Assisted Dying

Crispin Blunt Excerpts

Thursday 4th July 2019 Commons Chamber

[Crispin Blunt (Reigate) (Con)]

I have been engaged in this issue since the very early days when I arrived in this Parliament in 1997, guided, along with many other right hon. and hon. Members, by the experience within my own wider family.

By 2040, nearly one in seven people is projected to be aged over 75, so we will be engaged in supporting an ageing population who will lead fuller lives, working longer, by adapting the workplace and ensuring that individuals can reskill throughout their life. But people will be living with chronic conditions, and multiple morbidities and cognitive impairments will become more common within our population. I have no doubt that our innovative and caring society will solve, or certainly ameliorate, these conditions, but the hard truth is that more of us will have to grapple with surviving with the pain and indignity of crippling progressive infirmity in later life.

If we do not change the law, even more people than the current one every eight days may travel to Switzerland for an assisted death—and, of course, there are all those people who do not have the means to travel and all those travelling to Switzerland early so that they can exercise the autonomy available to them there. I do appreciate the views not only of right hon. and hon. Members but of the public who express concerns over assisted dying. It is of course a controversial subject. However, the injustice and the tyranny of having no escape from pain and indignity that our law continues to impose on a growing number of our fellow citizens will not go away until we address it. In Oregon, since 1997, a total of 1,127 patients have died from ingesting these medications. Not only does the yearly figure barely rise above the 0.003% mark, but only 64% of those who have received prescriptions for the medications since 1997 have actually taken them.

When we discuss this emotional topic, the most grotesque characteristics of greedy, overbearing relatives are conjured up in some hypothetical dark fantasy, but these arguments about a slippery slope or the vulnerability of people simply ignore the fact that this applies only to terminally ill people. When the Assisted Dying Bill came to this House in 2015, its terms would require two doctors to sign off on the fact that the person would be dead within six months and the process to be overseen by a High Court judge. How many more measures would opponents of this principle want to satisfy them? The difficult truth is that for many, it is none. This is about the imposition of a faith-based view of the sanctity of life overriding any sensible application of personal autonomy for people in dreadful and terminal strife.

[Lyn Brown]

Will the hon. Gentleman give way?

[Crispin Blunt]

No, I will not. I might want to pick up on the example the hon. Lady gave later in my remarks.

That personal autonomy on any individual application of universal human rights includes the freedom to control and direct one’s own life and, in this case, death. Yet again, despite a poll in March of more than 5,000 people showing that 84% of Britons wanted a change in the law on assisted dying, they have to contend with the moral certainties of those who are not suffering extreme pain and who are taking these decisions on their behalf—us. We have a responsibility to discuss this issue in an honest, compassionate and evidence-based manner, and we have a swathe of evidence available to us.

The whole Oregon experience entirely supports that this is a practical, sensible, humane and decent measure. Over two decades later, the opinion of the people has not changed one iota. This Parliament, in not facing up to its responsibilities, is party to increasing tyranny, pain and despair.

Ultimately, this is about potential control. Just as people exercise control over how they live, they should be able to exercise control over how they die. In reality, the vast majority of people will never take this choice, even when faced with it. With strong safeguards, Oregon, Washington state, Montana and Vermont have had no documented reported cases of abuse. Why, when the evidence is clear, do we deny everyone the comfort of some personal control over the end of their life?

To return to the point made by the hon. Lady, I wonder what her mother’s view was, because under the law, she could not exercise her autonomy. I am utterly certain that the hon. Lady would have wanted, with all the generosity in the world, to ensure that her mother had the full support available to her. Well, that just might not have been the view of her mother, in the pain and difficulty that she was facing. Why was she not allowed the opportunity to make that decision?

[Lyn Brown]

The hon. Gentleman is absolutely right; she would have argued that she should have had the right to take her own life, but let me put one statistic to him. He mentioned Washington state—51% of the people who took the tablets there said that their reason for doing so was that they were a burden to the people they loved. That is the exact reason that my mother would have done the same. We must weigh the evidence properly.

[Crispin Blunt]

The evidence is there to be weighed by two doctors and a High Court judge, and the hon. Lady’s mother and other people in those circumstances would have had the right to exercise their autonomy. It is that autonomy and that control that we are choosing to suppress. Sadly, for now, it remains that we have a cruel, outdated law that forces people to die earlier by traveling to Switzerland while they are fit enough to travel, or to suffer pain, indignity and degradation that we would never impose on a suffering animal.

--- Later in debate ---

[Martin Vickers (Cleethorpes) (Con)]

Thank you, Madam Deputy Speaker, for giving me the opportunity to speak in this important debate. I congratulate my hon. Friend the Member for Grantham and Stamford (Nick Boles) on initiating yet a further discussion on this subject. We have heard some passionate contributions, and very moving ones, including that by the hon. Member for Sheffield Central (Paul Blomfield), who delivered his speech with great dignity; I congratulate him on that.

We discuss a wide range of matters in this House, from rather mundane ones, such as those which we were discussing before this debate, to those that affect life and death. Nothing, of course, can be more important than issues that affect life and death.

I am not a lawyer; nor do I claim any particular insight. Indeed, I see through a glass darkly. I have an uneasy feeling, which I know is shared by some hon. Members, that we as a society are moving towards a situation in which assisted dying is legitimised, and I recognise that many would support that, as we have heard this afternoon. For myself, I believe life to be sacred and God-given, and I readily acknowledge that that is a view that is not universally accepted. However, I am sure we can all agree that life is uniquely precious, and that we should do all we can to preserve it, and I do not in any way question the motives of those, be they Members of this House or members of the public at large, who take a different view. Many will have reached those conclusions having witnessed the slow, painful death of a loved one.

I believe that any move to lay out a statutory framework is a further step, however small, towards an acceptance that assisted dying is in some way given the seal of approval. Some things are best left in the grey area.

We are today discussing the functioning of the current law, and it is perhaps an argument to say that it is not as clear as some desire, but surely the question is whether we can give clarity to such a complex matter—can we, as the Legislature, frame an Act of Parliament to cover all the complexities—or is it better, in cases that are presented to the prosecuting authorities or the courts, to leave it to them to consider the unique circumstances that each case presents?

Both my parents died of cancer and suffered in their final months. I well remember the telephone call from a specialist who, having received the results of the tests on my father, said, “We must hope that God is merciful and does not allow him to suffer for too long”. Although he did suffer, it was not for too long. In fact, he lived for a further six months after I received that fateful call. In his final weeks, which he spent in St Andrew’s hospice in Grimsby, I saw what comfort could be offered through palliative care. No longer did he suffer the periods of pain that he had had in earlier weeks—and that happened as long ago as 1988. Through my visits to St Andrew’s since, and to Lindsey Lodge hospice near Scunthorpe, both of which serve my constituency, I have seen the advances that have been made in the years since. Sadly, my mother died in hospital on the day that she was to be transferred to St Andrew’s.

In the case of both my parents, it is probably true that their passing was hastened by drugs, such as morphine, and no doubt others would argue that it would have been better had they been given the opportunity to shorten their lives by a few weeks or months, but I firmly believe it is better that the situation is left as it is. If one is old, frail, weak and seriously ill, one needs help, support and compassion—not the added worry and the nagging doubt over whether everything possible is being done to preserve one’s life.

[Crispin Blunt]

I congratulate my hon. Friend. He is making an extremely good argument so far, except that it does not address the wider benefit that comes from a change in the law here, which is about the knowledge that you have that control available to you as you enter a period when you might be contemplating these very difficult decisions. That is the principal benefit that would come from a change in the law. By leaving a grey area in the law, we deny nearly all of us the benefit of knowing that we have that control at the end of our life.

[Martin Vickers]

I thank my hon. Friend for his intervention and acknowledge that that is a deeply held view for him and many others, but I am afraid it is not one that I share.

--- Later in debate ---

[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.

[Crispin Blunt]

Will the hon. Gentleman give way?

[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.