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11 Nov 2008 : Column 225WH—continued

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I want to raise with the Minister the review of the law of murder. The Law Commission has recommended that the Government undertake a public consultation on whether the law should recognise either a defence or partial defence of mercy killing and if so, to what extent. So far, the Ministry of Justice and the Government have not taken up that recommendation. It would be appropriate for them to do so, given that it was made by the Law Commission and given that the Government have pursued other approaches in the review of the law of murder, including a new definition of diminished responsibility.

The new definition—that a person must have a recognised medical condition that substantially impairs their ability to make a rational judgment about the criminal act— seeks to achieve something separate in respect of attacks in domestic situations by people claiming provocation. I understand that and I am not arguing against it, but even that definition will have an impact on a partial defence being available in the case of mercy killing. It is not a case of doing nothing; the Government are already doing something that will have an impact, so it must be right for there to be an holistic approach.

Although there is more that I could say, including on the figures that have been requested, I invite the Minister to recognise in her summing up that there are many views in Parliament and that the Government and any political party will find it difficult to put the issue in a manifesto. I hope, therefore, that she will at least be open to the idea that we need to have a review, and that Parliament must, from time to time, since 1961, have the opportunity to debate this matter in a careful, clear and informed way.

Several hon. Members rose

Hugh Bayley (in the Chair): Order. A great number of hon. Members want to speak. I have not quite done the calculations, but we are talking about three or four-minute speeches, if everybody is to be called. Am I right in understanding that the Liberal Democrats do not have a Front-Bench spokesman present?

Dr. John Pugh (Southport) (LD): I am speaking for the Front Bench.

11.23 am

Mr. David Winnick (Walsall, North) (Lab): I congratulate the hon. Member for Oxford, West and Abingdon (Dr. Harris) on securing the debate. It is about time that the issue was debated. Clearly, there are strong feelings on both sides, and it would be silly to pretend otherwise. I am much in favour of a change in the law along the lines put forward in Lord Joffe’s Bill, which was debated in the House of Lords some two years ago. Although it was defeated, it reflected to a large degree the sort of measure that I would like, with all the necessary safeguards. It was tightly drawn, as any such measure must be.

I raised the matter in the House of Commons at business questions on 30 October, and I asked for the opportunity to have a debate. Interestingly, the Leader of the House replied:

That was an interesting interpretation, and no doubt the Minister will echo it when she responds.

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Somehow, the impression tends to be given by opponents of the measure that those who want to see a change in the law want to encourage the terminally ill to end their lives by such means. Nothing could be further from the truth. Both sides in this controversy rightly take the same line on the need for the best palliative care to be available to the terminally ill.

The same applies to hospices. In my borough of Walsall, we have campaigned for more than a quarter of a century to have a hospice, and I am glad to say that at long last there is a reasonable chance that we will have one within two years. On those sorts of measure—on doing everything possible for the terminally ill—there is no difference between the two sides whatsoever. Again, I repeat that the idea that those of us who want a change in the law want to encourage people to die could not be further from the truth, and that should be emphasised.

As the hon. Gentleman said, we are faced with a small number of people—it will always be a small number—who take the position, as their health worsens, that they simply want to end their lives. Of course, if they were in a position to commit suicide, that would be quite legal; if they attempted suicide and did not succeed, they would not be prosecuted, because of the 1961 Act. Those people are either unable to commit suicide, because of their medical condition, or simply do not wish to do so. If I were terminally ill and I decided that I wanted my life to come to an end, I would not wish to commit suicide, perhaps for lack of courage or confidence that I could do it.

The question arises, which is the crux of the debate: should the law permit those who are in such a condition that they want to end their lives to do so in this country, without travelling abroad? That is the nub of the issue, and it is not going to go away. The controversy will continue, but I believe that, in time, although I do not know when—quite likely not in my lifetime—there will be a change in the law.

Last week a national newspaper carried a piece about a different person to the one mentioned by the hon. Gentleman. Her husband had been diagnosed with terminal cancer three years ago. He received treatment—I am sure that he received the best treatment available—but there came a stage, as she wrote in the article, when he decided that he simply did not want to continue to live. That was his wish. Some hon. Members who are strong opponents of what I am suggesting would no doubt take the view that he should not have that right, but he nevertheless believed that he had the right to control his own life and to decide that it should come to an end. He knew that it was not possible to do so in the United Kingdom, but he also knew that he could go to Switzerland, where the means would be provided for him to do so. Although there have been no prosecutions, there is always a possibility of prosecution. Despite that legal risk, his wife and adult children decided that they would accompany him. They were insistent that he should not go on his own, and they went to Switzerland. He was filmed confirming that he was acting on his own free will, before he was given a drug in liquid form, and the wife and the children held his hand as he died.

I accept that there needs to be the strictest safeguards against abuse. I would not wish to be a party to any change that did not have such safeguards. Hence, the measure in Lord Joffe’s Bill would be limited and apply
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only to the terminally ill, where two independent doctors had examined the person. Provision would include a palliative care specialist, who would explain all the available alternatives. At every stage, the person would have the right to change his mind.

There is no question of such a measure leading to large-scale abuse. I do not deny that abuse could occur—it would be wrong to say that it would be impossible—but I believe that the kind of measure that I have described, which was defeated in the House of Lords, would provide the widest possible provisions for dealing with abuse and all the other difficulties that obviously cause us concern.

The hon. Gentleman commented on the situation in Oregon, where the position is much along the lines that I have been advocating. Its assisted dying Act, the Death with Dignity Act, has been in existence since 1994. It is interesting that the number of people who die in hospice care—I emphasise “hospice care”—in that state has doubled since the Act came into operation. Therefore, the idea that providing facilities such as those that I have been recommending for the terminally ill means that there would be less care or that more people would decide to take their lives has been shown to be absolutely false in the one state in the United States where such facilities exist.

I note that during the presidential, state and Senate elections—whatever elections took place last week—there were several resolutions on the ballot paper. In Washington, a large majority voted in favour of having the same provision as in Oregon.

Dr. Brian Iddon (Bolton, South-East) (Lab): Is my hon. Friend aware that, in those elections, the states of California, Michigan and Maine rejected physician-assisted suicide?

Mr. Winnick: That reminds me of the House of Commons and the House of Lords. I am not surprised, as such things take time. Various reforms, changes and measures that affect private behaviour and things such as the abolition of the death sentence and so on all took time and a great deal of campaigning. Obviously, my hon. Friend, whose view is different from mine, is encouraged by what he just said. I am discouraged by it, but it is a matter of debate.

I hope that the debate will continue. Just as people were given a right to decide under the Suicide Act 1961 that they could take their lives, I strongly believe that people who are terminally ill should be able to decide that they want to end their life, despite all the care and facilities that are available, and be able to do so without travelling abroad. The sooner the law is changed, the better.

11.33 am

Mr. Mark Field (Cities of London and Westminster) (Con): Unlike the hon. Member for Oxford, West and Abingdon (Dr. Harris), I believe that the empire of the law should have some limits. It may be perverse for a legislator to say this, but I do not think that a change in the law would be the right way forward in this regard, although I very much understand the suffering involved in the individual cases to which he and the hon. Member for Walsall, North (Mr. Winnick) referred in their speeches.

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When my father was dying 18 years ago, I had a role, as his next of kin, to work with a long-standing family doctor to ensure that he had enough morphine—he was terminally ill with cancer—to ward off pain. To an extent, his life might have gone on a few days or weeks longer than it would have otherwise. That seemed to be the common-sense approach to the situation. This may seem rather hypocritical, but I think that, at times, we should perhaps turn a blind eye to what are often desperately difficult circumstances.

We must recognise that, as a compensation and blame culture becomes more prevalent around the world and in this country, medical professionals in particular will become increasingly reluctant to do the right thing if there are laws in place that may be seen to provide safeguards but simply regulate their lives more strongly.

I have fears about an assisted dying, or euthanasia, regime putting pressure on elderly people who do not have an immediately life-threatening condition. In essence, the right to die could morph into a duty to die.

I believe that I can refer to the recent high-profile case of the 23-year-old rugby player, Daniel James, who was taken by his parents to Switzerland. It was a dreadful case. One of the most disquieting aspects was that, when the story came into the public domain some months after his death in Switzerland, his parents referred to his having been a second-class citizen, given the injuries that he had sustained. Those injuries were serious and may not have come through even under the Joffe safeguards. They massively affected quality of life but were not life-threatening. It was envisaged that Daniel James could well have lived for some decades to come. What was worrying was the notion of his in any way having a second-class life or being a second-class citizen. Saying that some lives are more valuable than others is dangerous.

Mr. James Plaskitt (Warwick and Leamington) (Lab): Would the hon. Gentleman confirm, however, that if Lord Joffe’s Bill had been enacted that individual would not have been able to secure the right to die, because of the protections in that legislation?

Mr. Field: Absolutely. In many ways, the case demonstrates some of the difficulties that we face in trying to frame a law that will cover all the cases that we would wish to cover, while ensuring that individuals have the right to die or to go through an assisted-dying process.

What worried me most about the case was the lack of common sense shown by the police. The reality of the situation—this may sound rather hypocritical—is that the police must take a common-sense approach. As someone who believes in a higher being—unlike the hon. Member for Oxford, West and Abingdon—I think that perhaps the judge in these ethical and moral matters should not be on this planet but elsewhere.

I was encouraged by the Minister’s comment that there had been zero prosecutions in the nearly 50 years since the Suicide Act 1961. [Hon. Members: “Imprisonment.”] No imprisonment, although there may have been prosecution and some investigation.

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We need to take a much more common-sense approach to these desperately difficult ethical matters. I am glad that we are having this debate. I know that many hon. Members wish to speak, and I hope that as many people as possible will be able to put their viewpoints across in the course of the debate. We will obviously be interested to hear some of the Government’s thinking about how this element of the law should be changed, if at all.

11.37 am

Dr. Brian Iddon (Bolton, South-East) (Lab): First, I declare that I am chairman of the national Care Not Killing alliance and a patron of Alert. Those two organisations oppose the introduction of assisted suicide and voluntary or involuntary euthanasia to the law of this land. CNK promotes palliative care and tries to educate the general public about the arguments in this difficult policy area.

There is no doubt that the Voluntary Euthanasia Society—I still call it that but will come to its new title in a minute—has been behind many of the attempts in this country over many years to change the law. It has increased its lobbying recently. It was behind Lord Joffe’s Bills and has been involved in many of the high-profile cases that have ended up at Dignitas in Switzerland. It has used the media, particularly television, to put some hard cases to the public. I was on television last week after an emotional appeal by a Bristol lady, Kelly Taylor. It is difficult for someone with an opposing view to appear on that medium after an emotional appeal to end a person’s life has been made, but I believe that bad law would be the result if the general public, and this place in particular, were to listen to all the hard cases. We have to consider the whole area.

Mr. Winnick: Will my hon. Friend give way?

Dr. Iddon: I am sorry but I cannot, as I have limited time.

Over five years, Lord Joffe made three attempts in the House of Lords to change the legislation in this policy area. Each time, he softened his approach. Have hon. Members noticed? Let me mention what he has said in a Select Committee in the House of Lords:

So his real intention is to get a Bill in to open the door and then later, perhaps, he or some other person in either the House of Commons or the House of Lords would try to amend the law. We are at a critical stage. Once the law is amended, the door is open to all kinds of exploitation in future.

Dr. Evan Harris: I have a huge amount of respect for the hon. Gentleman and I know that he has considered these matters for a long time. Does he not accept that it is for Parliament to decide the law? Arguing that we should not make a change in the law because Parliament might later change it, forwards or backwards, is no sort of argument; it is not even a slippery slope argument,
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because Parliament is there to decide. I am sure that he understands that Parliament has made rules on embryo research, including on 14 days, which he supported, even though it could go to 28 days if an hon. Member proposed it and Parliament agreed. But we still do the right thing a step at a time.

Dr. Iddon: I think that my further remarks will answer that question.

The Voluntary Euthanasia Society started with terminally ill, mainly elderly, people suffering, initially, from cancer. It did not win the argument using such cases, so it then looked at long-term cases: people suffering from muscular dystrophy, multiple sclerosis and motor neurone disease. A number of cases have been paraded before us in the media, some of which have been mentioned today. All those cases are tragic. The Voluntary Euthanasia Society has even changed its name to Dignity in Dying and is also campaigning for improved palliative care, with a sting in the tail, of course, because it has supported, and has now successfully achieved, getting living wills on to the statute book. There is no doubt in my mind about what is happening. We will have a soft approach until the legislation is changed and then the very people who change that legislation will harden their stance later.

To answer the hon. Member for Oxford, West and Abingdon (Dr. Harris), I am pleased that a High Court judge said recently that the place to change the law is not in the courts, where the Voluntary Euthanasia Society has been taking its cases; the place to change the law is here, in the two Houses of Parliament. This is where we must have the debate and we must have a much more extended debate than we have time for this morning.

In 2005, Lord Goldsmith, when he was Attorney-General, said to the House of Lords Select Committee on Assisted Dying for the Terminally Ill Bill:

the Director of Public Prosecutions—

So the judiciary is clear on this: parliamentarians must change the law—

Mr. Winnick rose—

Dr. Iddon: I am sorry but I will not give way. The law cannot be changed significantly in the courts of law.

A number of hon. Members have mentioned various states and countries, including the Netherlands, the state of Oregon and Washington state, which has recently changed the law. The significant thing about Oregon is that, according to recent research published in the British Medical Journal, one in six Oregonians who have taken lethal drugs provided by their doctors were actually suffering from treatable depression, which the doctors had failed to diagnose. There is a danger that some people will want to go beyond terminal illness and serious long-term conditions and go to younger people and those seriously suffering from mental illness as well. Baroness Warnock said in a recent article in The Times:

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