Assisted Dying

Paul Blomfield Excerpts

Monday 29th April 2024 Westminster Hall

[Paul Blomfield (Sheffield Central) (Lab)]

I have spoken in previous debates since 2012, the year after my father took his life alone and prematurely with terminal lung cancer. However, today’s debate is different, because I believe that we are finally on the brink of catching up with public opinion and bringing about law change—not in this Parliament, but in the next.

Since 2015, over a dozen jurisdictions around the world have introduced laws enabling choice at the end of life. Today, over 30 offer that choice, with protections, covering hundreds of millions of people. In the UK, the medical profession has dropped its opposition. Legislators in Scotland, Jersey and the Isle of Man are crafting laws that will give choice and protection. The Leader of the Opposition has committed to ensuring parliamentary time for proper consideration of a Bill in the next Parliament, and that commitment has been echoed by the Prime Minister. So law change will be debated soon, and we have the opportunity today to inform that debate to some degree. That is what the Health and Social Care Committee report did. I was pleased to be part of that report, and want to confine my remarks to it.

Our report starts by looking at the impact of the current law. So many of the 68,000 submissions we received set out powerfully how the current law is failing people, forcing loved ones with a terminal diagnosis to plan their death secretly and take their lives alone, often violently. I do understand why debate focuses on the consequences of change, but the evidence that we heard underlines the consequences of leaving the law unchanged. It forces those who wish not to end their lives but to shorten their deaths to act while they have the capacity, and too many die too soon.

Our report drew heavily on the practical experience of jurisdictions that have legalised assisted dying. They take two routes, one based on terminal illness and the other on adding wider criteria, such as intolerable suffering. My remarks are based on those opting for terminal illness alone, because it is the approach of most countries and of previous legislation proposed here—and, I am sure, of the legislation that will be proposed in the next Parliament.

We listened hard to the concerns of those opposing law change. They fell into three areas, but our evidence provided reassurance on all three. We found that not a single jurisdiction that opted for assisted dying for terminal illness had extended it beyond that definition, so there is no slippery slope. We found no evidence of coercion in jurisdictions allowing assisted dying. That is not to say that coercion does not exist, but assisted dying laws seek to provide protection, in contrast to our current law. How do we know that the 650 people who take their own lives now are not coerced or did not take that decision because they felt themselves to be a burden? We talk rightly in this debate about safety, but it is the current law that is unsafe. Assisted dying laws are safer than blanket bans.

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[Danny Kruger (Devizes) (Con)]

I greatly respect the campaigners who are proposing a change in the law and the people who signed the petition. Nevertheless, it is not the case that the majority of the public support what is euphemistically called “assisted dying”. When the details of the proposed law change are explained to people, a majority of people oppose a change in the law. Crucially and most importantly, the doctors who work with the dying—people in palliative care and geriatric care, and GPs—overwhelmingly oppose a change in the law, because they know what we are talking about. Nor is it the case that in countries that have legalised assisted dying—

[Paul Blomfield]

When the BMA consulted its members, more doctors supported a change in the law than opposed it.

[Danny Kruger]

The BMA has decided to be neutral on this matter. Most of the doctors who supported a change in the law are do not work with the dying and the elderly. I accept that a majority of doctors have now accepted a change in the overall position. What I am talking about is people who know what they are talking about—I say that with great respect to the hon. Gentleman, who I understand has a lot of knowledge of this topic, as well. My point is that while there might be overall polls that suggest public support, in fact, when professionals, members of the public and MPs get the chance to look at this closely, they end up opposing a change in the law, and for good reason.

Palliative care services do not rise in countries that have legalised assisted dying compared with countries that have not; they flatline. Of course, all palliative care services are going up because the population is ageing, but they decline in countries that have legalised assisted suicide.

[Paul Blomfield]

Has the hon. Gentleman not read the Select Committee report? We looked at every single jurisdiction. There was no evidence that palliative care declined in countries that adopted assisted dying. There was only evidence that it had opened a debate that had led to an increase and improvement in palliative care.

[Danny Kruger]

The point I just made is not that it declines, but that it does not increase compared with countries where assisted dying is not legal. Often, the increase and investment in palliative care is actually because there is more spending on assisted dying, which has now been legalised in those countries. I am very happy to take up this point offline, because it is very important, and I recognise the Select Committee looked closely at it in its report. However, there is an important point about the investment in palliative care in countries that have assisted dying and those that do not.

I am not sure whether this point was in the report, but what does go up in countries that have legalised assisted suicide is suicide itself in the general population. The fact is that suicide is contagious. Suicides among people who would not be eligible for assisted suicide increase in countries that have legalised it. I am afraid that is understandable when we consider that the Government have told society that some people would be better off dead. We have policies in this country to prevent suicide—we want to stop people committing suicide. It is important that we recognise the potential implication of a change in the law for others.

As that suggests, this is a profoundly moral question. I recognise that there are people with deeply held beliefs on both sides. There is a quasi-religious belief in the notion of autonomy and choice as the only moral question in this debate, and I have heard that suggested. It is important to acknowledge that the people with the least agency and autonomy—the vulnerable, the disabled, the mentally ill, the frail, the lonely—are the ones who suffer in every country where the law has been changed. It is not surprising that every country that legalises assisted suicide starts with very tight restrictions, and then the scope and the access expands. I will demonstrate that offline after the debate, because it is true.

[Paul Blomfield]

We looked at this in detail as a Select Committee. Not a single jurisdiction that has defined its law in terms of terminal illness has chosen to broaden it.

[Danny Kruger]

The definition of terminal illness is incredibly difficult, and people can always find a doctor to demonstrate it. That has happened in Oregon, in Canada and other countries. Again, let me take this up offline. [Interruption.] I respect position of the hon. Member for Sheffield Central, but I stand on the point that the scope, access and eligibility expand, and of course it does, because expansion is implicit in the principle.

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[Carla Lockhart]

As we have heard and as I will go on in my speech to say, when the law is introduced it is expanded and the potential safeguards are not safeguards at all—it is a slippery slope. By investing in social care, by continuing to be a world leader in palliative care, and by being a society that respects life and upholds the dignity of the elderly and of people with disabilities, we can give hope to the hopeless and create a society where assisted suicide is not needed.

The consequences of introducing assisted suicide are not a matter for speculation. The practice has been implemented in other countries not unlike ours, and when assisted suicide is permitted, it is a slippery slope. Whenever assisted suicide has been legalised, however tight the initial safeguards and however sincere the assurances that it will be a narrowly defined law for rare cases, the practice has rapidly expanded.

[Paul Blomfield]

Will the hon. Lady give way?

[Carla Lockhart]

I am going to make progress. In Canada, it took only five years from the 2016 introduction of assisted suicide for those whose death was “reasonably foreseeable” to be expanded to the ill-defined “serious and incurable illnesses” criteria in 2021. In Oregon, in the US, people have been given assisted deaths because of diabetes, hernias, arthritis and anorexia, with the “terminal illness” interpretation now wide and wieldy. In the Netherlands and Belgium, child euthanasia has been legalised, as well as euthanasia for mental illness and dementia.

I conclude by quoting the national Danish Council of Ethics. Having considered the issue in detail, including examining the evidence from supposedly safe places such as Oregon, it concluded:

“The only thing that will be able to protect the lives…of those who are most vulnerable in society will be a ban without exception.”

It is time to invest in better palliative care and support those who go over and above to support those in their dying hour. Leave the law as it is. We must resist this change.

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[Jim Shannon]

rose—

[Paul Blomfield]

rose—

[Robin Millar]

I will give way to the hon. Member for Sheffield Central (Paul Blomfield) and then to the hon. Member for Strangford (Jim Shannon).

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[Paul Blomfield]

I think it is necessary to have accuracy in this debate. I refer the hon. Gentleman to paragraph 7 on page 96 in which the Select Committee says:

“We also conclude that jurisdictions which have introduced AD/AS on the basis of terminal illness have not changed the law to include eligibility on the basis of ‘unbearable suffering’.”

[Robin Millar]

I thank the hon. Member for putting that on the record.