Nikki da Costa Profile picture
Feb 16 8 tweets 3 min read Read on X
Kim Leadbeater and 6 pro-Bill MPs on the Committee have tabled 123 amendments. Concerned Committee MPs 88. This is a bad faith argument.

Amendments from across the House include those from 'Ayes' such as Tessa Munt, Wera Hobhouse, Brian Matthews, Claire Hazelgrove 1/ Image
"consequentials" complicate a numbers game but this kind of assertion is very poor.

Would she rather not see amendments from @DamianHinds requiring specific guidance if a doctor suggests assisted suicide to someone who has Downs syndrome? 2/ Screenshot of text of Damian Hinds amendment: Clause 4, page 2, line 20, after “person” insert “, unless that person has Down syndrome, in which case the registered medical practitioner must be acting in accordance with any statutory guidance issued by the Secretary of State under the Down Syndrome Act 2022 to meet the needs of adults with Down syndrome.”
Or @danfrancis02 raising concerns that a doctor might raise assisted suicide with someone under the age of 18 3/ Text of Daniel Francis amendment: Clause 4, page 2, line 20, after “person” insert “who has attained the age of 18”
Or @BrianMathewLD asking for a referral to be made to social workers to check for coercion and pressure 4/ Text of Brian Mathew MP amendment:  Clause 9, page 6, line 26, at end insert— “(ab) must refer the person for assessment by two social workers who are registered with Social Work England or Social Care Wales in order to provide an opinion on matters related to coercion and pressure.”
Or @libdemdaisy amendment requiring a doctor to refer if they have any doubt as to a person's capacity 5/ Screenshot of text of Daisy Cooper's amendment: Clause 9, page 6, line 26, at end insert— “(ab) must refer the person for assessment by two social workers who are registered with Social Work England or Social Care Wales in order to provide an opinion on matters related to coercion and pressure.”
Or @hbaldwin amendment to ensure that reasons for refusal by a doctor are communicated to the CMP and made available to the other doctors and to the Court 6/ Screenshot of text of Harriett Baldwin's amendment:   Clause 9, page 6, line 41, at end insert— “(6) Where the assessing doctor declines to sign the relevant statement, they must set out their reasons for doing so in a statement to the relevant Chief Medical Officer who shall ensure that it is made available to any other assessing doctor and to the Court.”
This Bill is dealing with very complex matters. It will completely change our society. Report stage may be as little as 5 hours, only some amendments will be selected. This is the one chance MPs have to get this right 7/
More progress could have been made on the first two days of line-by-line scrutiny, but it was pro-bill MPs who moved to adjourn at 5pm.

This is more smoke and mirrors and it is not befitting legislation of this gravity. /end

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More from @nmdacosta

Feb 16
Sunday Times @doctor_oxford on “judge plus” panel:

It “is not a [multi disciplinary team], nor does it come close…no one on the panel knows the patient..scrutiny comes only at the end …not at the beginning, when a patient first asks…Yet this is a moment of peak vulnerability 1/4
“[require] MDT when a patient first asks for assisted dying. By pooling the collected expertise of those who know the patient — biologically, psychologically, socially — the MDT could genuinely minimise the risks of coercion” 2/4
“I cannot understand why this obvious safeguard — so vital for protecting vulnerable individuals — was not considered before the bill was drafted. This feels like rushed, slapdash, on-the-hoof legislation, and I believe my patients deserve better.” 3/4
Read 5 tweets
Feb 15
Dignity in Dying treatise 'Last Rites' argues:

🚨Palliative care doctors are anachronistic, 'guarding the pearly gates', controlling, and power hungry.

🚨 Disabled people's concerns dismissed with 34 words nullifying “self appointed spokespeople”.

#notnoise Text from "Last Rights' written by Dignity in Dying Chief Executive: “In addition, the great majority of disabled people also want the right to an assisted death.Their most ardently opposed self-appointed spokespeople don’t reflect the views of the section of society they purport to represent”
Only other ref to disabled people is oblique re pandemic blanket DNACPRs making case for AS i.e. could have avoided, if agreed already

"If [those] already dying or frail or had underlying conditions understood the consequences of CPR they would be less likely to expect it" Quote from 'Last Rites' by Dignity in Dying Chief Executive: "It shouldn't have taken a national emergency to prompt the decision...And it comes back to honesty. If people who were already dying or frail or had underlying conditions understood the consequences of CPR, they would be less likely to expect it; a preference not to receive it could then have been discussed and documented, and there would not have been a sudden panic to issue blanket orders at the outset of the pandemic".
They mention who the policy covered but do not appear to understand why those groups may be concerned now.

There is a casual dismissiveness to why somebody might want CPR: "Even if it is successful, for most people with an underlying condition it will only defer death by days"
Read 6 tweets
Feb 13
Instead of High Court, a quango.

PM appointed Commissioner - judge or ex-judge - main job (a) choose panels (b) pass on applications. Much of job can be delegated to staff. Up to 10 year paid gig.

Only gets involved again if panel says no. Not safeguard for vulnerable, but appeal route for determined 1/
Panels can be judge or ex-judge/KC, psychiatrist, social worker. No court powers. Procedure up to them. Can sit in private.

Only have to hear from 1 doctor. Do not have to hear from applicant. Can just hear from proxy 2/
Must assume capacity, if person meets criteria, they MUST approve

If the Panel is concerned by anything they hear or read they can do nothing if criteria met.

ONLY if panel reject application does the Commissioner get involved and then only on judicial review grounds 3/
Read 5 tweets
Feb 12
The @thetimes: "whether you are for or against assisted dying, this is no way to legislate for what would represent one of the most profound changes in the relationship between the state and its citizens".

🧵on last two days and a very novel form of govt neutrality 1/ Image
First a recap. Cabinet Office guidance says when govt takes a neutral stance on a PMB they should do an impact assessment.

Neutrality indicates that the Government is prepared to accept it reaching the statute books with ALL of the consequences. 2/

Yesterday, @NazShahBfd and @danny__kruger asked again why an impact assessment could not be provided, given that it would strengthen the Committee's ability to scrutinise the Bill.

The Minister gave - in my view - a novel response, which would not cut the mustard for a govt bill 3/Image
Read 15 tweets
Feb 12
Committee starts at 9.25am. First up - debate on risks of coercion, undue influence, encouragement to end ones life

Clause 1, Group 5 - Sarah Bool, Rebecca Paul and Juliet Campbell are pushing for this to be taken more seriously.
Watch here:

Will pull out elements of morning debate as it progressesparliamentlive.tv/Event/Index/11…
Amendments on coercion, undue influence, encouragement, manipulation...

Read 66 tweets
Feb 11
Day 1 of line-by-line scrutiny. 5 reflections:

1. Complex issues being decided by non-experts, & govt hands-off approach leaves vulnerable over-looked

Daniel Francis on why MCA is a problem for those with learning disabilities. Minister says it's 'adequate legal base to operationalise' AD.
2. The two MP doctors' confidence in capacity assessments and judgement of doctors... Image
Image
...met the lived experience of Daniel Francis advocating for those with learning disabilities, @mencap_charity, and young adults who would be reliant on doctors and the judge
Read 9 tweets

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