Assisted Suicide
Joan Ruddock Excerpts(12 years, 8 months ago)
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Dame Joan Ruddock (Lewisham, Deptford) (Lab)
I beg to move amendment (a), at the end of the Question to add,
‘and invites the Government to consult as to whether to put the guidance on a statutory basis.’.
I very much welcome this debate and the fact that the Backbench Business Committee has found time for it. I congratulate the hon. Member for Croydon South (Richard Ottaway) on the very considered way in which he presented the motion. The amendment, which stands in my name and those of the hon. Members for Amber Valley (Nigel Mills) and for Solihull (Lorely Burt), invites the Government to consult as to whether to put the policy on a statutory basis. I believe the time has come to give the public and stakeholders an opportunity to comment on the Director of Public Prosecutions’ policy in practice. The amendment invites the Government to place the DPP’s policy on a statutory footing but does not demand that.
The final version of the policy on assisted suicide has now been in place for more than two years. The draft policy was the subject of heated debate, particularly in relation to the health or disability status of the assisted person, the actions of health care professionals and the relative weight to be given to the motivation of the assister. However, there are still some areas of concern in relation to the policy, most notably its impact on doctors where there is less clarity. A patient with a terminal condition may wish to discuss with a health care professional their desire for assistance to end their life. Similarly, a patient who has come to a decision may wish to obtain their medical records in order to be assisted to die overseas.
If the Government were to hold a consultation on whether the DPP’s policy on assisted suicide should be placed in statute, I am confident that we would learn much from the response of the public and the stakeholders working with the DPP’s policy. Essentially, placing the policy in statute would reinforce not only that the DPP has discretion in deciding on prosecutions in assisted suicide cases, which is already plain in the wording of the Suicide Act 1961, but also the factors that must be considered in taking these decisions. Placing the policy in statute would signal in the strongest possible way that Parliament agrees that those who maliciously or irresponsibly encourage suicide should be prosecuted, but that it is not normally in the public interest to prosecute an otherwise law-abiding citizen who helps a loved one to die on compassionate grounds.
John Pugh (Southport) (LD)
It is clear that the DPP has discretion. How does placing something on a statutory footing show that the DPP has discretion?
Dame Joan Ruddock
Clearly, if the existing guidelines were put into statute they would lie alongside existing statute. I will go on to explain why I think it is very important that they should be in statute.
Mr David Burrowes (Enfield, Southgate) (Con)
Would not one of the implications of the amendment, if it were passed, be to fetter the discretion of the DPP to amend the code? It would drive a coach and horses through section 10 of the Prosecution of Offences Act 1985, which gives the DPP complete discretion to draft his own codes.
Dame Joan Ruddock
I completely disagree. First, the amendment invites the Government to consult, which could not possibly contravene an Act in itself. Furthermore, the Act that gives the discretion is not overturned by putting the guidelines into statute. What the statute would then say is, “These are the circumstances…” but it would not remove from the DPP the discretion he has in existing statute.
Dame Joan Ruddock
I am not going to give way again because I have used up my time for interventions. I am sorry but I will run out of time completely if I give way.
There is also a question of accountability to consider. The DPP is, of course, answerable to the Attorney-General and in this way is accountable to Parliament, but we as Members of Parliament are accountable to our constituents. Public interest in the law on assisted suicide and related issues is extremely high. As the hon. Member for Croydon South has told us, a YouGov poll in 2010 for The Daily Telegraph asked 2,000 people whether they agreed with the DPP’s policy. For the benefit of the House, let me repeat the outcome of that poll: 82% agreed with the compassionate treatment of people as laid out in the DPP’s guidelines, only 11% disagreed and 8% said they did not know.
As it stands, the policy could be changed by the DPP, who is after all an individual who holds the role of DPP for a term of five years. It is unlikely that a future DPP would make significant changes to the policy, but it is always possible. That is why placing the DPP’s policy on a statutory footing would mean that this sensible, humane and popular policy could be changed only by Parliament. In conclusion, I welcome the DPP’s policy and this debate. The policy is sensible, humane and provides clarity on how the law is applied in assisted suicide cases. The public strongly support that approach, which is why I believe the Government should consult on whether they want the clarity provided by the policy to be placed on a statutory footing. I have always known that in compelling circumstances I would assist a loved one to die. That is why I think it is so important that the DPP’s policy should be placed in statute. I urge hon. Members to support this amendment and the motion.
Dame Joan Ruddock
I am grateful to the Minister. I want to take him up on that point, because he has made the seminal point that this is a very unusual—perhaps unique—circumstance, in which assisting is a criminal offence, but suicide is not an offence. Because it is such an unusual case, it may be reasonable for the Government to consult on whether the guidelines should go into statute.
The Solicitor-General
I listened to the right hon. Lady’s speech and although I understood it, I am not convinced by her argument. None the less, she is perfectly entitled to make it.
Assisting or encouraging suicide is an offence and the maximum penalty for it is 14 years. It should not be thought that the law is not clear. We are talking about the application of the law when it comes to a decision about whether or not to prosecute. Those are discrete issues.
It cannot be acceptable to permit people to encourage others to kill themselves. Most often the people concerned would know each other, but the growth in suicide websites means that the person doing the encouraging could well be wholly unknown to, and not even present with, the person being assisted or encouraged to kill himself. To clarify the position the Coroners and Justice Act 2009 updated section 2 of the 1961 Act. That change was made amid growing concern about misuse of the internet to promote suicide and suicide methods, and to reassure the public that the internet was not outside the law. It is now clear in that 2009 Act that it is not necessary for a person committing the offence of assisted suicide to know the person whom he is encouraging to commit suicide, or even to be able to identify him. The change to section 2 came about via the Coroners and Justice Act, and any further changes to the law must, I suggest, be a matter for Parliament to decide.
Although today’s motion does not call for a change in the substantive law, and the amendment tabled by the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock) calls for the DPP’s guidance to be put on a statutory basis—no doubt following consultation, but I think I can paraphrase in that acceptable way—she does not ask for a change in the statute itself. I have no doubt that some may suggest during this debate that there should be a change in the criminal law relating to assisting or encouraging suicide. I do not advocate a change in the law, nor do I think it sensible to place the DPP’s guidance on a statutory footing.
The Solicitor-General
There is a growing confusion—perhaps it was there already—between the guidelines, which are the DPP’s policy statement on when it is and is not thought appropriate to prosecute and the factors that he will consider, and the substantive law that is set out in section 2 of the Suicide Act. The two are quite different. As I mentioned to the right hon. Lady, it is a criminal offence to encourage or assist the suicide of another, and if people are prosecuted and convicted, they are very likely to receive a prison sentence measured in years, the maximum being 14 years. But the DPP’s guidelines are not the law. They are a public document that informs us how it is that he considers whether or not it is right to bring a prosecution in any given case.
I agree with my hon. Friend the Member for Croydon South in commending the DPP for producing a document that is notable for both its clarity and its compassion. The House is fully entitled to consider the way the criminal law it enacts is applied in practice, but I hope that by considering the guidelines, the House will not only commend them, but also note that they are based on the principle of independent prosecutors exercising their discretion in their decision making, which, ultimately, must be in all our interests.
Dame Joan Ruddock
I am really grateful to the Solicitor-General for giving way. Will he just acknowledge that a future DPP could overturn the guidelines, and does he think that that would acceptable?
The Solicitor-General
If a future DPP overturned the guidelines, he would be judicially reviewed for behaving in a rather whimsical way. I also suspect that the right hon. Lady would be one of the first to stand up in the House and censor him for doing so. I can assure her that placing things in statute will not assist her cause. She and I share the view that the DPP’s guidelines are a good thing. Why not leave them where they are and let them remain a good thing?
As I said, I hope that by considering the guidelines the House will not only commend them but also note that they are based on the principle of independent prosecutors exercising their discretion in their decision making, which, ultimately, is in all our interests. The guidelines inform others how he will exercise his discretion, but as with any guidance or policy issued by the DPP, it is subservient to the law of Parliament and the decisions of the higher courts. If the law changes, any relevant prosecutor’s guidance must also change. It will change the more flexibly if it is not ossified in statute.
I make a trite point, but the law cannot do everything. We need flexibility in its application, and to be able to apply the law and to make decisions about whether or not to prosecute on the facts and the surrounding circumstances of each case and on a case-by-case basis. In this area of law, perhaps almost if not exclusively above all others, we need to approach the question of whether to prosecute with sensitivity and with care. Indeed, the High Court, in its judgment on 29 October 2008 in the Purdy case—the very action that, once it had been considered by the House of Lords in 2009, gave rise to the guidelines—said that the nature of the offence created by section 2(1) of the Suicide Act is such that
“the variety of facts which may give rise to the commission of that offence, and therefore which may result in a person being prosecuted, is almost infinite”.
The section 2 offence is very widely drawn. It covers all situations and creates no exceptions, which is why, I suggest, the DPP’s consent to a prosecution is so necessary, and why the House of Lords directed the DPP to publish the policy that we now have before us.
Guidelines or a policy statement are not required in every criminal case, but I invite the House to consider that such guidelines are best issued by prosecutors and for prosecutors, although available for public inspection and comment. Quite apart from the propriety of guidelines for prosecutors being a matter for prosecutors, there are some practical considerations to guidelines remaining on a non-statutory basis. Surely to place them in statute would be to attempt to confine the infinite. Policies and guidance are there to provide practical assistance to prosecutors on how particular categories of cases should be approached and the internal processes that should be followed. Therefore, there needs to be a certain amount of flexibility, not least because, as case law develops and public opinion and our collective moral view alter, the law changes and these guidelines and the policies will need to change in response, often quickly.
I therefore urge the House, as a matter of good practice, to conclude that the current flexible and—I admit—pragmatic approach should be retained. That said, we are all entitled, inside and outside the House, to comment on the guidelines themselves or on a decision to prosecute or not prosecute in any given case, subject to any temporary constraints imposed by the law of contempt and defamation. We should not build into the process a sclerotic arrangement that will not improve the application of the law from year to year.
The CPS has published a number of policies and guidance documents over the years. They are available on its website and are there to help the public understand how decisions are taken by prosecutors. During the past two years or so, that has included policies on prosecuting human trafficking cases, public protest cases and cases about perverting the course of justice when victims in rape and domestic violence cases make false retractions. Should these policies be codified, too? Should they be placed on a statutory footing? As my noble Friend Baroness Berridge said in the other place when this matter was debated last month:
“It is imperative that DPP policy and decisions are free from, and seen to be free from, Government interference…If the House were asking how the Government are assessing the application of DPP policy for prosecutions in cases of phone-hacking, constitutional alarm bells would, I believe, have gone off immediately.”—[Official Report, House of Lords, 13 February 2012; Vol. 735, c. 629.]
I agree with her.
My hon. Friend the Member for Croydon South said that the application of the existing law and, by implication, the application of the guidelines in this area is a pressing issue. It is not so much the application of the existing law that is the issue, but what the substance of the existing law is. I leave others to decide how pressing the issue might be. At the risk of repeating myself, I will say that if Parliament wishes to change the law in this area, that is a matter for Parliament, but we should not confuse the way prosecutors apply the law with what the law is or should be.
As I draw my remarks to a close, I will briefly address the amendment tabled by my hon. Friend the Member for Congleton and supported by a great many right hon. and hon. Members. She is encouraging—I assume—the Government to develop specialist palliative care and hospice provision further and, in responding, I transmogrify my role as a desiccated, boring and apolitical Law Officer to that of a thoroughly exciting political Minister.
The Government recognise that many people, their families and carers do not receive the quality of end-of-life care that we would all wish to receive. Hardly a month passes without our reading in the national or local press or hearing in the broadcast media of some terrible episode of personal suffering endured by an elderly person at the end of their life. Every such story demands of us that something more should be done to ensure that the care of the terminally ill, no matter what age they are, should be improved. The Government are committed to developing and supporting end-of-life and palliative care services to ensure that the care people receive, whatever their diagnosis, is compassionate, appropriate, of good quality and permits the exercise of choice by patients. That choice is, of course, within the current legal framework. For many, that means being able to choose to be cared for and to die at home, or in a care home when that has become someone’s home. However, we know that most people die in hospital, the place where they would least prefer to be.
Although realistically many people will continue to die in hospital, we know that more people could be cared for and die at home. We want services to be set up to help people make that choice, and commissioners and providers need to ensure that the right services are available in the right places and at the right time. Much needs to be done to make that happen, and we will review progress in 2013 to see how close we are to being able to offer that choice. It is very much part of the work to implement the Department of Health’s end-of-life care strategy. Published in 2008 under the previous Government, the strategy received cross-party support. It aims to improve care for people approaching the end of life, whatever their diagnosis and wherever they are, including enabling more people to be cared for and to die at home.
Mr Field
That is precisely the situation that we have, and that situation has been clarified and developed further by the DPP; that is why we are, totally correctly, praising him in this debate. However, to think that the world is populated by people of great charity who think only of the person on the receiving end is to mislead ourselves, look foolish before our electors, and do vulnerable people harm.
I disagree with the second point that my hon. Friend the Member for Poplar and Limehouse made; I do not believe that we are autonomous. I find it amazing that those who are clearly on the centre left should have an individualistic view about human life. We are dependent on one another, and one person’s actions can affect another person. One might have a slightly different view if there had not been a whole series of reports about the horrors done to old people in hospitals and euphemistically named care homes. We tut, nod the reports through the House, and do damn all about them. We as a nation allow very nasty things to happen to many of our vulnerable constituents, and we do nothing, or very little, to prevent them.
Today’s debate, if I have understood it, is not really about the motion, or how it was seconded; it is about the amendment that my right hon. Friend the Member for Lewisham, Deptford, tabled, not because hon. Members wanted to talk about euthanasia, but because they believed that the amendment would be seen as a staging post on the way to gaining that objective. Although we are now confused about what we are supposed to be debating and what we are voting on, I hope that the House will agree with what the outside world thinks the debate is about, and what I read the motion on the Order Paper as being about.
Dame Joan Ruddock
I must make it absolutely clear to my right hon. Friend and the House that the amendment only asks the Government to consult on putting the guidance into statute. If it was in statute, the DPP would still have discretion, and assisting suicide would still be a crime.
Mr Field
Nobody in this debate has said, in concrete terms, how making that move would better protect more vulnerable people. As that case has never been made in this debate, I hope that when we vote tonight, we will vote for what we thought was the main motion, and vote strongly for the amendment in the name of my very honourable Friend the Member for Congleton (Fiona Bruce) and many other Members of the House.
Sir Peter Bottomley (Worthing West) (Con)
We can understand the individual cases that have been brought to the House this afternoon. There are about 5,000 suicides a year in this country. If we had an equivalent system to that in Oregon, which is the total reverse of what some have been talking about—it has physician-assisted suicides—we would have about 10,000 assisted suicides a year. If we were like the Dutch, whose position goes beyond assisted suicide to death with or without request—that is different from suicide—we would, again, have about 10,000. My wife and I were impressed by a Dutchman who had been working abroad but went back to his home country. He was asked by his doctors why he was keeping his handicapped son alive. He asked for a transfer to this country, where there is care—and not just palliative care.
No one in this House would want to argue for ending the life of those who are physically handicapped or mentally ill, or for agreeing to the requests of the clinically depressed—those most likely to commit suicide—who want to end their life. If we start to go down that line—and that is the only purpose that there can be behind amendment (a)—we will be in a different debate from the one so well introduced by my hon. Friend the Member for Croydon South (Richard Ottaway). I pay tribute to him for the letter that he sent to us all, for the way he spoke on his motion, and for what he has on his website, on which he has kept his constituents up to date with his views.
There is only one reason for amendment (a), and it is not to ensure statutory enforcement of the DPP’s guidelines. I have not found a precedent for any statutory enactment of the DPP’s guidelines. If my hon. and learned Friend the Solicitor-General knows of any, I would be grateful if he would correct me. The only reason to want the Government to decide on whether to consult is in order to go way beyond—first slightly beyond, and then further beyond—to the question of whether the issue be confined to assisted suicide.
Dame Joan Ruddock
I hate to repeat myself, but the amendment is absolutely clear. It suggests only that the Government should consult on the matter. There is no certainty in that; the consultation may go completely the other way. The situation is unique, as I said. The framework of the law on suicide and assisted suicide is quite different from that on other matters.
Sir Peter Bottomley
But when I asked one of the right hon. Lady’s hon. Friends—the hon. Member for Walsall North (Mr Winnick)—whether he would support the amendment, the answer was not clear.
Sir Peter Bottomley
It is not a question of whether I am satisfied; the question is: what is the purpose of the amendment? We all heard the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock) the first time round, and what she said was engaging, but it was not the reason for amendment (a). If we are not talking about going beyond assisted suicide, what are we talking about?
Sir Peter Bottomley
I will not give way again. It would have been better, if we had more time, if someone had read out all 16 of the DPP’s public interest factors tending in favour of prosecution, and the six public interest factors tending against prosecution, which, interestingly, start at nought rather than one. It is worth getting those into people’s minds. I hope that the newspapers will report those factors, if they report any part of the debate.
I have probably been with as many dying people as others. I have been in the House for 36 years, there are about four people a year with whom I spend a lot of time in my constituency, and I have had family experiences, too. I have probably seen more dead people than anyone, because of various things that I have been witness to in my life. Death is not something to be worried about; pain is, and misery is. I shall not even think of contradicting the things that many hon. Friends and Opposition Members have said, but on the DPP’s role, I point out that I back what Ken Macdonald said in 2004, when he issued a nine-point statement of independence. One of the points was as follows:
“The people of this country want a prosecution service that is confident, strong and independent. Casework decisions taken with fairness, impartiality and integrity will deliver justice for victims, witnesses, defendants and the public. Casework decisions that, for whatever reason, lack these characteristics risk miscarriages of justice. They undermine that confidence in the rule of law, which underpins our democratic society.”
If we had a statutory declaration of the principles that we have all accepted, and the DPP brought up some other issue that he wanted to bring in, it would require a statutory change. What is the point of that? If the DPP thought one of his current points was too strong and should be weakened, would he have to come to Parliament again? That is the argument against even considering whether the Government should consider consultation.
The last area I wish to examine relates to the fact that too many suicides take place in this country. Whether we ought to have an extra 20 or 30 instead of having people going abroad is one issue, but multiplying the number of assisted suicides by 100 relates to a completely different debate. What sort of number would there be then? What sort of pressures would people feel if they thought that they were being awkward or untidy, or they were experiencing pain they did not want to experience? Pain is a part of life. It is experienced by women giving birth—
Guy Opperman
There is a great need for strong protections. Everybody accepts that. Not a single person disagrees with that, just as there is not a single person who does not wholeheartedly endorse the need for palliative care. However, that is not enough. I suggest that the principle of clear self-determination must be the core of any concept of human rights.
I am a huge supporter of palliative care, like all other Members. I pray in aid the Charlotte Straker home and the Tynedale hospice in my constituency. If I need to declare an interest, it is that I have raised considerable sums for both those organisations.
I welcome many constituents of mine who have come from Northumberland today. Many of them were friends of Geraldine McClelland, the former BBC TV producer and founding member of Newcastle’s Live theatre, who took her life at Dignitas last December following an unsuccessful battle with cancer. Her letter has already been read out. Her good friend Nick Ross, the “Crimewatch” presenter, said:
“Gerry had to abandon her home and be driven across Europe…to end her life in a light commercial estate in an impersonal Swiss suburb.”
He continued:
“It sometimes seems that each concession to freedom in this country has had to be dragged out of a reluctant and controlling instinct that someone else knows best.”
I endorse entirely those remarks and urge the House to address the issue that dare not speak its name, which is that we need to consult properly about assisted suicide. I will of course support the amendment tabled by my hon. Friend the Member for Congleton (Fiona Bruce) and the motion moved by my hon. Friend the Member for Croydon South (Richard Ottaway), but in the longer term, the matter will not go away.
Dame Joan Ruddock
The hon. Gentleman said that he would support the motion and amendment (b), on palliative care, as I will. He did not mention my amendment (a), but I think it may be of use to the House if I say that I and the other Members who have spoken in favour of it have come to the conclusion that it might be in the best interests of the House if it were not pressed. Some will undoubtedly regret that, but I hope he agrees that it is an appropriate course to take in the spirit of the debate.
Guy Opperman
That is very helpful, because we would all concede that a consultation on putting in statutory guidelines what is already in guidance from the DPP, who has done an excellent job and whom we should all thank for his tremendous efforts, is not necessarily the way forward for long-term consultation on assisted suicide.
To enable others to get in, I will try to draw my comments to a close. Many people do not have self-determination, because of their disability and illness, and such people need help to escape from their imprisonment. They want to know that individual friends and family will not be prosecuted. The Solicitor-General said in reply to me that guidance could change as public opinion altered, but he refused a consultation on this particular issue. He will need to revisit whether to consult on assisted suicide, because we need to be brave. The issue will not go away, and the likes of Geraldine McClelland and the amazing Melanie Reid, about whom we all read on Saturdays in The Times with ever-increasing incredulity at her great efforts, have shown us why the law must change. Our life belongs to each and every one of us, and that must be enshrined in law.