On Friday 11 September 2015 the House of Commons will be debating and voting on a Private Member's Bill to legalise assisted suicide. This is a bill that proposes to enable competent adults who are terminally ill to be provided at their request with specified assistance to end their own life; and for connected purposes. Members of Parliament will be free to vote as they wish on the Bill as there is no "party line".
I have received over 100 letters and emails from constituents on this Bill - urging me to vote both in favour and against- and so I know how strongly many people feel about this important issue. After carefully taking into account my constituents' (including patients and their families) views I have also listened to doctors and, in particular, specialists in palliative care, end of life teams and hospices. I have learnt the stories of hundreds of people who have been in this difficult situation. I have also borne in mind my own experience in caring for my seriously infirm grandmother during the last years of her life, and how I witnessed her health and quality of life decline.
After weighing up all of these matters, I have decided that I will vote against the Bill on the 11th September. I am aware that my decision in this vote may disappoint some people, however I wish to reassure people that I have researched the issue comprehensively and I appreciate people's concern on this very sensitive issue.
I am against the Bill for 3 main reasons. Firstly, I am not persuaded that there is sufficient protection in place to prevent inappropriate use of the right. We must accept that there can never be sufficient safeguards once the state legalises one type of death at the hands of another. There can never be a safeguard, for instance, which prevents a vulnerable and confused person from feeling they have a duty to ask a doctor in private to end their life prematurely. Nor can you prevent a selfless person from seeing a law permitting euthanasia as an opportunity to cease being a burden - even when they have no wish to die themselves.
The bill refers to people who could be 'reasonably expected to die' within six months. This definition is much more vague than it sounds, and would include many disabled people who in fact have lived fulfilling lives for many years. The Bill also fails to acknowledge the negative assumptions that people make about their own quality of life when they are diagnosed with a terminal illness or disability. These feelings of depression and despair can change over time. People need support to come to terms with these feelings, rather than help to end their lives.
Secondly, international experience shows that this kind of legislation is being used for reasons other than pain, by people who are not terminally ill and by other people. In Oregan, USA on which this Bill is modelled, 40% of those requesting to end their life do so because they feel a burden on friends and family - nothing to do with being in pain. In Washington State, where assisted suicide is legal for those who are terminally ill, 61 per cent of all those given lethal drugs to end their lives listed feeling a burden on family, friends or care-givers as one of the reasons for wanting to die.
In Belgium, the assisted suicide law was extended recently allowing euthanasia for children. A Dutch ethicist said: "Don't go there". He wrote that recent developments in Holland include "a shift in the type of patients who receive these 'treatments'". He said: "Whereas in the first years after 2002 hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering of those given euthanasia or assisted suicide consisted in being aged, lonely or bereaved. Some of these patients could have lived for years or decades."
And third and finally, the overwhelming expert and professional opinion opposes assisted dying. This includes the British Medical Association, the main professional association for doctors and medical professionals, and Scope a leading Disability Rights charity. To my mind, these factors outweigh the perceived rights created by the Bill.
Importantly, the status quo is compassionate and measured. Assisting or encouraging suicide is a criminal offence under Section 2 of the Suicide Act 1961 for which the maximum penalty is 14 years' imprisonment. I am aware that the Director of Public Prosecutions has published guidelines primarily concerned with advising the Crown Prosecution Service about the factors which they need to consider when deciding whether it is in the public interest to prosecute a person for assisting or encouraging another to commit suicide. The House of Commons has discussed the DPP's guidelines and these were unanimously commended as being a humane and reasonable way of dealing with one of the most emotionally-charged crimes in the statute book.
The Director of Public Prosecutions has now further clarified the CPS Policy on the likelihood of prosecution of health care professionals, to specify that the relationship of care will be the important aspect and it will be necessary to consider whether the suspect may have been in a position to exert some influence on the victim. The notion of external influence is a reason too why I have decided to vote against the bill. I believe the application of the law should be flexible enough to distinguish the facts and the circumstances of one case from another. To this end, the DPP's policy offers important and sensitive guidance.
It is understandable that people fear being disabled and dying for themselves or their loved ones. Everyone would agree that terminally ill patients should receive the highest quality palliative support and end-of-life care, and that they and their families should be certain that their end-of-life care will meet all of their needs. With that in mind I welcome the Department of Health's End of Life Care Strategy which is intended to improve access to good quality palliative care and encourage the Government further to develop specialist palliative care and hospice provision.
Coping with terminal illness is distressing and difficult both for the patient and their families. However, an acceptance of assisted dying not only carries the risk of the right to die developing into a duty to die. It makes way for the inadvertent sanitisation of death.
Thank you again for taking the time to contact me.