Terminally Ill Adults (End of Life) Bill
Catherine Fookes Excerpts(2 weeks, 1 day ago)
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Dame Meg Hillier
I must make progress.
I also want to talk about how the teenage brain works. The Bill would apply to a young person at the age of 18. A month or so after they reach that age, they could undertake an assisted death. Let me highlight some of the good conversations that I have had with people who have generously given their time to speak with me about these important issues, which I am worried have not been addressed at any point in the Bill’s passage, except for a short and important discussion in Committee.
Dame Meg Hillier
Let me finish my point about doctors’ advice before I move on to the issue of 18-year-olds. Dr Alexandra Mullock, who is a senior lecturer in medical law and co-director of the centre for social ethics and policy at the University of Manchester, said in written evidence to the Bill Committee:
“The freedom for a registered medical practitioner (RMP) to raise/discuss the option of seeking help to die in clause 4(2) is ethically problematic.”
She also highlighted:
“Professional advice regarding treatment will be received by the patient as a recommendation”,
as the hon. Member for Sleaford and North Hykeham (Dr Johnson) said. That is a really big concern. The UK coalition for deaf and disabled people is very concerned, and would like this provision removed as well.
Dame Meg Hillier
I thank the hon. Lady for her comments. If I have time, I will touch on social media, but I want to put on the record my thanks to some of the professionals who gave of their time to speak to me in preparation for my amendment.
Dame Meg Hillier
Not at the moment.
I had some very interesting conversations with Sophie Scott, professor of cognitive neuroscience at University College London; Sallie Baxendale, professor of clinical neuropsychology at UCL; Sarah-Jayne Blakemore, professor of psychology and cognitive neuroscience at the University of Cambridge; Dr Richard Hain, consultant and clinical lead, all-Wales managed clinical network in paediatric palliative medicine at Cardiff and Vale university health board; and Dr Anna-Karenia Anderson, consultant in paediatric palliative medicine and medical director for Shooting Star children’s hospice. I am only sad that there has not been a bigger debate, because the process has not allowed for one. I apologise to them in advance that I will not be able to do justice in the time that I have to the very many careful and thoughtful points that they raised.
Dame Meg Hillier
I have said no—I need to explain the issues, and give due credit to the people who have assisted me in raising them.
Adolescents’ brains develop differently. From the age of puberty, there is a rapid change in how young people make decisions. As adults, we have the experience to imagine what the future might look like, but younger people, up to about the age of 25, often cannot plan or predict their future because that part of the brain has not developed well, and they are not good at understanding regret. The comparisons are different for adults. Role models and social groups matter a great deal.
Dame Meg Hillier
I need to make some progress. Madam Deputy Speaker, I am trying to speak at great pace.
Teenagers are passionate about their beliefs and peers can change their minds in a way that their parents often cannot. There is not always a logical decision-making path. A doctor would carry weight. In response to the point made by the hon. Member for Edinburgh West (Christine Jardine), a child may be thinking about dying but somebody—that doctor or professional—could make their decision a legitimate option.
There are many issues in palliative care. We talked about Gillick competency, but to be clear, young people under the age of 18 can make their own decisions about healthcare. Even young people under the age of 16 can have such conversations because of Gillick competency, which is a good principle, but the issues around mental capacity and Gillick competency are often not well put in place—
Dame Meg Hillier
I have said no to my hon. Friend—I have moved on from the points that she wanted to talk about.
The law is ambiguous about Gillick competency. The Mental Capacity Act 2005 and Gillick competency triangulates through the person but also the condition, so it relates to the complexity of the condition as well as to the individual. Peer pressure is a big part of what has an impact on people, as well as the view of the professional or doctor.
Dr Shastri-Hurst
I will make a little progress, if I may.
In respect of new clause 2, those who have had the privilege of meeting a young person living with a terminal illness will know that they often display a maturity and a depth of understanding far beyond their years. To deny them the opportunity of a considered conversation about their future upon reaching adulthood is not an act of compassion, in my view; it is to abandon them. It is to leave them isolated, navigating a complex and deeply personal journey through the filter of online forums, rather than in dialogue with trusted, qualified professionals. We owe them better than that.
Catherine Fookes
My constituent Noah was diagnosed at 16 with an inoperable brain tumour, and he has said he would like the right to choose:
“The thought of being locked in unable to communicate is not how I want to spend the last months of my life. To end my life on my terms when the time comes would give me comfort.”
Noah does not want to be infantilised; he wants to be treated like the adult that he is. Does the hon. Gentleman not agree that the Bill will give him that protection?
Dr Shastri-Hurst
I am grateful to the hon. Lady for her intervention. That is a very powerful personal story from Noah, who I think reflects the maturity of many young people when dealing with these challenging issues.
By imposing, in effect, a statutory gag in this one area, new clauses 1 and 2 risk infantilising terminally ill patients, creating a chilling effect on communication at the very moment when clarity and compassion are most needed. If anything, new clauses 1 and 2 may result in harm to patients, forcing them to suffer in silence, unaware of lawful options simply because they do not know how to ask.
Finally, I turn to new clause 9, which presents a number of issues. In the first instance, subsection (1) would permit there to be, in effect, two different standards of proof. That must be legal nonsense. The boundaries of any legal test or hurdle must be clear. A failure to do so creates a great deal of uncertainty. Furthermore, the proposal to shift the standard of proof from the civil to the criminal, requiring panels to operate on the standard of beyond reasonable doubt, is deeply inappropriate. The balance of probabilities is the cornerstone of medical and civil decision making. To adopt a criminal threshold risks freezing the entire process, creating a very risk-averse system.
Oral Answers to Questions
Catherine Fookes Excerpts(7 months, 1 week ago)
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Neil O’Brien (Harborough, Oadby and Wigston) (Con)
Catherine Fookes (Monmouthshire) (Lab)
The Minister for Development (Anneliese Dodds)
October is likely to see the least aid enter Gaza since the start of the conflict. That is unacceptable. As the Foreign Secretary stated on 16 October, the UK is pressing Israel, alongside our partners, to allow the aid into Gaza that is so clearly needed in this desperate situation, and to enable the UN and its humanitarian partners to operate effectively.
Anneliese Dodds
We have indeed seen some extremely disturbing scenes. Of course, it is important that we ensure that there is verified information in the fog of such a horrendous war. We have all seen those scenes and been disturbed by them. The UK Government are determined to do all that we can to ensure that aid is accessed by those who need it. We are using every opportunity to do so, which involves working with UN agencies in detail. I have had many meetings with them. The hon. Gentleman will know that we have resumed support for the United Nations Relief and Works Agency. We have been in close contact with it, the World Food Programme and all others working on this, and we have also been working bilaterally with all our partners in the region. There are a number of different countries working with us to try to ensure that there is access to aid, which is desperately needed.
Catherine Fookes
I thank my right hon. Friend for all that she has done so far on this issue. My constituents, including Damon and Annie, are extremely concerned that every day things are only getting worse. The UN says that all essential supplies for survival are running out. Given the abject conditions in north Gaza, the fact that humanitarian access is nearly non-existent is unconscionable. A year on from the start of the conflict, we are still debating restrictions on the flow of aid by Israeli authorities. What more can my right hon. Friend do to ensure that people who are dying from hunger, thirst and lack of medical care receive the attention they need?
Anneliese Dodds
I can only underline the fact that the new UK Government are doing all that we can to get aid in as quickly as possible, supporting trusted partners on the ground to deliver life-saving humanitarian aid. As has been mentioned, we have agreed to match up to £10 million of public donations to the Disasters Emergency Committee’s middle east humanitarian appeal. That will provide life-saving aid, including medical supplies, shelter and clean water, to people in need, on top of the support that we have released to UNRWA. That aid needs to get to the people who desperately need it, and I refer to my response to an earlier question on that point. We are using every avenue to advance that cause.
Middle East Update
Catherine Fookes Excerpts(8 months, 4 weeks ago)
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Catherine Fookes (Monmouthshire) (Lab)
I thank the Foreign Secretary for his statement. I absolutely share his pain, horror and dismay at the number of innocent civilians killed in Gaza. I recently received a letter from constituents under the banner of Families for a Ceasefire, signed by over 70 families in Monmouthshire, calling for a ceasefire and a ban on all arms sales to Israel, so I welcome the suspension of 30 arms licences. Will my right hon. Friend share with us when a further review of the remaining licences will be available? Will he consider encouraging other countries around the world to do as we have done and suspend their licences to Israel?
Mr Lammy
I recognise that this is a really big issue for my hon. Friend’s constituents. I recall being in Wales a few months ago and the issue being raised with us both, when I was speaking on behalf of the Opposition. Our regime is our regime; different countries will have different arrangements. It is for them to democratically determine those arrangements, and they will have made a range of different assessments. She will also understand that, as I said, there are really only two or three countries that sell substantial amounts to Israel and, in truth, we are not one of them. I think the assessment that has regrettably been reached today should satisfy all those who have been concerned with any breaches of international humanitarian law on the basis of a clear risk, which is the export licensing criteria. As I said in my statement, it is not a judgment. It is not for me, the Government or any of us in this place to act as judge and jury. That is a matter for the appropriate international courts and must be determined in the usual way. I emphasise that it is the clear risk judgment of our export licensing criteria that has required me to make this judgment.