Nikki da Costa Profile picture
Jan 30 12 tweets 5 min read Read on X
What did we learn from the final day of evidence?

1. This is far more complex than bill backers (and frankly No 10) anticipated and want to admit.

There are huge problems with writing a bill, and then asking the policy questions.

e.g. capacity

Professor Gareth Owen is a Professor of Psychological Medicine, Ethics and Law at the Institute of Psychiatry, Psychology and Neuroscience at King's College
2. This will be a profound cultural shift. Australian assisted dying specialists, like US witnesses, believe 'feeling a burden' is a valid reason to choose assisted suicide.
3. That there is a big division between those that think capacity is enough - as in this bill - and those (e.g. psychiatrists, social workers, palliative care doctors) that want to look at what else may be going on when somebody wants help ending their life

Professor Meredith Blake, University of Western Australia; Professor Gareth Owen, Professor of Psychological Medicine, Ethics and Law, King's College
4. That for medical practitioners that participate in assisted dying/suicide it is "just another treatment option" to be raised
5. GPs do not want Assisted Dying to become part of their normal practice and think - as others have suggested - the Government should create a separate service to provide it

Michael Mulholland, Honorary Secretary, Royal College of General Practitioners echoed the BMA
6. The judicial stage needs to be "completely rethought" in the view of Professor Laura Hoyano, and the appeal stage is completely one-sided. Other legal witnesses have suggested entirely different approaches.
7. There's a 'record no evil, hear no evil' approach to record keeping and national reporting - you cannot look behind the veil

[Nor did the Committee get the chance - only overseas practitioners that are positive about assisted dying/assisted suicide got invited
8. We heard moving testimony from several people whose family members had died by suicide or sought assisted dying. They were supportive of the bill but did not go into bill specifics.

The Committee did not hear from any that had opted for assisted dying and developed doubts
9. The Bill is cavalier with Welsh devolution, a situation worsened by the Senedd's recent vote against Assisted Dying.

I cannot stress enough how much outcry there would be if this was the government doing this.

Professor Emyr Lewis
10. The Committee will get no assistance from the Government in understanding how the vulnerable will be affected (as suggested by Baroness Falkner, Chair of EHRC).

Daniel Francis MP asked for assessments prior to line-by-line scrutiny. Ministers said no.
11. Our words will be redefined

Alex Greenwich, MP for Sydney, Parliament of New South Wales (did for NSW what Kim Leadbeater hopes to do for England and Wales)
Hansard link here (at time of posting the afternoon session wasn't uploaded yet) hansard.parliament.uk/commons/2025-0…

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More from @nmdacosta

Jun 5
Arrogantly, Kim Leadbeater's supporters have told
@HansardSociety and @DArcyTiP
"they're now over the hump" and "the most difficult section of debate has now been dealt with". Are they fantasising or are MPs just that irresponsible? Hot issues next Friday...🧵 1/
1. This Bill, 6 months on, is still a blank cheque to fundamentally reconfigure the NHS to end lives.

MPs are still in the dark about what this will look like in practice and safeguards that will govern doctors, will rely on non-binding codes of practice and training 2/
2. This Bill signs off a cost-cutting, for profit service, where commercial relationships and drivers are hidden.

The NHS will save £13k for every patient who ends their life four months early and Ministers are open about outsourcing the service to “independent contractors” 3/
Read 7 tweets
Apr 4
I’ve been given a copy of the briefing Kim Leadbeater issued journalists and MPs.

There are so many misleading statements in 7 pages, I've just chosen 8. 3 on the first page. This is not ok.

A thread 👇
1) DOCTOR INITIATED PROCESS
There is no mention that the Bill explicitly allows - and the Committee defended - doctors raising ending the patient's life.
🚨 ANY doctor can decide if, and when, to raise (5.2)
🚨 With anyone, no matter how vulnerable Extract from briefing: “Initial discussion: There is no obligation on any doctor to conduct the initial discussion but, fi they do, an assisted death can only be discussed alongside all other options including any available palliative, hospice or other care, including symptom management and psychological support.”
2) UNDER 18s:
On discomfort with raising with minors, the document says that applicants must confirm “they were 18 at the time of *the* initial discussion”. This is not the same.
🚨 Only relates to a specific discussion, before requesting assistance, and signing the form Extract: “First declaration: If a person wants to request an assisted death they must first prove their identity and make a declaration confirming their eligibility, age and residency and that they are registered with a GP in England and Wales. They must confirm they were 18 at the time of the initial discussion. This declaration must be witnessed.”
Read 5 tweets
Mar 25
Final day on the bill in committee, (probably). Kicking off at 9:25 am we start with a huge Henry VIII power to amend any act of parliament to make this happen. It makes explicit ‘services’ can be commissioned out to private businesses. Promised cap on profit making is MIA
"It is a hard thing to do to take a red pen to Bevan's legacy", to go "from the National Health Service to the National Health and Assisted Suicide Service...in the same clause...designed to enable the private sector to be paid from NHS funds to end the lives of terminally ill"
Read 22 tweets
Mar 18
Debate now focussing on who can opt-out of providing assistance to end someone's life. Danny Kruger argues no individual should be under any duty to be involved, directly or indirectly. Kim Leadbeater indicates support for principle, but not for specific amendment 1/ Image
Also NC22 to allow hospices or care homes (specific premises) to opt out of facilitating assisted dying on their premises. If living in community, supported by members of staff, rights of community as a whole should be acknowledged and those overseeing service. Image
Malthouse: other beliefs can discriminate against?

Kruger: not beliefs, but what happens on premises - a hotel can say prostitution can't take place on their premises. Appropriate to consider the impact on certain places live - and give specific protection.
Read 23 tweets
Mar 18
"Assisted Dying" Committee starts shortly. They will be sitting to 10pm according to reports. You can watch live here and I'll aim to pull out highlights as they go until about 5pm: parliamentlive.tv/Event/Index/bf…
Committee starting with Cl13 - the second declaration, and the 14 day period of reflection that follows. The bill allows that to be shortened to 48 hrs if death expected within a month. Sarah Olney raising issue of overriding the reflection period by refusing food and water.
Naz Shah raising risk of those wanting to hasten death, voluntarily stopping eating and drinking to accelerate their deterioration. Quotes evidence from other jurisdictions where this is happening.
Read 87 tweets
Mar 4
Committee resumes. Danny Kruger notes MPs this morning were saying 'conscious of time', 'need to hurry up', but important to do what's necessary and take time needed. Chair agrees and says it is important that Members deal with this in a sensible fashion.
Minister says effect of sponsor's Amdt 183 is that assisted dying should not be discussed in isolation (govt helped draft). Continues with outline of what govt understanding of amendments are. On the MDT says obligation to refer each and every time has resource implications
Kim Leadbeater 'will keep comments brief'. Mirroring other pro-bill MPs saying "conscious of time' this morning, and genuine speed at which they are rattling through speeches. They've only sat for 4.5 days!
Read 7 tweets

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