Terminally Ill Adults (End of Life) Bill
Debate between Caroline Johnson and Rebecca Paul(2 weeks, 3 days ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Rebecca Paul
My hon. Friend makes a good point, and I agree. In the interests of time, I will make some progress.
The current situation, whereby fully funded palliative and end-of-life care is not available in certain postcodes, means that those unfortunate patients do not have a real choice. We know that 25% of people who die in this country do not get the palliative care they need—that is more than 100,000 people a year—and if the Bill goes through, they will be offered a fully funded assisted death as the only reliable way to end their pain. That is no choice. I urge Members who want to see improvements in palliative and end-of-life care to vote for my amendment 80, and for amendments 30 and 31, tabled by my hon. Friend the Member for Runnymede and Weybridge, if they are pushed to a vote.
Rebecca Paul
I will not because I do not have much time.
I will move on to the lack of a best interests test in the Bill, which my new clause 16 seeks to remedy. Patient autonomy is of course important, but it must be balanced against what is in someone’s best interests. In certain situations, when it is in their best interests, treatment can be given against a patient’s will—for example, force-feeding a young girl with anorexia. It is not an easy balance to get right, but in the absence of any best interests test in the Bill, following the process rigidly would lead to devastating results in some cases.
The Bill currently prioritises autonomy of the patient in a specific moment of time, rather than what might be in their best interests in the long run. It makes no allowance for the fact that someone may feel a certain way temporarily due to other considerations. For example, when someone has just received a terminal diagnosis, it can understandably cause a depressive state and suicidal feelings, but those feelings do not necessarily last, so it may be in the best interests of the patient to allow a little time to pass, to give them a little breathing space before considering the assisted death route.
New clause 16 essentially tries to provide a best interests test by excluding certain reasons, other than the alleviation of pain, that might be driving a patient’s decision. For example, we have heard a great deal about the internal pressure from patients themselves that is driven by their concern not to be a burden, and we heard clearly in Committee that a patient could tell a doctor that they are want an assisted death only for financial reasons, and that would still be approved. We know from the experience of overseas territories that patients will often opt for an assisted death because of social and welfare issues, such as being homeless.