Rachael Maskell

Rachael Maskell

Labour (Co-op) — York Central

Speaking in the House of Commons on 16 May 2025

Debate

Terminally Ill Adults (End of Life) Bill

Contribution

I will not. Dr Lade Smith, the president of the Royal College of Psychiatrists, could not have been clearer, and academic research says the same: when someone is in receipt of a terminal diagnosis, there is frequently an episode of depressive disorder. Dr Price said in evidence: “Those who had a wish to hasten death were 18 times more likely to also feel suicidal”.––[Official Report, Terminally Ill Adults (End of Life) Bill Public Bill Committee, 30 January 2025; c. 275, Q359.] They say that mental disorders are treatable. The spike in suicidal ideation and action is highest in the first few months following terminal diagnosis and then dissipates with time or intervention. Again, that is evidenced. People change their mind and no longer want to die. As with other aspects of the Bill, poor care, poor pain management and poor symptom control—or the fear thereof—are reasons why people seek to end their life. That can be palliated. Colleagues must recognise the paucity of mental health provision given to somebody when they receive a terminal diagnosis. Often there is no psychological aftercare. People are failed, but that should not be a reason to die. I ask for a panel, which would include a social worker, to assess the psychological needs of a patient. They are experts in detecting coercion, whether intrinsic or extrinsic, and understanding people at their most vulnerable with a fusion of complex emotions, anxiety and fear. Solutions can be found by them. There would also be a psychiatrist. Depression, anxiety and fear are natural responses to trauma, but they can be treated with the right interventions, if detected at the point that somebody expresses a wish to die, and a person can have a wish to live. The travesty of getting it wrong is unconscionable. There would be a palliative care consultant who is registered on the GMC’s specialist register. They would understand the actions that could alleviate someone’s suffering. Evidence to the Bill Committee from Sue Ryder showed how poor provision led to someone considering an assisted death. Likewise, the president of the Association for Palliative Medicine, Dr Sarah Cox, said: “We know that effective palliative care can change a terminally ill person’s point of view from wanting to die to wanting to live.”––[Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 28 January 2025; c. 70, Q84.] That is evidence. It is a point I have heard from all leaders on the Commission on Palliative and End-of-Life Care. These are the specialists who know how to palliate the physical, psychological, social and spiritual problems of a patient, and they have techniques that many people have not had access to, because of poor provision. The palliative care commission reported on Tuesday and I urge hon. Members to read its evidence-rich report, which draws on best practice. We reported that excellence in end-of-life provision is achievable, but that too many people are not getting access to it. Without that, I fear that the Bill only leads the patient down one route—to die. This is not a choice at all, but a path to an assisted death.

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