Bishop of London repudiates ‘crude cost savings’ identified in assisted-dying Bill

THE Government’s impact assessments of the Terminally Ill Adults (End of Life) Bill, which returns to the House of Commons next week, make “chilling reading”, the Bishop of London, the Rt Revd Sarah Mullally, has said.

Church leaders, led by Bishop Mullally, have continued to campaign against the Bill, which seeks to legalise assisted dying, saying that its proposed safeguards should not strong enough to guard essentially the most vulnerable in society, including the elderly, who may consider themselves to be a burden to family or society (News, 21 March).

On Friday, the Department of Health and Social Care and the Ministry of Justice published an impact assessment and an equality impact assessment of the Bill which was brought by the Labour MP Kim Leadbeater. The Report Stage is attributable to be debated on 16 May.

The fundamental 149-page impact assessment estimates that, should the Bill be passed and voluntary assisted dying services introduced by October 2026, the method would lead to between 164 to 787 assisted deaths in the primary six months, and between 1042 to 4559 assisted deaths by the tenth yr of its implementation.

The assessment features a consideration of the economic effects of the Bill, surmising that costs and spending on palliative care, domiciliary care, care homes, state advantages and pensions, and native authorities can be reduced.

Responding on Monday, Bishop Mullally said: “It is crude to see these cost savings set out in this fashion, and it is simple to see how numbers of this nature could contribute to someone feeling that they need to pursue an assisted death moderately than receive care. Each human life is immeasurably more beneficial than the cash that could be saved through their premature death.

“Every person is made within the image of God and holds an irreducible value that’s worthy of care and support until the tip of their life. We must oppose any change within the law that puts the vulnerable in danger moderately than working to enhance access to desperately needed palliative care services.”

The separate equality impact assessment sets out how the Bill, because it stands, would affect certain groups, including people who find themselves disabled, assessing capability, susceptibility to coercion and pressure, and barriers to accessing voluntary assisted dying services.

It states: “Evidence suggests that disabled people could also be more liable to feeling as if they’re a burden on those around them. Pressure shouldn’t be necessarily felt or applied by other people — disabled people may feel subtle pressure attributable to attitudinal barriers or a scarcity of other appropriate services and support (for instance, when accessing palliative care).

“Disabled individuals are also twice as likely (in comparison with non-disabled people) to be victims of domestic abuse which incorporates coercive behaviour.”

In terms of gender, the assessment says that, in other jurisdictions with comparable assisted dying policies, “men have proportionately submitted more applications for assisted dying or died via these means, though this was only by a small margin. We should not capable of accurately determine whether this could be the case in England and Wales.”

The careers of girls are, nonetheless, more likely to be disproportionately affected by the Bill, because there are significantly more women working in hospice care in England and Wales. “Women are inclined to disproportionately provide unpaid care and end of life care, each professionally — 91% of hospice staff in 2022 to 2023 were female (see reference 24) — and as unpaid carers,” it says. “Women could also be more impacted by way of the intersectional impact on female carers.”

Women are also significantly more vulnerable to domestic abuse, including coercive control (News, 11 April, Analysis). “We wouldn’t have evidence on what number of victims of domestic abuse have a terminal illness and would or wouldn’t need to request assistance to finish their very own life,” the assessment says.

The Bill currently requires a “co-ordinating doctor” and “independent doctor and panel to be satisfied that the person is making their declaration voluntarily, without coercion or pressure from one other person. Bishop Mullally has previously argued that coercion is just too nuanced to be detected by third party safeguards.

She said on Monday: “The impact assessment of the Terminally Ill Adults (End of Life) Bill makes for chilling reading because it highlights particular groups who can be put in danger by a change within the law, including those that are subject to health inequalities, and people vulnerable to domestic abuse.”

On sexuality, the equality assessment says: “Evidence suggest that lesbian, gay, bisexual, transgender and queer (LGBTQ+) people often access palliative and end of life care services late, or by no means, attributable to fear of discrimination.”

Race can also be assessed. “People from minority ethnic groups experience health inequalities by way of access, outcomes and experiences,” it says, “which can extend to this service.”

On age, it says: “We haven’t any evidence on what number of terminally ailing people under the age of 18 with a life expectancy of six months or less will want to access assisted dying in England and Wales. . . Elderly people, who’re in all other jurisdictions the fundamental recipients of assisted dying, are sometimes depending on those that take care of them, putting them at increased risk of elder abuse, although we have now no data on this within the context of assisted dying.”

Other aspects considered include pregnancy. “As drafted at the tip of committee stage within the House of Commons, a pregnant one that also meets the eligibility criteria within the bill, wouldn’t be explicitly excluded from looking for assistance to finish their very own life. Notwithstanding, clinicians may use their right to conscientious objection and never assist an eligible pregnant person or recent mother to access assisted dying.”

Health professionals may consciously object to providing assisted-dying services. On mental health, the assessment says: “Having a mental illness wouldn’t exclude an individual from accessing assisted dying in the event that they are otherwise eligible.”

It concludes: “Government is neutral on this bill, nonetheless, has offered technical support on workability. If it’s the desire of Parliament that this bill becomes law, government will be sure that it’s implemented in such a way that attempts to mitigate illegal discrimination, harassment and victimisation and manage any equality issues which will arise.”