Revisiting the Mackay Committee into Assisted Dying

In 2005, the House of Lords Select Committee on the Assisted Dying Bill for the Terminally Ill Bill presented its conclusions after a comprehensive investigation. The Committee, also known as the ‘Mackay Committee’, broke down its findings into three volumes: Volume I (Report); Volume II (Evidence): Volume III (Evidence – Individual Submissions).

Ultimately, the committee recommended that any ‘assisted dying’ bill should draw a “clear distinction […] between assisted suicide and voluntary euthanasia in order to provide the House with an opportunity to consider carefully these two courses of action, and the different considerations which apply to them, and to reach a view on whether, if such a bill is to proceed, it should be limited to the one or the other or both”.

Additionally, “any future bill should set out clearly the actions which a doctor may and may not take either in providing assistance with suicide or in administering voluntary euthanasia”.

Regarding terminology, “if a future bill should include terminal illness as a qualifying condition, this should be defined in such a way as to reflect the realities of clinical practice as regards accurate prognosis”. Furthermore, “consideration should be given in any future bill to including ‘unrelievable’ or ‘intractable’ suffering or distress rather than ‘unbearable’ suffering as a criterion”.

The Committee also investigated the impact of palliative care, and suggested that “if a future bill is to claim with credibility that it is offering assistance with suicide or voluntary euthanasia as complementary rather than alternative to palliative care, it should consider how patients seeking to end their lives might experience such care before taking a final decision”.

Commenting on waiting or ‘cooling-off’ periods between an applicant’s first and second request for assisted suicide or voluntary euthanasia, the Committee noted that “in setting a waiting period between an application for assisted suicide or voluntary euthanasia and the carrying out of such actions, any future bill should seek to balance the need to avoid increased suffering for determined applicants against the desirability of providing time for reflection for the less resolute. Such a waiting period is of less importance in the case of assisted suicide but needs to be considered carefully in the case of voluntary euthanasia”.

The report also covered conscientious objection: “any new bill should not place on a physician with conscientious objection the duty to refer an applicant for assisted suicide or voluntary euthanasia to another physician without such objection; it should provide adequate protection for all health care professionals who may be involved in any way in such an application; and it should ensure that the position of persons working in multi-disciplinary teams is adequately protected”.

Finally, the Committee recommended “any new bill should not include provisions to govern the administration of pain relief by doctors”.