Assisted Dying (No. 2) Bill

Nadine Dorries Excerpts

Friday 11th September 2015 Commons Chamber

[Rob Marris]

My hon. Friend knows the constitution of our country. If someone wants to change the law in another way, they will have to have the guts to introduce another Bill to this House.

[Nadine Dorries (Mid Bedfordshire) (Con)]

Will the hon. Gentleman give way?

[Rob Marris]

I will not; I must make some progress. I am conscious of the time.

I appreciate that in England and Wales the medical profession is divided on the Bill, and that, probably, the majority are against. However, as far as one can tell, there is a significant minority who are in favour of the Bill, some of them, one suspects—this is what polling indicates—because they would themselves like to have the proposed option were they terminally ill. There is no contradiction between what is proposed in the Bill and having widespread high-quality palliative care. It is not a contradiction; it is not a question of one or the other. A minority of patients’ needs cannot be met through palliative care. Despite the best efforts of palliative care from professionals, those patients keep suffering.

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[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—

--- Later in debate ---

[Nadine Dorries (Mid Bedfordshire) (Con)]

It is a privilege to follow the hon. and learned Member for Holborn and St Pancras (Keir Starmer). I would have liked to have intervened on his speech, because cases such as those of Nicklinson and Purdy, which he highlighted, are not covered by this Bill. Locked-in syndrome, in which the person is paralysed except for movement of the head and the eyes, has no six-month limit. This Bill applies to people who are terminally ill and will die anyway within a six-month period. Neither of the cases that the hon. and learned Gentleman highlighted falls into that category.

I met a neurologist earlier this week who told me of a skiing accident he had had. He said, “Of course, the one thing all we neurologists fear is locked-in syndrome,” and that was what he feared from his head injury. I told him, “But this Bill wouldn’t apply to you.” I asked him for how long people with locked-in syndrome can live. He replied, “30 or 40 years—that’s why we fear it.” What doctor can tell someone with locked-in syndrome, “You have six months”? They cannot.

One of the issues with the Bill that has really bothered me is the conflation of those illnesses, conditions and diseases it can cover and those it cannot. I have heard locked-in syndrome mentioned many times. Motor neurone disease is another illness on which a six-month time limit cannot be put. We always quote Stephen Hawking, who is an ambassador and is still alive many years later. Who would have put six months on his life at any time? People keep mentioning illnesses such as motor neurone disease and locked-in syndrome, but this Bill does not apply to them. We must not conflate them and what the Bill covers.

[Robert Flello (Stoke-on-Trent South) (Lab)]

rose—

[Simon Hoare]

rose—

[Nadine Dorries]

I am not going to take any interventions, because so many people are waiting to speak.

In the 1980s, as a nurse, I had the privilege or the honour—I do not know the right word to use—to hold the hand of a young gay man when he was given a diagnosis of AIDS. It was not HIV, but AIDS—he was in a very bad way. He was given not six months, but 12 weeks. He is still alive today, as are so many of the other young men and women who were diagnosed at that time with HIV and AIDS and given fewer than six months to live.

Medical research ran ahead and found treatments for them to hold on to their lives for longer while even better treatments were developed. That race is still in progress: treatments are still being developed. We have now reached the point where somebody diagnosed with AIDS is far more likely to die of something else, but we would never have thought that in the 1980s. Many people present are probably thinking, “But this isn’t the 1980s,” but we did not know that AIDS was going to arrive in the 1980s and we do not know what is down the road, what new viral disease will land—it will probably be a virus, given the information we have—and what the AIDS of tomorrow will be. Six-month prognoses worry me, because no doctor can predict a life expectancy of six months.

I will use a personal case. Last August one of my closest friends visited her consultant after a series of tests had been ordered by her GP. At that meeting with the consultant, she was given 14 days to live. That was an accurate prognosis—it was accurate because it was 14 days. She went home, we got into bed and I spent 14 days on her bed. Her death was painless and peaceful; it was not for everybody around her, but it was for her, and those last 14 days were wonderful, until the very end when she was fast asleep and unaware. That is the beauty of palliative care today: no one needs to die a painful death. The combination of drugs that are administered to people in their final days ensures that they do not suffer pain.

The poison administered when someone makes the choice to take their own life, however, is not pleasant. They do not swallow a concoction of drugs and fall asleep. It is not a nice end. It is certainly not peaceful. They choke. It is not a good death. To people who argue that it is a good death, I say that it is not: it is painful and barbaric to die in that way.

I listened to the head of the hospice movement on Radio 4 this morning and I know of the fears and have read all the emails from people representing the hospice movement in my constituency. The hospice movement has very rightly highlighted that the pressure on people in hospices will shift over a period of time.

I want to make a final point. There are people all over the country who do not have a family member or relative as their next of kin. They do not have loved ones. For them, the next of kin is the state. It sends a shiver of fear down my spine to think that such a Bill might be legislated for and approved when so many people who are protected by the law may not have such protection in future because their next of kin is the state. When they feel that they are a burden or they feel under pressure, who will coerce them and who will feel the budgetary constraints involved in looking after them? I will end with that concern.