Assisted Dying Bill Scrutiny: Coercion Detection Concerns Raised

The Legislative Council, the Isle of Man’s upper chamber, has concluded its evidence gathering phase for the Assisted Dying Bill 2023. This legislation, which aims to grant terminally ill adults the option to end their lives, will proceed to clause-by-clause scrutiny by members on 17 December. During the evidence stage, Manx politicians received input, including concerns regarding the ability of doctors to identify coercion. Witnesses included Alex Allinson, the MHK who introduced the bill, retired palliative care consultant Claud Regnard, and forensic investigator Bridget Carter. In the course of the session, Dr. Regnard asserted that entrusting the validation of a patient’s choice to two “isolated doctors” presented an “inherently risky” approach. The private member’s bill, sponsored by Alex Allinson and steered through the Council by Peter Greenhill MLC, proposes to allow adults with a life expectancy of 12 months or less the right to opt for an assisted death. This proposed legislation, which received approval from the House of Keys in July, stipulates that eligible individuals must be over 18 years old and have resided on the Isle of Man for five years, with their decision requiring verification by two independent medical practitioners. However, both Dr. Regnard and Ms. Carter advocated for the implementation of a “multi-disciplinary team” to evaluate for coercion, suggesting this as an additional safeguard. Dr. Regnard contended that medical professionals are typically trained to collaborate with and trust families. He suggested that while further training could be advantageous, individuals possessing professional experience in such scenarios would be better equipped to provide assistance. Ms. Carter stated that establishing such a team would introduce “checks in place,” thereby fostering a “more robust and safeguarded system.” She informed the members that, in her view, doctors lack the training to comprehend a patient’s family dynamics and potential patterns of abuse, and are therefore unable to assess an individual’s capacity solely through a “tick-box” process. She further explained that older individuals frequently do not “recognise” when they are being coerced, and even if they do, they might feel “embarrassed” or wish to avoid harming a family member’s reputation. Conversely, Allinson expressed apprehension regarding the extra time that this “extra step” would entail, contending that “an additional barrier” should not be erected for individuals seeking an assisted death. He additionally informed MLCs that it was “eminently possible” for assisted dying services to be “initially” offered in individuals’ homes. He stated that this approach would guarantee “the right degree of safeguards,” noting that “most people” prefer to die at home. Following the conclusion of the evidence session, Greenhill, who had initially indicated his intention to seek support for an immediate transition to the bill’s clauses stage during the sitting, instead suggested that the Council undertake this on 3 December, which is one week earlier than stipulated by standing orders. Paul Craine MLC rejected this proposal, citing an “enormous amount of information” that required time for consideration, while Diane Kelsey MLC expressed a desire for time to contemplate potential amendments. Greenhill acknowledged these comments but proceeded to put the motion to a vote, which ultimately failed.