This transcript has been edited for clarity.
Hello. I’m David Kerr, professor of cancer medicine at the University of Oxford. You may have noticed that, over the past couple of weeks, there has been an intense debate in the United Kingdom about the introduction in our Parliament of an assisted dying bill.
This is a piece of legislation that has been introduced — not finally approved, but certainly it’s a bill past its first reading — in which it says that anyone who wants to end their life must be over 18; live in England or Wales; and have been registered with a general practitioner, a primary care consultant, for at least 12 months.
They must have the mental capacity to make the choice and be deemed to have expressed a clear, settled, and informed wish, free from coercion or pressure. That’s terribly important. They need to be expected to die within 6 months. You need to make two separate declarations, witnessed and signed, about their wish to die, and satisfy two independent doctors that they’re eligible, with at least 7 days between each assessment.
This was a backbench bill introduced by one of our members of Parliament. Members of Parliament had a free vote. That means that there was no voting along party lines, right vs left (or Democrats vs Republicans, if it was the United States).
Members of Parliament were allowed to vote according to their conscience. That creates an interesting discussion — not for today — about how representative parliaments work in terms of expressing the wishes of their own constituents, the area where they’re elected, the people that they’re elected by, pushing that to one side.
The bill was passed. It was a relatively narrow majority. The majority was only 55 votes in a Parliament that has around 600 members. There was a televised, passionate, balanced, thoughtful debate on both sides of the argument.
Of course, the people arguing for this new bill gave many heartbreaking stories of individuals who suffered terribly in those final months before their death. No one could not be moved by their stories. Of course, I, as a cancer physician, have personal experience with this.
On the other hand, the side who opposed the bill said they’re worried about coercion, they’re worried about the state having the capacity to kill people, using emotive language of that sort, and they’re worried about the relatively poor quality of palliative care. They’re worried about additional pressures on our legal system, on our National Health Service, to create space and room for this assisted dying methodology, looking at it that way.
The bill passed, so what happens now is that the bill will be further scrutinized within both our Houses of Parliament, lower and upper, and amendments and improvements made. It’s not yet passed into law, so there’s still quite a long way to go.
I wonder what you think about the concept of assisted dying, and how one would prepare the legislation in such a way that balanced both sides and pros and cons.
For those of you who live in countries like the Netherlands, Canada, and so on, in which assisted dying bills have already passed, how do you feel it’s changed your societal view of death or the end of life? How do you consider it might impact us in the United Kingdom within a national healthcare, socialized healthcare system? I’d be very interested in your views on it.
I chair a medical think tank for Gordon Brown, one of our former prime ministers, and he came out very firmly against the bill. Personally, I agree with him. I would rather that we invest in improved palliative, supportive end-of-life care.
I’d rather that we considered something around the right to try or the right to hope about the better introduction of novel medicines that might make a difference—who can say—but to consider how we might be able to bring more experimental treatments to bear in those individuals, rather than this, a kinetically unstable bill that’s come forward.
I’d be very interested in your own views. This is a highly personal issue, but one in which the personalia are going to be enshrined in law. What are your thoughts about it? I’d be very interested and moved by your own stories if you’re prepared to tell us.
For the time being, Medscapers, over and out. Thanks for listening, as always.
COMMENTARY
UK’s Assisted Dying Legislation: Balancing Pros and Cons
David J. Kerr, CBE, MD, DSc
DISCLOSURES
| December 27, 2024This transcript has been edited for clarity.
Hello. I’m David Kerr, professor of cancer medicine at the University of Oxford. You may have noticed that, over the past couple of weeks, there has been an intense debate in the United Kingdom about the introduction in our Parliament of an assisted dying bill.
This is a piece of legislation that has been introduced — not finally approved, but certainly it’s a bill past its first reading — in which it says that anyone who wants to end their life must be over 18; live in England or Wales; and have been registered with a general practitioner, a primary care consultant, for at least 12 months.
They must have the mental capacity to make the choice and be deemed to have expressed a clear, settled, and informed wish, free from coercion or pressure. That’s terribly important. They need to be expected to die within 6 months. You need to make two separate declarations, witnessed and signed, about their wish to die, and satisfy two independent doctors that they’re eligible, with at least 7 days between each assessment.
This was a backbench bill introduced by one of our members of Parliament. Members of Parliament had a free vote. That means that there was no voting along party lines, right vs left (or Democrats vs Republicans, if it was the United States).
Members of Parliament were allowed to vote according to their conscience. That creates an interesting discussion — not for today — about how representative parliaments work in terms of expressing the wishes of their own constituents, the area where they’re elected, the people that they’re elected by, pushing that to one side.
The bill was passed. It was a relatively narrow majority. The majority was only 55 votes in a Parliament that has around 600 members. There was a televised, passionate, balanced, thoughtful debate on both sides of the argument.
Of course, the people arguing for this new bill gave many heartbreaking stories of individuals who suffered terribly in those final months before their death. No one could not be moved by their stories. Of course, I, as a cancer physician, have personal experience with this.
On the other hand, the side who opposed the bill said they’re worried about coercion, they’re worried about the state having the capacity to kill people, using emotive language of that sort, and they’re worried about the relatively poor quality of palliative care. They’re worried about additional pressures on our legal system, on our National Health Service, to create space and room for this assisted dying methodology, looking at it that way.
The bill passed, so what happens now is that the bill will be further scrutinized within both our Houses of Parliament, lower and upper, and amendments and improvements made. It’s not yet passed into law, so there’s still quite a long way to go.
I wonder what you think about the concept of assisted dying, and how one would prepare the legislation in such a way that balanced both sides and pros and cons.
For those of you who live in countries like the Netherlands, Canada, and so on, in which assisted dying bills have already passed, how do you feel it’s changed your societal view of death or the end of life? How do you consider it might impact us in the United Kingdom within a national healthcare, socialized healthcare system? I’d be very interested in your views on it.
I chair a medical think tank for Gordon Brown, one of our former prime ministers, and he came out very firmly against the bill. Personally, I agree with him. I would rather that we invest in improved palliative, supportive end-of-life care.
I’d rather that we considered something around the right to try or the right to hope about the better introduction of novel medicines that might make a difference—who can say—but to consider how we might be able to bring more experimental treatments to bear in those individuals, rather than this, a kinetically unstable bill that’s come forward.
I’d be very interested in your own views. This is a highly personal issue, but one in which the personalia are going to be enshrined in law. What are your thoughts about it? I’d be very interested and moved by your own stories if you’re prepared to tell us.
For the time being, Medscapers, over and out. Thanks for listening, as always.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
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