Royal College of Pathologists voices concerns over assisted dying Bill
It said it could not support Kim Leadbeater's Terminally Ill Adults (End of Life) Bill because of the role its members were expected to play in the assisted dying process.
If the Bill becomes law, assisted deaths would not automatically be referred to a coroner. It is normal practice to refer potentially unnatural deaths or cases in which a drug, authorised or otherwise, brings about death.
This would mean medical examiners would have to scrutinise assisted deaths. The royal college says they are not qualified to do so, and warns that a lack of resourcing means medical examiners might be pulled away from other vital work.
On Tuesday, Ms Leadbeater defended not involving coroners in the process. She said there would be 'no justification for putting the family and loved ones of the deceased through an unnecessary and potentially traumatic coroner's inquiry' because adequate safeguards would be in place.
The Bill returns to the Commons for a debate on Friday, and a vote is expected next week.
Need for 'significant' training
Dr Suzy Lishman, senior adviser on medical examiners for the Royal College of Pathologists, said the college had no position on the 'ethical issues' of legalising assisted dying.
In a statement, she said: 'The college's concerns relate only to the involvement of medical examiners after an assisted death has taken place. As part of their scrutiny, medical examiners would need to review the process leading up to the decision to authorise an assisted death and the circumstances of the assisted death, which they are not qualified to do.
'Notification to the coroner following an assisted death would ensure independent judicial review, which is particularly important given the concerns raised by many individuals, organisations and medical royal colleges about the lack of adequate safeguards in the Bill for vulnerable people.
'Lawyers, not doctors, are the most appropriate professionals to review these deaths. The medical examiner system was implemented to detect problems with medical care, not to identify discrepancies or malintent in the legal process required for assisted deaths.'
Dr Lishman also raised concerns about the need for 'significant' training and resources for medical examiners to be able to perform the role. She said that this would risk 'potentially taking medical examiners away from their current important role'.
The Royal College of Pathologists concluded: 'Coronial referral for assisted deaths would be in line with current regulations, with all deaths due to a medical intervention or medicinal product being notified.'
Last year, Thomas Teague KC, the chief coroner for England and Wales from 2020-24, expressed concern about the lack of coroner involvement in the Bill.
In a letter to The Telegraph, he wrote: 'Since the coroner's jurisdiction affords a powerful deterrent against misfeasance, the public may wonder why the Bill proposes to abandon such a robust safeguard.'
'Threat to patients and medical workforce'
A letter signed by around 1,000 doctors from across the NHS, published this week, said the Bill was a 'real threat to both patients and the medical workforce'.
They wrote: 'We are concerned that the private member's Bill process has not facilitated a balanced approach to the collection of evidence and input from key stakeholders including doctors, people with disabilities and other marginalised groups.'
Last month, the Royal College of Psychiatrists voiced its opposition.
Ms Leadbeater said: 'The Bill does not prevent any assisted death being referred to a coroner. However, this would not be required in the majority of cases.
'Coroners investigate deaths that have been reported to them if they think that the death was violent or unnatural, the cause of death is unknown, or the person died in prison or in custody. None of these would apply to a legal, assisted death under the terms of this Bill.
'Eligibility for an assisted death would have been assessed in advance by two independent doctors and a multi-disciplinary panel overseen by a commissioner who would be a High Court judge or retired judge.
'Each of these assessments would be subject to the extensive safeguards contained in the Bill to protect everybody, including the most vulnerable.
'Consequently, most cases would not require a judicial investigation after a person has died, and there would be no justification for putting the family and loved ones of the deceased through an unnecessary and potentially traumatic coroner's inquiry.
'However, in the event of any doubt at all, it would be open to a medical examiner, a family member or anybody with concerns to ask a coroner to investigate.'
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