnosis, as this will facilitate scrutiny in the future. The existing data already serves as a sobering reminder that the support and care around people who are managing a terminal diagnosis must be improved.
The way this is phrased is slanted towards AS, even though rates of suicide have increased in some jurisdictions with AS.
The ONS needs to monitor baseline suicide rates also, due to possible increases. [ONS: the Office for National Statistics.]
18. Suffering, pain and managing a terminal diagnosis will be a subjective experience, unique to the person experiencing them, and although there may be in the future, there is not currently a medical intervention available to manage every symptom or pain.
Mirroring the argument from pro-AS agencies who want AS to remove absolutely “every symptom or pain.”
MISSING ISSUES
The H&SCC made no comments about:
A possible review of each AS/Euthanasia request by an external agency before provision of AS/Euthanasia;
Having an appeal process for the family before provision of AS/Euthanasia if they suspect incompetence or coercion;
Required consultations (Psychiatry / Palliative Care, etc) not just recommended / offered.
Under what circumstances there would NOT BE legal immunity for a Health Care Provider against prosecution;
Indeed, clarification as to why AS/Euthansia has to be administered by Health Care providers; what evidence support this?
what number of errors is acceptable. Why is it acceptable to kill incompetent or coerced people?
Kevin Hay
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