Patients seeking assisted death must have palliative care assessment – expert

All patients seeking an assisted death need to have a palliative care assessment, a leading medic in the field told Parliament.

Baroness Finlay of Llandaff, who is a professor of palliative medicine, urged that this safeguard be added to the Terminally Ill Adults (End of Life) Bill as peers continued their line-by-line scrutiny of the legislation on Friday.

Lady Finlay told peers that this assessment was essential for informed consent, so that patients can make their decision with the full knowledge of what options are available.

The independent crossbencher also noted that access to appropriate specialist palliative care can make people change their minds about wanting an assisted death.

She said: “When patients access appropriate specialist palliative care, the desire for a hastened death is often alleviated, and they experience improved quality of life they never believed possible.”

Lady Finlay called for all those seeking an assisted death to have their needs “fully assessed by a multi-professional specialist palliative care team, and appropriate care provided to the extent necessary to enable them to decide whether such care would affect their wish to end their life”.

She added: “I would stress that this is not a bad faith amendment.

“This is to ensure that patients know what they could have and are making an informed choice, respecting their autonomy.”

Lord Falconer of Thoroton, who is sponsoring the Bill in the upper chamber, said under the draft legislation “all of the palliative care options that are available to you have got to be discussed with you by the doctor”.

The Labour former minister pointed to clause five of the Bill, which says a medical practitioner must explain and discuss “all appropriate palliative, hospice or other care, including symptom management and psychological support, and offer to refer them to a registered medical practitioner who specialises in such care for the purpose of further discussion”.

‘Patchy’

Their comments came after care minister Stephen Kinnock admitted on Wednesday that end-of-life care is “patchy” across the country as he announced additional funding for hospice services.

He told the House of Commons Health and Social Care Committee: “I think it’s absolutely clear that there is unwarranted variation. It’s patchy.

“There are pockets of really good practice, and there are areas of the country, and also the way in which certain socioeconomic groups and geographical areas are underserved.”

He told the committee that the Government was adding £25 million to the £100 million capital funding available for adult and children’s hospices this financial year.

Peers made it through two groupings of amendments on the assisted dying bill on Friday, finishing just after 3pm, after a call for extra time to consider it was backed by peers on Thursday.

Labour’s chief whip in the Lords, Lord Kennedy of Southwark, said he could not give any firm commitments on what would happen next, and ruled out any debates in Government time.

For the Bill to become law, both the House of Commons and the Lords must agree on its final drafting, with approval needed before spring, when the current session of Parliament ends.

If passed, it would allow people with terminal illnesses in England and Wales who have less than six months to live to apply for an assisted death.

Second reading

It was narrowly supported by MPs in the Commons in June last year, and received an unopposed second reading in the Lords in September before proceeding to committee stage.

Supporters of the law change have accused some opponents in the Lords of filibustering and trying to “talk out” the contentious legislation, having tabled more than 1,000 amendments – a record number for a private member’s bill.

But critics of the Bill have said they are simply doing their job of scrutinising it, and that it is not safe in its current form and needs to be strengthened.

Lord Falconer told peers on Friday: “We’ve got to get through this in time.”

There are 10 sessions listed for the Bill in the Lords between Friday and April 24.

Analysis by the Press Association has suggested the cost for peers to debate the Bill could reach nearly £2 million.

It shows that, if average attendance remains the same and the proportion of peers claiming the maximum income tax-reallowance of £371 per day continues, then the overall bill for peers alone will be £1.95 million for the 16 days allocated so far for the consideration of the legislation.