Select Committee · Health and Social Care Committee

Assisted dying/assisted suicide

Status: Closed Opened: 5 Dec 2022 Closed: 30 May 2024 6 recommendations 14 conclusions 1 report

The Health and Social Care Committee is holding an inquiry into assisted dying/assisted suicide. The deadline for submitting written evidence or responding to our online form has now passed. We are publishing the written evidence we have received on the publications page of the inquiry. Please note that the written evidence and roundtable transcripts contains …

Reports

1 report
Title HC No. Published Items Response
Second Report - Assisted Dying/Assisted Suicide HC 321 29 Feb 2024 20 Responded

Recommendations & Conclusions

20 items
1 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Report offers comprehensive evidence base for future parliamentary debate on difficult AD/AS subject.

Our aim for this report is for it to serve as a basis for discussion and debate in future Parliaments. We have therefore endeavoured to bring together a comprehensive and up-to-date body of evidence relating to this difficult, sensitive, and yet, crucial subject. The debate on AD/AS is not new, …

Government response. The government states that should Assisted Dying/Assisted Suicide legislation be enacted, it will discuss its practical and constitutional implications for England and Wales with the devolved administrations and Crown Dependencies.
Department of Health and Social Care
2 Conclusion Second Report - Assisted Dying/Assisted… Accepted

End-of-life care: common desire for a good death, diverse views on achieving it.

Throughout our inquiry, a common theme across the evidence was the pursuit of the very best end of life care, and what many witnesses called “a good death”, where the person dying was cared for with compassion and high-quality care and provided with as much agency and choice as possible. …

Government response. The government details ongoing work and existing policies aimed at improving end-of-life care, including mandatory commissioning for Integrated Care Boards, statutory guidance from NHS England, the development of a palliative care dashboard, and recognition of personalised care in the Major …
Department of Health and Social Care
3 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Current law on assisted dying and suicide perceived as unclear by some.

A view put forward by some who have provided evidence to us was that the current state of the law is unclear.

Government response. The government's response details funding for hospices, including £25 million for children's hospices in 2024/25, and discusses disparities in hospice access, completely sidestepping the recommendation regarding the clarity of the law on Assisted Dying/Assisted Suicide.
Department of Health and Social Care
4 Conclusion Second Report - Assisted Dying/Assisted… Accepted

Individuals have assisted loved ones in pursuing assisted dying abroad.

During our inquiry we have heard statements from people who have been involved in assisting a loved one to pursue AD/AS abroad.

Government response. The government is investing £3 million in a new Palliative and End of Life Care Policy Research Unit to build the evidence base for all-age palliative and end-of-life care, and highlights existing NHS Talking Therapies services for mental health support.
Department of Health and Social Care
5 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Issue revised guidance for doctors on providing medical reports for assisted dying abroad.

We also heard about the documentation which has had to be secured as part of the application, including a medical report for the person applying. We note that the General Medical Council’s guidance for Investigation Committees assessing a doctor’s fitness to practice following an allegation of a doctor’s encouragement or …

Government response. The government states it does not plan to establish a national strategy for death literacy and outlines existing palliative and end-of-life care strategies and training, but does not address the recommendation for revised guidance from the GMC and BMA on …
Department of Health and Social Care
6 Recommendation Second Report - Assisted Dying/Assisted… Accepted

Require UK Government to prepare for legislative divergence on assisted dying in UK jurisdictions.

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. Following the recommendation by the Jersey Citizens’ Assembly, it looks increasingly likely that at least one jurisdiction …

Government response. The government confirms it will discuss with devolved administrations and Crown Dependencies the practical and constitutional implications for England and Wales should any assisted dying/suicide legislation be enacted elsewhere.
Department of Health and Social Care
7 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Assisted dying introduction has not degraded palliative care; eligibility not expanded beyond terminal illness.

In the evidence we received we did not see any indications of palliative and end- of-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. We also conclude that jurisdictions …

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
8 Conclusion Second Report - Assisted Dying/Assisted… Deferred

International examples demonstrate complexity of assisted dying debate, providing valuable lessons for the UK.

When we undertook this inquiry, we were keen to learn as much as we could from international examples and we hope that by putting the evidence we have gathered into the public domain, we can help to further inform the debate on AD/AS in the UK. The fact that people …

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
9 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Diverse assisted dying models exist; better data collection and independent oversight are crucial.

There are as many ways to operate AD/AS as there are jurisdictions which have legalised it, but there are two distinct models: one limiting its availability to those with a terminal illness and the other adding provision for unbearable suffering. What has become clear to us is that better data …

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
10 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Ensure healthcare professionals' participation in assisted dying is voluntary, never imposed, if legalised.

Medical professionals would have an important role in any system of AD/AS, although the details are for Parliament to determine should it move to legalise AD/ AS. During our inquiry we have heard from healthcare professionals who were content to be involved, from others who were supportive of the practice …

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
11 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Require trained professionals to undertake capacity assessments for assisted dying, particularly for vulnerable groups.

Practice across the world where AD/AS is legal is varied in the respect of capacity assessments for AD/AS. 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.

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
12 Conclusion Second Report - Assisted Dying/Assisted… Deferred

Healthcare professionals express clear hesitation regarding accurately assessing capacity and safeguarding in all cases.

Throughout our inquiry into AD/AS, the importance of safeguards and protections, and the question of whether they can be sufficient, has been a central feature, as has the related question of assessing capacity. Hearing from various representatives of healthcare professionals, as well as from healthcare professionals directly, it is clear …

Government response. The government redirects responsibility for any change to the law regarding Assisted Dying/Assisted Suicide to Parliament, stating it is a matter of conscience for individual parliamentarians rather than a government policy matter.
Department of Health and Social Care
13 Recommendation Second Report - Assisted Dying/Assisted… Accepted

Ensure universal coverage of palliative and end of life care services, including hospice care at home.

The UK has long been a world leader in palliative and end of life care, but access to and provision of palliative and end of life care is patchy. The Government must ensure universal coverage of palliative and end of life services, including hospice care at home. It is important …

Government response. The government highlights that palliative care is now a mandated commission for ICBs, supported by statutory guidance. NHS England is further ensuring consistency by including palliative care in performance discussions from April 2024 and developing an all-age palliative and end-of-life …
Department of Health and Social Care
14 Recommendation Second Report - Assisted Dying/Assisted… Accepted

Integrated Care Boards need better population data to understand and support service provision.

As identified in the report of the HSIB (now the Health Services Safety Investigations Body (HSSIB)) on variations in palliative care services to adults, 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 …

Government response. The government states the NHS is already required to commission appropriate palliative and end-of-life care services. Palliative care services were added to the list of services an integrated care board (ICB) must commission, promoting a more consistent national approach and …
Department of Health and Social Care
15 Recommendation Second Report - Assisted Dying/Assisted… Accepted in Part

Commit to an uplift of funding to guarantee support for hospices requiring financial assistance.

We understand that the flexible nature of the current funding model for hospices is valued by some hospice leaders, and rather than suggesting that the Government funds 100% of hospice operations, we call on the Government to commit to an uplift of funding to guarantee that support will be provided …

Government response. The government explains the current funding model for hospices and does not commit to a general uplift for all hospices requiring assistance. However, it details significant increases and renewals of funding specifically for children's hospices, including £25 million allocated for …
Department of Health and Social Care
17 Conclusion Second Report - Assisted Dying/Assisted…

Existing data underscores the urgent need to improve support for terminally ill individuals.

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 …

Department of Health and Social Care
18 Conclusion Second Report - Assisted Dying/Assisted…

No current medical intervention can manage every symptom or pain for terminally ill patients.

We have heard a lot of evidence around the importance of a “good death” for both the person managing their terminal diagnosis, and their loved ones. Suffering, pain and managing a terminal diagnosis will be a subjective experience, unique to the person experiencing them, and although there may be in …

Department of Health and Social Care
19 Recommendation Second Report - Assisted Dying/Assisted… Accepted

Commission research into providing better mental health support and guidance for terminally ill people.

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.

Government response. The government has accepted the recommendation by investing £3 million through the National Institute for Health and Care Research into a new Palliative and End Of Life Care Policy Research Unit to build the evidence base. It also highlights existing …
Department of Health and Social Care
20 Recommendation Second Report - Assisted Dying/Assisted… Rejected

Establish a national strategy for death literacy and support following a terminal diagnosis.

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. (Paragraph 308) 98 Assisted Dying/Assisted Suicide

Government response. The government explicitly states it does not plan to establish a national strategy for death literacy. Instead, it will address related issues through the inclusion of palliative care in wider strategies, existing training for professionals, and ongoing research by the …
Department of Health and Social Care

Oral evidence sessions

5 sessions
Date Witnesses
4 Jul 2023 Dr Matthew Doré · Association for Palliative Medicine of Great Britain and Ireland, Dr Paul Perkins · Sue Ryder, Helen Whately MP · Department of Health and Social Care, Jonathan Ellis · Hospice UK, Professor Stephen Powis · NHS England View ↗
27 Jun 2023 Bernhard Sutter · EXIT (Deutsche Schweiz), Dr Georg Bosshard · University of Zürich, Dr Yvonne Gilli · Swiss Medical Association (FMH), Professor Samia Hurst-Majno · University of Geneva, and member of the Swiss National Advisory Commission on Biomedical Ethics, Silvan Luley · DIGNITAS - To live with dignity - To die with dignity View ↗
6 Jun 2023 Dr Scott Kim · Department of Bioethics at National Institutes of Health USA, Professor Irene Tuffrey-Wijne · Kingston University London, Professor James Downar · University of Ottawa, Professor Jan L Bernheim · Vrije Universiteit Brussels, Professor Rutger Jan van der Gaag · Royal Dutch Medical Association, Professor Trudo Lemmens · University of Toronto View ↗
16 May 2023 Dr Chandana Banerjee · City of Hope National Medical Center, Dr Gary Gheung · University of Auckland, Dr Lydia Dugdale · Columbia University, Professor Brian Owler · Westmead, the Sydney Adventist Hospital, Norwest Private Hospital and Westmead Private Hospital, Professor Roderick MacLeod former Senior Consultant and Senior Medical Specialist in Palliative Care, The Hon Kyam Maher MLC · Government of South Australia View ↗
28 Mar 2023 Dr Alexandra Mullock · University of Manchester, Dr Naomi Richards · University of Glasgow, Professor Nancy Preston · University of Lancaster, The Baroness Finlay of Llandaff, The Baroness Hollins, The Baroness Meacher, The Rt Hon. the Lord Falconer of Thoroton View ↗

Correspondence

2 letters
DateDirectionTitle
17 Apr 2024 GMC on the Committee's report on Assisted Dying - Assisted Suicide 25.03.24
21 Jun 2023 Correspondence from the Chair of the Joint Committee on Human Rights on the Com…