In a statement on the precarious situation facing care homes and hospices if the Terminally Ill Adults (End of Life) Bill passes its Third Reading on Friday, 20 June, Cardinal Vincent Nichols, Archbishop of Westminster, and Archbishop John Sherrington, Archbishop of Liverpool, said:
“We call attention to the fact that the future of many care homes and hospices will be put in grave doubt if the Terminally Ill Adults (End of Life) Bill becomes law.
“Our Parliament has now rejected amendments that would have allowed such institutions not to be involved in assisted suicide. Minister Stephen Kinnock MP, Kim Leadbeater MP, as well as other MPs, indicated that the rights that this Bill will give to individuals to seek assisted suicide, and to employees to participate in an assisted suicide, are likely to trump the mission and values of institutions such as hospices and care homes.
“In other words, a right to assisted suicide given to individuals is highly likely to become a duty on care homes and hospices to facilitate it. We fear that this Bill will thereby seriously affect the provision of social care and palliative care across the country.
“Institutions whose mission has always been to provide compassionate care in sickness or old age, and to provide such care until the end of life, may have no choice, in the face of these demands, but to withdraw from the provision of such care.
“The widespread support which hospices attract from local communities will also be undermined by these demands which, in many cases, will require these institutions to act contrary to their traditional and principled foundations.
“This tragedy can only be avoided by the defeat of this Bill on Friday.”
Cardinal Vincent Nichols is Archbishop of Westminster and President of the Catholic Bishops’ Conference of England and Wales.
The Most Reverend John Sherrington is Archbishop of Liverpool and Lead Bishop for Life Issues for the Bishops’ Conference.
Introduction
In the vast majority of jurisdictions in which assisted suicide has been legalised, care homes and hospices have been required to facilitate it. It is highly likely that this will be the case in the UK if the Terminally Ill Adults (End of Life) Bill passes. The mechanisms by which this can come about are many and varied.
An amendment to the Bill, which would have explicitly allowed institutions to not be involved with assisted suicide, was rejected at the report stage. The lack of protection that the Bill offers, and the tenor of debate around the amendment, including points made by the Bill’s sponsors, suggest that there is a high likelihood that Catholic hospices and care homes will be required,
by some mechanism, to be involved with assisted suicide if the Bill passes at third reading. This Bill therefore threatens the future of such Catholic institutions.
Key points
The specific ways through which hospices and care homes might be forced to collaborate with assisted suicide include:
1. The Secretary of State will be given the power to make regulations to ensure the availability of assisted suicide. These regulations are unlikely to be debated in parliament. They could impose requirements on hospices and care homes. In other similar fields equality of access to a “service” is, almost without exception, given priority over institutional freedom.
2. The provision of assisted suicide could be tied to government funding of hospices, to the local authority funding of care home residents or to local health authority contracts. This has been the experience in Canada. In its evidence to the Bill Committee, St. Gemma’s hospice in Leeds stated: “If compliance with assisted dying provision becomes a condition for NHS funding, institutions like St. Gemma’s may have no alternative but to cease operations entirely”. And the CEO of Hospice UK (which is not against assisted suicide in principle) has written: “The implications for hospices must not be underestimated or sidelined. There are huge unanswered questions.” When St Joseph’s Hospice in Hackney, East London, published its position in October 2024, it stated: “As a Catholic hospice, our position is that assisted dying plays no part in our specialist palliative care practice and is not consistent with our ethos or values. We neither hasten death nor postpone it. We cherish life, but also embrace a natural death when it comes.”
3. Employers will not be able to take action against employees who choose to facilitate assisted suicide. In opposing the amendment that would have allowed care homes and hospices to not participate, one MP said quite clearly that it was wrong to allow care homes or hospices to prevent an employee exercising their conscience right to help a client of such an institution commit suicide. Bill proposers have made clear that they believe that the “rights” of employees and residents of institutions must be put ahead of the freedom of an institution. This may put Catholic hospices and care homes in an impossible position if staff, especially senior staff, take it upon themselves to make arrangements for a resident who wishes to have an assisted suicide or, in the case of a doctor, to provide direct assistance.
4. Human rights or Equality Act challenges may well establish that somebody who is seriously ill and who cannot be comfortably moved will have their human rights undermined or be subject to detriment under the Equality Act if the institution in which they are being cared for does not help provide assisted suicide on the premises. The relevant minister dealing with the implementation of the Bill indicated in parliament that a human rights challenge to a care home that did not facilitate assisted suicide would be likely to succeed.
Conclusion
There is a significant danger that Catholic hospices or care homes may have to withdraw services if this Bill becomes law. Other similar areas of law in the UK, and the experience of assisted suicide legislation internationally, heightens these concerns. Parliament, and the Bill sponsors, have rejected amendments that would have protected care homes and hospices.
Comments by ministers and Bill sponsors in response to those proposed amendments, strongly suggest that our fears in relation to these issues are justified. Many Catholic hospices provide services for large proportions of our cities. Withdrawal from the sector could create enormous problems for the provision of palliative care just at the time when the provision of palliative care needs to be invested in and strengthened.
