Assisted Suicide

Naomi Long Excerpts

Tuesday 27th March 2012 Commons Chamber

[Mark Menzies (Fylde) (Con)]

I did not originally plan to take part in today’s debate, but such is the range of emotion and also the quality of some of the contributions that many hon. Members have made—in the columns of the press and in debate—I felt it important to make a contribution. I am not someone who has ever worked closely with the hospice movement, but I appreciate the work that it puts in. That is why I was heartened to see the amendment tabled by my hon. Friend the Member for Congleton (Fiona Bruce).

Palliative care should not just be an option when it comes to the decision to seek assisted dying. Instead, it must be at the heart of how we look after those who are nearing the end of their lives. In Fylde, we have several nursing homes that adopt what they refer to as the golden pathway. Every time I visit I leave feeling distressed, having seen people who are clearly getting to the end of their lives, some of whom do not have the benefit of loved ones to take care of them. However, they receive the highest level of nursing care possible in that environment to ensure that when they do leave this earth, they do so with as much dignity and as little pain as possible.

Anyone who knows someone in the harrowing situation of facing terminal illness, which—as we know—can come in many forms, knows that it is important that such care is available in whatever form we can give it. That should be not just through the work of the hospice movement, excellent as it is, but through care in the community and allowing people, where at all possible, to live in their home and to die with dignity in as pain-free and comfortable a way possible.

[Naomi Long (Belfast East) (Alliance)]

I had the privilege of nursing my mother at home with the help of Marie Curie and the Macmillan nurse service. Two weeks before she died, there was still dispute among her medical team as to whether her condition was terminal. Some people have made the point that this applies only at the end of life, but who can determine the end of life?

[Mark Menzies]

The hon. Lady makes a very important point and, when she was nursing her mother and was in a state of distress, the last thing she needed was the pressure and the uncertainty of questions about whether it was the end of life or something else. Every step of the way, we have to ensure that the care that is provided is of the highest quality, especially for those people whom we think may be entering the end of life. I commend the hon. Lady on the care that she gave to her mother.

I also ask that when we think of palliative care, we also think of the carers. Some people have a relative or loved one in a hospice, for example, and want to visit as often as possible, sometimes more than once a day, but they are trying to juggle family commitments, looking after children or other dependent relatives, and trying to hold down a job. When we consider amendment (b) we should think not only of those reaching end of life, but of those caring for them.

We also have to recognise the work that doctors do, and I know that many hon. Members who have been in the medical profession have reservations about anything that looks as though it moves us closer to assisted dying, because they do not want doctors to have the pressure and burden of being the person who instigates the act of bringing someone a step closer to death.

Many other right hon. and hon. Members wish to speak and I do not wish to take any more time, other than to say that I am very proud to be a signatory to amendment (b). I will continue to listen to the debate and I may well support amendment (c), but I cannot support the amendment tabled by the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock).

--- Later in debate ---

[Mr Leigh]

I recognise that point of view and that is why, although I have expressed myself so far, some would say, with too much moral certainty, I realise that we are in a moral maze here. It is not for us to lecture people on what they may or may not do at the end. That is why the guidelines are a fair compromise. I do not think anybody wants to prosecute and send to jail somebody who acts out of the depth of love and compassion when they are faced with a close relative who is suffering. Nobody wants such a person to be sent to prison if they assist their loved one out of this life.

We have a compromise, but it is not legalised euthanasia. I tabled an amendment, which was not selected. Why should it have been? I wanted to express the point of view that the House of Commons must firmly and unequivocally state, as it has done up to now, that for the absolute avoidance of doubt, it is opposed to voluntary euthanasia. There is a world of difference between the desperate situation in which a relative helps somebody out of this world, and a situation where a doctor, as part of the legal process, kills somebody. That is what so many of us on this side of the argument believe so passionately. It might be a cliché to talk in terms of slippery slopes, but it is there in Holland and in Oregon—in only about six jurisdictions throughout the world. We do not want this country to embark on this road.

I was with my best friend, a former Member of this House, Piers Merchant, as he lay dying. He was riddled with cancer, in great pain, and I was with him as he was dying. He was filled with morphine. I could see the morphine going through his body all the time. He was no doubt killed by the morphine, not by the cancer, and I respected that judgment. He was in a wonderful, caring hospice. Everybody was looking after him and everybody was loving him. At the end of the day his doctors, I suppose, killed him because the pain would have been unendurable, but that is not legalised euthanasia. That is allowing doctors to take an informed decision on the basis of what they know to be right.

[Naomi Long]

Does the hon. Gentleman agree that there is a subtle but important distinction between treatment that is administered by a doctor in order to ease pain which, as a side effect, may hasten death, and a doctor setting out to hasten death?

[Mr Leigh]

That is the point that I am trying to make, and that is the absolute principle that I hope this debate will proclaim. We want the law to recognise the appalling moral difficulties that people face. None of us in the Chamber speaking in this debate has yet embarked on that journey. We all will. That is the only thing we know with absolute certainty. There will come a moment when we are dying, in pain, and those around us have to make appallingly difficult decisions.

I want to live in a country where there is a moral assumption that although, at the end of the day, my passage into the next world might have to be eased, and the easing might be the killing of me, that decision will be taken in the final analysis by doctors who are simply trying to relieve pain, who have recognised that I am dying and who do not accept the principle that the state, the law, doctors or even relations have a right to come to an individual and say before their time is up, “Yes, you are a burden on society. Yes, you must go.” That is a moral principle, that is what the debate is about, and that is what we must abide by.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I support the amendment tabled by the hon. Member for Congleton (Fiona Bruce) and congratulate her on bringing it to the House for consideration today. The topic is a very emotive one and I will not pretend that it is ever an easy situation for people to live through, but I was taught that not every right decision is an easy decision. We have to make right decisions sometimes that are not easy ones. Today we are tasked to take a moral stand for people who are very ill and in more pain than many of us can even begin to imagine. We in this House are commissioned to look at the bigger picture.

The law is far more than an enabler of prosecutions and convictions. It is also a symbolic system and an indication that we are protecting people. That is what we will be doing here today, legislatively in this House. The BMA has said:

“Doctors have a duty to try to provide patients with as peaceful and dignified a death as possible but the BMA considers it contrary to a doctor’s role to hasten death deliberately or assist in a suicide, even at the patient’s request.”

The first precept in the physician code is “First, do no harm.” This should also be the first section in the parliamentarian handbook. The Hippocratic oath includes the affirmation,

“I will give no deadly medicine to anyone if asked, nor suggest such counsel”.

That is crystal clear.

I read an interesting article by a doctor recently. He wrote that

“a woman in her 40s with advanced multiple sclerosis, no longer able to speak, and completely dependent on family and carers for all her activities of daily living was regularly admitted to hospital with chest infections, and on this occasion had been admitted with pneumonia that was not responding to antibiotics. Her husband said 'she would never have wanted to be like this'. The palliative care team were called to provide specialist care and advice for what was likely to be the last days of Alice’s life. Against all odds, Alice pulled through and left hospital.”

Her husband met the doctor afterwards and said that the involvement of the palliative care team meant that she and her family had received specialist care and support in the community. The doctor continued:

“This goes to the heart of the debate about assisted suicide. I have sometimes wanted to have done things a little differently, to help my patients with the benefit of hindsight. With assisted suicide, death is final. No changing of decisions—and the potential for a lifetime of guilt and regret.”

I do not believe that anyone could be so callous as to judge those who come to the end of their tether and cannot bear to suffer or see their loved ones suffer, but by the same token it is my belief that the state cannot interfere and decide when and if it is okay to end someone’s life.

[Naomi Long]

Several hon. Members have talked about the difficult decisions that people may face and the fact that if they choose to end their life, they should be enabled to do so. Is the difficulty not that if we accept that premise we must go on to the people who do not have family support to make that decision, so it ends up being the doctors and nurses—the people who are relied on for care—who have to make that intervention? Surely that is a step too far for even the most compassionate.

[Jim Shannon]

I thank the hon. Lady for her wise words, with which I fully agree.

When I was at school, history was one of my favourite subjects. The history of pre-war and wartime Germany shows a clear policy—when people were old and infirm, they just got rid of them. I am not saying for one second that that would ever happen here, but when legal abortion was introduced—as the hon. Member for Isle of Wight (Mr Turner) said—it was never thought that 189,574 abortions would be carried out in one year, 2010, in England and Wales. That is a fact. Things escalate as time progresses and my greatest fear is that people would begin to think that rather than cause their family pain, they should end their own life or have someone do that when there could still be hope of recovery or a good quality of life.

My brother was a motorbike man, and he raced bikes. He came off and was seriously injured. He was in a coma for 19 weeks and a machine kept him alive. The prayers of Gods’ people, the skills of the surgeon and the palliative care given kept him alive. He does not have full capacity, he cannot ride a bike—which he would love to do—drive a car or work, but he is at home and can interact with his family.

Macmillan, Marie Curie and Northern Ireland Hospice were all very active in delivering palliative care for my brother—and do so for others as well. I have been contacted by Care Not Killing and read through much of its information which struck a chord with me. The European Association for Palliative Care has affirmed that assisted suicide is extremely rare when patients’ physical, social, psychological and spiritual needs are properly met. It says that the vast majority of people dying in the UK, even from diseases such as motor neurone disease, do not want assisted dying. The 1,000 MND patients who die annually in the UK do so, in the main, comfortably and with good palliative care. A good friend of mine is dying. I have known him for many years, and I am well aware of the palliative care that he is getting.

Our key priority should be to build on the excellent tradition of palliative care in this country and to make the best-quality palliative care more readily accessible. Given the choice, most people would prefer to die at home. By 2020, over-50s will comprise half the adult population, so it is essential that we rethink current service provision and end-of-life care to ensure that it can meet the demands of an ageing population. In 1994, the last House of Lords Select Committee to report on euthanasia unanimously recommended no change at all. Its chairman later said that

“any liberalisation of the law in the United Kingdom could not be abused. We were also concerned that vulnerable people - the elderly, lonely, sick or distressed - would feel pressure, whether real or imagined, to request early death.”

It has been said that hard cases make bad laws, and no law allowing assisted dying could ever be controlled. I fully agree with that and urge the House to support the amendment tabled by the hon. Member for Congleton. I understand the emotions around the subject, but I cannot support the introduction of a law that will continually evolve and could leave our elderly and infirm working out the sums to see if the cost of the care justifies the continuance of their life. Some may say that will never happen. I say we have to keep the legislation as it is to ensure that it never does.