Assisted Suicide Bill Fails to Protect Those With Eating Disorders and Disabilities, MPs Hear

People take part in a demonstration at Old Palace Yard to oppose the Terminally Ill Adults (End of Life) Bill in Westminster, London, on Nov. 29, 2024. Yui Mok/PA Wire

Wording in the assisted suicide bill does not provide enough safeguards to protect the disabled and those with mental illnesses, MPs have heard.

Chelsea Roff, director of the eating disorder charity Eat Breathe Thrive, addressed the committee on the Terminally Ill Adults (End of Life) Bill on Wednesday.

She said that while the bill’s definition of terminal illness excludes individuals with mental disorders and disabilities, it fails to account for clinical interpretations of anorexia as a terminal condition. Additionally, she pointed out that the physical effects of mental illnesses on the body could also be classified as terminal.

“There’s a false distinction being made between a mental health disorder and its somatic or its physical manifestations in this bill. Mental disorders, especially eating disorders—not just anorexia—impact the body and they have life-threatening consequences,” she said.

Roff said that last year, there were 20,000 people hospitalised for eating disorders, “who, if they were to choose to forgo treatment, would qualify under this bill.”

She explained that she had co-authored a review of assisted suicide and eating disorders and found that at least 60 people with eating disorders had been assisted in suicide in jurisdictions around the world, including in Colorado, California, and Oregon where assisted death is legally restricted to terminal conditions.

“Laws in other countries have expanded through clinical interpretation—not just legislative amendments,” Roff said, adding that there was a small minority of clinicians who have characterised anorexia as a terminal illness and who have also said that eating disorders qualify because of the physical manifestation of the disorder.

Concerns Over Interpretation

Roff was one of several specialists called to give oral evidence for the committee stage of the assisted suicide bill, which was put forward by Labour MP Kim Leadbeater.

The bill would allow terminally ill adults who have been given a life expectancy of less than six months to end their lives with the assistance of the state.

Leadbeater has said that her bill, which covers England and Wales, has “layers and layers of safeguards and protections which I believe will probably make it the most robust piece of legislation in the world.”

University of Leeds lecturer Miro Griffiths, who holds several advisory positions in disability across the UK and Europe, likewise expressed concern over clinical interpretation of aspects of disabled peoples’ conditions.

Griffiths, who is disabled, said: “I have had meetings with clinicians where some have referred to [my condition] as a terminal illness, some have referred to it as a life-limiting condition, others have referred to it as a progressive condition. So the articulation of these ideas and the ways in which we think about conditions, again, shows the complexity.”

The Leeds lecturer also raised his concerns over the reliability of the six-month prognosis, which is a requirement under the proposed law for assisted suicide to be granted. He said that even if doctors tell a patient they have six months to live, that person could live for months or years more, either due to medical interventions or errors in diagnosis.

Bill Has ‘Many Safeguards’

Hearing concerns from these specialists, Leadbeater said that the bill’s definition of terminal illness rules out those with mental illnesses or disabilities.

She said: “I’m very clear who this bill is aimed to help, and who it is aimed to involve. The definition says that the person has to have an inevitably progressive illness, disease, or medical condition, which cannot be reversed by treatment. It also says, for the avoidance of doubt, this cannot be a mental disorder or a disability.”

People take part in a demonstration organised by campaign group Dignity in Dying outside the Houses of Parliament in support of the Terminally Ill Adults (End of Life) Bill in Westminster, London, on Nov. 29, 2024. Stefan Rousseau/PA Wire

Professor Tom Shakespeare, who is a sociologist and professor of disability research at the London School of Hygiene and Tropical Medicine, gave evidence during the same session.

He supports the bill and agrees with Leadbeater that the definition of terminal illness in section two is “very clear.”

The professor told the committee that the bill has “many safeguards,” including five opportunities for patients to have conversations with doctors and other supporters, “so I think that is a good safeguard.”

Shakespeare also claimed that “most disabled people support the bill.”

He continued: “I think there is support because it restricts it to terminal illness [...] This is only relevant to people who are dying already, and it defines terminal illness very clearly. Mental illness, for example, cannot be the sole criterion. So that would rule out people who have eating disorders.”

On Tuesday, the committee had heard from palliative care specialists, including President of the Association of Palliative Medicine Sarah Cox. She had told MPs that end-of-life care must “massively improve” before assisted suicide could even be considered an option.