Doctor 'cautiously optimistic' Assisted Dying Bill would pass vote on Isle of Man

The doctor behind a bill which could see assisted dying legalised for the first time in the British Isles says he was "cautiously optimistic" it would pass a vote.

Dr Alex Allinson says while it is a sensitive issue he believes there is a "far larger" number of people interested in helping those facing difficult deaths to take control than those opposed to a change in the law.

The GP, who is also the Isle of Man government’s Treasury Minister, said he is confident the Island’s parliament has the time to “craft the right bill” which he said could see assisted dying services offered as soon as 2025.

The Assisted Dying Bill went through its second reading on Tuesday, 31 October, when the Isle of Man parliament then voted.

Dr Allinson introduced the Private Member’s Bill in 2022 in his capacity as a Member of the House of Keys (MHK) for the Ramsey area on the Island.

Asked how significant the progress of his bill is, Dr Allinson said: “If it is passed, this is just for Isle of Man residents, so it doesn’t satisfy the needs of people in other neighbouring jurisdictions.

“But I think what it does show is that appetite amongst our public, and their elected representatives, to bring forward progressive legislation that will provide for assisted dying.”

"If my husband was a dog I'd have been prosecuted"

Sue Biggerstaff, whose husband died from Motor Neurone disease, says had he had assisted dying an an option he would have "repeatedly" said yes to it.

Simon Biggerstaff was diagnosed with the degenerative disease in July 2021, and died in May 2022.

Just two months after his diagnosis he was paralysed from the neck down, and continued to tell his wife "I want to go".

“He really couldn't do anything," Sue said. "He was just just a rotting body with my Simon inside it, that's what you’re left with.

"If the option had been there before those last two days, then yes [we'd have taken it] he repeatedly said 'I want to go'.

"I only go on my experience of it, and he wanted it to stop."

She added: "I've got three dogs, I love my dogs but if I had one of them out there with his skin rotting away unable to move, just lay on the floor pooing and peeing itself, I'd be prosecuted.

"And yet my husband was expected to go through it. How is that right? It just can't be right."

As a practising doctor, Dr Allinson says he has also seen first-hand the experience of people and their families facing “difficult deaths”, which has spurred his action on the issue.

But he also accepted there is opposition to law change from some.

He said: “I recognise and respect their views – assisted dying is not going to be for everyone.

“And those people who are opposed to it will never have to take up its provisions. But for those small number of people who have unbearable suffering at the time of an inevitable death due to a terminal illness, this is an incredibly important provision.”

What is assisted dying?

Assisted dying is where a person suffering from a terminal illness or incurable condition is helped to take their own life, after requesting drugs provided by a doctor for the purpose.

Assisted dying is lawful in Switzerland and the Netherlands.

Dr Allinson said there would be "extensive parliamentary discussion" if the bill progresses, and he is hopeful it could receive royal assent in 2024, followed by a period to consider how the legislation would be implemented.

He said: “If we can do the work in terms of getting the regulations, the guidance, the training, the support, the education right, then we’d be looking at bringing it in around about that time (2025/26).”

He said he is “cautiously optimistic” it will clear this latest stage of the process, and said if it became law, strict criteria would be put on those wanting to use it.

"The criteria here really are for Island residents, if they live on the Island," he added.

"If they have a terminal illness, if they are reasonably expected to die within six months but crucially if they are adult, if they have capacity, if they have an intention and they actually want their life to end at a time and a place that is suitable to them."

Dr Allinson explains why he decided to take up the issue and raise it in parliament

Dignity in Dying, a pro-change campaign group, described it as a “landmark vote”, adding if it is approved "the Isle of Man will be on the path to become the first part of the British Isles to legalise assisted dying as an option for its terminally ill, mentally competent citizens, subject to strict safeguards".

But campaigners from Care Not Killing said changing the law would perpetuate a message “that those with a terminal or chronic condition will die in terrible pain, that current palliative care cannot help them, and they should instead opt to have doctors administer death row drugs to end their lives”.

Chief Executive, Dr Gordon Macdonald, said: “At a time when we have seen how fragile our healthcare system is, how underfunding puts pressure on services and when up to one in four Brits who would benefit from palliative care don’t get access to it.

"I would suggest this should be the focus of parliamentary attention, rather than discussing again this dangerous and ideological policy.”

Dr Ben Harris, the President of the Isle of Man Medical Society, says legalising assisted dying could lead to "death tourism" where people come to the Isle of Man to take advantage of the law.

The practitioner, who has worked in palliative care for 30 years, said: "There's great concern that there will be what you might call 'death tourism' where people will travel from other parts of the British Isles to the Isle of Man to request assisted dying.

"We don't restrict other health care for visitors to the Isle of Man, we have a reciprocal agreement, so I think it could be open to challenge."

He added: "A survey found only 10% of doctors felt it was straight forward to judge when a patient only had six months left to live."

If voted through the bill would immediately be put to another vote on whether it should be scrutinised by a small committee or debated by the whole parliament.

In July, social care minister Helen Whately told a Parliamentary Committee hearing evidence into assisted dying and assisted suicide in England and Wales that debate in this “sensitive area” is one that should be led by MPs at Westminster and that it is an “issue of conscience” for members of Parliament to decide.

The Health and Social Care Committee, which heard from peers, experts and Swiss organisations including Dignitas during its sessions, is expected to publish a report later this year.

How is assisted dying viewed in other parts of the United Kingdom?

Assisted suicide is currently banned in England, Wales and Northern Ireland, with a maximum prison sentence of 14 years.

In Scotland, assisted dying is not a specific criminal offence but assisting the death of someone can leave a person open to murder or other charges.

Scottish Liberal Democrat MSP Liam McArthur’s member’s bill, which seeks to enable mentally competent adults who are terminally ill to be provided with help to end their life if they request it, is expected to be published in Scotland later in the year.

The Republic of Ireland’s parliament has also been holding committee hearings into the issue of assisted dying to consider and make recommendations for any potential legislative and policy change.

The Isle of Man’s bill is worded as “a bill to enable certain adults who are terminally ill to be provided at their request with specified assistance to end their own life; and for connected purposes”.