Assisted Dying

Andy Slaughter Excerpts

Monday 4th July 2022 Westminster Hall

[Andy Slaughter (Hammersmith) (Lab)]

It is a pleasure to see you in the Chair today, Mr McCabe.

I start by thanking everyone for their contributions to today’s debate. Members have spoken with personal sincerity and faithfully represented their constituents’ views on a very emotive issue. We have heard passionate speeches this evening, proving that the topic of assisted dying is a compelling one for those on both sides of the argument.

I am sure that Members will forgive me if I do not mention everyone who has spoken, but I must acknowledge my hon. Friend the Member for Gower (Tonia Antoniazzi), who opened the debate with a dignified, moving and well-researched contribution. Although 31 Members spoke, I think around 50 Members were present at the beginning of the debate. My maths is not brilliant, but there were about 20 on one side and 11 on the other, which may be interesting given the vote the last time this matter was debated.

Seven years ago, I wound up for the Opposition—that shows how far my career has progressed—on Rob Marris’s Assisted Dying (No. 2) Bill. That is not the last time that this issue was debated—there was a Westminster Hall debate a couple of years ago, and the other place has debated it even more recently—but in 2015 there was a five-hour debate in the main Chamber, which ended with a vote.

Perhaps today is an opportunity to review how things have moved on in this contentious area. The answer is in some ways substantially, and in others hardly at all. It is clear now, as it was clear then, that—in the words of the noble Lord Faulks, who spoke for the Government in 2014—

“any change in the law in this emotive area is an issue of individual conscience. In our view, it is rightly a matter for Parliament to decide rather than government policy.”—[Official Report, House of Lords, 18 July 2014; Vol. 755, c. 919.]

That must be right, but it is also right that for Parliament to decide properly requires the Government’s co-operation and consent. I will come to that in a moment.

As a number of Members have mentioned, the higher courts have been consistent in their view that this is squarely a matter for Parliament. However sympathetic they may be to the harrowing cases that have come before them, they look to us to set policy in this matter.

Let us look at some of the areas where change has happened. Many more jurisdictions have legalised assisted dying: all six Australian states, seven more US states, New Zealand, Canada and Spain. Over 200 million people in those and other democracies are covered by such legislation. That shows not only the direction of travel but allows more evidence to emerge of the effect of legalising assisted dying, and whether the fears surrounding it—especially those around coercion, the so-called slippery slope and the challenges for the medical profession—have been proved well founded. On the whole, those concerns have not materialised.

One of the biggest arguments against assisted dying is concern about the possibility of coercion. Vulnerable adults nearing the end of their life could be at risk of pressure from family members who feel incapable, for whatever reason, of providing care and support for a terminally ill person. We must be alert to such possibilities. If Parliament is to decide on this matter, it is essential that there is a plan for robust safeguards against that, backed by evidence that they work. Again, we are in the fortunate position that other countries have walked this path before us and we may be able to use their knowledge and experience to our advantage. The petition makes it clear that such safeguards are essential.

The opinion of significant parts of the medical profession has moved to a neutral or more supportive view of assisted dying, with the British Medical Association and the Royal College of Physicians joining the Royal College of Nursing and several other royal colleges in adopting a neutral view. More evidence has emerged of the traumatic effect of the current restrictions, including travel abroad to die for those who can arrange and afford it, high suicide rates among the terminally ill, and many people dying without effective pain relief and in distressing and degrading circumstances.

Public opinion is overwhelming and clear, with over 80% supporting assisted dying. This is an issue where the gap between opinion in this place and in our constituencies has been at its widest. I wonder if it is now narrowing. When 5,000 people were polled on the subject, 84% of respondents were supportive of assisted dying, with strong support across all demographics. This petition, sponsored by Dignity in Dying, received over 155,000 signatures in support of legalising assisted dying. It proposes the narrowest form of assisted dying, for those of proven mental capacity nearing the end of their life. Some jurisdictions permit assisted dying in cases of chronic suffering, but that is not proposed here.

Some 75% of the public support a parliamentary inquiry into assisted dying. That perhaps tells us where we should be heading. An inquiry would allow us to learn more about the subject, hear from people with first-hand experience of the scenarios we have been discussing and look at the data from the countries that have legalised assisted dying to get greater insight into how it is working.

[Sir Edward Leigh]

Does the hon. Gentleman accept that, once we have assisted dying in this country, it will change the whole nature of the debate between GPs and old people? At the back of every GP’s mind, and for every old person, there will be that question: “Should I end it?” That is not a burden that we should place on GPs.

[Andy Slaughter]

I not only do not accept that; I find it the most appalling scaremongering. I have never met a GP who I do not think has a duty to their patients. They may vary in their competence and skills, but in their duty to their patients there is a very honourable tradition among general practitioners, and indeed the whole of the medical profession in this country. To throw such comments into this debate is not helpful to the right hon. Gentleman’s own side, let alone anyone else’s.

It is right that recently, under the former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), who spoke earlier, the Government undertook research, but they have so far not found the time or resource for a proper investigation and debate, potentially leading to legislation. I am a supporter of good local palliative care, and for several years I have been fighting to retain it for my constituents against attempts to restrict it. We should strive to provide the very best palliative care to all those who are nearing the end of their lives. For many families, palliative care and respite care for family members is essential, but in order to offer the very best palliative care, we need the tools, the people and the money to sustain it.

My hon. Friend the Member for Ilford North (Wes Streeting) has recently spoken about Labour’s plan for a national care service. To offer people real dignity in dying, we need a focused approach to care and end-of-life care, which a national care service could provide. Pembridge Hospice and Palliative Care in North Kensington served my constituents for many years until, several years ago, the in-patient unit was closed because it could not recruit a consultant. That is where we should look for problems. Assisted dying is not an alternative to palliative care; the two complement each other.

[Danny Kruger]

Does the hon. Gentleman acknowledge that the Health and Care Act 2022 included the amendment proposed by my noble Friend Baroness Finlay of Llandaff to ensure that palliative care becomes a commissioned service in the NHS for the first time in its history? Does he welcome that?

[Andy Slaughter]

I heard that from one of the hon. Gentleman’s colleagues earlier and I absolutely welcome it. However, as I said, we need not only a policy commitment but funding—and that includes workforce planning, because palliative care consultants are in short supply.

This should not be a debate only between different attitudes, religious practices or medical treatments; it should be a debate about ensuring that the needs of the terminally ill are met in the most appropriate and compassionate way. I understand the strongly held views of those who oppose assisted dying, but I am a firm believer in freedom of choice and bodily autonomy—issues that have come to the fore in the wake of the reversal of Roe v. Wade, and not just in the US. This is a matter of conscience. It is one of the most sensitive that we have to deal with, but we must not shirk our responsibility on those grounds.

I agree with the petitioners’ request for the Government to grant the means to debate and, if there is the will in Parliament, to reform the law in the interests of those who find themselves at the end of their life and in a perilous position. Whatever our difference of opinion here, we all agree that those nearing the end of their life deserve our compassion. There is more that we can do, not just in the debate on assisted dying, but in how we care for those who are terminally ill.

As the world changes around us, we cannot stand still. We have a duty to bring this matter before Parliament again and allow it to decide. How we begin that process is down to the Government. I hope the Minister agrees that, if the necessary time is made available in Parliament, we should be able to debate, vote and, if there is the will, legislate on this issue. It would be perverse if Scotland, Jersey and the Isle of Man had legislated on this matter before we have even had a chance to discuss it in a meaningful way. This has been a very good and measured debate, but the next stage must be to allow the voices of our constituents, which are very strong on this matter, to be heard—not just this in Chamber, but the main Chamber, and therefore through legislation.