Assisted Dying (No. 2) Bill

Keir Starmer Excerpts

Friday 11th September 2015 Commons Chamber

[Keir Starmer (Holborn and St Pancras) (Lab)]

May I lay out for the House the history of the guidelines that I issued and my experience in operating them? I am well aware of the deeply held views on all sides, and very respectful of them, as I have been throughout the past seven years. I will therefore attempt this exercise as a factual chronology objectively stated so that people can see the conclusions that I have reached.

I was six weeks into my post as Director of Public Prosecutions when I had to decide whether to prosecute the mother and father of Dan James, a young and very gifted rugby player who was paralysed after an accident on the rugby pitch in Nuneaton and wished to end his life. He did not want to die alone and persuaded his parents to go with him to Dignitas. When they came back, they were arrested and interviewed, and I had to decide whether they would be prosecuted. I decided that they should not be prosecuted.

[John Pugh]

Will the hon. and learned Gentleman give way?

[Keir Starmer]

I would prefer it if the House allowed me just to lay out the history so that everybody can understand it. I will of course try to take on board all the points that are being made.

I took it to be the compassionate act of a loved one, and using the exercise that the DPP had, decided not to prosecute.

A courageous woman with multiple sclerosis, Debbie Purdy, was in the process of bringing a case against the DPP in our courts. It started as a case against my predecessor, but became a case against me, and it was reaching the final stages. She noticed the reasons that I had given, and she argued before the House of Lords judicial committee that the DPP should be required to set out in guidance the approach that was being taken, and would be taken, to assisted suicide.

[John Pugh]

Will the hon. and learned Gentleman give way?

[Keir Starmer]

For the reasons I have given, I genuinely think it may be more helpful for the House if I just completed the exercise. I am deliberately trying not to put my views into this chronology so that people can simply see it for what it is, whatever view they take.

Debbie Purdy persuaded the committee that I should be required to produce guidelines. In the last judgment of the House of Lords judicial committee before it became the Supreme Court on the other side of Parliament Square, it ordered that I should do so. I was, of course, at that stage deeply aware of the views that were held on all sides, and I decided that a very wide public consultation was necessary so that the guidelines would be as fully informed as they possibly could be. I decided also to issue interim guidelines so that people could see the words on the page of the guidelines before the consultation exercise started, and so that it would be a meaningful consultation rather than one where views would be expressed in the abstract but without a real, detailed eye on what I was proposing.

The interim guidelines were underpinned by two principles. The first was that the criminal law should rarely, if ever, be used against those who compassionately assist loved ones to die at their request, so long as that person had reached a voluntary, clear, settled and informed decision to end their life. The second was that very strong safeguards are needed to protect those who might be pressurised in any number of subtle ways. Those who encourage the death of the vulnerable should feel the full force of the law.

The response to that consultation exercise was huge. Most criminal justice consultation exercises have responses numbered in the low hundreds; the response to my consultation exercise was nearly 5,000, and that is treating all the heads of faiths as one respondee when, in truth, they were responding on behalf of very many within their communities. It was probably the widest consultation on this particular area of our law ever conducted. It included, as one would expect, members of the public, doctors, other healthcare professionals, representatives of all faith groups, judges, public servants, Members of this House and Members of the House of Lords. In the course of that exercise, I personally met many who were most concerned about the guidelines.

There was overwhelming support for the interim guidelines that I had published and the two principles that underpinned them: compassionate assistance to those who are clear they want to end their lives, yes; pressurising the vulnerable, no. Accordingly, when I issued the final guidance that is still in force, I adopted the same two underpinning principles. They have now been used for five years. I personally oversaw about 80 cases, looking at the details in each of the files, and made decisions in 79 of those cases that no prosecution should be brought, and there was no clamour to change the guidelines.

Throughout the process, I thought long and hard about the position of doctors and health professionals, and whether their acts of assistance should come within the guidelines, in favour of prosecution or against. I took the view then, and I still hold the view now, that if the DPP indicated that doctors or medical professionals were unlikely to be prosecuted for assisting, that would undermine the intention of Parliament when it passed the Suicide Act 1961. I took the view that Parliament was not prepared to go that far when it passed that Act, and that the DPP should not, by the back door, as it were, indicate in the guidance that doctors and health professionals would be unlikely to be prosecuted if they assisted. Therefore, in the guidelines, when they were first drafted and as they are now, a factor making it more likely that someone will be prosecuted is that they are a doctor or a health professional assisting someone.

That particular issue came to a head in the Tony Nicklinson case, which went to the Supreme Court recently. Tony Nicklinson, as many people in this House will know, suffered a series of strokes and became completely paralysed save that he could move his head and eyes. Because of his paralysed state, he could not carry out his wish to end his life without assistance. He applied to the High Court for an order—a declaration—that he be permitted a doctor to assist him in his death. When he lost his case in the High Court at the first stage, Mr Nicklinson embarked on the difficult and painful course of self-starvation, refusing nutrition, fluids and medical treatment. His case proceeded to the Supreme Court, as everybody here knows, and in June 2012 the majority held that there was an incompatibility between our current position and fundamental human rights, but because of the margin of appreciation they should not themselves make a declaration to that effect but leave it to Parliament to further consider the issue, and today is that opportunity.

[Nadine Dorries]

rose—

[James Berry (Kingston and Surbiton) (Con)]

rose—

[Keir Starmer]

I do just want to complete this exercise—

[Several hon. Members]

rose—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. The hon. and learned Gentleman is not giving way.

[Keir Starmer]

I hope that I have been faithful to my obligation to try to put this in a neutral, objective way, setting out the position.

As Director of Public Prosecutions I never expressed a view on the law; I faithfully applied the law. I have come to the position I now hold on the basis of my experience of the guidelines. It was not a pre-conceived view that I held back then, in answer to a comment that was made earlier; it is a view that I have arrived at on the basis of my experience.

My experience is that there are two inherent limitations in the guidelines that I issued. For the reasons I have explained, my understanding of the constitutional role of the DPP was that doctors and medical practitioners are more likely to be prosecuted. The first limitation is that, as a result, those who have reached a voluntary, clear, settled and informed decision to end their lives can now be confident of the compassionate assistance of loved ones without exposing them to the law, but they cannot have the assistance of professionals. They can have amateur assistance from nearest and dearest, but they cannot have professional help in fulfilling their desire unless they have the means and the physical ability to get to Dignitas. One of the points that Debbie Purdy made to the judicial committee was that she wanted to live her life for as long as possible, although she wanted to end it at her own choosing, and that if she was forced to go to Dignitas she would have to end her life earlier because she would lose the physical means of getting there.

I understand those who say that we should revert to a position where nobody should be given any assistance at all, but we have arrived at a position where compassionate, amateur assistance from nearest and dearest is accepted but professional medical assistance is not, unless someone has the means and physical assistance to get to Dignitas. That to my mind is an injustice that we have trapped within our current arrangement.

On the second limitation in my guidelines, the only safeguard I could put into them was a requirement for an after-the-event investigation by the police into what had happened. Let me quote what the president of the Supreme Court said when he analysed that. This is what our most senior judge—not me—said:

“A system whereby a judge or other independent assessor is satisfied in advance that someone has a voluntary, clear, settled and informed wish to die and for his or her suicide then to be organised in an open and professional way would…provide greater and more satisfactory protection for the vulnerable, than a system which involves a lawyer from the DPP’s office inquiring, after the event, whether the person who had killed himself or herself had such a wish”.

I have heard the comments about the safeguards in the Bill and I know how hard it was to come up with the right safeguards in my guidelines. It took me time to arrive at safeguards that I think could be generally accepted.

[Mr Nigel Evans (Ribble Valley) (Con)]

On a point of order, Madam Deputy Speaker. At the beginning of this sitting, we were told that 85 Members had put in to speak and we were given guidance on how long our speeches should be. I fully appreciate that the current speaker is making a valuable contribution, but please could you remind the House yet again of the time limit you think people should adhere to without a compulsory time limit having to be set? [Interruption.]

--- Later in debate ---

[Madam Deputy Speaker]

Order. That is not a point of order. We are not wasting time this morning on points of order. There are many people who wish to speak.

[Keir Starmer]

Thank you, Madam Deputy Speaker. I will finish as quickly as I can. I understand the frustration of Members who are waiting to speak.

It took me a great deal of time and thought to arrive at appropriate safeguards in the guidelines. In my view the same amount of time and appropriate thought is necessary for the guidelines in the Bill. They have been discussed by others, so I will not repeat them, but what I will say is that I will be open to debate with anyone whether the safeguards are strong and robust enough, and I will work at Committee stage with anyone in this House to make sure not only that they are as strong and robust as possible, but that they have the best consensus possible among the different views held in this House.