AS a doctor who provides palliative care, I have the privilege of spending time with people nearing the end of their lives, meeting them in their vulnerability and addressing their needs.

I was deeply concerned, therefore, when Kim Leadbeater’s Bill passed its second reading last November. However, I endeavoured to take the sponsor of the Bill at her word that the committee stage would be an opportunity “to continue the debate.” I hoped that the committee process would make the Bill safer and protect the most vulnerable. Sadly, my worst fears have been realised.

While there have been some valiant efforts throughout the committee stage to make the Bill safer, these efforts have been thwarted time and time again by Leadbeater and her allies. MPs have tabled more than 100 amendments to improve safeguards for some of the most vulnerable groups in our society. Astonishingly, virtually all of these amendments have been rejected.

Tragically, a Bill that was already dangerous has become more so. The threat the Bill presented at second reading to some of the most vulnerable in our society has become exponentially greater.

The slippery slope is often talked about in debates on assisted suicide. Numerous examples have been provided internationally where, over time, laws in certain jurisdictions have loosened, and the eligibility criteria for assisted suicide have encompassed more and more people. Remarkably, in this case, the slippery slope is in plain view before the Bill is even on the statute book.

I watched the debate ahead of the vote at second reading, noting how many MPs mentioned the “High Court safeguard.” Leadbeater and her allies claimed that this would ensure the Bill would be the safest anywhere. Over 60 MPs specifically cited this safeguard as being a key factor in lending the Bill their support at second reading.

However, less than a week after second reading, a peculiar opinion piece emerged on Labour List, written by Jake Richards MP. Richards had played a key role in the debate to that stage and is a co-sponsor of Leadbeater’s Bill. Indeed, he is now one of the most vocal backers on the Bill Committee.

In his article, he floated the idea that perhaps, after all, the High Court safeguard was not up to scratch. Richards’s article was an early indicator, confirming the suspicions of many (myself included) that the High Court safeguard was only ever meant to assuage the guilty consciences of torn MPs in order to help Leadbeater’s Bill get through second reading, and that the intention was always to replace it with something far weaker.

Intended or not, that is exactly what has come to pass. Last week, Leadbeater and her allies stripped this key safeguard from her Bill and introduced in its place flimsy panels that seem destined to become simply rubber-stamping boards.

Disability campaigners have been among the most vocal in their opposition to the Leadbeater Bill, and with good reason. The Down’s syndrome community in particular was well-organised at committee stage and pushed hard to ensure that specific safeguards concerning Down’s syndrome would be added to the face of the Bill.

These efforts came to nought, however, as they were dismissed by Leadbeater and her supporters on the committee. Shockingly, one of Leadbeater’s Conservative allies, Kit Malthouse, even threatened to gag Down’s syndrome campaigners who sought to “misrepresent” what was debated at committee concerning this amendment.

The Down’s syndrome community were not the only ones thrown under the bus. As has been stated here before, many of those who are neurodivergent have real concerns about what this Bill might mean for them. Amendments to further safeguard people with autism or other learning disabilities were tabled, and were similarly dispatched. The same fate befell an amendment designed to protect vulnerable people with anorexia.

The key issue this week was the replacement of the High Court safeguard with “multidisciplinary” panels and a “commissioner.” Let me be very clear — this approach will not protect vulnerable people, including those I work with. The psychiatrist, social care worker and “legal member” who sit on this panel must hear from the patient, but this does not have to be in person (it could be via video or audio link), and they do not have to ask them a single question.

The panel must hear from one of the co-ordinating or independent doctors (they don’t have to hear from both) — again, this can simply be via video or audio link, and they don’t have to ask them a single question.

The panel members can choose to hear from “any other person” but don’t have to, and can choose to ask someone with “relevant knowledge or experience” to report to them about the patient. There is no requirement that they hear from family or next of kin. How can the panel possibly be in a position to do anything other than tick its box, stamp its certificate of eligibility and move on?

Ultimately, it seems likely that Labour MPs will be crucial in deciding whether or not this dangerous Bill becomes law. It largely lies in their hands. Some of the most passionate and well-informed speeches at second reading came from Labour MPs. For many, being a Labour MP is about standing up for the most vulnerable and the marginalised. Being opposed to this dangerous Bill was a no-brainer for them.

Sadly, too many Labour MPs seem to see it differently, though I fervently hope that the farcical and unseemly committee process has begun to give them pause for thought.

With the critical third reading vote on the horizon, there is still time for this Bill to be recognised for the existential danger it poses for many of the most vulnerable people in our communities. For my patients and many more like them, I hope that recognition doesn’t come too late.

Dr Cajetan Skowronski is a geriatric medicine and palliative care doctor.