Depressed people who are terminally ill could be eligible for assisted dying

Yahoo

11-02-2025

Depressed people who are terminally ill could get medical help to end their lives after MPs rejected proposals to tighten legislation on assisted dying.
On Tuesday, MPs scrutinising Kim Leadbeater's private members' Bill voted down amendments designed to stop people taking life-ending decisions if their judgment is impaired by mental disorder.
The Labour MP for Spen Valley had proposed changing the law so that mentally competent, terminally ill adults with six months to live were able to receive an assisted death.
However, her draft legislation – The Terminally Ill Adults (End of Life) Bill – relies on a definition of mental competence in the Mental Capacity Act 2005 regarded as 'not sufficient' for such a profound decision by the Royal College of Psychiatrists (RCP).
It comes after Ms Leadbeater was accused of 'watering down' assisted dying protections after proposing to scrap the requirement for a High Court judge to approve each assisted death – a safeguard critical to securing support at the Bill's second reading, when MPs voted 330 to 275 in favour.
Critics of the proposed change have claimed that it represents a 'slippage' in the safeguards, and has thrown the future of the Bill into doubt.
One MP who previously backed the Bill said that they would need further reassurance that the panel system 'will amount to a strengthening of the safeguards, not a weakening'.
They said that while they were 'still minded to support the Bill', they wanted to be 'sure on the detail' and were concerned about the regulation and 'accountability' of the change.
Meanwhile, some supporters have said that they believe that the input from other professionals, such as social workers and psychiatrists, will make the safeguards even stronger.
The Bill passed the previous stage in the Commons with a majority of 51, and only needs 28 MPs to change their minds for it to collapse.
A group of 10 Labour MPs, who all voted against the Bill, issued a statement warning that the legislation had 'fundamentally changed' and that 'proponents of the Bill have changed their argument'.
The MPs, including Dame Meg Hillier, added: 'Each MP voted at second reading with a promise of High Court scrutiny of each application for assisted dying.
'Supporters of the Bill insisted that it was a key part of the protections for vulnerable and marginalised people'.
In written evidence at the Bill committee on Tuesday, the body representing psychiatrists pointed out that someone with cancer and depression 'may have clinical depression which is influencing their wish to die but be determined in accordance with the [Mental Capacity Act] as having capacity to decide to end their own life and therefore eligible for [assisted dying]'.
The RCP added: 'While they may be capacitous, they might feel differently at a future time if provided with appropriate interventions and support to treat a co-occurring mental disorder.'
To address these concerns, Sarah Olney, a Liberal Democrat MP, suggested replacing the word 'capacity' with 'ability' in the legislation, a move she said would help doctors to better gauge someone's eligibility for assisted death.
Ms Olney told MPs: 'If they are only partially able to [understand, retain and weigh information] they will still be considered to have capacity under the Mental Capacity Act. So it is not a safeguard to protect a terminally ill person who happens to be suicidal due to depression.'
However, on Tuesday afternoon, MPs on the bill committee voted 15 to 8 against the proposals, with both ministers on the committee – Stephen Kinnock and Sarah Sackman KC – opposing the amendments.
Ms Olney's amendments focused on preventing terminally ill patients with co-occurring mental illnesses, such as depression or personality disorders, from qualifying for assisted dying, out of concern that these conditions could affect their decision-making.
Some psychiatrists, researchers and MPs also worry that women with anorexia could qualify for an assisted death if their eating disorder, or the physical consequences of starvation, is considered to be a terminal illness.
The decision to reject Ms Olney's amendments was arrived at despite an appeal from Daniel Francis, a Labour MP, who told the committee that his experience caring for a child with a learning disability had taught him that doctors' understanding of mental capacity was not infallible.
He described a 'constant daily battle' with healthcare professionals who repeatedly assume his child 'has more capacity than she has or less capacity than she has'.
The MP for Bexleyheath and Crayford said doctors called 'all the time' asking to speak to his daughter, despite her medical notes clearly stating she is an 11-year-old girl who can speak only 12 words, who has a severe sight impairment and other complex conditions including cerebral palsy.
'Therefore I do query how well some aspects of the Mental Capacity Act are currently being carried out,' he said.
He added: 'I absolutely understand that somebody at the end of their life should have the autonomy and choice to make decisions, but if that comes at the price of one person where an [assisted dying] capacity decision is made on their behalf, then it is one death too many.'
On Monday night, Ms Leadbeater announced a plan to change the Bill, effectively replacing the judge's role in the legislation with an expert panel.
She argued it would be a 'change for the better' and would actually strengthen safeguards. However, opponents of the legislation have argued the opposite amid a growing backlash.
James Cleverly, the Tory former home secretary who voted against the Bill when it cleared its first major parliamentary hurdle in November, wrote on social media: 'The protections that were promised in the assisted dying Bill are being watered down even before this becomes law.
'This Bill is being rushed, it is not properly thought through, none of the concerns raised at second reading have been addressed.'
Other opponents also voiced concerns.
Diane Abbott, the veteran Labour MP who also voted against the Bill, wrote on social media: 'Safeguards on the assisted dying Bill are collapsing. Rushed, badly thought-out legislation. Needs to be voted down.'
Danny Kruger, a Tory MP and vocal opponent of the Bill, said MPs would have rejected the legislation in November if it had included Ms Leadbeater's new plan.
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