Latest news with #endoflifebill
Telegraph
2 days ago
- Health
- Telegraph
Royal College of Pathologists comes out against assisted dying
The Royal College of Pathologists, which represents medical examiners, has come out against assisted dying. It said it could not support Kim Leadbeater 's Terminally Ill Adults (End of Life) Bill because of the role that it was expected to play in the assisted dying process. Under the Bill, assisted deaths will not be automatically referred to a coroner, which is usual practice for potentially unnatural deaths and when a drug, authorised or otherwise, brings about death. This will mean that it is for medical examiners to scrutinise assisted deaths. The professional body that represents them says that they are not qualified to do so and warn that a lack of resourcing means that medical examiners may be pulled away from other parts of their vital work. Ms Leadbeater on Tuesday defended not involving coroners in the process. She said there was 'no justification for putting the family and loved ones of the deceased through an unnecessary and potentially traumatic coroner's inquiry' because adequate safeguards were in place. It comes as the Bill returns to the Commons for a debate on Friday, and a vote on the legislation is expected next week. Dr Suzy Lishman, senior adviser on medical examiners for the Royal College of Pathologists, said that the college had no position on the 'ethical issues' of legalising assisted dying. In a statement, Dr Lishman 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 of 'significant' training and resources needed for medical examiners to be able to perform the role in the process. 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 former 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.' A letter signed by around 1,000 doctors from across the NHS published this week said that the Bill is a 'real threat to both patients and the medical workforce'. They said: '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.' The Royal College of Pathologists is the latest royal college to come out against the legislation, after the Royal College of Psychiatrists voiced their opposition to the Bill last month. 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.'
The Independent
15-05-2025
- Health
- The Independent
Royal College of Physicians adds voice of concern on assisted dying Bill
Another leading medical body has raised concerns about the risks of the assisted dying Bill 'failing to protect vulnerable patients', on the eve of its return to Parliament. The Royal College of Physicians (RCP) said it believes there are 'concerning deficiencies' with the proposed legislation as it stands. Its statement follows one earlier this week from the Royal College of Psychiatrists (RCPsych), which said it has 'serious concerns' and cannot support the Bill in its current form. That statement was branded by one opponent of the Bill as a 'blow to its foundations'. The Terminally Ill Adults (End of Life) Bill, which relates to England and Wales, returns to the House of Commons on Friday for the first time since a historic yes vote in November. Prime Minister Sir Keir Starmer, who voted for the Bill last year, has indicated he remains supportive of the proposed legislation. Reports speculating on the numbers of MPs who had supported the Bill last year but are now considering voting against it have been dismissed by the Bill's backers who reject the idea the proposed legislation is at risk of collapse. But the RCPsych statement prompted MPs, some with medical and clinical backgrounds, who back the Bill, to urge their colleagues in Parliament to support it. A statement, signed by supportive MPs including doctors Neil Shastri-Hurst, Simon Opher and Peter Prinsley, insisted 'most healthcare professionals understand that the current law is not working', that it 'criminalises compassion', places clinicians 'in an impossible position' and cannot be tolerated or defended. In their position statement on Thursday, the RCP said despite changes to the Bill in recent months which supporters argue have strengthened it, the college believes 'there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals'. It said there are 'key factors' which must be in place should assisted dying be legalised. These include decisions around a patient's prognosis to be informed by 'expert clinical professionals including those who know the patient', decisions on capacity, and safeguards around coercion to be informed by face-to-face assessments of 'relevant and appropriately skilled health and care professionals', regulations of medicines and a guarantee resources will not be diverted from other end-of-life care. Their concerns follow those from RCPsych which said it has 'unanswered questions' about the safeguarding of people with mental illness, and warned of a shortage of consultant psychiatrists to meet the demands of the Bill. Both colleges said they remain neutral on the principle of assisted dying. The RCP's clinical vice president, Dr John Dean, said: 'The ultimate decision on assisted dying rests with society through Parliament, but professional and clinical issues are integral to legislation, regulation, guidance and safe and effective implementation. 'Our members and fellows who we represent have a wide range of views on assisted dying. While the RCP neither supports or opposes a change in the law on this matter, the Bill in its current form has concerning deficiencies. 'Notably, the proposed mechanisms of decision making are not in line with good clinical and professional practice. Further statutory guidance is also required to ensure effective regulation of drugs, providers, and the involvement of clinicians. 'Parliament must address these critical issues in the legislation or risk failing to protect vulnerable patients and uphold the integrity of clinical practice.' The chair of the Royal College of GPs also told the BBC this week that doctors have 'real concerns about the practical and legal implications of a change in the law on assisted dying', which she said 'must be acknowledged and addressed, so that any legislation is watertight'. Speaking during a visit to Albania, Sir Keir was asked if his views on assisted dying had changed during the passage of the Bill. He told broadcasters: 'I do understand there are different views, strongly held views on both sides that have to be respected.' Pressed for his current opinion, Sir Keir said: 'My views have been consistent throughout.' Dozens of amendments have been tabled and many could be debated and voted on during a five-hour sitting in the Commons on Friday. It is not yet clear whether time will allow for a third reading vote, with the possibility that the report stage could instead run into a second day next month because of the large number of further amendments proposed. As it stands, the Bill would allow only terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death – subject to approval by two doctors and the three-member expert panel featuring a psychiatrist, social worker and senior legal figure. Kim Leadbeater, the Labour MP behind the Bill, defended the scrapping of the High Court judge safeguard which has been replaced by the expert panel. She told LBC Radio this was a 'more holistic approach, a more patient-centred approach' and is 'much, much stronger' as a result.
