Nurses choosing to opt out of taking part in assisted dying will not suffer any detriment for doing so, under a change approved by MPs last week.
The Terminally Ill Adults (End of Life) Bill, which would legalise assisted dying in England and Wales for terminally ill adults under certain circumstances, is currently being considered by parliament.
“If people do not want to be involved, they should not have to be involved, and those who do, should”
Kim Leadbeater
The legislation passed its first stage in the House of Commons last November and is now at the report stage, where MPs are debating amendments to the bill.
An emotional five-hour debate took place on Friday (16 May) which resulted in just two amendments being passed.
A further debate on additional amendments is expected to take place on 13 June.
MPs will then be asked to vote on passing the amended bill in its entirety, which would push it through to the last stage of scrutiny in the House of Commons.
It would then need to pass all stages in the House of Lords before it could become law.
One amendment given the green light last week aims to strengthen protections for health and social care workers wishing to opt out of helping patients end their life.
Previously, the bill set out that “no registered medical practitioner or other health professional is under any duty…to participate in the provision of assistance in accordance with this act”.
Now, this has been extended to all professionals, stating instead that “no person is under any duty to participate in the provision of assistance in accordance with this act”.
Kim Leadbeater, Labour MP for Spen Valley who proposed the change, said: “That is something I feel strongly on a personal level.
“If people do not want to be involved, they should not have to be involved, and those who do, should.”
Ms Leadbeater also tabled supplementary information under ‘schedule 1’ to add additional protections into employment law for professionals in relation to assisted dying.
Schedule 1 will now amend the Employment Rights Act 1996 to include Terminally Ill Adults (End of Life) Act 2025.
It sets out that a worker has the right “not to be subjected to any detriment” for either opting-in or opting-out of assisting someone to die.
Ms Leadbeater said: “New schedule 1 provide robust protections for employees, regardless of their choices about participating in the provision of assisted dying services.”
Overall, the debate was emotional and heated, with multiple interruptions meaning that many MPs were unable to speak.
Conservative MP for New Forest West, Sir Desmond Swayne, warned that the current form of the bill allowed applicants to “shop around for doctors” and that some doctors might specialise in the provision of assisted dying.
In response, Ms Leadbeater said: “I reject the assertion that patients will shop around.
“Bearing in mind that we are talking about dying people, they are not in a position to start shopping around for services, but I also agree that the bill is strict in that regard.
“There are very strict protocols that doctors will have to follow.”
MPs also debated an amendment tabled by Naz Shah, Labour MP for Bradford West, which would ensure that anyone who voluntarily stops eating or drinking is ineligible for assisted dying.
Ms Leadbeater highlighted that she would support this amendment but suggested further changes may be needed to make it workable.
It comes as several MPs raised concerns that people with anorexia could be considered terminally ill and eligible for assisted dying if they refused to eat or drink.
Ms Leadbeater argued that this risk was “negligible”.
Kim Leadbeater
She said: “Someone with severe anorexia would be highly unlikely to be assessed to have capacity to make a decision on assisted dying.
“The other tragic reality is that if a patient was so ill as a result of not eating and drinking for whatever reason, they would die before the process of assisted dying was able to take place.”
The amendment did not go to a vote.
Meanwhile, an amendment tabled by Conservative MP for Reigate, Rebecca Paul, which would prevent employees from providing assisted dying while working for an employer that had chosen not to take part, was rejected.
Ms Leadbeater said: “If an employer can stop their whole workforce participating in any sort of assisted dying services, it could prevent the sharing of information or the recording of information in a patient’s records.
“That could relate to safeguarding, and it could put patients at risk as a result of the employer’s decision.
“Terminally ill patients may be receiving different treatment at different places and from different healthcare professionals, and it would potentially be harmful if they were not able to transfer information or records.”
“We have the opportunity to improve the safeguards in the bill so that some of those groups are better protected”
Rebecca Paul
Labour MP Ms Shah told the commons that she would not be “complicit” in pushing through a piece of legislation without adequate safeguards.
She said: “I take my responsibility extremely seriously, as I am sure everybody in this house does.
“This is literally a matter of life and death. If the bill passes without these safeguards, there is no coming back from those decisions.”
Meanwhile, Tory MP Ms Paul said she was not against assisted dying in principle but was “against this bill”.
She added: “I am against the bill for the simple reason that it will harm far more people than it will help.
“The people who will be harmed are the most vulnerable in our communities, and I am not willing to accept that collateral damage.
“Today is important, because we have the opportunity to improve the safeguards in the bill so that some of those groups are better protected.”
Separately, MSPs in Holyrood voted last week to pass the Assisted Dying for Terminally Ill Adults (Scotland) Bill at stage one of the parliamentary process.
However, the Royal College of Nursing (RCN) in Scotland warned that the bill does not sufficiently protect registered nurses and have called for further protections for this staff group.
Among the recommendations the RCN has called for is an “opt-in” model of delivery so that only registered nurses who positively choose to participate, and who have completed mandatory training, will be expected to do so.
