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House of Commons

Friday 28 January 2000

The House met at half-past Nine o'clock


[Madam Speaker in the Chair]

Point of Order

9.33 am

Mr. Nick Gibb (Bognor Regis and Littlehampton): On a point of order, Madam Speaker. Yesterday, the Postal Services Bill received its First Reading in this House. The Secretary of State for Trade and Industry has been all over the media this morning, debating and discussing the Bill with the country. However, I was not able to get a copy of the Bill from the Vote Office, and will not be able to get one until later this morning.

Given the Government's general contempt for the House and their obsession with the media, can it be right that the procedures of the House encourage such practices? Should we not change our procedures so that, when Bills receive their First Reading, hon. Members are able to get copies of them?

Madam Speaker: The hon. Gentleman is quite right. Our procedures have been such that, when a Bill receives its First Reading, it is not made available immediately. The hon. Gentleman may have a very good point to make, and perhaps he will take it up with the Procedure Committee. We talk about modernisation, and a modern practice such as the hon. Gentleman has described can be employed here.


Sexual Offences (Amendment)

Mr. Secretary Straw, supported by the Prime Minister, Mr. Secretary Blunkett, Mr. Secretary Milburn, Mr. Secretary Mandelson, Mr. Secretary Reid, Mr. Secretary Murphy and Mr. Paul Boateng, presented a Bill to reduce the age at which, and to make provision with respect to the circumstances in which, certain sexual acts are lawful; to make it an offence for a person aged 18 or over to engage in sexual activity with or directed towards a person under that age if he is in a position of trust in relation to that person; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Monday 31 January, and to be printed. Explanatory notes to be printed [Bill 55].

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Medical Treatment (Prevention of Euthanasia) Bill

Order for Second Reading read.

9.35 am

Mrs. Ann Winterton (Congleton): I beg to move, That the Bill be now read a Second time.

In previous years, I must admit that I have been one of the last to sign the book for the private Members' ballot. However, last year, quite by accident, I was in the No Lobby when I happened to see the Clerk with the ballot book. I said, "My goodness, you're not open for business yet, are you?", and he said, "Yes, I am." I saw that no one had signed the book, and we exchanged some banter about being able to sign No. 1, which I did. I did not appreciate that that number had as good a chance as any other, and in the event it emerged first when the ballot was held. So that is how winning the ballot is done.

It was a great surprise to me. After the initial excitement and euphoria died down, I had to deal with the mountain of post that all hon. Members who are successful in the ballot receive virtually automatically.

I gave the question of what should be the subject of my Bill a great deal of consideration. I came to the conclusion that I had chanced upon the one opportunity that a Member of Parliament gets to try to introduce to the House of Commons a measure that has very personal importance. I therefore chose this Bill, which deals with a subject on which I have campaigned for a number of years, to which I am committed and in which I believe, heart and soul. That is the way in which the Medical Treatment (Prevention of Euthanasia) Bill came to be born.

The purpose of the Bill is to call a halt to what has become the slide towards the acceptance and practice of euthanasia by making it clear to doctors that they cannot intentionally bring about the death of their patients, by action or by omission. Before I expand on the Bill, perhaps I should explain the context in which the need for it arises.

Food and fluid, administered by mouth or with the assistance of tubes, has always been regarded as a basic human right. Everyone is entitled to food and water, which are basic needs. However, for many years the international euthanasia bodies have promoted the idea of withdrawing assisted feeding from profoundly disabled people as a first step towards achieving euthanasia.

Another aim was to have living wills made legally binding, so that people could state in advance whether they wanted treatment in any given situation. I believe that that too was a first step towards people being allowed to say in advance whether they wanted a lethal injection if they became incapacitated.

In 1992, the British Medical Association produced a report in which the suggestion was made that assisted food and fluid amounted to treatment that could be withdrawn. The following year, assisted food and fluid was first legally defined as treatment by the Law Lords' decision in the case of the Airedale NHS trust against Mr. Anthony Bland. The BMA report was cited by some of the judges in justifying their decision.

The judgment caused such public concern that the House of Lords established the Select Committee on Medical Ethics to consider euthanasia and the treatment

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of the sick and dying. Its unanimous report was published in 1994 and opposed euthanasia. It also opposed the concept that living wills could be legally binding, and it was against enshrining the Bland judgment in statute.

In addition to opposing the principle of doctors killing patients, the Committee was seriously perturbed about the obvious abuses that that could lead to, when old and vulnerable people might be pressured into agreeing to have their lives ended. We all know that elderly people do not wish to be a burden on their family or society.

There was disagreement on the Committee about the legal definition of assisted food and fluid as treatment. None the less, it recognised the dangers of having this enshrined in statute, thus allowing doctors to withdraw tubal feeding from patients who were not dying.

It had been made clear to the Select Committee by a number of organisations, including doctors involved in care for the dying, that the only reason for defining assisted food and fluid as treatment was to enable doctors to bring about the deaths of patients whose lives they considered should be ended. Shortly thereafter, however, the Law Commission report on mental incapacity was published in 1995. Although the law commissioners paid lip service to the House of Lords Committee, purporting to support its decisions against euthanasia, their report included a proposed Bill in which were clauses to make advance directives--living wills--legally binding. There was also a clause that would have enshrined the Bland judgment in statute.

The previous Government declined to introduce the proposed Law Commission Bill on mental incapacity, fearing that it would weaken our laws against euthanasia. In addition, both the previous Government and the present Government have cited the House of Lords Select Committee when voicing their opposition to euthanasia.

In December 1997, the Government published "Who Decides", a consultation document on care of the mentally incapacitated. This followed very closely the report of the Law Commission, and appeared to accept the concept of medical killing by the withdrawal of assisted food and fluid, thus causing death by starvation and dehydration. The document provoked a large and robust response, with more than 4,000 submissions. Indeed, it is the first time in more than 30 years that Churches of virtually every denomination, as well as the Muslim and orthodox Jewish communities, have united on a single issue.

The Government's response to the consultation, "Making Decisions", was published last October. The Government have subsequently made it clear that they have no intention of enshrining the Bland judgment in statute, and that they do not intend to take forward legislation to put advance directives on a statutory footing.

Since the Bland judgment, the British Medical Association has sought to widen the circumstances in which it is allowable to withdraw assisted food and fluid. In June 1999, the BMA produced guidance on withholding and withdrawing life-prolonging medical treatment. It included the recommendation that tubal feeding should be withdrawn on the agreement of only one independent doctor for a wide selection of people such as those who have had severe strokes or those with dementia.

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The guidance states that its main focus is on

This clearly indicates that the BMA intends the guidance to apply to those who are not dying as well as to those who are. That is of concern, because a recent statement published in the Voluntary Euthanasia Society of Scotland newsletter shows how, with the BMA's concurrence, we are sliding towards the practice of euthanasia. An article penned by Professor Sheila McLean, co-author of a draft assisted suicide Bill, as well as pro-euthanasia publications, tells us:

    "My suspicion is that the routes taken by courts have been tailored so they cannot be seen as endorsing voluntary euthanasia . . . Yet, arguably, the conclusion must be that the courts are endorsing a form of non-voluntary euthanasia . . . "

That is significant because Professor McLean, an academic lawyer, was an important contributor to the British Medical Association guidelines on withholding and withdrawing life-prolonging medical treatment.

The BMA maintains that it is opposed to euthanasia and that its guidelines do not seek to extend any such practice. But as I have already said, its guidelines seek to widen the categories of cases from whom treatment, including assisted feeding, could be withdrawn, with the clear intention of ending the lives of patients who are not dying. In other words, the BMA guidelines extend the cases to whom they could apply what Professor McLean describes as "non-voluntary euthanasia". By contrast, the American Medical Association is actively opposed to any form of doctor-assisted dying, by either action or omission.

There has been much recent publicity about a number of cases throughout the United Kingdom in which it was alleged that many elderly patients were being denied appropriate medication and food and fluid in our hospitals. While the cases highlighted differed from those in which assisted food and fluid is deliberately withdrawn with the aim of ending the life of patients who are not dying, they reveal a growing lack of respect for and value of the aged and those with disabilities. I know that that is of great concern to many people in the country and in the House of Commons.

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