I received a very large amount of correspondence from constituents about the Assisted Dying (No. 2) Private Members' Bill and I wanted to take time to consider all the correspondence properly, together with all of the issues that it raises, before reaching an informed conclusion about the Bill, which was debated on 11th September. MPs were given a free vote on the Bill.
I absolutely understand the strength of feeling that the issue of assisted dying raises for many people. End of life care and the law concerning assisted dying are extremely complex and emotive issues and there are very strongly held ethical and moral arguments both sides. Those views are often informed by personal circumstances and/or experiences. They certainly are in my case. I fully understand and respect every view that has been put forward.
Having read the Bill, studied the arguments on both sides of the debate, researched and given it much thought, I supported the Bill.
I believe that a terminally ill adult who is of sound mind should have the choice, with strong safeguards and the alternative of good palliative care, to self-administer medicine to end their own life. I believe it is undignified to deny such patients a choice.
I value life. There is no evidence that, if this law was passed, vulnerable people would be made to feel they are a burden and would therefore be pressured to take this option. In Oregon, where there has been a similar law for 17 years, every such death has been and is investigated, and there is absolutely no evidence of such pressures being brought to bear.
There would be no undue pressure on doctors. Again, there is no evidence of that in Oregon. Moreover, the Bill provides for any medical person to refuse to participate on the grounds of conscience.
Properly resourced palliative care should be much more widely available, to help make the terminally ill comfortable in a caring environment. Although it is not a reason for promoting the Bill, we are more likely to get that care if this Bill were to become law than if it does not. That is because there will be pressure, which I welcome, on the authorities to improve palliative care so that patients have a real alternative to Assisted Dying.
The current law is a mess. In summer 2014 the Supreme Court issued Parliament with a final warning to address the problems with the current law. The Director of Public Prosecution's (DPP) guidance on assisted suicide sets out the factors that weigh for and against prosecution, and broadly confirms that compassionately motivated assistance by an amateur will not be prosecuted.
There is an argument that the law’s threat of prosecution, combined with the DPP’s discretion, works well. Yet the status quo does not prevent assisted deaths, nor does it offer protection to dying people considering ending their lives.
In my view, that approach is an unacceptable compromise. The DPP is doing the best she can. However, in a democracy it is elected representatives who should make the laws, not an unelected civil servant.
In his decision on the Nicklinson case, Lord Neuberger, President of the Supreme Court, provided this compelling analysis: “…A system whereby a judge or other independent assessor is satisfied in advance that someone has a voluntary, clear, settled, and informed wish to die and for his suicide then to be organised in an open and professional way, would, … provide greater and more satisfactory protection for the weak and vulnerable, than a system which involves a lawyer from the DPP’s office inquiring, after the event, whether the person who had killed himself had such a wish, and also to investigate the actions and motives of any assister….”
Contrast that to what is currently happening, which is usually hidden. Terminally ill patients are ending their own lives, often in undignified and desperate ways. Anecdotally, for compassionate reasons, some doctors are complicit in hastening patients’ deaths. Some relatives and loved ones are doing likewise. Some richer patients are going to Switzerland.
As an MP, as a lawyer, and as an individual, I am convinced that we can do better for dying people. At present, it is illegal to assist or encourage a suicide, and the law makes no distinction between the suicide of a vulnerable person, due to depression or problems in their personal life; and the choice of a well-informed, competent, adult who is already dying, to control the manner and timing of their death.
Having considered the Bill, I was satisfied that it has a clear process, with multiple safeguards. It covers:
- A patient who is 'terminally ill', i.e. life expectancy of less than 6 months. (Hence those people with disabilities, however serious, are not covered unless they also have a terminal illness).
- The patient must be aged 18 or over.
- The patient must have been ordinarily resident in England or Wales for at least one year.
- The patient must be of sound mind. (Hence dementia patients, for example, are not covered).
- The patient voluntarily (i.e. not coerced) signs a declaration that they wish to end their own life.
- The patient’s own doctor counter-signs the declaration that the patient is terminally ill and of sound mind and acting voluntarily.
- An independent specialist doctor counter-signs the declaration that the patient is terminally ill and of sound mind and acting voluntarily.
- If a doctor has a conscientious objection to any of this, then he or she does not have to participate in any way.
- Upon the application of the patient, a High Court judge agrees that the patient is terminally ill and of sound mind and acting voluntarily.
- After the court order, there is a 14-day cooling off period.
- After that cooling off period, the doctor takes the medicine to the patient, and waits there.
- The patient must choose: to take the medicine themselves, or to change their mind and not take it.
- The medicine is self administered by the patient, and by no-one else. So not by any third party such as the doctor, the spouse or other relative.
- If the patient decides not to take the medicine, the doctor leaves and takes the medicine away – i.e. the medicine is not left with the patient.
- The Chief Medical Officers must monitor the operation of the Act and submit an annual report, which must be laid before Parliament and the Welsh Assembly.
- The Bill does not cover Scotland or Northern Ireland.
For these reasons, I voted for the Bill as I believe it provides believe that safeguards, transparency, choice and dignity.
Following a long and detailed debate in Parliament on 11th September the bill was voted down.