THE first steps in introducing assisted dying into English and Welsh law were taken by the House of Commons on Friday afternoon, when it voted to progress a Bill giving permission in limited circumstances (Comment, 29 November).
The first parliamentary debate on the Terminally Ill Adults (End of Life) Bill was followed by a free vote, carried by 330 to 275.
The Bill will now go to Committee Stage before one other reading within the House of Commons. If it passes an additional vote, it’ll go to the House of Lords, where the method is repeated.
The Private Member’s Bill was introduced by the Labour MP Kim Leadbeater, who described the proposals as “a chunk of laws which might give dying people, under very stringent criteria, alternative, autonomy, and dignity at the tip of their life”.
On concerns concerning the state of palliative care, and calls for improvements in end-of-life care before any further consideration of assisted dying, Ms Leadbeater said: “Assisted dying just isn’t an alternative choice to palliative care; it just isn’t an either/or.”
The DUP MP for Strangford, Jim Shannon, asked what guarantees Ms Leadbeater could give on the restriction of assisted dying to patients with a terminal illness and not more than six months to live.
Ms Leadbeater said that her Bill laid out “strict, stringent criteria . . . that can’t be modified”, and so fears of a “slippery slope” resulting in an expansion of those eligible wouldn’t happen.
Sir Oliver Dowden, Conservative MP for Hertsmere, asked how they might ensure that “judicial activism” wouldn’t shift these criteria. Ms Leadbeater countered by saying that the courts had consistently deferred to Parliament on this issue.
She drew attention to the name of the Bill, saying that it outlined the proven fact that it might apply only to adults who were terminally ailing and at the tip of their life, and that this might not be modified. “It is doesn’t apply to individuals with mental-health conditions, it doesn’t apply to the elderly, it doesn’t apply to individuals with chronic illness, and it doesn’t apply to disabled people — unless after all they’ve a terminal illness,” she said.
Dangers of a “slippery slope” were unfounded, she said, as, in jurisdictions world wide by which assisted dying had been passed solely for those with terminal illness, there had not been any widening of its scope.
The Conservative MP for East Wiltshire, Danny Kruger, made the primary speech in opposition to the Bill, saying that he bore “heavily” on his conscience the pain of individuals whose pain could be prolonged consequently of rejection of the Bill. But supporting the Bill would depart on his conscience “many more people whose voices we cannot hear”.
Mr Kruger said that the Bill would wish “wholesale restructuring with a view to make it secure”, and this could not be possible within the confines of the Committee Stage — an argument disputed by some MPs, including the Reform MP Richard Tice.
Mr Kruger went through the Bill, stating his concerns: they included the term “terminally ailing”, which was of “great elasticity, almost to the purpose of meaningless”, he said, and it was not possible for doctors to predict with any accuracy that somebody was going to die inside six months.
He argued that the safeguards that supporters of the Bill had outlined would, in time, be dropped, as they’d be considered barriers to the “latest human right” to have an assisted death.
He said that the Bill would “not only create a latest option for a number of, and leave everyone else unaffected, but impose on everyone . . . this latest reality”. It would, he said, “change life and death for everybody”. Better end-of-life care must be the main target, not a “state suicide service”, he said.
The Labour MP Diane Abbott, Mother of the House, said that she was not against assisted dying in all circumstances, but didn’t imagine that the safeguards within the Bill were sufficient.
She asked whether the justice system had the capability to take care of the requirement for every application to be scrutinised by a High Court judge, and she or he feared that this step would grow to be simply a “rubber stamp”.
Ms Abbott said that protections against terminally ailing patients’ being coerced to go for assisted death were insufficient: it was hard to detect coercion.
The Conservative MP for Sutton Coldfield and a former health minister, Andrew Mitchell, said that he had modified his mind about assisted dying, after hearing the stories of constituents whose members of the family had suffered.
“The current law forces people to plan their deaths in secret. Their bodies are found by their family members. They often die in probably the most horrific circumstances; they haven’t any probability to say goodbye to their family members. It’s devastating for his or her families,” he said. He referred to the Office for National Statistics’ estimate that between 300 and 650 terminally ailing people took their very own lives every yr.
Mr Mitchell said that, as drafted, the proposals were “modest and controlled”, and he was confident that there would enough committee time to scrutinise the Bill intimately.
The Conservative MP for North West Hampshire, Kit Malthouse, a co-sponsor of the Bill, said that he saw “no compassion and wonder” in people suffering on their deathbed, and took up Mr Mitchell’s point about suicide: “People with terminal illness will still take their lives. If the Bill falls today, we’re consigning those people to take their lives in brutal, violent ways,” he said.
The Liberal Democrat MP for Oxford West and Abingdon, Layla Moran, who chairs the Health Select Committee, spoke in support of the Bill, but called for greater than “woolly words” from the Government about how palliative care could be improved.
ALAMYKim Leadbeater, MP for Spen Valley, speaks in the talk
The Labour MP for Hackney South and Shoreditch, Meg Hillier, spoke against the Bill and the principle behind it. “This is a fundamental change in the connection between the State and its residents,” she said. Members who had “a scintilla of doubt” should vote against the Bill.
She said that the right discussion about palliative care had not happen, and conversations must proceed, but “this Bill must stop today.”
The Liberal Democrat MP for Westmorland and Lonsdale, and former leader of the party, Tim Farron, said that he acknowledged that those proposing the Bill were motivated by compassion, but so was his opposition to it. “Neither side has a monopoly on compassion,” he said.
There was a risk that individuals would make a alternative born out of “self-coercion”, and that there was no safeguard that might be in place to forestall people feeling that they need to decide to die because they were a burden on family members, no matter reassurances on the contrary.
People may also select an assisted death due to pain that might be alleviated by higher palliative care, and he joined the chorus of voices calling for improvements in such care.
He said that he was against the Bill because he was a liberal, and never a libertarian. “I haven’t any right to impose that ultimate and most appalling constraint on the liberty of probably the most vulnerable people in society,” he said.
The Labour MP for Penistone and Stocksbridge, Marie Tidball, said that she had been on a “difficult journey”, but could be voting for it to proceed to the Committee Stage. A disability-rights researcher and campaigner before entering Parliament in the summertime, Ms Tidball has a congenital disability which affects her limbs. She said that she was reassured that the Bill was tightly focused on terminally ailing patients at the tip of their lives, and would give people “the dignity they need”.
The former Conservative minister Sir David Davis said that he had modified his position, and was now in favour of introducing assisted dying. “I’m a believer within the sanctity of life, but I’m also an antagonist to torture and misery at the tip of life,” he said.
The vote on Friday was about some extent of principle, not the conclusion of the legislative process, he said, and, if the Bill gave the impression to be getting in the unsuitable direction after the Committee Stage, he would vote against it at that time. He called on the Government to allot sufficient time to this.
Even the very best palliative care had its limits, he said, and the choice of assisted death must be there for individuals who had reached that time.
The Labour MP for Shipley, Anna Dixon, said that she could be unable to support the Bill with no detailed public consultation. She was sympathetic to the principle, she said, but had concerns about whether the NHS had the capability to make sure that it might be delivered fairly and safely.
The DUP MP for Upper Bann, Carla Lockhart, was one in every of the few MPs to invoke a non secular argument concerning the sanctity of life. “Life in all its forms is of inherent value and value. But while I actually have come to that conviction partly due to my faith, like everyone across the House I actually have listened rigorously to the evidence,” she said.
More high-profile Christian MPs who opposed the Bill, akin to Danny Kruger, the Conservative MP for East Wiltshire, and Mr Farron, didn’t mention their religious convictions of their speeches.
Ms Lockhart said that the Bill was “rushed and ill-thought out”, and urged members to reject it.
The next speaker, the Labour MP for Luton South and South Bedfordshire, Rachel Hopkins, said that, as a humanist, she believed that life must be lived well, and that individuals must have autonomy and agency.
The Conservative MP for for Rutland and Stamford, Alicia Kearns, addressed members whose religious beliefs “drive” their arguments: “I’ll all the time defend your right to practise your faith and protect your personal life selections. . . But to disclaim alternative to others, especially those with only six months to live, where their personal alternative does you no harm, is unsuitable.”
The Labour MP for Birmingham Erdington, Paulette Hamilton, said that Bill was not the reply. A former nurse of 25 years’ experience, Ms Hamilton said that she didn’t trust that the Bill might be implemented ethically and safely. “It is being rushed too quickly, and with too little scrutiny,” she said, and it might place “enormous pressure on disabled, elderly, and poor people to go for ending their life so to not be a burden on their family members”.
She criticised the Bill’s failure to ban doctors from raising the problem of assisted death with patients, and said that the system being proposed was vulnerable to “misunderstanding, error, and, at worst, abuse”.
The Green Party MP for Brighton Pavilion, Siân Berry, invoked polls suggesting that a majority of the general public were in favour of a change to the law, and that the testimony of constituents backed up this impression.
Dr Neil Shastri-Hurst, Conservative MP for Solihull West and Shirley, who worked as a surgeon and a health-care lawyer before entering Parliament, spoke of the patients whom, he felt, he had failed due to manner by which they’d suffered before death.
MPs weren’t, he said, faced with a “binary alternative” between assisted dying and palliative care. While he understood the concerns expressed, they need to proceed to interact with the Bill moderately than vote against it at this point.
The Labour MP for Brent East, Dawn Butler, emphasised that end-of-life prognosis was “not a precise science”, and there have been many cases by which people lived far longer than doctors had expected. She said that 80 per cent of her constituents were against the Bill, and confirmed that she could be voting against its going to Committee Stage.
The Labour MP for Vauxhall and Camberwell Green, Florence Eshalomi, opposed the Bill on the premise that “freedom in death is barely possible if you will have had freedom in life”; and she or he drew attention to inequality in health outcomes. “We know that Black and minority-ethnic disabled people have far worse health outcomes than the national average,” she said.
The final backbencher to talk in the talk was the Liberal Democrat MP for Mid Dorset and North Poole, Vikki Slade, who said that calls for improved palliative care shouldn’t lead Parliament to “condemn those that are at their end of life to terror, loneliness, to be forced into terrible circumstances” — an argument in favour of the Bill.
The Shadow Minister for Justice, Dr Kieran Mullan, and the Parliamentary Under-Secretary of State for Victims, Alex Davies-Jones, made speeches that avoided taking a transparent side: a mirrored image of the proven fact that each of the foremost parties had given their MPs a free vote.
