🧵The Safeguards Parliament Rejected: A System Built for Abuse
This past week, Parliament passed one of the most ethically weighty pieces of legislation in modern times: the Terminally Ill Adults (End of Life) Bill.
Much of the public believe this law introduces "compassionate choice" for the terminally ill. But what they were not told is this:
Almost every amendment designed to protect the vulnerable was rejected.
The final version of this Bill passed without the core safeguards that would have made it ethically defensible, clinically robust, or socially safe.
Below is a breakdown of what Parliament chose not to include and how the final Bill fails to protect the very people it affects most.
This past week, Parliament passed one of the most ethically weighty pieces of legislation in modern times: the Terminally Ill Adults (End of Life) Bill.
Much of the public believe this law introduces "compassionate choice" for the terminally ill. But what they were not told is this:
Almost every amendment designed to protect the vulnerable was rejected.
The final version of this Bill passed without the core safeguards that would have made it ethically defensible, clinically robust, or socially safe.
Below is a breakdown of what Parliament chose not to include and how the final Bill fails to protect the very people it affects most.
Section 1: Mental Competency and Coercion
What Parliament Rejected and What It Means for Consent and Control
When a person decides they want help to die, the first and most important question is whether that decision is truly free. Not made in despair. Not made in fear. Not made because they feel they are a burden. Not made because they have been subtly encouraged to die.
The second most important question is whether those around them, the doctors, the family, the legal system, have taken every possible step to make sure of that.
Parliament had multiple chances to lock in protections for both. It rejected every one.
🟥 Parliament Rejected
• Amendment 17 (Dr Ben Spencer)
Required a formal mental capacity test based on the Mental Capacity Act 2005. This would have ensured doctors confirmed not just that the person “understood,” but that they had properly processed the implications of their diagnosis and the consequences of their request, including palliative care and alternatives to assisted death.
❌ Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that people should not be eligible if their desire to die was substantially motivated by feeling like a burden, by depression, or by poor living conditions. While it addressed internalised pressures, it did not explicitly reference coercion
❌ Rejected by a vote of 283 to 230
• Amendment 2 (Dame Meg Hillier)
Aimed to stop doctors from initiating assisted dying conversations with patients. This safeguard would have reduced the risk of undue influence by ensuring only patients could raise the topic
❌ Rejected by a vote of 256 to 230
🟩 What the Bill Actually Includes
• Clause 1
Defines eligibility as any “adult” with a terminal illness. It does not restrict eligibility based on state of mind, motivation or coercion
• Clause 3
Requires signoff from two independent doctors and review by an Assisted Dying Review Panel consisting of a lawyer, psychiatrist and social worker, not a judge as originally proposed.
However:
• Neither doctor is required to specialise in the patient’s condition
• The second doctor is not required to meet the patient
• There is no obligation to assess the presence of depression, trauma or internalised pressure
• The psychiatrist on the panel is not required to assess the individual patient
• There is no formal Mental Capacity Act test
• There is no requirement for family input or consultation
• There is no right of appeal for concerned relatives
• Clause 5
Makes coercion a criminal offence (up to 14 years’ imprisonment) but does not provide any mechanism to detect it, such as mandatory psychological evaluation or independent safeguarding review
❗ The Result
Despite what supporters claim, this Bill does not protect people from making life ending decisions under pressure.
Yes, it requires two doctors, but neither needs to know the patient, understand their condition or be trained in mental health. One can simply review the forms and approve the death.
Yes, it requires a panel to confirm the request, but that panel’s role is limited to checking whether procedures were followed, not independently assessing whether the decision is truly free or safe.
There is no mandatory mental health assessment
There is no family consultation requirement
There is no appeals process for concerned relatives
While patients can withdraw consent before administration (Clause 6), there is no mechanism for others to pause the process or ensure the patient hasn’t changed their mind.
No safeguard if the person changes their mind.
🧩 Additional Context
• The Royal College of Psychiatrists has warned that 65 percent of its members do not believe consent is a reliable safeguard in assisted dying cases
• Leading MPs including Rachael Maskell stated in the Commons that the rejection of amendments like NC16 left clear openings for coercion and emotional manipulation
• Despite these warnings, Parliament pressed forward
This is not a framework for dignity.
It is a fast track to death, signed off without certainty, supervision or accountability.
And those left behind will never know if it was truly what the person wanted.
What Parliament Rejected and What It Means for Consent and Control
When a person decides they want help to die, the first and most important question is whether that decision is truly free. Not made in despair. Not made in fear. Not made because they feel they are a burden. Not made because they have been subtly encouraged to die.
The second most important question is whether those around them, the doctors, the family, the legal system, have taken every possible step to make sure of that.
Parliament had multiple chances to lock in protections for both. It rejected every one.
🟥 Parliament Rejected
• Amendment 17 (Dr Ben Spencer)
Required a formal mental capacity test based on the Mental Capacity Act 2005. This would have ensured doctors confirmed not just that the person “understood,” but that they had properly processed the implications of their diagnosis and the consequences of their request, including palliative care and alternatives to assisted death.
❌ Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that people should not be eligible if their desire to die was substantially motivated by feeling like a burden, by depression, or by poor living conditions. While it addressed internalised pressures, it did not explicitly reference coercion
❌ Rejected by a vote of 283 to 230
• Amendment 2 (Dame Meg Hillier)
Aimed to stop doctors from initiating assisted dying conversations with patients. This safeguard would have reduced the risk of undue influence by ensuring only patients could raise the topic
❌ Rejected by a vote of 256 to 230
🟩 What the Bill Actually Includes
• Clause 1
Defines eligibility as any “adult” with a terminal illness. It does not restrict eligibility based on state of mind, motivation or coercion
• Clause 3
Requires signoff from two independent doctors and review by an Assisted Dying Review Panel consisting of a lawyer, psychiatrist and social worker, not a judge as originally proposed.
However:
• Neither doctor is required to specialise in the patient’s condition
• The second doctor is not required to meet the patient
• There is no obligation to assess the presence of depression, trauma or internalised pressure
• The psychiatrist on the panel is not required to assess the individual patient
• There is no formal Mental Capacity Act test
• There is no requirement for family input or consultation
• There is no right of appeal for concerned relatives
• Clause 5
Makes coercion a criminal offence (up to 14 years’ imprisonment) but does not provide any mechanism to detect it, such as mandatory psychological evaluation or independent safeguarding review
❗ The Result
Despite what supporters claim, this Bill does not protect people from making life ending decisions under pressure.
Yes, it requires two doctors, but neither needs to know the patient, understand their condition or be trained in mental health. One can simply review the forms and approve the death.
Yes, it requires a panel to confirm the request, but that panel’s role is limited to checking whether procedures were followed, not independently assessing whether the decision is truly free or safe.
There is no mandatory mental health assessment
There is no family consultation requirement
There is no appeals process for concerned relatives
While patients can withdraw consent before administration (Clause 6), there is no mechanism for others to pause the process or ensure the patient hasn’t changed their mind.
No safeguard if the person changes their mind.
🧩 Additional Context
• The Royal College of Psychiatrists has warned that 65 percent of its members do not believe consent is a reliable safeguard in assisted dying cases
• Leading MPs including Rachael Maskell stated in the Commons that the rejection of amendments like NC16 left clear openings for coercion and emotional manipulation
• Despite these warnings, Parliament pressed forward
This is not a framework for dignity.
It is a fast track to death, signed off without certainty, supervision or accountability.
And those left behind will never know if it was truly what the person wanted.
Section 2: Protection for the Vulnerable
What Parliament Rejected and What It Means for You
When someone is already struggling with poverty, isolation, disability or mental distress, are they truly choosing to die, or are they being offered death because no one is offering them help to live?
This Bill could have built protections for the most vulnerable people in our society. Parliament chose not to.
🟥 Parliament Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that assisted dying should not be offered to those who were substantially motivated by feeling like a burden, by poverty, debt, poor housing or social pressure.
❌ Rejected with a vote of 283 to 230
• Amendment 101 (Damian Hinds)
Proposed that doctors should be barred from raising the option of assisted dying with patients who have learning disabilities or Down syndrome, to avoid undue influence.
❌ Rejected
• Amendment 102 (Rebecca Smith)
Required doctors to check for known suicide risk factors such as depression or psychiatric history before certifying an application.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 1
Does not exclude people from eligibility based on financial hardship, social disadvantage, learning disabilities or autism.
• Clause 3
Requires two doctors to approve the request, but does not require them to:
Have experience with vulnerable groups.
Recognise signs of suicidal ideation, guilt or emotional manipulation.
Make any adjustments for communication difficulties or cognitive impairments.
• Clause 5
Criminalises overt coercion, but does not require any evaluation of whether a vulnerable person’s decision was truly free of internalised pressure or despair.
❗ The Result
This legislation now permits some of the most vulnerable people in society, those who already struggle to be heard, understood or properly supported, to be quietly guided toward death without any additional scrutiny.
A person with autism or a learning disability who expresses suicidal thoughts due to misunderstanding their diagnosis or feeling overwhelmed by care needs can be considered eligible. There is no requirement for a specialist in learning disability or communication to be involved. There is no extra safeguard for people with limited verbal reasoning. And there is no legal obligation to investigate whether their distress is treatable or temporary.
A person experiencing severe financial distress who believes they are a burden on their family or society, who may be unable to afford treatment or support, can now be helped to die instead of being helped to live. Poverty, homelessness and dependence are not barriers. The law does not even require that financial hardship be explored or recorded as a motivating factor.
Even more disturbingly, if a person explicitly says "I feel like a burden", which in any other medical setting would be a clear warning sign, the process does not have to pause. The doctor is under no legal obligation to refer for counselling or delay the process. That expression is not treated as a red flag. It is treated as noise.
This is not a compassionate safeguard.
This is a system that absorbs despair and processes it as consent.
In a just society, the response to suffering should be to relieve it.
Under this Bill, suffering becomes the gateway to death.
Parliament had the chance to protect the vulnerable
And it chose not to.
What Parliament Rejected and What It Means for You
When someone is already struggling with poverty, isolation, disability or mental distress, are they truly choosing to die, or are they being offered death because no one is offering them help to live?
This Bill could have built protections for the most vulnerable people in our society. Parliament chose not to.
🟥 Parliament Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that assisted dying should not be offered to those who were substantially motivated by feeling like a burden, by poverty, debt, poor housing or social pressure.
❌ Rejected with a vote of 283 to 230
• Amendment 101 (Damian Hinds)
Proposed that doctors should be barred from raising the option of assisted dying with patients who have learning disabilities or Down syndrome, to avoid undue influence.
❌ Rejected
• Amendment 102 (Rebecca Smith)
Required doctors to check for known suicide risk factors such as depression or psychiatric history before certifying an application.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 1
Does not exclude people from eligibility based on financial hardship, social disadvantage, learning disabilities or autism.
• Clause 3
Requires two doctors to approve the request, but does not require them to:
Have experience with vulnerable groups.
Recognise signs of suicidal ideation, guilt or emotional manipulation.
Make any adjustments for communication difficulties or cognitive impairments.
• Clause 5
Criminalises overt coercion, but does not require any evaluation of whether a vulnerable person’s decision was truly free of internalised pressure or despair.
❗ The Result
This legislation now permits some of the most vulnerable people in society, those who already struggle to be heard, understood or properly supported, to be quietly guided toward death without any additional scrutiny.
A person with autism or a learning disability who expresses suicidal thoughts due to misunderstanding their diagnosis or feeling overwhelmed by care needs can be considered eligible. There is no requirement for a specialist in learning disability or communication to be involved. There is no extra safeguard for people with limited verbal reasoning. And there is no legal obligation to investigate whether their distress is treatable or temporary.
A person experiencing severe financial distress who believes they are a burden on their family or society, who may be unable to afford treatment or support, can now be helped to die instead of being helped to live. Poverty, homelessness and dependence are not barriers. The law does not even require that financial hardship be explored or recorded as a motivating factor.
Even more disturbingly, if a person explicitly says "I feel like a burden", which in any other medical setting would be a clear warning sign, the process does not have to pause. The doctor is under no legal obligation to refer for counselling or delay the process. That expression is not treated as a red flag. It is treated as noise.
This is not a compassionate safeguard.
This is a system that absorbs despair and processes it as consent.
In a just society, the response to suffering should be to relieve it.
Under this Bill, suffering becomes the gateway to death.
Parliament had the chance to protect the vulnerable
And it chose not to.
Section 3: Age and Eligibility
What Parliament Chose to Include and What It Refused to Protect.
Who is allowed to die under this law? That question should be easy to answer. But the way Parliament handled this section tells a deeper story, not just about eligibility today but about how quickly lines can shift tomorrow.
✅ What Parliament Included
Clause 1 subsection 2 paragraph a
Defines an eligible person as “an adult” which under UK law means 18 years or older.
This is a clear minimum age in law. Under 18s cannot currently request assisted dying.
🟥 What Parliament Did Not Do
No amendment was tabled or adopted to lock this age threshold in place long term. There were no proposed amendments requiring parliamentary approval for future changes to age criteria, or reinforcing the 18 plus rule through secondary legislation. This leaves the age barrier open to revision at any time by a future majority government.
No amendment was tabled or adopted to exclude prisoners. The Bill does not exclude people in prison or detention from applying for assisted dying. No proposals were made or debated to consider additional safeguards for this uniquely vulnerable group.
🟩 What the Bill Actually Includes
Clause 1 subsection 2 paragraph a
Sets a minimum age of 18 for eligibility.
No clauses exclude applicants based on incarceration
A person in prison who meets the terminal illness requirement is eligible under the same terms as any member of the public.
No clauses require extra scrutiny or support for applicants in custodial settings. There is no role for advocates, mental health specialists or external reviewers to ensure that prisoner decisions are truly free and informed.
❗ The Result
While the Bill does not permit under 18s to request assisted dying today, Parliament made no attempt to future proof this safeguard. It could have passed an amendment requiring a supermajority to lower the age. It could have required that any change in eligibility criteria come back to Parliament for full debate. It did not.
This is significant. In other jurisdictions where assisted dying laws began with strict adult only rules, such as Canada and the Netherlands, age limits were quietly lowered within a few years. In Canada it was first extended to those with mental illness, and then discussions began about minors. In the Netherlands assisted dying is now available for children as young as 12 with parental consent and under ministerial review.
There is nothing in this Bill to prevent the same slide from happening here. And because the 18 plus rule is embedded in primary legislation without added legislative protection, future Ministers could reduce it through a new Bill, a statutory instrument or simple political pressure.
As for prisoners, their inclusion is silent but total. They can apply. They can be approved. There is no legal mechanism to determine whether their desire to die is rooted in despair, mental illness, punishment or coercion. There is no advocate to ensure the state is not simply facilitating the suicide of a person it has already failed.
This should alarm every serious legislator. When the state holds someone in a locked cell and also gives itself the power to help them die, without safeguards, without independent review and without consent from family or outside witnesses, what message does that send?
This is not neutrality.
This is state assisted abandonment.
What Parliament Chose to Include and What It Refused to Protect.
Who is allowed to die under this law? That question should be easy to answer. But the way Parliament handled this section tells a deeper story, not just about eligibility today but about how quickly lines can shift tomorrow.
✅ What Parliament Included
Clause 1 subsection 2 paragraph a
Defines an eligible person as “an adult” which under UK law means 18 years or older.
This is a clear minimum age in law. Under 18s cannot currently request assisted dying.
🟥 What Parliament Did Not Do
No amendment was tabled or adopted to lock this age threshold in place long term. There were no proposed amendments requiring parliamentary approval for future changes to age criteria, or reinforcing the 18 plus rule through secondary legislation. This leaves the age barrier open to revision at any time by a future majority government.
No amendment was tabled or adopted to exclude prisoners. The Bill does not exclude people in prison or detention from applying for assisted dying. No proposals were made or debated to consider additional safeguards for this uniquely vulnerable group.
🟩 What the Bill Actually Includes
Clause 1 subsection 2 paragraph a
Sets a minimum age of 18 for eligibility.
No clauses exclude applicants based on incarceration
A person in prison who meets the terminal illness requirement is eligible under the same terms as any member of the public.
No clauses require extra scrutiny or support for applicants in custodial settings. There is no role for advocates, mental health specialists or external reviewers to ensure that prisoner decisions are truly free and informed.
❗ The Result
While the Bill does not permit under 18s to request assisted dying today, Parliament made no attempt to future proof this safeguard. It could have passed an amendment requiring a supermajority to lower the age. It could have required that any change in eligibility criteria come back to Parliament for full debate. It did not.
This is significant. In other jurisdictions where assisted dying laws began with strict adult only rules, such as Canada and the Netherlands, age limits were quietly lowered within a few years. In Canada it was first extended to those with mental illness, and then discussions began about minors. In the Netherlands assisted dying is now available for children as young as 12 with parental consent and under ministerial review.
There is nothing in this Bill to prevent the same slide from happening here. And because the 18 plus rule is embedded in primary legislation without added legislative protection, future Ministers could reduce it through a new Bill, a statutory instrument or simple political pressure.
As for prisoners, their inclusion is silent but total. They can apply. They can be approved. There is no legal mechanism to determine whether their desire to die is rooted in despair, mental illness, punishment or coercion. There is no advocate to ensure the state is not simply facilitating the suicide of a person it has already failed.
This should alarm every serious legislator. When the state holds someone in a locked cell and also gives itself the power to help them die, without safeguards, without independent review and without consent from family or outside witnesses, what message does that send?
This is not neutrality.
This is state assisted abandonment.
Section 4: Medical Oversight and Clinical Standards
What Parliament Rejected and What It Means for Public Safety.
When the state empowers doctors to authorise someone’s death, the least it should do is ensure that the right doctors are involved, that the process is thorough, and that the patient is truly informed.
Parliament was given multiple opportunities to put clinical safeguards in place. It declined every one.
🟥 Parliament Rejected
• Amendment 45 (Rachael Maskell)
Proposed creating a multidisciplinary clinical panel to include a palliative care consultant and other specialists in the person’s condition.
❌ Rejected
• Amendment 51 (Sarah Bool)
Required doctors to inform the patient about the potential side effects, failure rates or complications of the assisted dying medication.
❌ Rejected
• Amendment 17 (Dr Ben Spencer)
Aligned the mental capacity assessment with the Mental Capacity Act 2005 to ensure formal and structured decision making.
❌ Rejected
• Amendment 30 (Dr Ben Spencer)
Required that patients be informed about palliative care options and other alternatives to assisted dying.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 3
Originally required confirmation by a High Court judge.
This was later replaced during the Committee Stage by an Assisted Dying Review Panel, made up of a lawyer, a psychiatrist and a social worker. But:
There is no requirement for either doctor to be a specialist in the person’s illness.
There is no requirement for either doctor to meet the patient in person.
There is no requirement to discuss side effects, drug efficacy or failure rates.
There is no mandatory assessment by a mental health professional.
The mental capacity test is informal and not based on the Mental Capacity Act.
The psychiatrist on the review panel does not assess the patient, their role is procedural, not clinical.
❗ The Result
This law now permits assisted death without requiring that either of the approving doctors be qualified in the condition the patient is dying from. A person with terminal cancer could be signed off by two general practitioners. A person with a rare neurodegenerative disease could be declared eligible by doctors who have never encountered the condition before.
Even worse, neither of the doctors is legally required to meet the patient in person. A patient’s decision to die could be reviewed and approved on paper alone. There is nothing to stop an assessment from being based solely on a written form or brief virtual exchange.
There is no legal requirement for a psychiatrist to evaluate whether the patient is suicidal, experiencing trauma, or suffering from a treatable depressive episode. The law does not require that either doctor be trained in mental health at all.
Doctors are also not required to explain the pharmacological process of assisted dying. The law does not require them to inform the patient that the medication may fail, may cause pain or distress, or may result in a prolonged dying process. This is not informed consent. This is consent without clarity.
The judges originally responsible for reviewing the case have now been replaced by a review panel, but its role remains limited to checking that the paperwork has been completed correctly. Its members are not required to meet the patient. They do not conduct interviews. Their oversight is procedural, not clinical.
Parliament had every opportunity to make these standards mandatory. It was offered amendments that would have required specialists, face to face consultations, psychiatric reviews and transparent explanation of what the drugs would do.
It rejected them all.
This is not medical oversight. This is bureaucratic authorisation for death.
No other area of medicine would tolerate such weak standards. Yet here, where the outcome is irreversible, Parliament decided to lower the bar.
And it did so with full knowledge of what it was doing.
What Parliament Rejected and What It Means for Public Safety.
When the state empowers doctors to authorise someone’s death, the least it should do is ensure that the right doctors are involved, that the process is thorough, and that the patient is truly informed.
Parliament was given multiple opportunities to put clinical safeguards in place. It declined every one.
🟥 Parliament Rejected
• Amendment 45 (Rachael Maskell)
Proposed creating a multidisciplinary clinical panel to include a palliative care consultant and other specialists in the person’s condition.
❌ Rejected
• Amendment 51 (Sarah Bool)
Required doctors to inform the patient about the potential side effects, failure rates or complications of the assisted dying medication.
❌ Rejected
• Amendment 17 (Dr Ben Spencer)
Aligned the mental capacity assessment with the Mental Capacity Act 2005 to ensure formal and structured decision making.
❌ Rejected
• Amendment 30 (Dr Ben Spencer)
Required that patients be informed about palliative care options and other alternatives to assisted dying.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 3
Originally required confirmation by a High Court judge.
This was later replaced during the Committee Stage by an Assisted Dying Review Panel, made up of a lawyer, a psychiatrist and a social worker. But:
There is no requirement for either doctor to be a specialist in the person’s illness.
There is no requirement for either doctor to meet the patient in person.
There is no requirement to discuss side effects, drug efficacy or failure rates.
There is no mandatory assessment by a mental health professional.
The mental capacity test is informal and not based on the Mental Capacity Act.
The psychiatrist on the review panel does not assess the patient, their role is procedural, not clinical.
❗ The Result
This law now permits assisted death without requiring that either of the approving doctors be qualified in the condition the patient is dying from. A person with terminal cancer could be signed off by two general practitioners. A person with a rare neurodegenerative disease could be declared eligible by doctors who have never encountered the condition before.
Even worse, neither of the doctors is legally required to meet the patient in person. A patient’s decision to die could be reviewed and approved on paper alone. There is nothing to stop an assessment from being based solely on a written form or brief virtual exchange.
There is no legal requirement for a psychiatrist to evaluate whether the patient is suicidal, experiencing trauma, or suffering from a treatable depressive episode. The law does not require that either doctor be trained in mental health at all.
Doctors are also not required to explain the pharmacological process of assisted dying. The law does not require them to inform the patient that the medication may fail, may cause pain or distress, or may result in a prolonged dying process. This is not informed consent. This is consent without clarity.
The judges originally responsible for reviewing the case have now been replaced by a review panel, but its role remains limited to checking that the paperwork has been completed correctly. Its members are not required to meet the patient. They do not conduct interviews. Their oversight is procedural, not clinical.
Parliament had every opportunity to make these standards mandatory. It was offered amendments that would have required specialists, face to face consultations, psychiatric reviews and transparent explanation of what the drugs would do.
It rejected them all.
This is not medical oversight. This is bureaucratic authorisation for death.
No other area of medicine would tolerate such weak standards. Yet here, where the outcome is irreversible, Parliament decided to lower the bar.
And it did so with full knowledge of what it was doing.
Section 5: Process Integrity
What Parliament Rejected and What It Means for Transparency and Time to Reflect.
When a person faces the end of their life, time matters. Time to think. Time to feel. Time to understand. Time to change their mind. Any system that claims to honour autonomy must make space for that pause.
But the law that passed makes no such space. Parliament was offered multiple ways to ensure honesty, reflection and documentation. It refused every one.
🟥 Parliament Rejected
• No amendment was adopted to introduce a longer waiting period after diagnosis. The Bill includes a 14 day reflection period after formal application, but Parliament did not adopt any amendment requiring a longer pause following diagnosis. No 28 day safeguard was added at that earlier stage.
• Amendment 9 (Kim Leadbeater)
Proposed that declarations and decisions be shared with the Assisted Dying Commissioner to improve transparency. This did not include full discussion documentation and was not adopted.
• Amendment 32 (Dr Ben Spencer)
Required that one of the doctors assessing the request be trained in mental health, recognising that suicidal ideation and emotional trauma are common after terminal diagnosis.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 4
Sets a minimum of 14 days between formal application and prescription of life ending drugs, but not between diagnosis and decision.
A person may begin the process immediately after hearing they are terminally ill.
• Clause 3
Does not require any mental health evaluation, even for those with known history of depression or suicide attempts.
• Clause 7
Mentions record keeping, but does not mandate any audio, video or written transcript of discussions between doctors and patients.
❗ The Result
There is no legal minimum waiting period between receiving a terminal diagnosis and requesting assisted dying. The law only pauses the process for 14 days after the patient formally applies. This means someone could receive devastating news and within a few days begin the process of dying.
There is no requirement that the individual be given time to come to terms with the diagnosis, to consider palliative care, to consult family or to seek counselling. That moment of despair, when everything feels hopeless, is not treated as a warning. It is treated as a green light.
There is no requirement that doctors document what was said in their consultations. No obligation to keep notes of concerns raised, doubts expressed, or hesitations voiced. No requirement to record whether the person asked questions, wept, showed signs of fear, or hesitated. No independent party is involved in these conversations. And families will never see what happened.
If a doctor signs the form, that is enough.
There is also no requirement for a psychiatric assessment. No matter how emotionally unstable the patient might be, no matter how recent the trauma, no matter how evident the risk factors for suicide, the process does not stop. There is no obligation to refer for mental health care, no requirement for stabilisation, and no mechanism to delay for treatment.
This is a process that can move quickly, silently and without review. It leaves no trail that families can follow and no standard that courts can test. It happens behind closed doors, under emotional stress, and without mandatory expertise.
Parliament could have chosen honesty, reflection and care.
Instead it chose speed, discretion and silence.
What happens next will not be seen.
Only signed off.
And ended.
What Parliament Rejected and What It Means for Transparency and Time to Reflect.
When a person faces the end of their life, time matters. Time to think. Time to feel. Time to understand. Time to change their mind. Any system that claims to honour autonomy must make space for that pause.
But the law that passed makes no such space. Parliament was offered multiple ways to ensure honesty, reflection and documentation. It refused every one.
🟥 Parliament Rejected
• No amendment was adopted to introduce a longer waiting period after diagnosis. The Bill includes a 14 day reflection period after formal application, but Parliament did not adopt any amendment requiring a longer pause following diagnosis. No 28 day safeguard was added at that earlier stage.
• Amendment 9 (Kim Leadbeater)
Proposed that declarations and decisions be shared with the Assisted Dying Commissioner to improve transparency. This did not include full discussion documentation and was not adopted.
• Amendment 32 (Dr Ben Spencer)
Required that one of the doctors assessing the request be trained in mental health, recognising that suicidal ideation and emotional trauma are common after terminal diagnosis.
❌ Rejected
🟩 What the Bill Actually Includes
• Clause 4
Sets a minimum of 14 days between formal application and prescription of life ending drugs, but not between diagnosis and decision.
A person may begin the process immediately after hearing they are terminally ill.
• Clause 3
Does not require any mental health evaluation, even for those with known history of depression or suicide attempts.
• Clause 7
Mentions record keeping, but does not mandate any audio, video or written transcript of discussions between doctors and patients.
❗ The Result
There is no legal minimum waiting period between receiving a terminal diagnosis and requesting assisted dying. The law only pauses the process for 14 days after the patient formally applies. This means someone could receive devastating news and within a few days begin the process of dying.
There is no requirement that the individual be given time to come to terms with the diagnosis, to consider palliative care, to consult family or to seek counselling. That moment of despair, when everything feels hopeless, is not treated as a warning. It is treated as a green light.
There is no requirement that doctors document what was said in their consultations. No obligation to keep notes of concerns raised, doubts expressed, or hesitations voiced. No requirement to record whether the person asked questions, wept, showed signs of fear, or hesitated. No independent party is involved in these conversations. And families will never see what happened.
If a doctor signs the form, that is enough.
There is also no requirement for a psychiatric assessment. No matter how emotionally unstable the patient might be, no matter how recent the trauma, no matter how evident the risk factors for suicide, the process does not stop. There is no obligation to refer for mental health care, no requirement for stabilisation, and no mechanism to delay for treatment.
This is a process that can move quickly, silently and without review. It leaves no trail that families can follow and no standard that courts can test. It happens behind closed doors, under emotional stress, and without mandatory expertise.
Parliament could have chosen honesty, reflection and care.
Instead it chose speed, discretion and silence.
What happens next will not be seen.
Only signed off.
And ended.
Section 6: Prevention of Abuse
What Parliament Rejected and What It Means for Influence and Ideology.
When assisted dying becomes legal, it changes how society talks about suffering, illness and worth. The way we speak about death begins to influence how people feel about living. That influence must be handled with caution, because once death becomes a promoted option, it is no longer simply a personal choice, it is a cultural direction.
Parliament was given the chance to draw a clear line. It was asked to protect against ideological pressure, subtle marketing and the targeting of vulnerable people with messages that encourage them to end their lives. It chose not to.
🟥 Parliament Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that people should not be eligible for assisted dying if their motivation was substantially shaped by feeling like a burden, by poverty, by depression, or by a lack of housing or support.
❌ Rejected with a vote of 283 to 230
• Amendment 2 (Dame Meg Hillier)
Aimed to prevent doctors from raising assisted dying with patients unprompted. This would have restricted one of the most direct forms of promotion within a clinical setting.
❌ Rejected with a vote of 256 to 230
• Amendment NC14 (Kim Leadbeater)
Proposed regulatory oversight over how assisted dying might be advertised or promoted. This was not adopted. There is no ban or legal framework for controlling public messaging.
❌ Not adopted
🟩 What the Bill Actually Includes
• No clause restricts the public promotion of assisted dying
Campaigns, charities, influencers and pressure groups are free to promote assisted dying in any forum. There is no prohibition on advertising it through emotional storytelling, media campaigns or advocacy networks.
• Clause 1
Sets criteria for eligibility based on terminal illness, but does not address the source or nature of motivation.
• Clause 3
Does not require that doctors assess whether a person’s request is being shaped by external influence, internalised pressure or persistent exposure to pro-euthanasia messaging.
• Clause 5
Criminalises overt coercion, but only where there is evidence of threat or pressure. It does not account for psychological conditioning, societal expectations or cumulative influence over time.
❗ The Result
There is now nothing in UK law to prevent the normalisation and promotion of assisted dying. There is no firewall between a vulnerable person and the voices that tell them life is no longer worth living. There is no restriction on influencers or campaigners telling stories that glorify euthanasia. There is no restriction on interest groups presenting assisted death as an act of courage or dignity, even to people who are not yet dying but are simply afraid.
A person in emotional distress, suffering from depression or dealing with poverty, may see repeated media messages suggesting that asking to die is brave and that enduring suffering is selfish. That person can now legally request to die and the state will approve it.
The law contains no protection against this influence. It does not even require that patients be asked what led them to their decision. No mental health assessment is required to determine whether they are under emotional pressure. No mandatory discussion of alternatives is required. No reflection period is required after exposure to pro-euthanasia messaging.
The rejection of Amendment NC16 means that people who feel like a burden are now eligible for assisted death.
The rejection of Amendment 2 means doctors can raise the option without being asked.
The rejection of Amendment NC14 means assisted dying can be promoted, normalised and publicised without restriction.
This is not autonomy.
This is engineered consent.
And once these messages take hold, we may never again know whether a person truly wanted to die, or simply believed they should.
What Parliament Rejected and What It Means for Influence and Ideology.
When assisted dying becomes legal, it changes how society talks about suffering, illness and worth. The way we speak about death begins to influence how people feel about living. That influence must be handled with caution, because once death becomes a promoted option, it is no longer simply a personal choice, it is a cultural direction.
Parliament was given the chance to draw a clear line. It was asked to protect against ideological pressure, subtle marketing and the targeting of vulnerable people with messages that encourage them to end their lives. It chose not to.
🟥 Parliament Rejected
• Amendment NC16 (Rebecca Paul)
Proposed that people should not be eligible for assisted dying if their motivation was substantially shaped by feeling like a burden, by poverty, by depression, or by a lack of housing or support.
❌ Rejected with a vote of 283 to 230
• Amendment 2 (Dame Meg Hillier)
Aimed to prevent doctors from raising assisted dying with patients unprompted. This would have restricted one of the most direct forms of promotion within a clinical setting.
❌ Rejected with a vote of 256 to 230
• Amendment NC14 (Kim Leadbeater)
Proposed regulatory oversight over how assisted dying might be advertised or promoted. This was not adopted. There is no ban or legal framework for controlling public messaging.
❌ Not adopted
🟩 What the Bill Actually Includes
• No clause restricts the public promotion of assisted dying
Campaigns, charities, influencers and pressure groups are free to promote assisted dying in any forum. There is no prohibition on advertising it through emotional storytelling, media campaigns or advocacy networks.
• Clause 1
Sets criteria for eligibility based on terminal illness, but does not address the source or nature of motivation.
• Clause 3
Does not require that doctors assess whether a person’s request is being shaped by external influence, internalised pressure or persistent exposure to pro-euthanasia messaging.
• Clause 5
Criminalises overt coercion, but only where there is evidence of threat or pressure. It does not account for psychological conditioning, societal expectations or cumulative influence over time.
❗ The Result
There is now nothing in UK law to prevent the normalisation and promotion of assisted dying. There is no firewall between a vulnerable person and the voices that tell them life is no longer worth living. There is no restriction on influencers or campaigners telling stories that glorify euthanasia. There is no restriction on interest groups presenting assisted death as an act of courage or dignity, even to people who are not yet dying but are simply afraid.
A person in emotional distress, suffering from depression or dealing with poverty, may see repeated media messages suggesting that asking to die is brave and that enduring suffering is selfish. That person can now legally request to die and the state will approve it.
The law contains no protection against this influence. It does not even require that patients be asked what led them to their decision. No mental health assessment is required to determine whether they are under emotional pressure. No mandatory discussion of alternatives is required. No reflection period is required after exposure to pro-euthanasia messaging.
The rejection of Amendment NC16 means that people who feel like a burden are now eligible for assisted death.
The rejection of Amendment 2 means doctors can raise the option without being asked.
The rejection of Amendment NC14 means assisted dying can be promoted, normalised and publicised without restriction.
This is not autonomy.
This is engineered consent.
And once these messages take hold, we may never again know whether a person truly wanted to die, or simply believed they should.
Final Reflection
Now it falls to the House of Lords to try to insert the protections that our elected representatives refused to provide. It is an unacceptable position. The duty to safeguard life should never have been left to a revising chamber to clean up after the Commons.
Let us be clear. The British public overwhelmingly supports giving terminally ill people the right to choose how and when they die. So do I. Compassion and dignity are not in question. But this legislation is not compassionate and it is not dignified.
It is careless.
It is rushed.
It is dangerous.
Because in its current form, this law places the most vulnerable in our society directly in the crosshairs. People with mental illness. People with learning disabilities. People who feel like a burden to their family or the state. People who are not choosing death freely but feel like they have no choice at all.
They are now eligible. No mental health checks. No appeals. No specialists in their condition. No legal requirement for the doctors to meet them. Just a process designed for speed, not safety.
Assisted dying should never become expected dying.
It should never be quietly suggested to those who most need support.
And it should never be easier to approve a death than to offer a reason to live.
Parliament had a chance to build a law that was truly safe, truly balanced and truly worthy of the people it claims to serve.
It failed.
And now the burden falls on the unelected to prevent a catastrophe that our elected refused to face.
@Fox_Claire @danielmgmoylan
Now it falls to the House of Lords to try to insert the protections that our elected representatives refused to provide. It is an unacceptable position. The duty to safeguard life should never have been left to a revising chamber to clean up after the Commons.
Let us be clear. The British public overwhelmingly supports giving terminally ill people the right to choose how and when they die. So do I. Compassion and dignity are not in question. But this legislation is not compassionate and it is not dignified.
It is careless.
It is rushed.
It is dangerous.
Because in its current form, this law places the most vulnerable in our society directly in the crosshairs. People with mental illness. People with learning disabilities. People who feel like a burden to their family or the state. People who are not choosing death freely but feel like they have no choice at all.
They are now eligible. No mental health checks. No appeals. No specialists in their condition. No legal requirement for the doctors to meet them. Just a process designed for speed, not safety.
Assisted dying should never become expected dying.
It should never be quietly suggested to those who most need support.
And it should never be easier to approve a death than to offer a reason to live.
Parliament had a chance to build a law that was truly safe, truly balanced and truly worthy of the people it claims to serve.
It failed.
And now the burden falls on the unelected to prevent a catastrophe that our elected refused to face.
@Fox_Claire @danielmgmoylan
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