'Coercion' fears over assisted dying as critics warn bill could be pushed to 'cut costs' for families and the state

3 May 2025, 09:19 | Updated: 4 May 2025, 13:53

Speaking to LBC, campaigners have cautioned against 'coercion' influencing decisions on assisted dying.

Almost 800 assisted deaths might occur in the first year of an assisted dying service being in place in England and Wales and end-of-life care costs could be cut by millions, according to the Government's analysis.

A 149-page impact assessment into the Terminally Ill Adults (End of Life) Bill was published on Friday, exactly a fortnight ahead of the next Commons debate on the proposed new law.

It set out estimates for how many people might apply and go on to have an assisted death, as well as potential costs of the service and reduced end-of-life care costs.

Speaking to LBC's Matthew Wright on Saturday morning, Baroness Tanni Grey-Thompson, 11-time Paralympic gold medallist, disability rights campaigner and crossbench peer who has campaigned against the assisted dying bill, warned against "coercion" if "money comes into it".

She said: “Unfortunately, money always comes into it, and this is one of the reasons I'm worried about coercion and always have been in terms of either saving the country money or saving the family money and what pressures are going to be put.

Speaking about the released impact assessment, she said: "It just highlights there's even more gaps in terms of what this bill might do.

“There's very little [detail] on training, doctors will get two-days training, some of it could be online.

“There's no mention in there of the 2021 UK law criminalising coercion into suicide, there's nothing in there about anorexia and the figures that are used are quite complicated.”

Meanwhile, Jean Eveleigh, member of My Death My Decision, who has given evidence to MPs on the assisted dying bill, said the "chronically underfunded" NHS is "constantly making decisions about whether or not it costs them money to keep us alive".

Ms Eveleigh continued: “The NHS is constantly deciding whether or not people who are sick or disabled is costing too much money, whether they are willing to fund lifesaving treatment.

“What we're asking for now is the other end of the spectrum, when our lives are so painful, so intolerable, when we are already dying and we want to have some control over that death, should we be allowed to have that choice?

Referring to the argument of 'coercion', she said people "are already coerced in this country as it stands".

"We just don't know how many, because there is no reporting on the deaths of people and what leads up to their deaths, whether there is coercion, who benefits from that person's death? Would they have lasted a little bit longer if they had gone for extra chemotherapy or an extra round of whatever medication is necessary for their condition, but they told the doctors they wanted to stop, they didn't want to continue?

“This law actually says that you have to be assessed multiple times by multiple doctors and legal professionals and psychiatric professionals and social workers to try and prove your case over and over and over again.”

Speaking to LBC's Matthew Wright, caller Rebecca, who has ME and a mother who is being treated for end of life care for ovarian cancer, said she supports assisted dying on a case-by-case basis.

Rebecca explains that her condition is not covered by the assisted dying bill and says she is resistant to pain medication. For this reason, she has decided not to undergo further medical screenings.

"I've decided I turned 50 last year, and I've decided that I'm not going for any screening programs, because I don't see the point in having a disease diagnosed like cancer, to go through the cost of treatment, the discomfort of treatment, to be cured, to lie in my bed for another 20 years."

She continued: "[Assisted dying] should be about whether a person could put themselves forward, not a family, and receive the right psychological assessment.

"For people like myself, it's hard enough to suffer the challenges of a medical condition but the government makes it harder for us as well, you're punished by your body. You're punished by the government for having a body like this."

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The Bill has undergone significant changes since it succeeded in an initial vote in the Commons in November.

The High Court safeguard has been dropped and replaced by expert panels, while the implementation period has been doubled to a maximum of four years for an assisted dying service to be in place, should the Bill pass into law.

The proposed legislation would allow terminally ill adults in England and Wales, with fewer than six months to live, to apply for an assisted death, subject to approval by two doctors and a panel featuring a social worker, senior legal figure and psychiatrist.

The impact assessment said the total number of assisted deaths is estimated to range from between 164 and 787 in the first year of the service to between 1,042 and 4,559 in year 10.

The establishment of a Voluntary Assisted Dying Commissioner and three-member expert panels would cost an estimated average of between £10.9 million to £13.6 million per year, the document said.

But it said it had "not been possible" to estimate the overall implementation costs at this stage of the process, which could include IT, recruitment and training and could begin to kick in within 12 months of the Bill getting Royal Assent.

While noting that cutting end-of-life care costs "is not stated as an objective of the policy", the assessment estimated that such costs could be reduced by as much as an estimated £10 million in the first year and almost £60 million after 10 years.

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Dr Gordon Macdonald, chief executive of Care Not Killing - which is opposed to a change in the law, said the document "confirms that changing the law will save money... exactly as we have seen in other jurisdictions which have introduced state assisted killing, placing pressure on vulnerable terminally ill people to end their lives".

The document was published on Friday after 4pm, as the results of the local elections across England rolled in, with the timing criticised by MP Meg Hillier.

The Labour MP, who voted against the bill last year, told the Guardian: "Releasing this long-delayed impact assessment while MPs are focused on local election counts far from Westminster and only weeks before the bill comes back to parliament is another example of the failure of this process to live up to the promises made to MPs at second reading."

MPs will gather for debate on May 16 in the House of Commons for the Bill's report stage, during which members are expected to vote on further amendments.

If time allows on that date, MPs could also vote on whether to approve the Bill at third reading - its final stage in the Commons - and decide if it is then sent to the House of Lords for further scrutiny.

Voting is according to conscience, so MPs do not vote along party lines, and the Government has said it is remaining neutral as a whole.

Health Secretary Wes Streeting, who confirmed last month that he still plans to oppose the Bill at the next vote, said last year that there were "choices and trade-offs", adding "any new service comes at the expense of other competing pressures and priorities".

It has been suggested some MPs who supported the Bill last year could change their stance when it returns for a further vote, after the change to the High Court safeguard.

But Kim Leadbeater, the Labour MP behind the Bill, has said it is now "safer, fairer and more workable" after undergoing weeks of scrutiny by a committee.

Following the impact assessment's publication, Ms Leadbeater said: "The cost in human terms of failing to act would be immense.

"It is difficult, if not impossible, to put a price on correcting injustice and providing dignity to our fellow citizens in their final weeks and months, but it is of course right that we look at what effect changing the law would have more widely. These impact assessments will help do that."

She urged MPs to read the documents "with care", adding that she remains "firmly of the view that the overall impact of this long overdue reform will be to make end of life care in England and Wales more compassionate and significantly safer".

A spokesman for the Department of Health and Social Care said the Government remains neutral on the matter but also "has a responsibility to make sure any legislation that passes through Parliament is workable, effective and enforceable".

He said the publication of the impact assessment was done "in order to help Parliamentarians in their consideration of the Bill".