Assisted Dying (No. 2) Bill

Fiona Bruce Excerpts

Friday 11th September 2015 Commons Chamber

[Rob Marris (Wolverhampton South West) (Lab)]

I beg to move, That the Bill be now read a Second time.

I thank all Members for giving up their constituency Friday to take part in this debate. I also thank Lord Falconer, who was the original author of the Bill, and Dignity in Dying—I have never been a member, but it has given me assistance on the Bill. I would also like Members to pass on my thanks to their staff, who have been dealing with quite a large volume of correspondence in many constituencies. Now we have got that vote out of the way, I hope that today will see Parliament at its best, with an open debate and a free vote on a matter of conscience.

I will take interventions, but, as you have requested, Madam Deputy Speaker, I will take very few because so many hon. Members wish to speak. So that hon. Members have some idea of where I am going and when I may address particular issues of interest to them, let me say that my speech is in three parts. I will start with the context of the debate, move on briefly to the content of the Bill and then seek to address the concerns that many people have raised with me.

The context is that the current law does not meet the needs of the terminally ill, does not meet the needs of their loved ones and, in some ways, does not meet the needs of the medical profession. We have amateur suicides and what is technically illegal assistance going on, and those who have the means to do so are going off to Dignitas in Switzerland. In the Tony Nicklinson case, the Supreme Court recognised that there is a problem that needs to be addressed by Parliament.

[Fiona Bruce (Congleton) (Con)]

If I am correct, in the Nicklinson case only two of the judges recognised that there was an issue. Seven of the judges—the majority—indicated that the law on this is in accordance with the margin of appreciation under the European convention on human rights, and that has recently been confirmed by the Strasbourg Court.

[Rob Marris]

My understanding is that five judges expressed grave concerns about a possible breach of article 8 of the convention.

The Supreme Court has indicated that Parliament should address this issue. We have a situation in which Directors of Public Prosecutions—principally, the previous DPP, my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), who hopes to speak today—have felt it necessary to issue pages and pages of guidelines on when it would be in the public interest not to prosecute in possible cases of assisted death. It is time for Parliament to grasp the issue.

Social attitudes have changed in the past 50 years. As politicians, we all know not to rely too much on opinion polls. However, opinion polling of 10,000 people by Dignity in Dying, carried out independently by Populus, has suggested that there is extremely strong support for the kind of measure I am proposing.

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[Fiona Bruce (Congleton) (Con)]

The hon. Member for Wolverhampton South West (Rob Marris) says that there has been a lot of misunderstanding about the Bill. There is no misunderstanding at all: the Bill would authorise doctors to provide a lethal substance for people to kill themselves with. That substance is not a “medicine”, as the Bill disingenuously describes it, but a poison. No wonder doctors oppose it, and we in this House should do so too.

The hon. Member for Wolverhampton South West says that the Bill sets out a clear procedure with multiple safeguards. What clear procedure? What safeguards? Let us look at the Bill. It states that doctors must be satisfied that a patient has a settled and voluntary intent to end his or her life. How should doctors be satisfied that the intent is settled? The Bill does not say. Would they need to see the patient once or twice, or over what period of time? The Bill is silent. What steps should doctors take to be satisfied that the intent is voluntary, and that there is no coercion behind the patient’s request? The Bill is silent. Given that Action on Elder Abuse reports that there are over half a million reported incidents of physical and emotional elder abuse in the UK each year, the Bill should be clear on that critical issue, but it is not.

[Simon Hoare]

It is actually worse than my hon. Friend suggests. Given the very low number of GPs who have indicated that they would seek a licence, it is more than likely that both doctors seeking to make the certification would not know the patient and therefore would not be able to tell whether they were more or less depressed or to assess their rate of degeneration. That is the fundamental weakness of the Bill.

[Fiona Bruce]

My hon. Friend is absolutely right. Those doctors could not be sure, and they would not be able to assess the even more subtle internal pressure that an individual might feel to express a wish to end their life because they feel a burden. What special procedure is there in the Bill for the particularly vulnerable in our society, such as those with mental health or learning difficulties? There is none. No wonder Mencap and Scope oppose it.

The hon. Member for Wolverhampton South West speaks of multiple safeguards. Where are they in the Bill? I do not see them. Does he mean the provision that the decision should be referred to a High Court judge? If this was not so serious, it would be laughable. The judge would not have to meet the patient; they would only have to confirm the doctors’ decision, and in a time frame of 14 days, making independent scrutiny all but impossible. Absent will be the detailed, rigorous examination that the family court gives to life and death issues, such as turning off a life-support system. Gone will be the investigative powers of the Director of Public Prosecutions under the current legislation rigorously to investigate cases of assisted suicide referred to him. Removed will be the strong deterrent against malicious behaviour that the current law provides.

[Gareth Johnson (Dartford) (Con)]

The Bill would require the dying person to make a declaration, and that declaration would have to be witnessed. Quite rightly, the witness cannot be a member of the dying person’s family, but they can be a beneficiary of their will. Is my hon. Friend as concerned about that as I am?

[Fiona Bruce]

I am extremely concerned about that “conflict of interest”, as we in this place might call it.

Vulnerable patients would be left in a weaker position than they are now. The inclusion of a judge effectively to countersign a form confirming the doctors’ decision adds no protective value whatsoever. But wait; here in clause 8 is a provision that would allow the Secretary of State to issue at some future date—not before we have passed the Bill—a code of practice. A code of practice would relate to such critical matters as assessing a patient’s capacity or what counselling should be given, or recognising that depression might impair a patient’s judgment.

In other words, the Bill says to us, “Parliament, decide now and sign this blank cheque, and at some future date as yet unknown some safeguards may be considered.” That is wholly unsatisfactory. That will be too late. The deed will have been done. We will have changed the law. We will have crossed the Rubicon, from killing people being illegal to killing people being legal. That is not doing justice. We are here to protect the most vulnerable in our society, not to legislate to kill them. This Bill is not merely flawed; legally and ethically it is totally unacceptable and we must reject it.

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[Sarah Champion (Rotherham) (Lab)]

I know death. I understand death because before coming here I used to run a hospice, and I firmly believe that everybody deserves a good death. That is possible, and the bigger debate that we need to have and bring back to this Chamber is about ensuring that everybody in this country has access to 24/7 palliative care and more hospices that are better funded. In reality, most people do not have a good death.

I am very supportive of this Bill, and I am also mindful that it will apply only to a very small percentage of the population. That is not just because of how specific the safeguards are, but it is from looking at 18 years of experience and data from Oregon. In Oregon, 0.3% of deaths per year are under the assisted dying legislation. The most recent data are from 2013 when 22 per 10,000 deaths were under that legislation—0.22%. In 18 years in Oregon, 1,173 prescriptions were written, and only 752 were actually enacted. This Bill will enable people to have peace of mind. We do not know—we do it only once—what our death will be like, but I would like to give people the peace of mind that if the situation becomes intolerable, they can make an informed choice about their own life.

There seem to be five main counter-arguments to the Bill. The first is about someone being given a six-month terminal diagnosis when perhaps they will live for nine or 12 months. Perhaps they will recover—that is fantastic; I want to celebrate that—but some people die after two days. The Bill is not about marching someone to a darkened room the second the paperwork is signed; it gives them the choice so that if during the deterioration of their condition towards death they choose to end their life earlier, that is their choice and they have that right.

Another argument is about disabled people. I find that quite insulting because disabled people are living full, wonderful, happy lives. Why do people want to include them in the Bill as though their lives are not fulfilled? Of course, once someone reaches a terminal position, if they want to enact the legislation that is their choice, as it is for everybody else.

On coercion, I do not doubt that perhaps there are evil relatives out there who will seek to coerce their elderly mother. However, that elderly mother will then have to persuade two doctors and a judge that this is her choice. I do not think that someone who is vulnerable enough to be coerced by their evil relatives could persuade a judge that they are taking such action from their own choice.

We then come to the argument about the thin end of the wedge. I am sorry, but we legislate for a living here. We know that if anything was to happen, the issue would have to come back to the Chamber and we would have to agree it. I do not accept at all the argument that this is the thin end of the wedge.

There is the argument that it is God’s will that we should suffer, if necessary, and that it is God’s choice how we end our lives. I have 100% respect for that view. If that is someone’s position and choice, this Bill is not for them and I do not expect them to seek to make use of its provisions. I feel, however, that I should be able to make a different choice and that others should not be able to stop me.

I feel strongly that this Chamber does not have moral superiority over those who we serve and have elected us. Eighty per cent. of the population are in favour of this Bill.

[Fiona Bruce]

Will the hon. Lady give way?

[Sarah Champion]

I will not. I find it patronising that we think that our opinion should carry more weight than that of the general population we serve.

Finally, I say to hon. Members: let us make this personal; let us make this about you. If you are suffering, if you have a terminal diagnosis and cannot cope with the pain or situation any longer, would you want this legislation to be in place? I certainly would.