Nick Boles
Main Page: Nick Boles (Independent - Grantham and Stamford)Department Debates - View all Nick Boles's debates with the Ministry of Justice
Assisted Dying
Nick Boles Excerpts(4 years, 9 months ago)
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Nick Boles (Grantham and Stamford) (Ind)
I beg to move,
That this House has considered the functioning of the existing law relating to assisted dying.
Six years ago this week, on a sunny July day like today, my father made a decision. At home in Devon, in the bed that he shared with my stepmother for more than 30 years, with his family around him, he took communion for the last time, said a few words of goodbye to each of us, and asked the district nurses to switch off the oxygen and make him comfortable. He could have clung on to life for several more days, but he was ready to go and, after talking it over with my stepmother, made his decision. A few hours later, he slipped away, with my brother by his side. This was the best of deaths: the saddest moments in our lives, filled with love and gratitude, and even joy.
A few months ago, Geoff Whaley made a similar decision. Cut from the same cloth as my dad, he was a gentleman of the old school, but Geoff had motor neurone disease and recognised that he was likely to suffer horribly in the final days and weeks of his life. He knew that his only chance of a good death was to arrange to go to Dignitas in Switzerland. Geoff was a determined and organised man, but there were some things that he physically could not do. He needed his wife Ann’s help. When someone tipped off social services about their plan, the police turned up at the Whaleys’ door and Ann was interviewed under caution. That caution remains on her record.
Thanks to the support of Ann and their daughter Sarah, Geoff died on his own terms, but several months earlier than he would have needed to had the same procedure been available here in the UK. Under Swiss law, none of the family was allowed to be present at his cremation. Yet Ann would describe herself as one of the lucky ones, because she and Geoff could afford the cost—the air fares, the hotels and the fees—of going to Dignitas. Every year, hundreds of other people in our country face the prospect of great suffering at the end of a terminal illness—suffering that cannot be alleviated by our wonderful palliative care nurses—and have no legal means of doing anything to stop it.
Susan Elan Jones (Clwyd South) (Lab)
I am most grateful to the hon. Gentleman for giving way during what is a heartfelt speech, but will he please answer the question of why he feels that the vast majority of disability organisations in this country remain opposed to assisted dying?
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
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.
Several hon. Members rose—
Kate Green
I am very grateful to the hon. Gentleman. I thank him for the case that he is making. I support it, but I, too, recognise what a very difficult and sensitive issue this is.
In relation to disabled people and the concerns to which my hon. Friend the Member for Clwyd South (Susan Elan Jones) rightly alluded, it is true that most disability organisations—perhaps all that I have spoken to—oppose the legislation that the hon. Gentleman and I would like to see, but that is not true of every individual disabled person, and we should acknowledge that. Is it not the case therefore that what we need to ensure is that we build into any legislation excellent regulation, excellent audit and an equal commitment to investment in assisted living alongside the investment in assisted dying?
Nick Boles
I could not agree more with the hon. Lady. The truth is that this is not in any way an alternative to the best possible palliative care; it is a complement to the best possible palliative care. We want to ensure that all those who want to choose to live out their lives and die naturally—even through a horrific illness with horrific symptoms—are given every support to be able to make that decision. Unfortunately, we also know—and all the evidence suggests this—that there are some people for whom palliative care cannot help in those final moments, and it is of them that I am thinking.
What do we think of a law that criminalises otherwise law-abiding people, such as Ann Whaley, who are simply trying to act with love in accordance with their marriage vows and their conscience? What do we think of a law that forces people in the final months of a terminal illness to take desperate and even dangerous steps, which may cause even more suffering to themselves and to the people whom they love, in secret and without any safeguards or support? What do we think of a law that denies hundreds of innocent people dignity and control as their lives draw to a close and condemns them to extreme suffering instead? I will tell you what I think, Madam Deputy Speaker: it is a bad law and it should be changed.
However, the purpose of today’s debate is not to propose a new law on assisted dying, but to understand the effect of the current law on people suffering from terminal illnesses, on their families, on the doctors, nurses and carers looking after them, and on social workers and the police. It is only when we have fully understood all the different ways in which the current law impacts on the British people that we should consider returning to the question, last debated in 2015, of what kind of change in the law might be justified.
To that end, I have a request for my hon. Friend the Minister. We all understand and accept that laws such as these are matters of conscience and that it is for Parliament to initiate a change of the law, but Parliament’s ability to gather evidence is very limited. On behalf of those affected by such laws, and in honour of Geoff and Ann Whaley, I ask the Lord Chancellor and his boss, the Secretary of State for Justice, to initiate a formal call for evidence on the impact of our existing laws on assisted dying, so that Parliament can benefit from a comprehensive assessment of the facts when it next decides to debate and vote on a possible change in the law.
Sir Bernard Jenkin (Harwich and North Essex) (Con)
I am most grateful to the hon. Gentleman for giving way. I came into the Chamber in 2015 fully intending to vote for a change in the law. However, as I listened to the debate, although I was completely persuaded by the points that he is now making, I was unpersuaded that that was the right law or that the right people had been persuaded that it was the right law. What has changed between then and now that he thinks would bring the House to a different conclusion?
Nick Boles
I do not think that I have ever had a more intelligent set of interventions, so I thank the hon. Gentleman for another one. There has been change, but I do not want to pretend that the change has gone far enough, which is why we are not proposing, at this point, to bring forward a new set of legal measures.
Perhaps the most significant change is in the opinion of the medical profession. We have seen a number of royal colleges move from having a formal position of opposing assisted dying to having a position of being neutral about it, which reflects the fact that they will always have some members who are very much opposed to it, but they now have an increasing number of physicians who are in favour of it.
We have seen not so much a change as a consolidation of public opinion on this issue. In the latest opinion poll, which, frankly, is not very different from any of the opinion polls over the past couple of years, more than 80% of the British public support an assisted dying law for people in the final six months of a terminal illness, and well over 50% of people who declare that they have an active faith take that view. So although Church leaders, apart from the very honourable exception of the former Archbishop of Canterbury George Carey, are opposed, their flocks are actually finding that they, too, believe that a change in the law is justified.
I also agree with the hon. Gentleman that, before any further proposals come forward, we should study closely the experience in the state of Victoria in Australia, for example. As he will be aware, New Zealand recently passed on Second Reading an assisted dying law, and there is the much longer standing experience of Oregon as well as Canada more recently. We should study all those and look at the precise legal and medical safeguards used to try to devise something that avoids many of the risks that have been raised by other hon. Members.
Sir Peter Bottomley
I am grateful to the hon. Gentleman for his response to my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin). In the Netherlands, the number of physician-assisted deaths is 3.5%, which, in this country, would translate into 21,000 deaths a year. There are about 5,000 suicides a year in this country, of which about 400 are estimated to be people dying at their own hand because they have a terminal illness that they do not want to live with. How can one explain to anyone else the difference between that 300 or 400 and 21,000, which is four times the number of suicides that we have at the moment?
Nick Boles
I am grateful to the hon. Gentleman for raising that point, because it allows me to point out that the Netherlands law is a completely different law, and I would vote against it if anyone proposed it in the House of Commons. It is a law to enable people to commit suicide more or less whenever they want. That may work for the Dutch—I have nothing but respect for the Dutch people—but I could not vote for it, and I do not believe that it would get more than 100 votes in this House.
What we are proposing is something that has existed in the state of Oregon in the United States for 20 years, and it has never crept anywhere near being the kind of law that the hon. Gentleman is talking about. Yes, of course, there will be much more lax and liberal laws of assisted suicide in other jurisdictions. That is of no relevance at all to the question of whether, in the final six months of a terminal illness, a narrow assisted dying law, with legal and medical safeguards, can operate safely in the United Kingdom, as it does in Canada and in the state of Oregon. I am entirely confident that it can.
Jim Fitzpatrick (Poplar and Limehouse) (Lab)
Will the hon. Gentleman give way?
Nick Boles
I must wind up, because Madam Deputy Speaker has pointed out that there are many, many Members who wish to speak.
I am keen to hear from as many Members as possible during this debate. I will listen to all contributions with sincere respect, because this is a very difficult issue and one on which I myself have changed my mind since 2015. Before I sit down, I would just like to say a word on the role of religious faith in the debate about assisted dying.
I admire people who are blessed with religious belief. My own father was, and I envied him. Faith groups play a very positive role in our society and I salute them for it, but this country is a democracy, not a theocracy. When we make our laws, we must focus on men and women, not on God. Parliament was right to legislate to allow abortion for women in the early months of a pregnancy, despite the opposition of Church leaders. Parliament was right to legislate to extend the institution of marriage to gay people although most organised religions still consider homosexuality a sin. When Parliament next debates the reform of our laws on assisted dying, I hope that it is not religious doctrine, but humanity—our humanity as Members of Parliament and the humanity of all those suffering from terminal illnesses—that wins the day.
Several hon. Members rose—
Fiona Bruce (Congleton) (Con)
Let us look at some of the reasons given by those advocating a change in this law. They say the current law is not working and point to cases such as that of Ann Whaley—a case surely deserving of our compassion, but one that contradicts their arguments for change. It shows that our current law is working.
No prosecution was proceeded with in Ann’s case. I understand how unpleasant it must have been for her to be interviewed under caution, but the CPS approaches such cases on the basis that if someone is in some way involved with the suicide of another person, yet has compassionate rather than self-interested motives, it is highly unlikely that they will be taken to court. Indeed, there have been only three successful such prosecutions in England and Wales in the last 10 years, and during that period just 148 cases were referred to the CPS.
The small number of cases and rarity of prosecutions indicate that our law is an effective deterrent to those with malicious or self-interested motives and protects against the very real danger of the abuse of the disabled, sick, frail or elderly and the danger that they could feel pressured into ending their own lives.
Why change this? Proponents of change argue, as we have heard from the hon. Member for Grantham and Stamford (Nick Boles), for a very focused, very limited, legal change on assisted dying, but it would not stop there.
Fiona Bruce
In fact, that is not the case: in Oregon now there are clear public pressures for a widening of the law there.
Nick Boles
But the law has not changed in Oregon; it has remained exactly the same for 20 years.
Fiona Bruce
Let me turn then to the case of Canada, whose law in this area was also cited by the hon. Gentleman as an example we should follow. Just a few days ago, a clinical director from Canada came to this place and made a presentation. I was privileged enough to chair the meeting; it was called “ ‘Assisted dying’ in Canada? A cautionary tale.” To clarify, at about the same time as this House rejected assisted suicide here, in Canada there was a court case that decriminalised assisted suicide on the basis that it should be up to capable adults who clearly consent to the termination of life and are suffering intolerably from a grievous and irredeemable medical condition.
What the clinical director told us was startling. She told us of grave problems now being encountered in that country in connection with the practice of assisted suicide. She told us that in fact medical assistance in dying, or MAID as it is called there, involves in 99% of cases euthanasia, not assisted suicide. She told us of funding allocated to palliative care previously now being diverted for these purposes; of assessments being done on a very rudimentary basis, including even by telephone; of safeguards such as the 10-day reflection period being regularly shortened; and of MAID being used for non-terminal illnesses, even in a case of arthritis. There are now even proposals for it to be extended to so-called mature minors.
The suggested need for two clinicians to give consent is apparently being effectively flouted, too: all anyone has to do if they cannot find one of the clinicians from the first two approached to give consent is approach another and another until one who will give consent is obtained. Conscientious objection by practitioners is not statutorily provided for, so practitioners are feeling increasingly obligated to undertake this. In Canada the safeguards simply are not working, and I was interested to hear Baroness Meacher, the chair of Dignity in Dying, stand up at the end of that meeting and say, “We don’t want that in this country.”
Those advocating change argue that legal opinion has changed, but it has not. In the most recent court case—that of Noel Conway, who has been mentioned here today—arguments for a change in our current law were rejected not just by three judges of the divisional court, but by three judges of the Court of Appeal, and three judges of the Supreme Court, our highest court, then declined permission for a further appeal.
Advocates of change have wrongly and selectively argued that in a Reith lecture this year the former Justice of the Supreme Court, Lord Sumption, called for a change in this law. He did not. In fact, if his speech is read in context and comprehensively, it is clear that he said the very opposite. He did no more than state a fundamental principle of the criminal law—namely, that it is there to protect society by prohibiting acts regarded as unacceptable, and that one such act is encouraging or assisting suicide. He said that
“we need to have a law against it in order to prevent abuse”.
Yes, he referred to what he called the “untidy compromise”, which recognises that, as with other criminal laws, there can be exceptional circumstances where a person breaks the law for altruistic reasons, and that in such cases prosecution may not be warranted, but there is a world of difference between not prosecuting in such situations and licensing acts in advance.
Next, those arguing for change say that medical opinion is shifting. On what basis? A recent Royal College of Physicians poll of its members is mired in controversy. The RCP was, before the poll, opposed to any change in the law. However, this poll unprecedentedly required a super-majority of 60% of those voting to maintain the status quo. How strange! Bizarrely, the RCP’s council is now arguing that the result of this poll justifies a change in the college’s stance, despite the result of the poll showing that the highest number of those members voting—43.4%—opposed any change in the law and that the lowest number—25%—thought that the RCP should be neutral. Yet, strangely, the RCP has chosen to adopt a neutral stance. It is no wonder that the poll has been the subject of a referral to the Charity Commission for investigation. And for what? As Baroness Finlay said in another place, “neutrality adds nothing”. Let us also note that, within that vote, more than 80% of palliative care physicians wanted the RCP to remain opposed to change.
The fact that the British Medical Association and the Royal College of General Practitioners are set to consult their members is neither a surprise nor an indication of a change in their position. Professional membership consultations can be expected every few years. Indeed, the RCGP said five years ago that it would do this about now. It is to be hoped that both the BMA and the RCGP will reaffirm their opposition to any change in the law.
Finally, the proponents for change argue that public opinion is shifting, but it all depends on the question people are asked. That is the problem with the 80% figure that the hon. Member for Grantham and Stamford cited. The more deeply we probe this issue and the more aware people are of the implications of change, the more concerned people become. I can quote from another poll from February this year indicating that more than half the public say that
“some people would feel pressurised into accepting help to take their own life so as not to be a burden on others”
if assisted suicide were legal. Only 25% disagreed with that.
Nick Boles
I should like to thank you, Mr Deputy Speaker, and your colleague Deputy Speaker very much for chairing this debate so well. I should also like to thank all hon. Members for contributing to it so powerfully and persuasively. I would particularly like to thank Ann Whaley for attending the debate. She has inspired us all to be here, and, whatever arguments we have made, I know that we all think she is a truly marvellous woman. Her husband would be very proud of her today. I would also like to thank all the other family members and those suffering from terminal illnesses who have taken the trouble, at a time of great stress in their lives, to join us and to observe our debate.
I should like to end on this note. I have changed my mind about this issue. Many people have changed their minds about it, and I hope that more people will change their minds about it so that we can get on and change the law and make this country a more humane place for people to live and die.
Question put and agreed to.
Resolved,
That this House has considered the functioning of the existing law relating to assisted dying.