(8 years, 11 months ago)
Commons ChamberNo, I must make some progress. I am sorry.
The European Association of Palliative Care says there is no correlation between the quantity and quality of palliative care in any jurisdiction and whether or not that jurisdiction has legislation like or similar to the Bill. The legislation I am proposing today, as many Members will know, is broadly based on the Oregon Death with Dignity Act, which came into effect in 1997. It has been in operation for 18 years. My Bill has the additional safeguard of judicial oversight.
When the Act was passed in 1994, the Oregon Hospice Association was strongly opposed to it. It has reversed its position, and it now recognises—in my view correctly, although I am not an expert—that assisted dying is one of the choices that ought to be available to dying people. In Oregon, 90% of people who have an assisted death—0.25% of those who die each year—are enrolled in hospice care, and Oregon is ranked among the best states in the United States of America for palliative care provision.
Would the hon. Gentleman care to comment on the Wagner case? Mrs Wagner was encouraged to take assisted suicide, rather than chemotherapy, on the grounds of cost. It worries many of us that market forces and family pressures will promote ever more assisted suicides.
I will take a detour for the hon. Gentleman, because there are urban myths. Barbara Wagner was a 65-year-old lifelong smoker with lung cancer, who was insured—this is America—under the state plan. Her doctor prescribed medication that cost $4,000 a month which had an 8% chance of extending her life by four to six months. Her insurance health plan did not cover treatment where there was less than a 5% chance that the patient would be alive after five years. When she told her health plan provider that she would not be paying for the treatment, it informed her that one of the other options was the Oregon Act. It should not have done that, and it has since revised its notification process.
I am told that depression is often present among those who have a terminal illness. That is not surprising; if I had a terminal illness, I think I would get depressed. It is up to the two doctors to determine whether depression has driven someone to make this choice, or whether it is a free choice, and if those doctors have doubts, they can refer the patient, as part of the process, for an independent psychiatric evaluation.
Another concern is that patients will feel that they are a burden on their loved ones or the health service and so wish to exercise this option. I hope that patients do not feel that, but I cannot guarantee it. It is patronising and wrong to say that someone should be denied the choice because one factor in their decision making is that they would feel that they are a burden. They should have the choice.