My vote on the Assisted Dying Bill

Today, I voted against the assisted dying bill. Here's why...

First and foremost, I want to thank everyone who has been in touch with me about the Assisted Dying Bill today. This was an incredibly important debate, and I am very grateful to my friend and colleague, Kim Leadbeater, for bringing it to the House.

I write to explain why, having listened to the debate very closely, I decided to vote against the Bill and instead recommend that the government establish a commission to urgently review the issues at stake and propose ways to radically improve palliative care.

I have been genuinely moved with sadness and compassion by the stories that people have shared with me. Of course, like everyone else, I have stories of my own. I lost my mum to a terrifically painful pancreatic cancer that took her life when she was just 52. I then experienced the long journey of supporting my dad through his subsequent struggle with alcohol addiction in the wake of losing the wife he loved so much. Inevitably, these experiences profoundly shaped the way I considered today’s vote.

My starting point is a fundamental belief in the dignity and sanctity of human life.

• All cultures and societies recognize this, which is why almost every nation has such tight constraints around the legality of suicide.

• At the core of today’s Bill was the question of whether these constraints should be relaxed and, if so, how.

• My conclusion from today’s debate about the Assisted Dying Bill is that the proposed safeguards are not strong enough, not least because the condition of the NHS and the legal system simply could not support the demands that the Bill would place on them. Additionally, the Bill could have several unintended consequences that would significantly impact not only those in the last weeks of their lives but crucially their families, who live with the decisions long after their loved ones have left this earth.

Let me explain the five key issues that led me to my decision.

1. The dignity and sanctity of life are fundamental starting points for me.

   
   

   1. This has long been a rock-solid belief in our society, as it is for nations around the world. For many, this is rooted in religious teachings that regard life as sacred and a gift from God. But there is also a long philosophical tradition that underpins our legal system, teaching us to protect human life as a fundamental value. The question at the heart of today’s Bill is: “In what circumstances should it be permissible to depart from these principles?”

      
      

   2. The unbearable pain of chronic illness and the desire for the dignity of a ‘good death’ is completely understandable. Indeed, the moment for this Bill was always going to come because the extraordinary advances in medical technology mean that many more people are able to live longer with chronic and terminal illnesses. Confronting, indeed, confounding these advances in science and technology is in many ways the core demand of the Bill.

2. The Bill provides for several safeguards to protect the individual seeking to end their life. However, having served in public life for twenty years, including many years as a minister in the Department of Health, the Home Office, and the Treasury, my judgment is that the proposed safeguards are irreparably inadequate.

• Someone who is terminally ill and seeks to end their life must obtain the approval of two doctors.

• However, Section 4(5) allows a patient to seek a second or even third opinion if a doctor refuses to approve their request.

• Combined with the chronic shortage of GPs in our NHS today (consider how hard it is for most people to get an appointment), I am convinced this proposal will lead to both “doctor shopping” and the emergence of “specialist doctors” who become well known as the “place to go” to get the sign-off to end one’s life. This has, in fact, happened in Canada, where assisted dying is legal.

• This challenge is compounded by the vague definition of “terminal illness” used in the Bill. I fear it is so vague that it could be interpreted to include situations such as mental health conditions.

3. Second, there are merely weak safeguards against coercion.

• Section 15 of the Bill allows a proxy to sign the paperwork if the patient is unable to do so. But what is to stop someone from doing this when a relative is so ill or paralyzed that they cannot act to stop it?

• In theory, a judge must certify that no coercion has been involved. But, where will these judges come from? The backlog in the courts is already years long. We do not have enough judges to deliver a basic justice system as it is. Where will new judges appear from? And how will they have the resources to genuinely investigate whether coercion has taken place?

4. Finally, I deeply fear the unintended consequences for those in the last months or years of their lives, who worry that they are a “burden” on their loved ones. If assisted dying becomes legal, I fear that many will self-sacrifice not because they want to end their own pain, but because they wish to end the pain of others on whose love and care they depend. And that cannot be morally right or good.

5. There are a host of other issues. I fear that if assisted dying becomes legal, we will completely undermine the incentive for governments to invest much more in palliative care and hospices. We will fundamentally change the relationship between GPs and patients. Evidence from Canada and the Netherlands indicates that legal cases multiply quickly, expanding the scope of those who can apply for an assisted death because they cannot bear the burden of living. There is also confusion about what lethal drugs should be used and how they should be administered. The reliance on today’s definition of mental capacity is problematic and in my experience as the child of an alcoholic, may not be a strong enough safeguard for those struggling with addiction.

This has been an important debate. Because of advances in medical technology, the debate is not going to go away; it will become more acute. That is why I believe the right outcome is the in-depth commission that some have proposed, to ensure a proper study of these questions.

Thank you once more to everyone who has taken the time to write to me. I appreciate many will disagree with the way I voted today, but if there is one thing I owe my constituents more than anything else, it is my judgement.