Assisted dying: What is in the legislation?

Published

3 hours ago

November 26, 2024

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MPs will on Friday have to make one of the biggest decisions of their careers – whether or not to back assisted dying.

The proposed law would make it legal for over-18s who are terminally ill to be given medical assistance to end their own life in England and Wales.

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The bill – called the Terminally Ill Adults (End of Life) Bill – sets out detailed requirements in order to be eligible.

The Labour MP proposing it, Kim Leadbeater, says the safeguards are the “most robust” in the world, but others argue it is a “slippery slope towards death on demand”.

What is in the bill?

The purpose of the bill is to allow adults aged 18 and over, who have mental capacity, are terminally ill and are in the final six months of their life, to request assistance from a doctor to die.

This is subject to “safeguards and protections” which include:

• They must have a “clear, settled and informed wish to end their own life” and have reached this decision voluntarily, without coercion or pressure;
• They must have lived in England or Wales for 12 months and be registered with a GP;
• Two independent doctors must be satisfied the person meets the criteria and there must be at least seven days between the doctors making the assessments;
• If both doctors state the person is eligible, then they must apply to the High Court for approval of their request;
• If the High Court decides that the applicant meets the bill’s requirements, then there is a 14-day reflection period (or 48 hours if death is imminent);
• After this, the person must make a second declaration, which would have to be signed and witnessed by one doctor and another person.

What happens if the eligibility criteria is met?

If a person meets all this eligibility criteria, a life-ending “approved substance” would be prescribed.

This would be self-administered, so the individual wishing to die must take it themselves.

This is sometimes called physician-assisted dying and is different from voluntary euthanasia, when a health professional would administer the drugs.

As well as all the conditions set out above, the bill would make it illegal to pressure or coerce someone to make a declaration that they wish to end their life, or take the medicine.

These offences will be punishable by a maximum 14-year prison sentence.

How is this different from the current law?

Suicide and attempted suicide are not in themselves criminal offences. However, under section 2(1) of the Suicide Act 1961, it is an offence in England and Wales for a person to encourage or assist the suicide (or attempted suicide) of another.

Ms Leadbeater says the current framework is “not fit for purpose”, as people who are terminally ill and in pain only have three options – “suicide, suffering or Switzerland”.

Assisted dying has been legal in Switzerland since 1942, with the Dignitas group becoming well-known as it allows non-Swiss people to use its clinics.

There is no government-held data on the number of Britons travelling abroad for assisted dying, but other countries where a form of this is legal include the Netherlands, Belgium, Spain, Luxembourg, Canada, New Zealand, Australia and some US states.

Why is it being debated now in England?

The issue has gained renewed attention recently due to campaigning by broadcaster Dame Esther Rantzen. The 84-year-old Childline founder has stage-four lung cancer and revealed last year that she had signed up to Dignitas.

Over the past two decades, the debate has largely been driven by legal challenges to the current regime, brought by people who are suffering and say the current laws violate their human rights.

Parliament last considered the issue in 2015, when MPs voted down assisted dying by 330 votes to 118.

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Ms Leadbeater has brought the issue to the fore through a private members bill, meaning it has been introduced by an MP who is not a government minister.

She wants to give people who are terminally ill and in pain a choice, insisting the bill is about “shortening death rather than ending life”.

What are the main arguments for and against?

Lots of campaigners support Ms Leadbeater’s position. The Campaign for Dignity in Dying says it will give people who are facing unbearable suffering control, so they can have a peaceful death.

They do not support a wider law, unlike My Death, My Decision, who want the bill to apply to people who are suffering with an incurable condition, even if it is not terminal.

However some people oppose any change to the current position. This can be for a variety of reasons, but one of the main arguments is the risk of a “slippery slope” – that the eligibility criteria would widen over time.

Others say good end-of-life care needs to be prioritised, and fear some people will feel pressured to opt for assisted dying if they feel like a burden to society.

How will the bill be scrutinised?

MPs will debate and vote on this bill on Friday 29 November.

It is a free vote, meaning MPs can side with their conscience and not party lines.

The government is taking a neutral position, though individual cabinet ministers have come out both strongly for and against the proposal.

If passed on Friday, the bill will have to pass many more parliamentary hurdles before it becomes law.

MPs will get a chance to debate the bill again in greater depth during its committee stage and peers will also have ample opportunity to express their views on the legislation in the House of Lords.

Politics

Council services ‘could suffer due to social care costs’ if government creates ‘super councils’

Published

47 seconds ago

November 26, 2024

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Council services 'could suffer due to social care costs' if government creates 'super councils'

Council services such as leisure centres and waste collection could suffer due to the cost of social care if the government goes ahead with plans to scrap district councils in favour of “super councils”, local government sources have claimed.

They told Sky News the government is considering getting rid of district councils, which are responsible for waste collection, housing, leisure centres, local economics and regeneration.

District councils, also called borough or city councils, along with larger county councils would be merged to make “super councils” – or unitary councils – covering an entire region, the sources said.

The changes are expected in the English devolution white paper, set to be published soon, after Chancellor Rachel Reeves said in her October budget she wanted to make council structures “simpler” by reorganising them.

However, there are concerns the rising cost of social care, which larger county and unitary councils have to legally fund, will pull funding away from the basic but essential services district councils provide.

There is also a worry these large councils will become detached from local communities, despite Ms Reeves saying she wanted the reorganisation of council structures “to meet the needs of local people”.

Bridget Smith, Lib Dem leader of South Cambridgeshire district council and vice chair of the District Councils’ Network (DCN), told Sky News: “Unitary and county councils are struggling financially, and in many cases going under, because of the ever-increasing demands of social care.

“It will be no different for these proposed ‘super councils’.

“The danger is social care will suck up all the resources which districts currently spend on place making, economic development, preventing ill health, improving quality of life and so much more.”

She added that simply reorganising local government is “simplistic and naive” and will cause new problems for local communities, and for the government’s housing targets as district councils are responsible for housing.

There is also concern if councils were merged it would take about three years to convert, which would take up all a council’s time, potentially bringing projects to a halt, including house building.

Sam Chapman-Allen, chair of the DCN and leader of Breckland district council in Norfolk, said there are examples across England where devolution – handing power and funding from national to local government – is working well, such as Manchester where 10 district councils work together under the mayor of Greater Manchester.

Smaller examples include South Lincolnshire, where three councils work together with a shared senior team.

“I wouldn’t say my members are nervous about change because they’re really nimble, agile organisations, but we want to work with government to get the best outcomes for their residents and businesses,” he told Sky News.

He said district councils also provide lots of preventative “non-traditional” social care schemes off their own backs, such as supporting people to live a healthy life, which means they take pressure off the traditional social care system.

Conservative shadow housing, communities and local government secretary Kevin Hollinrake told Sky News: “Services have to come first so you want to make sure they’re maintained and improve social care, and of course it’s the biggest part of the discretionary budget. It’s a valid concern.

“On the face, there are savings moving from two tier to one tier, but you don’t want the council or councillors to become too removed from what they’re serving.

“The worry here is this is an imposition rather than asking councillors if they want to move to unitary – that’s top down rather than bottom up.

“It’s perverse, you’re talking about devolving then telling councils what to do. It’s a bit of a paradox.”

A spokesman for the ministry of housing, communities and local government said there are “no plans to abolish district councils” and any organisation will be “from the bottom up”.

He added: “No decisions have been taken on council reorganisation.

“Our priority is to focus on the transfer of power from Westminster and work with councils to create structures that make sense for their local areas and work effectively for local people.

“We have announced £1.3bn to help councils deliver essential services – including an additional £233m to help prevent homelessness, and will be providing greater stability with multi-year funding settlements, so we can get councils back on their feet.

“We will set out further details in the upcoming English devolution white paper.”

Politics

Fianna Fail doubles down on refusal to form coalition with Sinn Fein

Published

1 hour ago

November 26, 2024

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Fianna Fail doubles down on refusal to form coalition with Sinn Fein

Fianna Fail leader Micheal Martin says his party has made “a policy decision” not to enter coalition government with Sinn Fein after Ireland’s general election.

Current polling shows the three largest parties – Fine Gael, Fianna Fail and Sinn Fein – in a three-way tie.

In the third of our leader interviews ahead of Friday’s vote, Mr Martin told Sky News that Sinn Fein’s housing strategy would “crucify first-time buyers”.

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He said: “They want to get rid of the help-to-buy scheme and the first home bridge-the-gap scheme.

“If you put them together, they can give up to €80,000 to a first-time buyer.”

“Sinn Fein’s housing policies would mean delay, disruption and higher prices at the end of the day,” he added.

With nearly 15,000 people in emergency accommodation, compared to just over 10,000 in 2020, housing has dominated the campaign.

Asked why the crisis had deepened while his party had been in coalition with Fine Gael over the last four years, he replied: “We need to do more.

“We acknowledge the serious challenges facing us, but we have the better policies.

“125,000 houses were built over the last four years, so Fianna Fail did take the portfolio, we did change momentum on housing,” he added.

Mr Martin, who was taoiseach for the first half of the outgoing coalition’s term, currently serves as tanaiste (deputy prime minister) and foreign affairs minister.

He said he understood the concerns people have about “the very significant increase in those seeking asylum in this country” and vowed to establish a new department of domestic affairs to address it.

Reflecting on “a world in turmoil,” he also disagreed with Sinn Fein on the need to prioritise Irish unity.

He said: “My focus is on uniting people, Protestant, Catholic and dissenter, and that’s always been my creed.

“I put practical flesh on the bones of that when I became taoiseach, when I set up the Shared Island Initiative, the most consequential initiative since the Good Friday Agreement.

“We put €1bn behind that initiative to get a lot of projects done. To me, that’s the pragmatic flesh on the bone.

“Let’s build reconciliation. We’ve had enough of rhetoric and all these calls Sinn Fein go on about.

“We’ve had that for 75 years. It didn’t achieve a whole lot, but it’s about getting behind reconciliation. It’s about people.”

Watch Micheal Martin’s interview in full on Politics Hub with Sophy Ridge. Sky News has also interviewed the Fine Gael and Sinn Fein leaders.