Assisted Dying

Fiona Bruce Excerpts

Thursday 4th July 2019 Commons Chamber

[Fiona Bruce (Congleton) (Con)]

Let us look at some of the reasons given by those advocating a change in this law. They say the current law is not working and point to cases such as that of Ann Whaley—a case surely deserving of our compassion, but one that contradicts their arguments for change. It shows that our current law is working.

No prosecution was proceeded with in Ann’s case. I understand how unpleasant it must have been for her to be interviewed under caution, but the CPS approaches such cases on the basis that if someone is in some way involved with the suicide of another person, yet has compassionate rather than self-interested motives, it is highly unlikely that they will be taken to court. Indeed, there have been only three successful such prosecutions in England and Wales in the last 10 years, and during that period just 148 cases were referred to the CPS.

The small number of cases and rarity of prosecutions indicate that our law is an effective deterrent to those with malicious or self-interested motives and protects against the very real danger of the abuse of the disabled, sick, frail or elderly and the danger that they could feel pressured into ending their own lives.

Why change this? Proponents of change argue, as we have heard from the hon. Member for Grantham and Stamford (Nick Boles), for a very focused, very limited, legal change on assisted dying, but it would not stop there.

[Nick Boles]

Is it not the case that it has stopped there in Oregon for 20 years?

[Fiona Bruce]

In fact, that is not the case: in Oregon now there are clear public pressures for a widening of the law there.

[Nick Boles]

But the law has not changed in Oregon; it has remained exactly the same for 20 years.

[Fiona Bruce]

Let me turn then to the case of Canada, whose law in this area was also cited by the hon. Gentleman as an example we should follow. Just a few days ago, a clinical director from Canada came to this place and made a presentation. I was privileged enough to chair the meeting; it was called “ ‘Assisted dying’ in Canada? A cautionary tale.” To clarify, at about the same time as this House rejected assisted suicide here, in Canada there was a court case that decriminalised assisted suicide on the basis that it should be up to capable adults who clearly consent to the termination of life and are suffering intolerably from a grievous and irredeemable medical condition.

What the clinical director told us was startling. She told us of grave problems now being encountered in that country in connection with the practice of assisted suicide. She told us that in fact medical assistance in dying, or MAID as it is called there, involves in 99% of cases euthanasia, not assisted suicide. She told us of funding allocated to palliative care previously now being diverted for these purposes; of assessments being done on a very rudimentary basis, including even by telephone; of safeguards such as the 10-day reflection period being regularly shortened; and of MAID being used for non-terminal illnesses, even in a case of arthritis. There are now even proposals for it to be extended to so-called mature minors.

The suggested need for two clinicians to give consent is apparently being effectively flouted, too: all anyone has to do if they cannot find one of the clinicians from the first two approached to give consent is approach another and another until one who will give consent is obtained. Conscientious objection by practitioners is not statutorily provided for, so practitioners are feeling increasingly obligated to undertake this. In Canada the safeguards simply are not working, and I was interested to hear Baroness Meacher, the chair of Dignity in Dying, stand up at the end of that meeting and say, “We don’t want that in this country.”

Those advocating change argue that legal opinion has changed, but it has not. In the most recent court case—that of Noel Conway, who has been mentioned here today—arguments for a change in our current law were rejected not just by three judges of the divisional court, but by three judges of the Court of Appeal, and three judges of the Supreme Court, our highest court, then declined permission for a further appeal.

Advocates of change have wrongly and selectively argued that in a Reith lecture this year the former Justice of the Supreme Court, Lord Sumption, called for a change in this law. He did not. In fact, if his speech is read in context and comprehensively, it is clear that he said the very opposite. He did no more than state a fundamental principle of the criminal law—namely, that it is there to protect society by prohibiting acts regarded as unacceptable, and that one such act is encouraging or assisting suicide. He said that

“we need to have a law against it in order to prevent abuse”.

Yes, he referred to what he called the “untidy compromise”, which recognises that, as with other criminal laws, there can be exceptional circumstances where a person breaks the law for altruistic reasons, and that in such cases prosecution may not be warranted, but there is a world of difference between not prosecuting in such situations and licensing acts in advance.

Next, those arguing for change say that medical opinion is shifting. On what basis? A recent Royal College of Physicians poll of its members is mired in controversy. The RCP was, before the poll, opposed to any change in the law. However, this poll unprecedentedly required a super-majority of 60% of those voting to maintain the status quo. How strange! Bizarrely, the RCP’s council is now arguing that the result of this poll justifies a change in the college’s stance, despite the result of the poll showing that the highest number of those members voting—43.4%—opposed any change in the law and that the lowest number—25%—thought that the RCP should be neutral. Yet, strangely, the RCP has chosen to adopt a neutral stance. It is no wonder that the poll has been the subject of a referral to the Charity Commission for investigation. And for what? As Baroness Finlay said in another place, “neutrality adds nothing”. Let us also note that, within that vote, more than 80% of palliative care physicians wanted the RCP to remain opposed to change.

The fact that the British Medical Association and the Royal College of General Practitioners are set to consult their members is neither a surprise nor an indication of a change in their position. Professional membership consultations can be expected every few years. Indeed, the RCGP said five years ago that it would do this about now. It is to be hoped that both the BMA and the RCGP will reaffirm their opposition to any change in the law.

Finally, the proponents for change argue that public opinion is shifting, but it all depends on the question people are asked. That is the problem with the 80% figure that the hon. Member for Grantham and Stamford cited. The more deeply we probe this issue and the more aware people are of the implications of change, the more concerned people become. I can quote from another poll from February this year indicating that more than half the public say that

“some people would feel pressurised into accepting help to take their own life so as not to be a burden on others”

if assisted suicide were legal. Only 25% disagreed with that.

--- Later in debate ---

[Andy Slaughter (Hammersmith) (Lab)]

It is almost four years since we last debated and voted on this issue, after Rob Marris introduced the Assisted Dying (No.2 Bill), which is now sponsored by Lord Falconer in the other place. I thought it was a thoughtful piece of legislation, and during the last debate I responded from the Front Bench on behalf of the Opposition. It was a highly charged debate, and 85 Members tried to speak. I was slightly surprised that the vote was so decisive, with 330 votes against the Bill and 118 in favour, particularly given that public opinion was then 80%—now perhaps 90%—in favour of such a change to the law. It is unusual for us to lag behind public opinion on matters of social legislation in such a way.

From reading that debate, and from some of the speeches this afternoon, I appreciate that a number of Members speak from a religious perspective. I entirely respect that and their right to make their own decisions, but I do not agree that they should be able to impose those decisions on me or those of my constituents who do not necessarily share that outlook. We have talked about choice, which is important, but I think this issue goes further than that. The ability to choose the time and manner of one’s own death under the circumstances that have been described, sometimes in horrific terms, is a basic human right. That is particularly true when we consider the issue of people’s means because, as many Members have said, someone’s ability to make that choice is restricted to those who can afford the organisation, time, money and support to go to Switzerland or somewhere else abroad.

The arguments about dignity and suffering have been very well made and are very difficult to rebut, but the more one looks into this the more compelling the case becomes. I met Ann and Geoffrey Whaley when they visited this House the week before Geoffrey went to the Dignitas clinic. Meeting them was one of the most profound things to have happened to me since becoming a Member. It was extraordinary to witness not just their courage but the certainty and the measured way in which they put forward their arguments. I pay tribute to them. They then had to go through the stress of a police interview. The fact that the police, I gather, interview in about 50% of such cases, is itself strange, but in 100% of cases the threat is there for those relatives—the feeling that the police might turn up on your doorstep at the most vulnerable time in your life.

There is also the risk of forfeiture, or at least having to go to the courts to apply for relief from forfeiture, because it is quite possible that joint assets cannot pass to a succeeding spouse, for example, because of their involvement in that regard.

[Fiona Bruce]

Does the hon. Gentleman recognise, though, that it is that concern that the police might call that protects so many vulnerable people from abuse? If we do away with that, there will be no reason for relatives not to support or even encourage vulnerable relatives to consider assisted suicide. What sanction will there be?

[Andy Slaughter]

I do not think the hon. Lady does herself any favours by making that argument. It is quite barbaric to think that relatives may sit in fear of a knock on the door from the police. The police themselves are in a very difficult situation. As Ann Whaley recalled, the police felt that they had to go through with an obligation which they perhaps did not want placed upon them.

Consider the case of Tony Nicklinson, who lost his case in the higher courts. I make no criticism of the higher courts— I think this is a matter for us rather than the judiciary—but he effectively had to starve himself to death to achieve the same objectives. The fact that people are going to their deaths earlier than they need to, and going through the most distressing of additional circumstances to do so, should prick our consciences rather more than it does. On the other hand, I do understand—this is why I have moved over a period of time—the arguments about undue influence and the slippery slope. It is important to look at what safeguards are there. I believe, from what we have heard today, that the safeguards are there, but I also believe that this is a balancing act.

Members will perhaps be aware of the case of another very brave man, Phil Newby, another sufferer of motor neurone disease, who is crowdfunding at the moment to take a case on the basis of proportionality. Yes, there are rights for those who are in a difficult circumstance and who might fear, or feel, pressure on them, but there are rights for those who are in great distress because they feel the need to end their own lives and are unable to do so.

The medical profession was mentioned by a number of hon. Members. I think there is a change of mood. If one looks at the Royal College of Physicians, the direction of travel even over the past decade has been from 70% of its members being against a change in the law to about 50% now. I think that trend will continue. I understand the additional pressures it would put on the medical profession. I understand that for some it looks like a conflict of interest and a compromise of their role, but I feel that everybody must take a mature view and I believe that opinion in the medical profession is changing.

I think we all support good quality palliative care for a number of reasons, including taking the pressure off the acute sector and off our hospitals. A palliative care setting can often be the best place to die. I am furious that the Pembridge palliative care unit, which serves my constituents, is being decommissioned; we only learnt of that last week. It is an excellent unit, and I will fight to preserve it. However, I do not believe that there is a conflict there with what we are discussing today. The two things sit alongside each other. They are both matters of compassion, and about doing the best for people in extremis in the most difficult parts of their lives.

So, with a lot of thought, I support what has been said and I congratulate the Members who tabled the motion.