Assisted Dying
Debate between Jim Shannon and Crispin Blunt(5 years, 4 months ago)
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Jim Shannon (Strangford) (DUP)
On 4 June, in making the case for holding this debate to the Backbench Business Committee, the basic justification set out by the hon. Member for Grantham and Stamford (Nick Boles) was that a lot has changed since the House last debated these matters, and therefore it would be opportune for the House to have an opportunity to discuss them. I would like to go into that in some detail, in the short time that I have.
First, I want to say that I respect the views of others in the House greatly, and I hope that right hon. and hon. Members will respect my point of view, which may be very different from some of those expressed in today’s debate. I am a man of faith. My father was a man of faith; he died, and I know he believed in the sanctity of life, as do I. I believe that in my constituency of Strangford, the vast majority of my constituents also believe in the sanctity of life, and they also believe that the law should not be changed. I want to put that on the record at the start of my speech.
Both the Royal College of Nursing and the Royal College of Physicians have moved to adopt a position of neutrality on the question of assisted suicide. The Royal College of Nursing actually adopted its position of neutrality some 10 years ago—six years before the Marris Bill came to this House. Neutrality is far from endorsement, and that has to be understood. It no more gives grounds to positively endorse assisted suicide in 2019 than it did in 2015.
The manner in which the Royal College of Physicians approached its poll, however, has had the effect of leaving a significant cloud hanging over it. In the 2014 poll, those who opposed assisted suicide were 44.4%; in the 2019 poll, they were 43.4%. The proportion opposed to assisted suicide is the largest by a significant margin, and almost identical to the 2014 result. For the Opposition side of the House—indeed, it is important for the whole House—I point out that in Tony Blair’s landslide 1997 general election victory, he received 43.2% of the vote. The Royal College of Physicians actually voted against this change by 43.4%. So there is a figure, when we come to stats in this House.
Before that poll, however, the council of the Royal College of Physicians, without consulting its members, decided that it wanted to go neutral, and structured the rules of the contest in such a way that that was bound to be the outcome. It took the extraordinary step of saying that unless 66% of respondents either opposed or supported assisted suicide, the college would adopt a neutral position. From that very moment, the result was a foregone conclusion. I want to talk about some reasons why it is the wrong one, and worded the wrong way.
Professor John Saunders, a former chair of the RCP’s ethical issues in medicine committee, wrote in The Guardian to accuse the college of carrying out
“a sham poll with a rigged outcome”.
Over 1,500 doctors and medical students signed an online petition expressing alarm over the college’s behaviour. Professor Albert Weale, chair of the college’s ethical issues in medicine committee, resigned in protest. He claimed that the RCP council failed to take notice of ethical advice that the committee had provided on the subject of the poll.
Jim Shannon
I am sorry; my speech is subject to a time limit.
Professor Weale commented:
“There is simply no point in the committee offering reasoned positions if they are ignored by council.”
The process has resulted in a legal challenge, which is ongoing, and damaging criticism from the Charity Commission as well:
“It is unclear whether the Council took into account that”
the majority of at least 60% required
“would make it almost impossible to achieve”
that majority.
In looking at the results of the RCP survey, it is very important to consider the detailed response to the 2019 poll by specialty. It reveals that those whose specialism means that they have a real expertise in the field of death and dying remain overwhelmingly opposed to assisted suicide: 80.9% of those participating in the poll working in palliative medicine were opposed to a change in the law. Some 48.3% working in respiratory medicine were opposed, 44.1% in geriatric medicine, 43.5% in neurology and 43.4% in gastroenterology. Again, those figures tell the story.
I appreciate that the Royal College of General Practitioners and the British Medical Association have said that they will poll their members on this issue, but we do not have any results yet. Both those bodies would be well advised to study the RCP experience and learn from its mistakes. In that regard, they would do well to study an important new paper written by the former chair of the ethics committee, Professor Weale. They would find it very helpful indeed.
There were questions about the wording of the ComRes poll. In Dr Al Baghal’s executive summary of his review of the poll, he says:
“Overall, we would caution MPs and the public…There are a number of problems noted with this survey.”
Those problems included the fact that the poll is likely to be unrepresentative because of the demographic profile of respondents; the fact that only one side of the argument was presented to respondents in the question wording, using emotive language including terms such as “unbearable suffering”; and the fact that response options for several questions were designed such that they led people to choose a certain answer, even if they did not have a strong opinion, and may have led to respondents tending to select positive options even if that was not their settled opinion.
The basic problem with the proposal to legalise assisted suicide remains unchanged. It costs about £5 to give someone a lethal dose of barbiturates. It costs between £3,000 and £4,000 to keep someone in a hospice for a week. In that context, the right to die for the eloquent and financially well off will become a duty to die for the vulnerable. That is how I and other hon. Members feel, and it is deeply shocking that anyone living in a so-called civilised society should avail themselves of a state-sanctioned means of killing themselves.
In both Oregon and Washington State, 52% of those questioned said that not wanting to become a burden was one of the motivations for their decision. I have no desire to live under a law like that, and no desire therefore to see the legalisation of assisted suicide in the UK. We need a system that supports and helps families so that no one feels they are a burden, and I will push for change on this rather than in the current law.
Drug Addiction
Debate between Jim Shannon and Crispin Blunt(7 years ago)
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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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Crispin Blunt (Reigate) (Con)
It is a pleasure to serve under your chairmanship, Mr Gapes. It is long overdue. It is also a pleasure to follow the right hon. Member for North Norfolk (Norman Lamb). I congratulate him on his speech. I agree with his analysis entirely. I also congratulate my hon. Friend the Member for South Thanet (Craig Mackinlay) on raising this issue. He is right to point out the dramatic risk of fentanyl-associated harm that is perhaps coming our way following what is happening in the United States.
Any examination of the global evidence shows that the costs my hon. Friend pointed to, financial and human, are infinitely higher than they should be owing to the global policy of prohibition and criminalisation of drugs since the 1961 UN single convention on narcotic drugs, which has been an unmitigated global public policy disaster. He rightly drew attention to the dangers of drug-driving and his concern at the increasing number of road deaths caused by drug-driving, as in the United States. That will require strong enforcement action to catch, warn and punish offenders, in the same way as drink-driving here in the UK has met with effective policing and societal attitude changes.
Crispin Blunt
Forgive me; I am short of time.
I come to this debate from the criminal justice perspective, having seen for myself as Minister for Prisons and Criminal Justice the time and costs incurred by the police, courts, prisons and probation service in managing the effects of drug-related crime. My hon. Friend the Member for South Thanet also drew attention to the problems of cannabis, particularly street cannabis, which, with its high levels of tetrahydrocannabinol, or THC, is more potent and liable to cause schizophrenia in long-term users.
However, those looking to use cannabis recreationally often have little to choose from and have no idea what their cannabis, acquired on the street from drug dealers, has in it. Legalisation and regulation would allow consumers to access less harmful forms of cannabis with lower levels of THC and higher levels of cannabidiol, or CBD, giving the desired high, in just the same way as drug users of tobacco and alcohol can be assured of the regulated quality and provenance of their products, together with the health warnings and all the necessary restrictions on advertising and sales that a properly regulated market can deliver.
Licensing and regulation proportionate to the risks of each type of drug and signposting users to services when they get into trouble would be the right place for public policy if we followed the evidence of what works. At a stroke it would deliver the massive good of eliminating the huge costs associated with criminal possession and supply. By permitting a legal but regulated market, we would decouple hundreds of millions of consumers around the world—millions in the UK alone—from funding and facilitating a world of criminality.
Just as prohibition in 1920s America provided a financial basis for organised crime to flourish in American cities, so our policy of prohibition has gifted an industry worth half a trillion dollars a year to serious and organised criminals producing and supplying untested substances. Their interest is hardly the health of their consumers, but far more to produce the addiction that will sustain a vastly lucrative business model.
Alongside the addiction, we then have to deal with the awful consequences of drug market violence as gangs and dealers vie for control of the trade, quite apart from the enormous amount of the lower-level criminality of burglary and other acquisitive crimes as addicts seek to fund their addiction. As well as keeping criminals, many of them young people, out of drug supply, licensing and regulation allows us to tackle the health-related harms associated with drugs and drug addiction that my hon. Friend was right to draw attention to. Criminalisation means that users are hidden from health practitioners, and there is a lack of guidance about how to find and access services. Taxation of sales by licensed retailers would pay for better prevention, treatment and public health education, available at the point of purchase—a dispensing pharmacist, for instance.
Colorado has raised half a billion dollars in state taxes and fees since it licensed recreational cannabis in 2014. The right hon. Member for North Norfolk referred to the the Home Office evaluation of its own drug strategy, which states:
“There is, in general, a lack of robust evidence as to whether capture and punishment serves as a deterrent for drug use”.
If we translate that out of bureaucratese, that means we know current policy does not work. Since we have been fighting the war on drugs for more than half a century, it might now be an idea to examine the evidence. So I say to my hon. Friend the Member for South Thanet, instead of doubling down on a failing policy and demanding yet more higher sentences for particular parts of the supply chain—in the example he gave, the failing policy has led to the highest level of opioid drug deaths since records began—we should learn from decriminalisation and public health approaches in other countries.
In Portugal, for example, where the possession of small amounts of drugs has been decriminalised since 2001, a step well short of licensing and regulation, usage rates are among the lowest in Europe, and drug-related pathologies, such as blood-borne viruses and deaths due to misuse, have decreased dramatically. Compare the drug mortality rate of 5.8 per million in Portugal with Scotland, where it is 247 per million. The Portuguese state offers treatment programmes without dragging users through the criminal justice system, where it becomes harder to manage addiction and abuse. I can tell my hon. Friend, drawing on knowledge of the effort to establish drug-free wings in prisons, that it is not easy to do. I accept that it is a perfectly sound policy objective, but do not think for a minute that there is a magic wand to deliver a part of the prison system that will be proof against drugs getting in.
In the criminal justice system, as I can testify from my own experience, it is hard to manage addiction and abuse. The reshaping of our drugs policies should be informed by the growing body of evidence that will come in from the legalisation of cannabis sales in several US states and, from next July, in Canada. We will be able to learn, too, from the Netherlands, Switzerland, Germany and others with drug consumption rooms, an example of the kind of regulation we could deliver around heroin consumption in supervised, safer environments where, as the right hon. Member for North Norfolk said, no one has ever died of an overdose. So we must listen to the Global Commission on Drug Policy, which seeks a balanced, evidence-based approach. The UK could have a royal commission to make evidence-based policy recommendations free of politicians’ trite response, “Drugs are bad; they must be banned.” That can give us a route to reframing the debate on drugs and finding evidence-based policy approaches that will truly reduce the costs of addiction, both financial and human.