Terminally Ill Adults (End of Life) Bill

Jim Shannon Excerpts

Friday 16th May 2025 Commons Chamber

[Kim Leadbeater]

Thank you, Mr Speaker. If I may just finish that point—

[Jim Shannon (Strangford) (DUP)]

rose—

[Mr Speaker]

Order. May I just say to people that if we are going to have continuous interventions, and if they continue to make the same intervention, they should not be shocked if they end up at the bottom of the list? I want to help people, because all this does is soak up time. Jim Shannon will be a good example.

[Jim Shannon]

Mr Speaker, I will always be at the end of the list, so it is important for me to make an intervention. The hon. Member for Spen Valley (Kim Leadbeater) set the scene very well on Second Reading, but since then things have changed. For instance, the Royal College of Psychiatrists has voiced strong concerns in opposition to the Bill about judicial oversight, robust protections against coercion and so on, as well as the effect it will have on vulnerable groups such as those with dementia, Down syndrome or mental illnesses. Does the hon. Lady not respect the viewpoints of my constituents who tell me that they are opposed to the Bill in principle and all the things that are coming forward? The new clause does not address the issues that the hon. Lady is referring to.

[Kim Leadbeater]

I thank the hon. Gentleman for that intervention and he is absolutely right that there are a range of views on this issue, and I am deeply respectful of that. I take all those points into consideration as we embark on this debate again today.

Perhaps most importantly, Mr Speaker, I have spoken to terminally ill people themselves over recent months. It is impossible to know what it must feel like to receive a terminal diagnosis and I have nothing but admiration for people who have bravely spoken about their personal situations, some publicly—including, of course, Dame Esther Rantzen—and others who have done so privately, many by emailing their MP. I know mine is not the only inbox full of such emails.

--- Later in debate ---

[Kim Leadbeater]

I will just finish this point. If we refer to the impact assessment, the number of people who will access assisted dying in the first few years will be very small. I think there are around 4,500 psychiatrists in the country, but there is also a period of time of a number of years to do the training required for psychiatrists taking part in the process, so I would not anticipate any problems there.

[Jim Shannon]

Will the hon. Lady give way?

[Kim Leadbeater]

I will keep going, if I may, because I think I have been fairly fair.

Amendment 78 ensures that all three members of the panel must agree before a certificate of eligibility is issued, so abstentions cannot result in approval. The amendment came about as a result of discussions in Committee. It is really important to clarify that when the panel of experts is doing its work, its decision must be unanimous for a certificate of eligibility to be granted and for the patient to proceed. If a panel member abstains, no certificate of eligibility can be granted to the person.

Schedule 2 also sets out that the panel must give reasons for its decision in each case. This is really important. Amendment 79 ensures that those reasons—the reasons for the panel’s decision—are communicated in writing in a document to the person to whom the referral in question relates, the co-ordinating doctor and the commissioner. This creates clear channels of communication and will enable those people to fully understand the expert panel’s decisions.

[Jim Shannon]

Will the hon. Lady give way on that point?

[Kim Leadbeater]

I am going to finish, if I may, because other people want to speak.

Amendment 14, which was tabled by my hon. Friend the Member for Bradford West (Naz Shah)—another outstanding member of the Committee—states:

“A person who would not otherwise meet the requirements of subsection (1) shall not be considered to meet those requirements solely as a result of voluntarily stopping eating or drinking.”

I suspect the amendment has been put forward as a result of the lengthy discussions in Committee regarding whether people with anorexia would be eligible for an assisted death under the Bill. In my previous career before becoming an MP, I worked with a number of people with eating disorders. I am very aware of the hugely sensitive and complex issues surrounding disordered eating, particularly anorexia. I also know that this is a personal issue for a number of colleagues across the House, as a result of their own experiences. Eating disorders cause huge distress for individuals, their families and loved ones, but with care and the right treatment, it is possible for people to recover and to go back to leading a full and fulfilling life.

--- Later in debate ---

[Kim Leadbeater]

The hon. Gentleman makes an important point. The amendment is not specifically about eating disorders; there is a broader context. I will come to that later.

It is with that experience in mind—my own personal experience and having spoken to many colleagues on this issue—that I say now, as I said in Committee, that under the Bill as it stands, having anorexia would not qualify a person to be eligible for an assisted death. The Bill is clear that a person cannot be considered terminally ill on the basis only of a mental disorder. Clause 2 makes it clear that a person must have an inevitably progressive illness or disease that cannot be reversed by treatment. Anorexia is a serious mental health condition that is not inevitably progressive and can, thankfully, be reversed by treatment. Of course, at every stage of the assisted dying process the patient must be found to have capacity to make the decision, and this is checked repeatedly throughout the process. Someone with severe anorexia would be highly unlikely to be assessed to have capacity to make a decision on assisted dying.

The other tragic reality is that if a patient was so ill as a result of not eating and drinking for whatever reason, they would die before the process of assisted dying was able to take place, as it could take up to two months to complete all the stages of the process as set out in the Bill, and the latest clinical guidance states that the general range of survival once voluntary stopping of eating and drinking has begun is between seven and 21 days. Stopping eating and drinking also leads to a range of symptoms that would make meaningful conversations, as required by the Bill, impossible.

Having said that, I know that some people have expressed concerns that the severe physical consequences of a decision to stop eating or drinking could still enable someone to claim eligibility for assisted dying when they would not otherwise be able to do so, and I believe that is the motivation behind amendment 14.

[Jim Shannon]

rose—

[Kim Leadbeater]

I will take one final intervention.

[Jim Shannon]

The hon. Lady is very kind. At the moment, she is outlining the case for those who have problems with their eating and their diets almost to the point where they are unable to make their own decisions, and she is outlining what is going to happen here. What would she say about the situation in Belgium and in Canada, where assisted dying has been legalised for people with eating disorders? This may progress from what she has said and go way beyond that, as has been proven in other countries across the world.

[Kim Leadbeater]

I thank the hon. Gentleman for that point. The eligibility criteria in this Bill are very different from those in the jurisdictions he mentions—people with mental health conditions are not eligible for assisted dying under the provisions of this Bill.

--- Later in debate ---

[Rebecca Paul]

I completely concur.

[Jim Shannon]

I commend the hon. Lady for tabling her amendments. Amendments that would have protected palliative care and hospices from facilitating assisted suicide services on their premises for ethical or practical reasons have been rejected, so the Bill leaves hospices with little choice but to comply. It also puts them in a difficult position when it comes to funding. Hospices will also have to provide a staff member to do this work. The problems that will create for palliative care and hospices cannot be ignored. The Bill goes against that right in its totality.