The right to die is a very hot topic in the United Kingdom. Yesterday, a committee of the House of Commons released a long-anticipated report about palliative care and “assisted dying”. Professor David Albert Jones, of the Anscombe Bioethics Centre, comments on its findings. 

From the perspective of ethics and of patient safety the most significant aspect of the House of Commons’ Select Committee Report on assisted suicide is what it did NOT say. Over the past two months there has been a relentless media campaign to change the law on physician-assisted suicide or “mercy killing”. Despite this pressure:

• The Committee did NOT conclude that the current law on assisted suicide needed to change;
• The Committee did NOT recommend that a Citizens’ Jury be established on assisted suicide;
• The Committee did NOT recommend that there be a referendum on assisted suicide;
• The Committee did NOT recommend that Parliament should debate legalising assisted suicide.

Rather than recommending that Parliament consider the issue, the Committee simply noted that it was a matter for Parliament and attempted to bring together evidence that Parliament could use, if it chooses to consider the question in the future.

There is much useful material in the Report. Unfortunately, however, the level of analysis is uneven, often presenting the claims of various witnesses without submitting these to critical scrutiny.

There are also flaws in the way the Report summarises the evidence. At one point, for example, the Committee concludes that “jurisdictions which have introduced assisted dying / assisted suicide on the basis of terminal illness have not changed the law to include eligibility on the basis of ‘unbearable suffering’.” This is inaccurate. Canada established a law in 2016 that was restricted to people whose death was “reasonably foreseeable” but in 2021 this was extended to include people with “unbearable suffering”. Other countries have expanded their law in other ways: to waive waiting periods; to scrap residence requirements; to include minors.

There are also some glaring omissions in the Report. Despite using the term “assisted suicide” alongside “assisted dying”, the Committee neglected to examine the adverse effect that a change in the law can have on suicide prevention among older or seriously ill-people. The Anscombe Centre has contributed to research showing that, in the United States, a change in the law to allow assisted suicide was associated with a rise in unassisted suicide, even taking into account sociodemographic factors.

Nevertheless, the Committee is to be commended in identifying the need for mental health support for people diagnosed with a terminal illness, including support in relation to suicide prevention.