Campaigners urge MPs to vote down assisted dying bill over anorexia ‘loophole'

Independent

a day ago

People with anorexia could be allowed to die by assisted death under a proposed Bill, more than 250 campaigners have warned, urging MPs to vote down the legislation when it returns to the Commons.
A letter to MPs, signed by 268 people who have suffered with eating disorders, warned: 'If this bill had been law during the years many of us were struggling, we would have used it to end our lives.'
Campaigner Chelsea Roff, founder of eating disorder organisation Eat Breathe Thrive, warned that the Terminally Ill Adults (End of Life) bill contains ' dangerous loopholes that have enabled suicidal women with anorexia to die by assisted death' in other countries around the world.
Only those diagnosed with terminal conditions would be covered under the assisted dying legislation, proposed by Labour MP Kim Leadbeater. But anorexia - which is primarily a mental health condition - can lead to lethal physical symptoms, including malnutrition, which campaigners say makes it difficult to entirely exclude it from the Bill.
There are also concerns over the recent use of the term 'terminal anorexia', a diagnosis that has been used by medical professionals to describe patients who they do not believe can recover.
The term – which has been widely criticised - was introduced in a case series published in the Journal of Eating Disorders, which described the deaths of three individuals with anorexia.
The authors argued that those diagnosed with this condition should be 'afforded access to medical aid in dying in locations where such assistance has been legalised — just like other patients with terminal conditions'.
It comes after a recent study found that individuals with eating disorders have died by assisted death in three US states - California, Colorado and Oregon. The legislation in each of these states limit eligibility to individuals diagnosed with a terminal illness.
But pro-assisted dying sources said the definition of terminal illness in the bill is most similar to the laws in Australia, where there have been no cases involving eating disorders.
The letter urges MPs to vote against the Terminally Ill Adults (End of Life) Bill as it returns to the Commons, warning that, in its current format, it is not safe for those affected by eating disorders.
'Eating disorders are amongst the most deadly mental illnesses', the letter warns. 'Despite eating disorders being a treatable illness, too often people are being failed by the system. Many people with eating disorders wait months and even years for treatment; they have to fight for access to basic care and support.'
Labour MP Richard Quigley, whose own child has been in and out of hospital with anorexia for the last four years, echoed these warnings.
While he said he is not opposed to assisted dying in principle, he argued that mental health care in the UK is not yet good enough to ensure the legislation is applied safely.
'Anybody that's experienced services will know that CAMHS (Child and Adolescent Mental Health Services), only scrapes the surface.
'You might get six sessions of therapy... but the system seems to be designed around pushing you out back into the world, rather than putting their arms around you until you're fully rebuilt. And sufferers end up relying on each other, which isn't the best form of treatment', he said.
But despite his concerns, Mr Quigley also said he is glad the country is having a conversation about assisted dying.
'It is one of those very emotive issues. Everybody who wants it to take place has got a very harrowing story about somebody they've seen die under difficult circumstances. And everybody that doesn't want it has got an equally harrowing story of somebody that survives two three years after', he said.
'But from personal perspective, both eating disorders and mental health, it's very very difficult to make it fit. There's too much evidence from other countries that already allow assisted dying showing that people with mental health issues - and especially eating disorders - can elect to end their lives early.'
Anorexia is a psychiatric disorder that can lead to severe physical deterioration and is known as the most lethal psychiatric disorder – with suicide being the second leading cause of death in anorexia. Individuals with anorexia are up to eighteen times more likely to die by suicide than their age-matched peers.
'With any other illness the patient wants to work with you. But with eating disorders, they actively work against you', Mr Quigley said. 'I'm just very much worried that we don't understand mental health well enough for it to be included in this bill, but I don't know how you'd exclude it. That's the problem', Mr Quigley said.
A number of amendments were proposed as part of an attempt to ensure people with eating disorders were excluded from the Bill when it was at committee stage, but each of them were rejected.
Labour MP Naz Shah, whose amendment was rejected last month, is tabling two amendments at the bill's third reading, one which will exclude people who have voluntarily stopped eating or drinking from the bill, and another which will exclude people are taking 'any action intended to bring about a state of terminal illness'.
While sources close to Ms Leadbeater said she would be supporting the first amendment, both Ms Shah and eating disorder campaigners are clear this would not be enough to prevent those with eating disorders from being included in the legislation - as the decision to stop eating is not a 'voluntary' one for those with eating disorders, it is the result of a psychiatric condition.
Ms Roff said she fears that, without appropriate amendments, a 'person with anorexia, in a moment of despair, might be given a lethal prescription rather than the treatment [they] desperately need.'
'That would be a terrible tragedy, mirroring what we have already seen happen in at least sixty known cases abroad, including three U.S. states where assisted death is only legal for terminally ill people. A third of these women never reached their thirtieth birthday', she said.
A spokesperson for Ms Leadbeater said: 'It's an old story. This issue has been debated at great length in Committee and Kim is now supporting Naz Shah's amendment 14 that excludes from eligibility somebody who has voluntarily stopped eating or drinking.
'This, along with the existing safeguards in the Bill, would rule out people with anorexia falling under the cope of the Bill.
'To be eligible a person must have 'an inevitably progressive illness or disease which cannot be reversed by treatment'. Anorexia is not inevitably progressive and can be reversed.'
But Ms Shah told The Independent: 'I have no idea what the amendment will actually be, and [Ms Leadbeater] is only accepting one, not the other, therefore I can't support the bill. The process is ultimately flawed'.
She said it is 'categorically untrue' that the bill excludes people with mental illness.