Assisted Dying

Before I call Tonia Antoniazzi to move the motion, I need to make a short statement about sub judice. I have been advised that there are ongoing cases relating to the subject of today’s debate, which, for the sub judice resolution, have not been waived. All Members must refrain from making reference to any active court cases. The Chair, whether it is me or my successor in the Chair, will call you immediately to order should you seek to raise any individual case. I have to make that point very strongly and clearly.

After the opening speech, it is already apparent that we shall have to confine speeches very rigidly indeed. As a courtesy to all colleagues, given that there will inevitably be some interventions, we had better start from the premise that we will limit all speeches to five minutes only. I am sorry about that, but I wish to accommodate as many people as possible for what is clearly a very important debate. I call Tonia Antoniazzi.

I beg to move,

That this House has considered e-petition 604383, relating to assisted dying.

It is a pleasure to serve under your chairmanship, Sir Roger.

Assisted dying is an emotive issue that I have thought about long and hard. I was grateful to the Petitions Committee and also to the creator of the petition, Sarah Wootton, for arranging a meeting with some of the families who have been through traumatic and upsetting experiences. I was really pleased to have the opportunity to speak to Liz Carr, who has long campaigned against the introduction of assisted dying. Both meetings were very emotional, but I was able to get a much better understanding of the situation by having those important conversations, so I am extremely grateful to Emma from the Petitions Committee for organising them.

My role today is to present this petition on behalf of the Committee, but I hope that I will be able to represent fairly the views of those I met. It was a real honour last week to meet the families who are here today in the room. Hearing their stories was emotional and informative. They spoke with dignity about their loved ones’ final days and weeks, and I am glad to see them here today. I hope that when making interventions in this debate Members will be mindful that this is a very real situation for many people here today. I also hope that Members will allow me the time to tell their stories without interruption. I understand that colleagues will want to make their own points, but plenty of time has been put aside for the debate this afternoon.

Opinion polls have shown that there is wide support for a change in the law to make assisted dying legal in this country. Research commissioned by Dignity in Dying in 2019 showed that 84% of Britons supported assisted dying for terminally ill people. That is a huge proportion of people who would like to see a change in the way we deal with this situation.

The examples my hon. Friend is using powerfully make the case. Does she agree that now is the time to legislate so that the end of life care issues she mentions can be accommodated? As she points out, there are people in circumstances where all quality of life is gone, yet the legal situation is, at best, muddy and unclear; at worst, it works against the interests of people whose quality of life is completely gone.

I thank my right hon. Friend for his contribution, because that is often the case. Clearly, Gareth wanted people to know that he does not think what his dad did was actually suicide, but bringing an end to his suffering.

Susan’s husband, Duncan, was diagnosed with motor neurone disease, which we all know has no cure. Susan described Duncan as a very strong character who, after researching MND, determined straightaway that he was going to be in control of his own death. Until he had a plan in place, he was distressed and unhappy, but once he had a plan, he could start to live again. Three years after his diagnosis, Duncan took his own life at home with help from Susan. He left information for the police about how and why he had done it. Although his intention had been to do it when Susan was not at home, Susan said that, after 42 years of very happy marriage, she could not not be there for him at the end.

Despite the information that Duncan left, it was six months before the Crown Prosecution Service deemed that it was not in the public interest to prosecute Susan. She was interviewed for six hours under caution by the police, which, after the death of her husband, was obviously very distressing. I cannot imagine how it must feel to have something like that hanging over you when you should be grieving the loss of a loved one. Susan had the means to fight these charges and her solicitor eventually got her arrest removed from her record. What happens to someone who does not have the money to stand up to a criminal justice system that demonises people who find themselves in this invidious position?

Susan also believes that because Duncan made his intentions clear, the doctor seemed reluctant to give him drugs to help him sleep, which exacerbated his problems. Ultimately, Susan takes comfort in the fact that Duncan got the death he wanted. However, it is a tragedy that his death was not within the law. We know that people falling foul of the criminal justice system is not uncommon in situations where someone ends their life, but empathy and sensitivity are required in these situations—not the heavy-handed approach we have seen too often.

My hon. Friend is representing the Petitions Committee superbly and speaks on behalf of the families we have met outside.

I think we all appreciate how difficult it is for people to come to us to talk about personal experiences. My hon. Friend has spoken about her father before. I know he would be very proud of her. We all know how strong her support is for this cause.

I thank my hon. Friend for that intervention to save me from a few more tears. I wanted to say that the PTSD my brother suffers as a result of my father dying is something we will all have to live with as a family. I think that is worth mentioning.

Tim said that palliative care can mitigate some of the pain, but it can never mitigate the suffering. This seems to be so true. Even the best palliative care cannot make it easy, and it never is going to be easy, but we could do a lot more to make it better. Research has shown that where assisted dying is an option, palliative care improves. I truly believe that everyone in this debate can get behind that. We must do better for those at the end of their life.

I am also grateful to Liz Carr for taking the time to speak to me on Friday evening. The worries that Liz and other campaigners have need to be heard, and I believe we have a duty as Members of Parliament to open up this debate and listen to all sides. There are so many debates where people are very polarised in their arguments, particularly in this House, and I feel very strongly that both sides should be heard and that we should listen to everyone.

I thank the hon. Member for giving way and for the way in which she is leading the debate. I voted for reform several years ago. I am really glad she has mentioned palliative care. There seems to be a misconception that those who support an avenue that people do not currently have unless they go to Switzerland are somewhat not supportive of good-quality palliative care. It is possible to have different paths for different groups of people, and I support everything the hon. Member has said so far.

I thank the hon. Member for his contribution. He is right that palliative care is important for everybody. We must have a conversation about death. Dying will happen to us all and we must talk about it. Palliative care is something we need to improve.

The hon. Lady is right that dying is not about ending life. It is about shortening death. She makes a point about the importance of Parliament. My constituent Phil Newby, who was diagnosed with motor neurone disease—a disease that has blighted my family very cruelly—went to the High Court and asked it to make a judgment about assisted dying. It said that it would not and that it was a matter for Parliament. Would the hon. Lady support my belief that it is vital we move past Westminster Hall and have a meaningful debate and vote on the Floor of the House, which will allow the people of Britain to have their say on this, since the judiciary will not?

The hon. Member makes a very valid point. It is one of the points I will make in this debate. We have not had a debate on this issue on the Floor of the House for a very long time, and the vote was seven years ago. I concur that that needs to happen.

Liz talked about Daniel James, a rugby player who was paralysed from the chest down in a rugby accident. Liz is disabled and a well-known actress and campaigner. She explained that, without exception, the press coverage said that Daniel had been brave, stressing how tragic it was that this man had been cut down in the prime of his life. Liz wanted to make the point that there was another side to the story that had not been told. People with a disability are seen as something to be pitied and as people who will never live a full life. I want to make clear today that I do not believe that. There are people with disabilities who make invaluable contributions to British life, and we should listen to them and their concerns.

Being disabled does not mean living a second-class life. I cannot even begin to understand how being considered in that way would make somebody feel. There are bigger problems in the health service, however, including dehumanising treatment—such as when someone waits hours for a carer to visit to take them to the toilet—and insufficient pain relief because the National Institute for Health and Care Excellence has made an economic decision about someone’s worth versus the cost. That is what we faced as a family—I have experienced it.

Liz also raised concerns about trust in the healthcare system. She said:

“The NHS has both saved my life, and destroyed my life.”

If we want to have a grown-up conversation about death, we need absolute commitment to properly funding end-of-life care and hospices. Some on the Government side will say that they are campaigning for “dying well”. They are in a position to make that happen, so I say to them: please do so. The palliative care system has been underfunded; rather than talking about dying well, please do something about that. As Liz said, it is outrageous that hospices are mainly charity funded. If we want people to be able to die well, let us fund palliative care, give people options and make everyone feel valued at the end of their life.

Order. May I invite any Members who are standing and who have not taken a seat to come and take one if they wish to do so? We do not stand on ceremony on occasions like this; you may well want to sit.

I draw Members’ attention to my entry in the Register of Members’ Financial Interests and to the fact that I am co-chair—with the hon. Member for Bristol South (Karin Smyth)—of the all-party parliamentary group on choice at the end of life.

I speak today as a convert to the campaign for the legalisation of assisted dying. My mind has been changed over the years, principally because of the number of constituents to whom I have spoken who have faced terrible suffering at the end of life, or who have witnessed loved ones dying in painful and undignified circumstances. I want the change for my constituents, for myself and for those whom I love.

Last Friday, in the royal town of Sutton Coldfield, I met Lyn Ellis, a constituent from Wylde Green whose husband died from prostate cancer. During covid, he was told that he had three to six months to live, and he died not long afterwards. Lyn told me:

“Until you’ve been through something like this, you don’t realise how hollow the argument is that there is a palliative answer. As John died, he shrank to nothing; he couldn’t eat; he was in pain; suicidal. I felt we’d been cheated. What could be a better way to go than a glass of champagne and saying goodbye to each other?

Those last few weeks of his life were incredibly painful; he shut down, wouldn’t speak, and we’d always had such a close and loving relationship. I feel the state let me down. A good and decent country would not have put us through this.”

We in the Commons have not been asked to vote on assisted dying for almost seven years. A great deal has changed in that time: California, Colorado, New Jersey, Maine, and even the District of Columbia have legislated for choice at the end of life. In just the past five years, every state in Australia has passed laws on assisted dying; New Zealand, too, legislated on assisted dying following a referendum that showed 66% support for the proposal. Other jurisdictions have gone further than the proposals that I support, including in Canada and Spain, and change is on the cards in Italy, Portugal and even Ireland. Proposals are under consideration in Scotland, Jersey and the Isle of Man that could be voted on before the end of next year.

It is a pleasure to serve under your chairmanship, Sir Roger, and to follow my fellow chair of the all-party parliamentary group on choice at the end of life, the right hon. Member for Sutton Coldfield (Mr Mitchell).

I am not a convert. I have wanted to change the law on assisted dying since I became a Member of Parliament, following my experience 14 years ago working with clinicians on how to communicate with patients about how to live and die with respiratory disease. That is not terminal, but the work opened my eyes to how we talk about death—how we do not prepare for the inevitable and, although we seek to have choice, agency and freedom throughout our lives, we have no power at the end. There will be many people listening to the debate who are facing death or the death of their loved ones. As we debate this issue, we must be mindful of the personal circumstances and experiences of those people, and of all of us in the Chamber.

End-of-life care has improved since my work in the health service 14 years ago, but there is still a contrast between how we talk about dying and how we attempt to talk about other care, which is indicative of the problem. In all my years working in the planning and commissioning of services in the NHS, it was all about co-production—the importance of patient voice and choice—but the co-production partnership disappears at the time we can least fight: the time we die. However, the reality is that a person can have choice—if they have an average of £12,000 spare. We can debate all we like, we can pretend this is not an issue, and the Government can turn an eye, but if a person has the money, they have the choice.

For campaigners, that is a really frustrating position. As we have heard, poll after poll suggests that we as MPs are far from our constituents on this issue. I have been humbled today by meeting families and friends who have travelled to speak to us and share their stories. It is absolutely right that, if Members of Parliament have not previously engaged with this subject, they should engage with it, they should be properly informed, and they should have the opportunity to scrutinise all the proposals and to be convinced that change is better and safer than what we have now. We seek parliamentary time to do just that.

It is an honour to serve under you, Sir Roger, and I welcome the debate. I should declare that I am chair of the all-party parliamentary group for dying well.

Let me start by saying how much I recognise the good faith, integrity and powerful arguments of the hon. Member for Gower (Tonia Antoniazzi), all hon. Members speaking in support of the petition and all the campaigners who support it. I recognise the extreme distress and anxiety felt by families who have been through the agonising death of a loved one who experienced suffering that no human being should go through. I will address the issue of bad deaths in a moment, but first I want to look at the implications of assisted dying as I see them, and what would happen if we did it in this country, based on our experience and that of other countries.

I do not have a suite of powerful personal stories, although I recognise the enormous moral value of them all; I invoke the nameless and numberless people who will be affected if we introduce this law. The main argument for assisted dying is the simple one of autonomy. I think a lot of the support for assisted dying comes from the simple and natural resentment that anybody should try to stop people doing what they want, especially about something as important as this—literally a matter of life and death. But in this case, things are the other way around for many people. In my view, we need to keep assisted dying illegal because, as a matter of practical fact, for many people, it would narrow their autonomy. It would reduce their freedom substantially, because it would put them on a path with only one destination. That is because of the incentives that assisted dying would introduce.

The first incentive would be in our healthcare system. The simple, blunt fact is that it is cheaper for the system to help people end their life early than to care for them for weeks, months or years. That is not an argument we hear for assisted dying, but it is compelling. The cat was let out of the bag rather when the Member of the Scottish Parliament who is trying to legalise assisted dying in Scotland cited research from Canada showing that the health service there has saved hundreds of millions of dollars in care costs. We see, in contraction to a point made by the hon. Member for Gower, that where assisted dying is introduced, investment in palliative care stalls or recedes in comparison with countries where assisted dying is illegal.