Assisted Dying (No. 2) Bill

Robert Flello Excerpts

Friday 11th September 2015 Commons Chamber

[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—

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[Helen Jones (Warrington North) (Lab)]

You have asked us to be brief, Madam Deputy Speaker, and I shall try to do so out of courtesy to my colleagues.

I oppose this Bill on two grounds. The first is that it asks us to cross a line in our attitude to life, which I believe as a decent society we should not cross. At the moment, our law strives to protect life. We regard murder as one of the worst crimes; we seek to deter people from suicide; we do not execute criminals. But if we cross the line, deciding that some lives are less valuable than others, we shall be opening ourselves up to a process that I think we would deeply regret.

Those who have said that this would require more legislation are, I believe, quite wrong. Our law works on case law and precedent, and it would undoubtedly be the case that people would go to court for equal treatment, to put their own cases—and gradually and insidiously the law would be extended. People need to look at what has happened in other jurisdictions—not just in Oregon, but in the Netherlands where assisted suicides have gone up by 60% over five years and where the law has been extended to include in the definition of “unbearable suffering” not only physical but mental suffering. It covers dementia and psychiatric conditions. In Belgium, the law covers children who cannot give consent. That is my first reason for opposing the Bill.

My second reason is that I think the Bill is badly drafted. My hon. Friend the Member for Wolverhampton South West (Rob Marris) asks us to allow those with six months or less left to live the option of assisted suicide. As has been made clear by many doctors, however, it is impossible to predict the length of time that someone will live. He says that lawyers decide this on the balance of probabilities. In criminal cases, though, the decision has to be beyond all reasonable doubt. What he offers in this Bill is a lower standard of proof for those who require assisted suicide than we allow to those charged with a criminal offence.

The Bill provides that people must have a settled intention. I ask how long does it have to be “settled” for? People with serious illnesses often go through periods of depression. Palliative care specialists know that people often request to die, but when their fears are addressed and their process towards death is discussed with them, it often changes their minds. It also has to be voluntary, but there is no safeguard against the insidious pressures that can be put on people to want to end their lives—fear of being a burden on their friends and family, for example. No two doctors can know what goes on beyond closed doors. We no longer have the family GPs who knew people and their families from birth. Doctors will simply not be able to tell. And the High Court having just 14 days is not sufficient to investigate the case properly.

[Robert Flello]

My hon. Friend will be aware that in Oregon, which is the example most cited, almost a quarter of all cases are seen by just three doctors—and they do not know anything about them.

[Helen Jones]

My hon. Friend is exactly right. Most of the lethal prescriptions in Oregon are written by a very small minority of participating doctors—something that we would want to investigate very closely if the same applied to prescribing in this country.

This Bill is not just about individual autonomy; it is asking us to take a decision that will have a profound effect on society.

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

Madam Deputy Speaker, I have dispatched three quarters of my speech, and will try to keep to your time requirements. First, let me pick up on something that my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer) said. He did not allow interventions, which was a shame because we could have teased this matter out. The cases he cited would not be covered by this Bill. The people would therefore still be going to Dignitas, and would still come across the desk of the DPP for decisions on whether to prosecute. Secondly, in the Oregon example, the drugs are issued to the people wishing to take them, but it is amateurs who are around when they are administered. I would love to have had a proper debate with him about this, but, sadly, time is against us.

Before I get into the detail of the arguments, it is important to highlight exactly what we are talking about with assisted suicide. Members can call it assisted death if they wish, but we should be specific. Not surprisingly, more than half the people polled think that assisted suicide involves no pain or discomfort. Well, assisted suicide can take two forms. The first, which this Bill says it advocates, is as follows. The person is given a powerful medication to stop them from being sick. That is because the barbiturates that are used to kill them are a powerful emetic. The urge to throw up is strong and can be distressing and uncomfortable. The barbiturates are then dissolved in a tumbler full of water and have to be drunk. It takes between one minute and 38 minutes until the person falls into a coma. In around 7% of cases, the person suffers from vomiting or spasms. In one in every 10 cases there can be problems with administering the barbiturates. In Oregon, it takes, on average, 25 minutes for the person to die. But the longest period before someone died was four days. In addition, in about 1% of cases, the person has woken up.

In the Netherlands, where an injection is administered to end life, it normally takes the form of thiopental or similar to put the patient to sleep followed by pancuronium, which is used to kill the person. Most terrifyingly of all, the person at this point is completely paralysed so cannot communicate if they are still awake or in distress. They then suffocate to death. How can either of those be described as a dignified death? That is not putting someone to sleep or easing their passing. It is wrong to say that it involves no pain or discomfort and it is not necessarily quick—it is up to an hour on average before the person dies.

I know that the people who are promoting this Bill are motivated by the desire to alleviate suffering and by compassion, and we have heard some very powerful speeches on both sides of the argument today. Of course we are all moved and saddened by what we hear and want to act with compassion, but that compassion is misguided if we think that by prematurely ending someone’s life, we are alleviating suffering. There are ways to alleviate physical, mental and emotional suffering and they are done extremely well in this country. We hear those in favour of helping someone to commit suicide say that they do not want themselves or their loved ones to die in pain, but that fear should galvanise us to ensure that there is good quality palliative care not just from hospices but from across the whole health and social care system. That does not exist at the moment, and the report in 2011 highlighted that.

What does the law say about suicide? The 1961 Suicide Act as amended said that it was no longer a crime to commit suicide, and that was for a very good reason. It is not because society now thinks that everyone should have the right to commit suicide, but because society rightly thinks that someone who has tried to commit suicide needs help and support, not criminal punishment. But the Act quickly goes on to make the point that if someone helps another to take their life, then that is tantamount to murder, punishable by sentence of up to 14 years. There is a very important caveat. As the law wants to ensure that people are kept safe, it imposes that threat of severe punishment, but at the same time it wants to be merciful, which is why the DPP will decide whether a case goes to court. That is an important point.

Let me conclude with a letter from Jane, one of my constituents. Her husband, Richard, was diagnosed with cancer in 2012. On 11 September 2013—two years ago today—he passed away. She said:

“I was able to care for him and the last few weeks we had together helped us to come to terms a little with the inevitable…At one stage because I was caring for him seven days a week, Richard began to feel he was a burden to everyone to which I assured him he was not a burden. I can understand totally where he was coming from. I think changing the law would place pressure on vulnerable people. Those who are elderly, disabled, sick or depressed could feel an obligation to agree to end their lives for fear of being a burden on others. From the bottom of my heart, Mr Flello, I would ask that you could be there…to oppose this piece of legislation.”

That is one constituent of mine. I know that others have written to me, asking me to support the Bill, but for Jane’s case, we cannot let it go through.

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[Andy Slaughter (Hammersmith) (Lab)]

The Government’s position, as set out by Lord Faulks in the Second Reading debate on the predecessor Bill in the other place, is that

“any change in the law in this emotive area is an issue of individual conscience. In our view, it is rightly a matter for Parliament to decide rather than government policy.”—[Official Report, House of Lords, 18 July 2014; Vol. 755, c. 919.]

No doubt the Minister will confirm that today. The Opposition also believe that it is a matter for individual conscience, and it is right therefore that Front-Bench comments have been constrained to allow the maximum number of Back-Bench contributions.

We have not yet had 85 speeches, let alone the 133 speeches over 10 hours the other place devoted to the subject last year, but the number and quality of speeches we have heard today leave no doubt that this is a matter of great weight and controversy. We reflect, as we should, the views of our constituents; like, I am sure, all Members, I have had hundreds of representations making a passionate and compelling case on both sides of the argument.

I warmly and sincerely thank my hon. Friend the Member for Wolverhampton South West (Rob Marris) for bringing this issue before the House after 18 years. He has had something of a rollercoaster ride of defeat and victory over the last two elections and he could have chosen a less controversial and easier life. Instead, he is totting up his staffing budget to see whether he can afford the additional assistance to deal with his engorged postbag. His aim, in his own words, is to do better for dying people.

Let me also acknowledge the work of Lord Falconer, who chaired the Commission on Assisted Dying and piloted the predecessor Bill through Second Reading and into Committee in the Lords.

There are many, including some who have spoken today, for whom the principle of assisted dying or the slippery slope argument are the start and end of their consideration. The current Archbishop of Canterbury has said that we are crossing a “legal and moral Rubicon” today, but that side of the argument does not enjoy monopoly support even among archbishops. Lord Carey has said:

“Some people have said on the issue of compassion that actually pain is a noble thing, to bear pain and to say that we are suffering with you is, in my view, a very poor argument indeed.

There is nothing noble about excruciating pain and I think we need as a nation to give people the right to decide their own fate.”

Many Members have expressed concern as to the role of the medical profession, saying that there would be a fundamental change in the doctor-patient relationship. Indeed that is an important consideration, but I equally take on board the comments of my hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), who says there is currently an inconsistency in the law as a result of his own guidelines. There is an opt-out for medical practitioners, and some would say that that heralds a more mature relationship between doctors and patients. My hon. and learned Friend explained with his customary precision the limits that he was able to achieve even with the excellent guidelines he introduced as Director of Public Prosecutions.

That brings me to my concluding point and, I think, the salient point for us to bear in mind today. Other bodies have tried to address this issue. The Director of Public Prosecutions has tried, as has the Supreme Court. We should bear in mind the words of the President of the Supreme Court, Lord Neuberger, who said that it was

“institutionally inappropriate at this juncture”

for the Court to declare that clause 2 was incompatible with article 8, as opposed to giving Parliament the opportunity to consider the position without a declaration. Lord Sumption referred to the “inherent difficulty” of the question, and to

“the fact that there is much to be said on both sides”—

for making—

“Parliament the proper organ for deciding it.”

Without drawing a conclusion on the rightness or wrongness of the Bill, I urge the House to take the same course that the other place took last year, which was not to vote down the Bill at this stage but to allow it to go forward into Committee where these matters could be debated further. That was the cogently expressed view of a strong opponent of the Bill in the other place, Lord Mackay of Clashfern, who stated:

“I am deeply opposed to the Bill but strongly in favour of it being afforded a Second Reading so that we may have the opportunity to discuss the many vitally important issues that it raises.”—[Official Report, House of Lords, 18 July 2014; Vol. 755, c. 778.]

We abdicate our responsibility if, after 18 years, we do not fully discuss these matters in detail and look at the safeguards and the possibilities in the Bill. It is wrong that those of our constituents who can afford to do so have the option to go to Switzerland when others do not have such options. We at least owe them the courtesy of discussing these matters more fully. I personally will support the Bill’s Second Reading, but I will be doing so in order to have a stronger, fuller debate.

[Robert Flello]

On a point of order, Madam Deputy Speaker. Is it in order for my hon. Friend the Member for Hammersmith (Andy Slaughter) to give his personal views at the Dispatch Box, when he is there in a party position?

[Madam Deputy Speaker (Natascha Engel)]

The hon. Member for Hammersmith is entitled to say what he likes from the Dispatch Box. It is up to him, and my understanding is that this is a free vote anyway. With that, I call Mike Penning.