What are the key current issues, what do you need to know, and what can you do?

Holyrood

The bill Patrick Harvie inherited from Margo MacDonald was rejected in May 2015, but Orkney MSP Liam McArthur lodged a new "proposal for a Member's Bill to enable competent adults who are terminally ill to be provided at their request with assistance to end their life" - assisted suicide for terminally ill adults without a specified life expectancy - on 22 September 2021. A public consultation closed on 22 December 2021, with a report summarising the vast response published on 8 September 2022. A bill is expected in 2023. Care Not Killing has supported experts in briefing MSPs at several dedicated sessions.

Visit our dedicated Scottish campaign website, carenotkilling.scot, for resources to use in contacting your MSPs to make clear your opposition to assisted suicide and euthanasia, and to ask their views on the subject.


Jersey & the Isle of Man

Following a deeply flawed Citizens' Jury and a vote in principle in November 2021, the Government of Jersey consulted on proposals to legalise assisted suicide and euthanasia, between October 2022 and January 2023, with a report and final proposals awaited.

In June 2022, Dr Alex Allinson MHK was given leave to bring an assisted suicide suicide bill before Tynwald, and a consultation ran from December 2022 to January 2023. Further developments are awaited.

Campaigners for assisted suicide in the UK describe the possibility of law change in Scotland and the Crown Dependencies as "piling on the pressure for MPs in Westminster": these debates are closely entwined.

A great many supporters answered the call to respond to consultations in Jersey and the Isle of Man, for which we are grateful. Residents should continue to engage with Assembly Members and MHKs.


Westminster

Immediately on the heels of three successive sets of 'assisted dying' proposals being put before the House of Lords - where they have failed to make headway - Labour MP Rob Marris, having won the 2015 Commons Private Members' Bills ballot in the Commons, brought Lord Falconer's proposals before MPs. Following the first legislative debate on assisted suicide in the lower house for 18 years, MPs rejected the Assisted Dying (No. 2) Bill by a massive 330-118 on 11 September and Mr Marris retired at the 2017 General Election.

Care Not Killing was instrumental in the establishment of the All-Party Parliamentary Dying Well Group, providing a from for MPs and Peers to hear the evidence on the reality of assisted suicide and euthanasia abroad. The Health Committee issued a call for evidence on assisted suicide closing January 2023, and is currently conducting oral evidence sessions.

Please consider contacting your MP to make clear your opposition to assisted suicide and euthanasia, and to ask their views on the subject, which we would be keen to hear.


Maintaining medical opposition

Healthcare professionals have long been opposed to legalising practices which their experiences tell them are uncontrollable, unethical and unnecessary. None of the major medical bodies have contradicted this view and a change in the law is formally opposed by the Association for Palliative Medicine, the British Geriatric Society and the World Medical Association. High profile consultations in 2018 and 2019 saw opposition remain the most favoured stance among members of the Royal Colleges of General Practitioners and Physicians, with the former reaffirming its opposition, and the latter clarifying 'that it does not support a change in the law to permit assisted dying at the present time,' noting that 'professional and clinical issues pose significant challenges to the success of any future legislation' and that 'the majority of doctors would be unwilling to participate actively in assisted dying if the law were changed to permit it.'

The Royal Colleges of Nursing, and of Psychiatrists*, are neutral; the Royal Colleges of Physicians and Surgeons of Glasgow*, and of Physicians of Edinburgh*, have no specific position (*confirmed 2021 in response to the McArthur consultation).

The British Medical Association (BMA) surveyed members on "physician-assisted dying" (which it used to refer to both euthanasia and assisted suicide) in 2020. Support for a change in the law was highest among those least involved in the treatment of patients (medical students and retirees) while opposition rose in line with proximity to dying patients (palliative medicine doctors, geriatricians, GPs and respiratory specialists.) The BMA adopted a motion of neutrality on "physician-assisted dying" by just four votes in 2021.

The Royal College of Surgeons of England, which remains opposed to a change in the law, is currently (2023) consulting members on its stance.

Opposition must be maintained; if you are a doctor, nurse or other healthcare worker, please sign up to Our Duty of Care, a grassroots campaign supported by Care Not Killing.

Courts

On 6 January 2017, it was announced that Noel Conway, a 67-year old man with Motor Neurone Disease, would, supported by Dignity in Dying (formerly the Voluntary Euthanasia Society), challenge the Suicide Act in the courts. Mr Conway's case is similar to that of Tony Nicklinson; the difference, it is argued, is that Mr Conway's conditional is terminal. Three High Court judges heard contributions on behalf of the claimant (Mr Conway), the defendant (the Secretary of State for Justice) and three interveners (CNK, Not Dead Yet UK and Humanists UK) from Monday 17 - Thursday 20 July; they dismissed the application on 5 October 2017, but an appeal was heard at the Court of Appeal Tuesday 1 - Thursday 3 May 2018. CNK again intervened, with counsel for the Secretary of State making extensive reference to our expert evidence; the appeal was dismissed, and the Divisional Court ruling upheld, on 27 June 2018. On 27 November 2018, the Supreme Court declined to hear a further appeal, bringing the case to an end.

A second, separate case, that of 54 year old Omid, who was diagnosed with Multiple System Atrophy (MSA) in 2014, 'seeks a declaration that the Suicide Act 1961 and the Coroners and Justice Act 2009 are incompatible with the Human Rights Act.' Omid ended his life at an assisted suicide facility in Switzerland on 5 October 2018.

CNK intervened at the Supreme Court in 'Y', concerning the necessity of court approval for withdrawal of Clinically Assisted Nutrition and Hydration (CANH) in cases of prolonged disorders of consciousness (PDOC) when five justices heard the appeal 26 - 27 February. Again, extensive reference was made by lead counsels to CNK's expert witness evidence.


Poor care

Requests for euthanasia and assisted suicide are extremely rare when patients' needs, including physical, social, psychological and spiritual needs, are properly met. Building on the excellent tradition of palliative care that we have in this country and making palliative care more readily accessible to all who need it are of the greatest importance, and poor practice must be identified and improved. The spectre of Covid-19 has seen new concerns raised over the patients being urged inappropriately to sign DNACPR orders.

Concerns relating to to a current care issue are often best put through your GP, who will best understand the personal and local factors in the case, and who is best placed to make contact with the necessary individuals or bodies. Complaints regarding poor care should, according to the seriousness and circumstances of the case in hand, be directed to the relevant employer or health trust, to the General Medical Council (regarding doctors), to the Nursing and Midwifery Council (regarding nurses and midwives) or to the Care Quality Commission. You can also seek to bring further attention to instances of poor care by contacting the Department of Health, your MP or Members of the House of Lords.

Media bias

Media outlets have access to people's homes and lives on a daily basis, and have a responsibility to portray serious issues such as these with impartiality and caution. Yet all too often, publishers and broadcasters happily give a free platform to campaigners for legal change (for example...) and high-profile advocates within the media use their abuse their position (for example...), while contempt shown for guidelines laid down by major health bodies like the World Health Organisation and the Samaritans to guard against suicide contagion - the 'Werther effect' - extends to drama and fiction (for example...). Some do better than others, as with ITV's treatment of the issue in 2011; they were strongly advised to aim for a similar balance in a January 2014 Coronation Street storyline. The BBC, on the other hand, has consistently failed to present euthanasia and assisted suicide with the objectivity required of a national broadcaster. From news and documentaries to soap, drama and comedy, the Corporation has justifiably been called a 'cheerleader for assisted suicide'.

If you consider a portrayal or report about assisted suicide, euthanasia or other end of life issues to be biased or in breach of media guidelines, you can complain to the broadcaster (e.g. BBC) or newspaper; to regulators like Ofcom; or to your MP or Members of the House of Lords (especially where the bias concerns the license fee payer-funded BBC). Social media is a useful way of engaging with others during or shortly after a broadcast or as soon as a media story has been published. On Twitter, be sure to include our handle: @CNKAlliance.