Assisted Dying Law

[Sir Graham Brady in the Chair]

I beg to move,

That this House has considered the law on assisted dying.

It is a pleasure to serve under your chairmanship, Sir Graham. I wanted specifically to examine the law on assisted dying as it stands, given that it affects not just those who want to have some control over the manner of their death, but those closest to them. The current law in this country simply is not working. I hope that we can begin to address today the effect of that law on terminally ill people and their loved ones, and on public servants such as doctors, health and social care professionals, police and coroners. They are all, in different ways, profoundly affected by our laws on assisted dying. I am well aware that this issue is hugely evocative, can involve issues of faith and puts the medical profession in the most difficult of positions. It is also, of course, the most personal, intimate and ultimate of decisions.

Like many people—possibly many people in the Chamber—I have been on a journey over this issue. I am not sure when it began, but I know it started with the point that it was not up to me. I did not know whether I would ever be in the position to have to make the decision, but I knew I had no right to interfere with anyone else. I suppose I could have been described then as a passive supporter, but over the years there have been several landmarks on my journey, to the point that I now see it as incumbent on me—on all of us, particularly all of us here—to ensure that our law is the best and most supportive law we can have, and that it puts the interests, needs and wishes of individuals first.

Does the hon. Lady agree that we need to be very careful to ensure that old and sick people do not feel a pressure to end their lives, perhaps from their children, who might want to inherit their assets and to whom they may feel they are being a burden?

I fully appreciate that point. That is why I am so concerned that we should have a very narrow and precise definition if we change the law. However, it has been ascertained that a third of patients who request assisted dying and meet the eligibility criteria in Oregon, for example, do not actually take the life-ending medication. They request it as an insurance policy—not because they feel they are being a burden, but because they want to have the opportunity to make the choice themselves.

As I said, there have been several landmarks on my journey to this point. The final one was just a few weeks ago, when I was chatting to a friend. We were talking about nothing in particular, but we decided that when people say, “You only live once,” they are not quite right; actually, you can have many lives. I certainly have, and I am sure many other hon. Members have. I been a journalist, a mother, a university lecturer and a politician, and I hope one day to be retired, but I will only have one death. When my time comes, I would like it to be the easiest possible for me and my family, and I would like to be able to choose for it to come at the end of a happy day.

The first step on my journey was, as I am sure it was for many other people, watching someone I loved go through an experience far from that: a long, painful death, which I still wonder about now, more than a decade later. Could it somehow have been eased? It took me years to come to terms with the emotional conflict between the despair over losing my mother and the relief I felt that she was no longer going through the pain of having her lungs destroyed a little bit every day. I have to be honest: I do not know whether she would have wanted the choice of how or when to end her life. Frankly, there would have been no point even asking, since it is not a choice allowed by the current law here, with its blanket ban, and most people cannot afford the fees to travel to Switzerland or elsewhere.

Does the hon. Lady agree that palliative care needs to be better funded? No matter the excellent care that is provided in hospices, it is funded nowhere near well enough. Many areas do not have hospices, and we need to ensure that they are fully funded to meet the need. That would greatly assist people as they face the end of their life.

I absolutely agree. I have also experienced final moments with a loved one who was being cared for in a hospice. They were incredibly well looked after. The whole family was looked after and supported. Changing the law should not under any circumstances mean depriving anyone of the option of palliative care. Indeed, palliative care is as important as a choice at the end of life. Again, it should be available to everyone, and we should support it in any way we can.

What is the hon. Lady’s response to the evidence that, in countries where assisted suicide has been made legal, investment in palliative care has fallen?

I thank the hon. Lady for that point. That is something we would have to be aware of, but I believe it is up to us to address it. It is up to the lawmakers and the Government in this country to ensure that we increase our investment in palliative care as a choice. There is that word again: choice. Free will—the ability to choose.

Seven years ago, in another landmark, my belief in that was firmed up by a conversation following a newspaper article I had written. At the time, the late, irrepressible Margo MacDonald was guiding her second, ultimately unsuccessful bid to make assisted dying legal in Scotland through the Parliament at Holyrood. I originally met Margo while I was a young journalist, and her amazing personality and commitment had a huge impact on me. That did not have an impact on my politics, of course—we had very different views—but I recognised in her someone who lived their beliefs and their politics. I had spoken to her while I was writing the piece, and I visited her office afterwards. On this issue more than any other, she had a profound effect on me. It was several years ago now, but that conversation has stayed with me and made me determined to protect the right of the individual—my right; your right—to choose to have the dignity that we want in our final moments. Why should any of us, knowing that we are not going to survive, be forced to endure unnecessary pain?

The hon. Lady is making a powerful speech. I am pleased that she has not brought any legislation before us, because I found this issue very difficult when we last faced it, in 2015. I actively abstained by voting in both Lobbies, and I was told off by the then Speaker for doing so. I get her point that saying goodbye in an airport is not the best thing for people who choose to go to Switzerland, but at the same time I worry about safeguards. This could be exploited as a shortcut if NHS funds are not as we want. Does she agree, at least, that more research is needed? Nothing seems to have happened in Parliament since 2015. We need more evidence before we decide on this.

I take the hon. Lady’s point. That is the purpose of this debate. It is intended to get the ball rolling, look for the evidence, find out what people are afraid of, and consider the safeguards we need and how the law can be improved. We are not going to do that overnight. We certainly are not going to do it today, and I will not suggest any changes today, other than to say that we should look for the evidence and at what people want from the law.

Since this debate was publicised, I have been contacted—I am sure we all have—by a number of constituents. In some cases, they called for caution; in others, they expressed their opposition. However, in very many more, they expressed support. One in particular that I found moving came from a woman who was a palliative care nurse for more than 20 years, and who during that time witnessed numerous examples of the current assisted dying law failing dying people. One example she gave was of a gentleman with motor neurone disease who had a particularly undignified final few months of life. He was cared for at home at first before moving into a hospice, where he clearly expressed the wish that he wanted help to die. The staff had to explain to him and go over the reasons why they could not do that; it simply was not possible.

This gentleman’s motor neurone disease had affected him in such a way that his legs were still working, but he was not able to use the top half of his body. One day, he tried to throw himself down the stairs as a way of ending his life. Despite him fully admitting that he was trying to end his life, some of the staff understandably claimed that he had probably fallen, and that it was an accident. Perhaps they did not want to admit or acknowledge what he had tried to do, because of the position in which the law put everyone, but that gentleman did not get to express his distress about the way he would die or have it addressed as he wanted. I understand he lived for another two months or so before he died in a hospice. I am grateful to my constituent for sharing that story because it highlights the invidious position in which the current law puts everyone.

Does my hon. Friend agree with me that that story highlights a key issue that we are all wrestling with: the capacity to consent? My hon. Friend has made the point clearly that this has to be a choice, and that safeguards must be in place to ensure a person has the capacity to make that choice.

My hon. Friend makes an excellent point. Capacity is important. As I have already said, it is not for me to say what the law should be; I simply ask that we address it, and that we take such points into account. I ask that we look at mental capability to make the decision, at when the decision might be made and at safeguards.

I thank the hon. Lady for giving way and for securing this important debate. Often, when people face debilitating illness or very difficult life events, suicide may come to their minds. Does she agree that at such times, we should provide better mental health support, psychological support and counselling to enable people to come to terms with their feelings and look much more positively towards their abilities and the contribution they make?

I agree that better mental health care should be available at all points in our lives. For every decision that we have to make, we should have support. If we are allowed to look again at the current law and the blanket ban, the question of what mental support exists is the sort of thing we should look at.

As I said, I am grateful to the constituent I mentioned, because that example highlights the invidious position in which everyone is put by the current law and its blanket ban. That includes the patient who knows they are going to die, and who simply wants help to ease their way through it; the medical staff who must not help; and the families who are powerless to support their loved ones, because the law threatens them with criminal procedures.

A recent policy paper considered by the homicide committee of the National Police Chiefs’ Council showed that investigators are frustrated with the current legislation, and that families whose loved ones have had assisted deaths are losing confidence in the police and criminal justice system. Families such as the Whaleys and Ecclestons, who suffered the ordeal of court cases, are perhaps the highest profile examples of how the law fails those who are facing their final days, and fails their loved ones. Sadly, they represent merely the tip of the iceberg.

Dignity in Dying has calculated that every eight days, someone from the United Kingdom travels to Switzerland for an assisted death, with their grieving families often treated as criminals once they return. Every year in England and Wales alone, an estimated 300 people take their own lives because they are faced with a terminal diagnosis and it seems their only option. A great many more are beyond the reach of palliative care, which, sadly, needs more investment, and they die in agony. Perhaps the cruellest thing of all is that this can all be avoided if people can afford it.

The law has created a two-tier system. If someone has more than £10,000, they can travel to Switzerland or elsewhere for the end-of-life care of their choice. It is time to look at whether and how our law can be improved. There is ample evidence that the majority of the public would support a change. According to the most recent surveys, 84% would like to see a change. They want a very narrow and specific change—perhaps that addresses some of the points that have been made—for those in the final stages of a terminal illness who are mentally capable of making a decision, but they do want a change.

I thank the hon. Lady for giving way. We had a discussion today, and we have very different opinions; clearly, I do not agree with what she is saying. The answer is not legalising assisted suicide. The answer is to help, to support and to be compassionate towards families. Does she acknowledge the good work that is done by many charities, particularly Macmillan, whose compassion and love make the unimaginable a little bit more bearable?

I absolutely agree with the hon. Gentleman that Marie Curie, Macmillan and other charities do outstanding work. The people who work in hospices up and down the country, and those who provide palliative care in our hospitals, perform an unenviable role and they are beyond reproach. However, it is not my view that people should have only that choice. For me, this is about being able to decide either to have palliative care—it should be there, and it should provide support—or to make another choice. That should be up to the individual, and the law should support them in that. As I said, 84% of people, according to the most recent surveys, would support a change.

As parliamentarians we are here to use our judgment, not simply to represent the views of our constituents. However, 84% of the public are in favour of a change. The last time the issue was voted on, in September 2015, 75% of parliamentarians voted against changing the law. There is concern among the wider public that Parliament may be out of step with the public on this. Does the hon. Lady agree?

I agree with the hon. Gentleman that it was unfortunate that on that occasion, Parliament took such a different position from that of the country. It is also understandable that the responsibility for making the decision is quite heavy. Many parliamentarians might like to see that change, but the thought of its magnitude perhaps makes them reserve judgment. If parliamentarians spoke to more people; if we had an inquiry and a public debate; if we had the opportunity to hear the views of the public; if we heard from the families of those who wanted to choose how to end their lives but were denied that choice by the law; and if we heard about what that had put them through, perhaps parliamentarians would have the confidence to reflect the public position.

The previous Government hinted at an inquiry into the law. When I asked about it yesterday in a point of order, Mr Speaker himself said that the time might have come for a debate. Perhaps the Minister will take the question of that inquiry back to the Government. Perhaps the time has come to think about whether the law is serving or protecting anyone. Perhaps we should have a public debate, which might allow parliamentarians to judge what is in everyone’s best interests.

I will say one last thing. Some Members may have noticed that there is a word I have not used—one that is normally central to this debate, and that is crucial to the campaigns that are going on outwith Parliament—and that word is “compassion”. That omission is deliberate on my part because, for me, there is no compassion in the law as it stands.