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Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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Kit Malthouse (North West Hampshire) (Con)
I am grateful to you, Sir Robert. I am co-chair of the all-party parliamentary group on choice at the end of life, so it should come as no surprise that I support the aspiration of the petition.
Over the last 10 years of my involvement in the campaign in Parliament, I have become used to converts—very welcome converts—to the cause, but of course they almost always convert to the cause after they have been through the horrible experience of watching someone they love go through an awful, agonising and degrading death. When Esther Rantzen stepped forward and talked about the impact that her disease was having on her, as well as about her decisions for the future, it should come as no surprise that there was an outpouring of support from the British people, because for many people she was part of the family. She regularly appeared in their front rooms, with her smiley, sunny demeanour, on a Saturday afternoon. Now that she is facing a horrible death and, with money, has decided to make the choice, the British people have obviously stood up and listened to the fact that she is supporting the campaign for a change in the law.
The British people listened to such an extent that they now do not really understand why politicians tolerate or talk about three particular things. First, they do not understand how so many Members in this House can stand for the status quo when, as has already been stated, the status quo is appalling. We have hundreds of people taking their own lives in this country—thousands dying agonising, horrible deaths when they may wish to do something different. Of course, we also have business class, so it is even worse: if you have the money, you can have what the law denies to everybody else. It is an outrage, and it should change. Worse than that, many Members who would oppose me making the choice are quite happy for a doctor to do it for me, as we have already heard. They are quite happy for a doctor to give an extra squeeze on the morphine and take away my own agency, choice and rights about my life. The British people just do not understand how so many people can tolerate that.
Secondly, the British people do not understand this view that the country is teeming with granny killers—that all of us are just waiting to bump off a wealthy relative so we can pocket the cash, like we are some kind of nation of Jeremy Bambers, intent on remunerating ourselves. The vast majority of British people love their parents and grandparents. They want the best for them, and they agonise when they die. If you go to the funerals or see them greeting each other at airport terminals, you will see the love there. That is not to say that there should not be safeguards, but we have safeguards in lots of other areas, and we should in this, too.
Thirdly, the British people do not understand how people of a genuine religious faith can seek to impose their own morality on the rest of us. They have not done so on gay marriage. They did not do so on homosexuality, adultery, abortion or sex before marriage. Why on this issue should the British people be denied a choice, because of the—certainly legitimately held—religious convictions of others? If the law changes, as I hope it will, and assisted dying becomes available, in extremis, to me and others, people need to realise that it is not compulsory. You may not want it yourself, and you may not want it for your relatives, but please do not stop me having it.
The Parliamentary Under-Secretary of State for Justice (Laura Farris)
I thank the hon. Member for Gower (Tonia Antoniazzi) for opening the debate, and I thank the Petitions Committee and the 200,000 people who signed the petition. I pay particular tribute to Hanna Geissler and to Dame Esther Rantzen for the way that they have articulated their own very moving cases.
It has been a privilege to listen to this debate. I will say at the outset that it calls into conflict two fundamental values—the right to individual autonomy and the sanctity of life. It was genuinely a privilege to hear voices on both sides of the debate, even when the disagreement was profound, acknowledging the moral difficulties and challenges that we face on this as parliamentarians.
Before turning to individual questions, I will set out the Government’s position. Our view remains that any relaxation of the law is an issue of conscience for individual parliamentarians, rather than one for Government policy. In the tradition of all conscience matters where the Government maintain a neutral stance, that is typically achieved through a private Member’s Bill.
As others have observed, the last occasion when the House of Commons debated legislative proposals on this subject was in September 2015. Then, just under nine years ago, the Assisted Dying (No. 2) Bill was rejected on Second Reading, as my right hon. Friend the Member for Suffolk Coastal (Dr Coffey) pointed out, by 330 votes to 118. However, this is not an area where opinion is static, and nor is the composition of Parliament a static thing. It was because of the growing strength of feeling on this issue that the last debate on this subject took place in this Chamber, less than two years ago, on 4 July 2022. I recall that because I was there, and it too resulted from an e-petition, calling for a change in the law, that also attracted many signatures.
Mr Ellwood
My hon. Friend eloquently summarises the difficulties on both sides of the debate, but it has also been expressed today that perhaps there is not the sense of faith that a private Member’s Bill would do justice to the details that we have been discussing in depth here today. How we get around that, I do not know, but I am now of the mind—I did not come here thinking this—that this needs to be done in Government time, so that it can go through the full Committee process, and so that we can do our job. We have illustrated that we can do that here today, but I do not think that tacking this on through a private Member’s Bill is the process that we should be pursuing.
Laura Farris
I do not for a moment disagree that this is a subject that would require extensive time in the House. Everybody knows that we are now in the months leading up to a general election, and there is significant Government legislation already planned. However, with those caveats in mind, I hope that I can address more of the substance of the debate, which is what this is really about. I should add that, if it becomes the clearly expressed will of Parliament to amend or change the criminal law to enable some form of assisted dying, then, of course, as the Prime Minister has made clear, the Government will ensure that the legislation is delivered in a way that is legally effective. However, it is within the context of the Government’s neutral position that I wanted to set out and summarise the contours of this debate.
I could pay tribute to so many speakers, so hon. Members will forgive me, I hope, if I whittle the list down to a few. I will start with the hon. Member for Sheffield Central (Paul Blomfield), who talked about his father, and then talked about constituents. Similar points were made by my hon. Friend the Member for Stroud (Siobhan Baillie), who is no longer in her place. They talked about people with terminal diagnoses making the decision to take their own lives in circumstances that were premature because they anticipated reaching a point where they would no longer be able to do that.
The former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), said that, when he looked at the data, he saw that people with terminal diagnoses were twice as likely to commit suicide. The point was made powerfully by myright hon. Friend the Member for North West Hampshire (Kit Malthouse), and also by my right hon. Friend the Member for Haltemprice and Howden (Sir David Davis), that we cannot disregard the fact that there is another route already taken by those with means: when they are at an early stage and have the resources, they can go to the Dignitas clinic. My right hon. Friend the Member for North West Hampshire called it “business class”, and we cannot ignore that.
It is also true to say, as many have observed, that the view of the medical profession has shifted or is shifting, with the BMA moving from a position of opposition to one of neutrality. In a “Moral Maze” programme on assisted dying for Radio 4, Michael Buerk said that he had recently chaired a series of medical conferences where doctors tried to reach an agreed position on assisted dying. The majority of doctors there said that they had not gone into the profession to kill people, but at the same time thought that they might choose assisted dying for themselves. The moral ambiguity was not lost on them.
Jane Hunt (Loughborough) (Con)
Having been diagnosed with bowel cancer last year, I know that doctors already provide an option. They provide an option of whether to have the operation or not, which is why I asked, “Will I die if I don’t have this operation?” When the doctor said, “Yes,” I said, “Well, I want to live, so let’s get on with it.” When moving into chemotherapy, they also provide the option of whether to have it or not. Why not have that last control where, if someone is terminal, they have that option of whether to die or not?
Laura Farris
May I say that I did not actually know that my hon. Friend had had that diagnosis. I am so sorry to hear that.
I will just repeat that although those from the medical profession said that they did not wish to be tasked with assisted dying, they also thought that they might want assisted dying for themselves. They recognised that was a morally inconsistent position to take, which was a point echoed by the hon. Member for Ealing Central and Acton (Dr Huq). We must recognise that this tension exists in the medical profession.
There were also counter-arguments elegantly expressed by my hon. Friends the Members for Aberconwy (Robin Millar), for Devizes (Danny Kruger), for Don Valley (Nick Fletcher) and for Congleton (Fiona Bruce), my right hon. Friend the Member for Suffolk Coastal and the hon. Member for North Antrim (Ian Paisley), to name a few. One of them more or less echoed the decision that was reached by the divisional court in the Noel Conway case in 2017, which said that section 2 of the Suicide Act 1961 served to
“reinforce a moral view regarding the sanctity of life”
and
“to promote relations of full trust and confidence between doctors and their patients”.
That position was echoed by the right hon. Member for East Ham (Sir Stephen Timms) and the hon. Member for Strangford (Jim Shannon). As parliamentarians, we cannot duck the difficult issues that this question engages.
Kit Malthouse
The Minister has talked about the medical profession and the various arguments for and against, but she is a distinguished member of the legal profession. One of the things that many people suffering with terminal diseases find so confusing is that the law as it stands is inconsistent and a mess. We have a situation where it is technically illegal to accompany somebody to Switzerland, but upon return, the Crown Prosecution Service has a policy of not prosecuting. We have the example of Mavis Eccleston, who agreed a suicide pact with her elderly husband, but survived. She was prosecuted in court, effectively for murder, but was acquitted, having gone through this dreadful experience. The current law is a mess, and I wondered if we could have the Minister’s professional view on that.
Mrs Pauline Latham (in the Chair)
Order. There is a Division in the House. The sitting is suspended for fifteen minutes.
Laura Farris
I was about to respond to the intervention from my right hon. Friend the Member for North West Hampshire about consistency in the law. Yes, I agree that consistency is a good thing.
I want to touch on four arguments made by Members who hold an opposing view on this issue. The example was given of Canada, where the law was changed, and the Chair of the Select Committee, my hon. Friend the Member for Winchester, made the point that no change had been implemented; but it is true to say that in 2016, when the Canadian medical assistance in dying legislation was introduced, the threshold was whether the individual suffered from a grievous and irremediable medical condition, where death was reasonably foreseeable. What has been delayed but none the less agreed is removal of the requirement that death be foreseeable. Canada is also mulling over whether the Act should apply to circumstances in which there is no physical disease at all—in other words, where the condition is mental.
Laura Farris
I think I have not got very much time, so I am going to crack on; I am sorry.
Laura Farris
Well, I have been told I do not.
The other issue is evolution of the wider principle. What if a right to die evolves, perhaps slowly and imperceptibly at first, into a duty to die? My hon. Friend the Member for Aberconwy put it beautifully. Once we have allowed people to rationalise the quality of their life, how do we avoid it becoming incumbent on them to do so? There are also the hard cases: some of the cases described in the Chamber today are heartrending and sound clearcut, but we cannot ignore the difficult ones. One in particular jumped out at me in relation to something that the hon. Member for Gower said: the case in Belgium of Nathalie Huygens, who ended her life because of the extreme psychological suffering that she experienced after she was raped. The hon. Lady—I mean this very respectfully—said we should give people the choice to take themselves out of suffering, but that is exactly what Nathalie Huygens would have argued she was doing. We cannot ignore these difficult cases.
Kit Malthouse
I am very grateful to the Minister for giving way and I appreciate the point that she is making. However, around the world, different countries have legislation to deal with abortion, and there are different time limits and different attitudes to it. For example, in Canada, it is technically legal to have an abortion up to the point of birth. The fact that other countries have different rules, or indeed different cultural nuances around this or any other issue, surely does not mean that we should not have and design our own framework for the same purpose.
Laura Farris
I am not presenting any particular argument; I am reflecting the arguments that were made. I accept that we would not be in any legislative straitjacket, but these are the concerns raised by Members and they deserve to be ventilated in my summing up.
The final issue was manipulation or coercion. The hon. Member for North Antrim made the point very powerfully. I was listening carefully to what the right hon. Member for Knowsley (Sir George Howarth) and my right hon. Friend the Member for North West Hampshire both said: that a majority of people are well meaning and love their relatives, but implicit in that is that a minority do not. Some people live in dysfunctional families, or may not have loved ones; we must consider the consequences or the potential risks for them, too.
My right hon. Friend the Member for New Forest East (Sir Julian Lewis) and, I think, the hon. Member for York Central (Rachael Maskell) talked about the subtle coercion that a person might experience from being made to feel a sense of guilt at the cost that their illness is imposing on family members, not just in terms of money but in terms of stress and time; they could feel that they are becoming a burden. It is right, necessary and incumbent on us as parliamentarians to contemplate and recognise the enormity of the proposition, given the moral and ethical and medical issues that it engages.
I thank the Health and Social Care Committee for its excellent report. One of the Committee’s recommendations is that the Government consider how to respond to potential changes in other jurisdictions in the UK and the Crown dependencies. Of course, should they move on this issue, we will work closely with them to consider the practical implications for England and Wales.
Finally, I emphasise that end of life and palliative care is of the utmost importance. In the Health and Care Act 2022, the Government added palliative care services to the list of services that an integrated care board must commission. Our response to the Health and Social Care Committee’s report was published today. The report’s recommendation 5 was a request for a national strategy for death literacy. I do not think that we went that far, but I reassure the Committee that the Government have committed to including palliative and end of life care in wider strategies.
To conclude, I thank everyone who has spoken and assure the House that the Government will reflect carefully on everything that has been said today. In the meantime, I thank all hon. Members for their sincere and heartfelt contributions to the debate.