Terminally Ill Adults (End of Life) Bill

Christine Jardine Excerpts

2nd reading
Friday 29th November 2024 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

It is an honour to follow the hon. Member for Brent East (Dawn Butler). I also pay tribute to the hon. Member for Spen Valley (Kim Leadbeater). The spirit in which this debate has been conducted today is a tribute to her leadership on this issue.

This debate has been harrowing for all of us. However, to us falls the responsibility and the privilege of making this decision on behalf of those who go through experiences so harrowing that I do not think any of us can imagine them, even though we have heard their tales—I know that I cannot.

Until recently, I put it to the back of my mind that I have actually been in the situation of waiting to find out whether I would have a terminal diagnosis. I was lucky, as it went the other way. I do not know what I would have wanted but, as I waited, I thought about all the things I wanted to do and might be denied. People with a terminal diagnosis think about what they planned to do with their life, such as seeing their children and grandchildren grow and marry.

When we came here today, we were all aware of that, and we thought seriously about the implications and the need for palliative care, but it is not our job to say that we should not do this because palliative care needs to be improved and because the NHS cannot cope. Our job is to say that we need to improve palliative care so that the NHS can cope, and so that we can do this.

On the safeguards that are needed and included in the Bill, I believe they are there. For those with religious beliefs that mean they cannot countenance the Bill, I understand and respect their concerns, but I would not be standing here if I was not convinced that in this Bill we have the best opportunity to provide a choice safeguarded by medical and legal professionals and protected from that slippery slope. It happened in Canada because they did not have “terminal diagnosis” in the definition of the Bill from the beginning, but we do. If we vote the Bill through, it will go on to have the further and tougher levels of scrutiny that every piece of legislation in this place and the other place must go through. I respect everyone’s concerns and beliefs, but I also ask them, and all hon. Members, to respect those who have already been denied so much in their lives—those things I said they might want that they might be denied.

We have a choice today: we can lead a national conversation that examines the issue before all of us, dissect the Bill line by line and check its effectiveness, or we can vote to close it down today, and then the country and the families who are suffering will be denied the light they want to see thrown on the issue and the voice they want their loved ones or perhaps themselves to have.

Many of us have watched loved ones die difficult deaths, and we have over the past few weeks, months and years in politics heard harrowing tales and spoken to families who have had no choice but to watch their loved ones pass in the most harrowing of circumstances, or make an expensive—for many, prohibitively expensive—trip to Dignitas alone. I cannot help about those things they have been denied by the cruellest of fates, but surely we cannot deny them choice at end of life.

Terminally Ill Adults (End of Life) Bill

Christine Jardine Excerpts

Report stage
Friday 20th June 2025 Commons Chamber

[Christine Jardine (Edinburgh West) (LD)]

We all, I believe, come to this place every day determined to improve not just our society, but the lives of those who live in it—our constituents. We want to give them more choice and opportunity, but we also have a responsibility to protect the vulnerable and alleviate suffering. I do not believe that that responsibility has ever weighed more heavily on any of us, or been more present in our thoughts and our debate than it has today.

We have debated this a number of times, and the Bill has been through the scrutiny of Committee. I thank the hon. Member for Spen Valley (Kim Leadbeater) for all her work, and the Committee for its work, in coming back with a Bill that I firmly believe will provide the choice that those people who are suffering at the end of life not only deserve but are calling out for us to give them.

I would like to reassure all of those in the disabled community and those perhaps suffering from an eating disorder or a mental health issue that they are not in any way put at risk by the Bill. The Committee went to extreme lengths to ensure safeguards, and those people will not be eligible for an assisted death because they do not have a terminal illness.

This has been difficult road for all of us. We have shared personal experiences and those of our constituents. I do not think that any of us will go through the Lobby without having had some doubts, and without having examined our own conscience and our own responsibility, but I believe that the Committee and the House have come up with a Bill that does what the people of this country want. It offers choice to adults with a terminal illness, with the safeguards that we need. I ask all Members to support the Bill.

Terminally Ill Adults (End of Life) Bill

Christine Jardine Excerpts

Report stage
Friday 13th June 2025 Commons Chamber

[Mr Kohler]

I agree entirely with the hon. Member. It would not be a free choice if we make that choice now, given the standard of palliative care.

[Christine Jardine (Edinburgh West) (LD)]

Will my hon. Friend give way?

[Mr Kohler]

This is the last one; I will.

[Christine Jardine]

I thank my hon. Friend for giving way. I share with him concerns about the level and quality of palliative care in this country. However, I do not agree that giving people the choice to end their life, if they are terminally ill and have been diagnosed as dying shortly, in any way undermines our ability as a House to insist on an improvement in palliative care. What is more, statistics from other jurisdictions show that once given that choice, people often turn to palliative care.

[Mr Kohler]

I thank my hon. Friend for her intervention. Giving people a choice when they look on the internet and see how awful their death might be because of the shocking state of palliative care is not a free choice.

This is an extraordinary Bill. It has 55 clauses and 38 regulation-making powers, of which five are Henry VIII powers—in other words, powers to modify primary legislation. As Ruth Fox of the non-partisan Hansard Society, which is absolutely neutral on assisted dying, made clear, there are lots of powers in the Bill conferred on Ministers. Why is that a problem? Lord Hermer KC, the Attorney General, in his Bingham lecture last year, puts the point as follows:

“Henry VIII clauses…upsets the proper balance between Parliament and the executive. This not only strikes at the rule of law…but also at the cardinal principles of accessibility and legal certainty.”

I am afraid the Bill is an example of such excessive reliance. That is a major problem because in large part the safeguards are left to be decided by regulations. What level of qualification and training will doctors need to have? How will mental capacity be assessed? Who can be a proxy? What happens if the self-administration of drugs goes wrong and a person suffers complications but does not die? When pressed on the key safeguards and key issues, supporters of the Bill say that they are problems that can be approved later.

The same goes for how the Bill will actually be delivered. Will it be delivered by the NHS, and if so, how? Will private providers be commissioned, and if so, how, by who and on what terms? Will for-profit providers be allowed? All those questions go unanswered by the Bill. I had hoped that they would be answered in Committee, but they were not, and instead we got even more reliance on delegated powers.

First, that means that MPs cannot make a judgment about assisted dying and how it will work in practice. On training, for example, MPs might assume that the training provided will be a robust two-week course on assessing coercive control, but there is no such requirement in the Bill. Indeed, the impact assessment suggests that it would be a short course. Secondly, regulations cannot override statute and are ultimately bound by it. While it might be reassuring that a code of practice must be issued to take into account how depression can impair a person’s decision making, as the Royal College of Psychiatrists recently reminded us, that does not change the fact that impaired judgment does not mean that someone lacks capacity. Thirdly, leaving all those matters to be considered by guidance and regulations places them outside the democratic control of MPs. With limited exceptions, we will not get a vote on those regulations, and will have no input, directly or indirectly, in formulating them.

The case for the defence might be that reliance on such guidance and regulations is inevitable with a Bill of this complexity, but the experience of other common law jurisdictions suggests that that is not the case. In Victoria, the first Australian state to legalise assisted dying, there are only 20 pages of regulations and much more has been included in the Act, which is necessarily longer than the Bill before us. That is a good thing, as it means more parliamentary scrutiny.

I wholly understand why it was not possible for the hon. Member for Spen Valley (Kim Leadbeater) to draft a Bill as detailed as the Australian Act before Second Reading, but I had hoped that with the help of Government resources, those gaps would have been filled in Committee and on Report. Sadly, that is not the case. [Interruption.] I had much more to speak about, but heeding your cough, Madam Deputy Speaker, let me say clearly that I will vote against the Bill, but even if Members disagree with me, they should please vote for my amendments.

--- Later in debate ---

[Christine Jardine]

On a point of order, Madam Deputy Speaker. I do not think it matters how one is going to vote on this issue; a lot of us are finding it very frustrating that some Members seem to be deliberately hanging about in the Lobbies to delay the process. In order to get the Bill through and for the public to see that we are respecting their wishes, can something be done to appeal to the better natures of those Members? It really looks petty and childish. Could they please abstain from doing it the next time?

[Madam Deputy Speaker (Judith Cummins)]

I thank the hon. Member for her point of order. She will have seen that I sent the Sergeant at Arms to investigate the delay.