Rollout of assisted dying service ‘best not done at speed’ says Chris Whitty

Work to provide an assisted dying service in England and Wales should not be rushed, and “simplicity” is key for good safeguards, a top medic has told MPs.

England’s chief medical officer Professor Sir Chris Whitty was the first witness to appear before a committee scrutinising the assisted dying Bill.

He is one of about 50 witnesses who will give evidence across three days this week as the committee prepares to look next month in detail at each part of the Terminally Ill Adults (End of Life) Bill.

The Bill could see terminally ill adults in England and Wales with under six months to live legally allowed to end their lives, subject to approval by two doctors and a High Court judge.

Kim Leadbeater, the MP behind the Bill, has previously said it is likely to be a further two years from a law being passed for an assisted dying service to be in place.

Sir Chris told MPs on Tuesday that he thinks two years “seems a reasonable starting point” but that he does not believe there should be a “firm deadline”, with the focus instead on providing a “safe, fair and secure service”.

He said he and the UK’s other chief medical officers are “completely neutral on the principles of this Bill, which we consider are entirely for society and therefore for Parliament”.

Sir Chris said he was appearing before the committee to answer technical questions, rather than questions on principle.

He told MPs that if the Bill is passed into law by Parliament, there will need to be time for technical guidance and legislation to be put in place, as well as “necessary training for people to be able to do this in an appropriate and dignified way”.

He added: “I think that what we would want to do is to have the time to do that. But you can do things at speed, if you need to. My view is this is something which is best not done at speed if we can avoid it.”

And he said be believed “most people in society would say the key thing is to get this right”.

Sir Chris added: “So personally, I would rather this wasn’t running against a timeline.”

The senior medic added that the “central person here is a person, an average citizen, in their last six months of life”.

He told MPs what is not wanted is for a person with a life expectancy of six months to be “stuck in a bureaucratic thicket”.

He added: “We do need to keep this simple. And my view is the best safeguards are simple safeguards. So over-complicating actually usually makes a safeguard less certain, to be honest.”

Asked about amendments which have been suggested to the Bill which would be more prescriptive in what factors doctors need to take into account, and the steps they would have to take when considering capacity, Sir Chris told MPs: “It’s very, very difficult – I could not, at this point, write down a law that would actually be helpful to someone dealing with a whole range of different scenarios where they’re going to have to have an end of life discussion.

“So my own view, for what it’s worth, is: I would do fewer rather than more, and that is partly because simplicity is the key to really good safeguards, in my experience.

“If safeguards are really clear and simple, everybody understands them.”

England’s chief nursing officer Duncan Burton, who also appeared before the committee, pointed out that the Bill as it stands does not specifically state that the NHS would be the provider of an assisted dying service.

Asked if that would need to be known quickly for planning purposes, Sir Chris replied: “I think that is a key question.

“And I think actually, to me, that does seem something which Parliament may want to debate. That’s not a question for us, but that is a point of principle, I think, one way or the other.”

Asked about the definition of terminal illness and whether the Bill could be improved with a specified list of illnesses instead, Sir Chris said this would be “extremely difficult”.

He told MPs: “Exact timings are tricky. But therefore, I think it’s quite difficult to actually specify ‘these diseases are going to cause death, and these diseases are not’, because in both directions, that could potentially be misleading.”

The panel is expected to start line-by-line scrutiny of the Bill a week later than originally planned, on February 11, to give MPs more time to consider the “large” amount of written evidence so far put forward to be considered.

Committee stage is likely to then last a week longer to account for the later start to the formal scrutiny, meaning overall timetabling would not be affected.

No date has been given yet for the Bill to return to the Commons for further debate by all MPs at report stage but it is likely to be towards the end of April.

While the Bill passed second reading stage after a lengthy debate in the Commons before Christmas, some MPs who voted yes said they might not continue their support if they are not convinced of strong safeguards around aspects including potential coercion.

The Bill will face further scrutiny and votes in the House of Commons and the House of Lords, meaning any change in the law would not be agreed until later this year at the earliest.