‘Palliative care could improve enough for assisted dying but concerns remain’

Health Secretary Wes Streeting has said he believes palliative care for terminally-ill people can become good enough for that not to be a barrier to legalising assisted suicide, but he still has concerns over coercion.

The Cabinet minister – who plans to vote against the assisted dying Bill when it is debated later this month – has repeatedly expressed his view that the palliative care system is not “where it needs to be to give people a real choice”.

Asked on BBC Radio 4’s Today programme on Wednesday “Do you think that palliative care can get good enough, quickly enough for that not to be a bar in your mind to the legalisation of assisted suicide?”, Mr Streeting said: “Yes, and that’s part of it.

“I mean, I also set out some concerns about coercion and how people might be coerced into taking their own lives, and not just through malevolent intentions on the part of people with a vested interest and something to gain from someone’s untimely death, but also the extent to which people might feel themselves to be a burden on their loved ones, even where their loved ones would say that is very much not the case.

This issue is fraught with a number of ethical considerations as well as practical considerations. This is a finely balanced judgment

“That’s why this issue is fraught with a number of ethical considerations as well as practical considerations. This is a finely balanced judgment.

“As far as I’m concerned, I’m definitely voting against the Bill, but I have enormous respect for colleagues who are taking a different view.”

Labour MP Kim Leadbeater has described her proposed legislation as the “most robust” in the world, and said she expects hundreds of dying people might initially opt to use a service which could see patients press a button to end their lives.

The Terminally Ill Adults (End of Life) Bill will be debated and is likely to be voted on on November 29, the first Commons vote on assisted dying since 2015.

Opposition campaigners have raised fears of coercion and a slippery slope to wider legislation taking in more people.

But Ms Leadbeater has rejected those arguments, saying her Bill has “three layers of scrutiny” in the form of a sign-off by two doctors and a High Court judge, and would make coercion an offence with a possible punishment of 14 years in jail.

Speaking at Cop29 in Baku, Azerbaijan, Prime Minister Sir Keir Starmer has said: “I will not be putting pressure on any MP to vote one way or the other.

“I personally will study the details of the Bill which has now been published today because safeguards have always been extremely important to me and were an essential part of the guidelines that I drew up when I was chief prosecutor.”

Sir Keir has previously supported assisted dying but the Government has pledged to remain neutral on the issue and all MPs will be able to vote according to their conscience, rather than along party lines.

Only terminally-ill adults with less than six months to live who have a settled wish to end their lives would be eligible under the new law.

Ms Leadbeater said the proposed legislation for England and Wales would offer the “safest choice” for mentally competent adults at the end of their lives and is capable of protecting against coercion.

Questioned at a press briefing on Tuesday, she suggested hundreds rather than thousands might apply to use such a service, with patients possibly pressing a button to self-administer the drugs to end their lives.

The Bill has safeguards “all over it” and is a “once-in-a-lifetime opportunity for Parliament” to change what is currently a “pitiful situation” with the current law, according to former director of public prosecutions Sir Max Hill.

He said the status quo is a two-tier system where the wealthy can travel to Dignitas in Switzerland while others have to consider assisting their loved ones to die and facing possible prosecution as a result.

High-profile supporters of a change in the law include Dame Esther Rantzen, who is terminally ill and revealed in December that she had joined Dignitas due to the current law.

The broadcaster has hailed the “wonderful” Bill, but acknowledged it is likely to come into effect too late for her, and recognised its narrow criteria will not help people enduring unbearable pain and distress through chronic illness.

Right To Life UK has branded the proposed legislation “a disaster in waiting”, and described the planned measures as a “monumental change to our laws”.

Campaign group Our Duty Of Care, representing doctors and nurses, has sent a letter to the Prime Minister arguing it is “impossible for any government to draft assisted suicide laws which include protection from coercion and future expansion”.