Kim Leadbeater’s assisted suicide Bill has been dealt a major blow after the Royal College of Psychiatrists (RCPsych) announced it “cannot support” the Bill, citing “many, many factors” that need addressing.
In a move described by journalist Dan Hitchens as “an absolute bombshell statement”, the RCPsych said “With too many unanswered questions about the safeguarding of people with mental illness, the College has concluded that it cannot support the Bill in its current form”.
Explaining this standpoint, Dr Lade Smith, President of the RCPsych, said “[T]he RCPsych has reached the conclusion that we are not confident in the Terminally Ill Adults Bill in its current form, and we therefore cannot support the Bill as it stands”.
“It’s integral to a psychiatrist’s role to consider how people’s unmet needs affect their desire to live. The Bill, as proposed, does not honour this role, or require other clinicians involved in the process to consider whether someone’s decision to die might change with better support”.
Smith urged MPs “to look again at our concerns” in order to “prevent inadequate assisted dying/assisted suicide proposals from becoming law”. She told BBC Newsnight that the RCPsych had “repeatedly” raised their concerns with parliamentarians but they had “yet to be addressed”.
Key concerns around “many, many factors” in assisted suicide Bill
RCPysch registrar Dr Trudi Seneviratne underlined the group’s problems with the Bill, saying “There would be many, many factors in the bill as it stands that would need to be addressed”.
In an extensive press release, the RCPsych outlined its concerns, including ambiguity over whether assisted suicide is considered a “treatment” – the RCPsych are clear it is not a treatment – and a lack of consultant psychiatrists to carry out what the Bill asks. Dr Seneviratne explained that “[t]he workforce simply isn’t there. There’s a huge increase in mental disorder across the board – we don’t have enough [psychiatrists]”.
This issue was also previously raised in March when the assisted suicide Bill Committee heard evidence. Professor Gareth Owen, Honorary Consultant Psychiatrist at King’s College London, warned that each assisted suicide application would “probably not” receive a proper psychiatric assessment, “given the current workforce” within the NHS.
“The Bill is all wrong”
Nikki da Costa, former Director of Legislative Affairs at 10 Downing Street, criticised the lack of available psychiatrists and said the Bill is “all wrong”. She said “The Bill does not work. The High Court didn’t work. Replaced with a poor imitation panel. The panel won’t work because there are not enough psychiatrists. What next? The legislative process cannot compensate for the lack of proper policy development. This Bill is all wrong”.
Highlighting another problem, the RCPsych said “It is not clear what a psychiatrist’s role on a multidisciplinary panel would be”, and suggested the role of a psychiatrist on the panel, as envisaged by the Bill, may not be “consistent with the core duties of the profession”.
Sky News Health correspondent Ashish Joshi said “There is uncertainty now in what role psychiatrists will play if the bill passes in its current form. As it stands a panel including a psychiatrist would oversee assisted dying cases”.
Depression and assisted suicide
The RCPsych said the Bill does not consider the unmet needs of people who might consider assisted suicide. Dr Annabel Price, representing the Royal College of Psychiatrists, pointed out that depression often accompanies terminal illness, and this can lead to a patient wishing to die. She noted that this outlook can be improved significantly by care and effective treatment, saying “A significant part of our engagement on this Bill to date has been to point out that people with terminal physical illnesses are more likely to have depression”.
“Terminal illness is a risk factor for suicide, and unmet needs can make a person’s life feel unbearable. But we know that if a person’s situation is improved or their symptoms treated, then their wish to end their life sooner often changes”. Dr Price also made this point during the Committee’s meeting at the end of January.
Another issue raised was the requirement of psychiatrists to “signpost patients to information on [assisted suicide]”, which, for some, “would constitute being involved in the [assisted suicide] process”.
The latest blow to Leadbeater’s “shambolic” Bill
The RCPysch’s withdrawal of support is the latest blow to the Leadbeater Bill, coming shortly after the Royal College of Physicians (RCP) warned the Bill contains “deficiencies” that make it unsafe for both patients and doctors.
The RCP said that, after the completion of the Bill’s Committee Stage, “there currently remain deficiencies that would need addressing to achieve adequate protection of patients and professionals”. Journalist Sonia Sodha described the RCP statement as “[a] pretty damning verdict” in a post on X and asked “Will MPs listen to doctors?”.
Professor Allan House, Emeritus Professor of Liaison Psychiatry at the University of Leeds, commented that the RCPysch’s “strong clear statement” would be influential in persuading supporters of the Bill to have a “rethink” about their vote, saying on X “[I]t doesn’t come from a fringe lobbying group or unrepresentative ideological position and should give MPs serious cause for a rethink if they are considering supporting the bill”.
Dr Philip Murray, Assistant Professor in Law at Robinson College, Cambridge University, went further, querying how MPs could vote for the Bill after the RCPsych statement. He said “This is massive. I don’t see how MPs can vote for a Bill that even the Royal College of Psychiatrists fear unsafe and unworkable”.
Dr Rajiv Shah, a former Government advisor, praised the RCPysch for its stance. Referring to the initial exclusion of representatives from the RCPsych as witnesses before the Committee in January, a decision that was later reversed in an apparent surrender to public criticism, Shah said “Credit to the Psychiatrists for having the courage to say this Bill is wholly flawed. It now makes sense why [Leadbeater] did not want them to give evidence”.
Spokesperson for Right To Life UK, Catherine Robinson, said “The Royal College of Psychiatrists has correctly recognised that Leadbeater’s shambolic Bill is riddled with major issues that have simply not been addressed”.
“There are now so many problems with the Bill, which has been defined by the removal of key safeguards and legitimate concerns being dismissed or ignored”.
“This is simply not good enough for an issue which is, quite literally, a matter of life and death. We call upon all MPs to vote against this dangerous Bill at Third Reading”.
