Today Parliament debated and voted on the Assisted Dying Bill. The Archbishop of Canterbury described this issue as one of the “biggest dilemmas of our time”. I have set out the basis for my vote below.
The current law is far from perfect. Yet legitimate concerns have been raised regarding the safeguards set out in this Bill.
Given the importance of this issue, I wanted to listen to the debate in the House of Commons before reaching a settled view on the merits of the specific legislation proposed.
Under the proposals, those with fewer than six months to live could request lethal drugs to end their life. Two doctors would need to agree that the patient had a terminal illness, and a High Court Judge would then be required to approve this action.
In making such a significant change, I believe the burden is on those proposing it to demonstrate that the safeguards in place are satisfactory. On this the case put was far from persuasive.
Firstly, how certain can we be that someone has only six months to live? I recall the Lockerbie bomber being released on the basis that he was terminally ill with just 3 months to live, supported by extensive medical evidence, yet he lived for two years and 9 months.
Secondly, does the signatory of two doctors provide adequate safeguard? In the case of abortion, recent cases have included doctors’ pre-signing forms of consent.
Thirdly, will the High Court Judge ensure independent oversight? The Bill is silent on how this would operate, but given that the Judge will not meet a patient it is difficult to see how this would involve any detailed investigation.
Fourthly, might patients feel under pressure to end their life in order not to be a burden? This is a particular concern. Whilst the majority of relatives nurture and care for their family member, the blunt truth is that some asset rich vulnerable patients might face unwarranted pressure. For the proposer of this Bill to simply say today in the debate that he “hoped” this would not be the case is simply not sufficient.
Fifthly, how will doctors be certain that the patient has a settled view and has exercised a free choice? Depression could shape a decision in the short term and it is difficult to see how doctors could fully assess this.
Sixthly, will the declaration signed by the patient provide comfort? Whilst the witness to the declaration cannot be a family member, they can be a beneficiary under the will which is surprising.
Seventhly, some examples cited by supporters of the Bill do not apply. For example locked-in syndrome where a patient is aware but cannot move or communicate verbally due to complete paralysis lasts far beyond six months and so would not qualify.
It is, however, often easy to point out what is wrong with new legislation, without accepting that failure to change the existing position is in itself not neutral. No change also carries risks in policy making. We need to assess whether that risk is lesser than the risk of the safeguards proving inadequate.
Palliative care remains variable, too many constituents die in hospital rather than at home especially in our area, some people have ended their life earlier than might have been the case because of the existing law, and individuals should have choice over their passing. As the former Archbishop of Canterbury noted, there is “nothing sacred about suffering”.
I will continue to campaign for improvements locally to palliative care. It is deeply frustrating that progress on North Cambs Hospital in particular has been so slow.
Constituents who have expressed an interest in this issue, both for the Bill and against, will I hope now write to Maureen Donnelly, Chair, Cambridgeshire and Peterborough Clinical Group, Lockton House, Clarendon Road, Cambridge, CB2 8FH asking for the north of the county to receive greater priority for its palliative care. For example we have still not had the review of the North Cambs, Doddington and Ely hospital sites that was promised to be published in April 2015.
In deciding to vote against this Bill, I took particular note of the views of the hospice movement who expressed significant concerns. I remain open to giving palliative clinicians greater discretion to ensure that the wishes of patients can be acted upon, but that is different from permitting assisted suicide.
The crux is that the safeguards in the Bill do not provide vulnerable patients which sufficient protection. I respect the strength of views both for and against this Bill, but have voted against it on that basis.
UPDATE: The House of Commons has voted 118 in favour and 330 against. This means that the Bill will not proceed to the committee stage.