Assisted Dying

Lyn Brown Excerpts

Thursday 4th July 2019 Commons Chamber

[Nick Boles]

I thank the hon. Lady for her question. It is incredibly important to understand all the concerns raised, perhaps especially those from such groups. What I think drives that very understandable concern is the fear that although a law might start off tightly constrained, there will be what people refer to as “the slippery slope”, and it might then be abused somehow: there might be situations in which people come under pressure to take their own lives when, in fact, they do not want to do so at all.

All I would say to the hon. Lady—I am happy to have further conversations with her about this—is that in jurisdictions such as Oregon, where for 20 years now there has been a law of the kind that was proposed here, there is no evidence of that slippery slope argument leading to people being put under pressure. If ever there were to be such a change of the law here, it would of course be essential to have safeguards that would prevent that and ensure that disabled people knew they had the same right to life as any of us, for as long as they wanted.

[Lyn Brown (West Ham) (Lab)]

rose—

[Kate Green (Stretford and Urmston) (Lab)]

rose—

[Nick Boles]

I will give way to the hon. Member for West Ham (Lyn Brown) first.

[Lyn Brown]

This is an incredibly difficult debate for many of us; most of us will have personal stuff that informs our judgments about it. My mum died suddenly, riddled with cancer. I know that had this law been passed at that time, she would have spent her last months consumed by guilt and anxiety about when she should press that button. She would have worried about the pressure on me and my sister, about the cost of her care, and that people would have thought she was consuming resources that she should not consume. Sometimes when we have this debate, we do not consider collectively the pressure we would put on people by giving them that choice.

[Nick Boles]

The hon. Lady makes a very good point. All I would say is that the law could operate only with independent assessment—both by doctors and by a High Court judge, under the proposal in the most recent Bill—that would be clear that the person could not show any signs of coming to a decision under pressure or because they felt they were a burden.

Interestingly, talking to the Whaleys about Dignitas, I heard how the Dignitas doctors explained that if at any point Geoff had said anything like, “I think it is time to go. My family wants me to go; they are ready, we are here,” they would have sent them home. On no account would they allow somebody to go through with it if there was any indication that they might have changed their mind or that they might be prioritising other people’s feelings.

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[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.

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[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.

[Lyn Brown]

I am grateful to the hon. Gentleman for giving way because, counter to that, there is the issue of vulnerability, which we have not really come to in this debate. On Friday an elderly couple came to me, terrified for their daughter, who was in a very expensive care facility. Their grandsons, who they love dearly, wanted to take that woman out of that expensive care facility because it was costing too much of their inheritance. We cannot have this debate in a vacuum; we need to understand people’s vulnerabilities—the vulnerabilities of my constituents’ daughter, the vulnerabilities of my mum, and the vulnerabilities of the constituent of whom the hon. Member for Eddisbury (Antoinette Sandbach) spoke, who ended her life. We must understand that this issue is a reality, and not just dodge the subject.

[Martin Vickers]

I thank the hon. Lady for that intervention. As I mentioned earlier, every situation is different and I think the complexity of framing a law that covers everything is beyond us, to be honest.

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[Jeff Smith (Manchester, Withington) (Lab)]

I do not plan to take the full six minutes, not least because we have heard so many really eloquent and brilliant speeches today. I pay particular tribute to the hon. Member for Grantham and Stamford (Nick Boles) and to my hon. Friend the Member for Sheffield Central (Paul Blomfield) for their incredibly moving and powerful contributions.

I supported changing the law in 2015, and I would do so again. I pay tribute to the Members who came to this debate with an open mind and said that they have changed their minds for having the bravery and open-mindedness to do so. I still support changing the law because I believe that it is not working. I want to emphasise three areas where is not. First, there is the unfairness of the current situation. We have already heard that roughly one person a week goes to Switzerland. However, people go to Switzerland if they have the financial resource, practical resource, and, very often, emotional support to do so. We should not be condemning those without the financial resources to an end that is not of their choosing while other people can afford to go abroad. Even that, I would argue, would not be their first choice and is not the ideal situation, but at least they have the financial means and support to be able to make a choice of some kind. We should be giving that choice to everybody who needs it.

Secondly, the current law results in perverse outcomes. My hon. Friend the Member for Sheffield Central and the hon. Member for Eddisbury (Antoinette Sandbach) pointed out that it results in people dying sooner than they should. I am not going to repeat those remarks because they put it far better than I could. I pay tribute to them for their speeches.

Thirdly, I want to touch on the issue of palliative care. This debate is often framed as a choice between good palliative care and the right to choose how to die, but that should not be the case. Of course we need to invest in good palliative care—we need the best that we can get—but even with the best palliative care, we cannot stop all suffering at the end of life. A person should have the opportunity to choose their way of dying in addition to the availability of great palliative care.

I also want to respond briefly to three points from the debate. First, I agree very strongly with the hon. Member for Grantham and Stamford in his request for a call for evidence to study the experience of Oregon and Canada. I do not share the pessimism of others that we cannot frame legislation that works for the people who need it to work, and gathering that evidence and learning from those examples will, I believe, allow us to do so.

I strongly disagree with the hon. Member for Cleethorpes (Martin Vickers), who said that introducing assisted dying will lessen the value we put on human life. If we value human life and if we value people, we should allow them to live the life they choose, and that includes the death they choose.

My hon. Friend the Member for West Ham (Lyn Brown) quoted a statistic about the number of people in Oregon who gave being a burden as their reason for choosing assisted dying. That only tells part of the story, because people who request assisted dying in Oregon give several reasons—

[Lyn Brown]

It is Washington.

[Jeff Smith]

People in Oregon and Washington give several reasons. In both those states, the most frequently given reason for requesting to die—by over 90% of people—is a loss of autonomy. Being less able to enjoy life is chosen by around 88%, and a loss of dignity is chosen by around 74%. It is important to tell the whole story with the statistics.

[Lyn Brown]

I really regret not putting myself down to speak in the debate, because I think there is an absence of understanding about just how difficult it is for many people in this country and elsewhere to withstand the pressures of family who might feel that they are a burden. We are tripping gently into a hellish nightmare for many people. I urge my hon. Friend to listen properly to what people say.

[Jeff Smith]

I hear what my hon. Friend says, and I accept that there is real concern, but I think we can create a legislative framework that takes account of those concerns and allows safeguards to be put in place to ameliorate those concerns.

In the end, it comes down to one key question: if faced with a terminal illness and a painful end, would we want the death of our choosing for ourselves and for our family? If the answer is yes, as I believe it would be, we should allow that choice for everyone.