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11 Nov 2008 : Column 231WH—continued

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What a statement for a peer of the realm to make! Let me remind hon. Members that some of the 700,000 Alzheimer’s patients in this country would follow the course proposed by hon. Members if Baroness Warnock and her supporters had their way.

David Taylor: Will my hon. Friend give way?

Mr. Winnick rose—

Dr. Iddon: I am sorry but I will not give way. We have limited time.

The majority of doctors are opposed to physician-assisted suicide, as is the British Medical Association and all the royal medical colleges. In 2005, the House of Lords Select Committee recorded the view of the General Medical Council:

physician-assisted suicide—

I agree. In the words of Lord Carlile of Berriew,

There are few of us who are not afraid of death, especially the uncertainty that is associated with it. We are all anxious not to become a burden on others and none of us would wish to suffer pain over a prolonged period. That is what organisations such as Dignity in Dying—I still prefer to call it the Voluntary Euthanasia Society—play on. The alternative is to ensure that people have dignity in dying and that their physical, spiritual and emotional requirements are met. I welcome the introduction by the Government of the recent end-of-life care strategy, which has many good things in it. Hopefully, dignity in dying will become much more prevalent when that strategy is practised across the country in future.

I do not want physician-assisted suicide to become a treatment option. I remind hon. Members what Hippocrates said in 400 BC:

How a society treats its dying patients is a litmus test for that society.

11.47 am

Mr. Crispin Blunt (Reigate) (Con): It is a pleasure to follow the hon. Member for Bolton, South-East (Dr. Iddon) for reasons that I shall explain. I claim responsibility for encouraging the Voluntary Euthanasia Society to change its name precisely because the allegations in respect of compulsory euthanasia were used quite neatly by opponents to muddle up in the public mind, and in the argument, what it stood for, which was voluntary euthanasia, and that is quite a different matter.

Following the arguments produced by the hon. Gentleman, I commend Lord Joffe and Baroness Warnock for their honesty. There are two sides in this debate, one of which, having watched how the arguments have been put forward, has been commendably straightforward about what it is seeking to achieve in tackling issues that many of us find profoundly difficult.

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The hon. Gentleman made it clear that each time Lord Joffe introduced measures, they were increasingly restricted to try to test the views of the other place. Lord Joffe did that because every time we deal with the fundamental principle of whether competent adults should be able to judge whether to end their lives if they are terminally ill, that proposition is overwhelmingly supported by the public. I understand that, when this matter was tested most recently, 85 per cent. of the public agreed with that basic proposition, and they do so because, like me, they see that it is only reasonable that people should have some autonomy at the end of their lives in circumstances where they have almost lost total control. If people have witnessed relatives dying in such circumstances, with total lack of dignity, they will understand that the change of name from the Voluntary Euthanasia Society is wholly appropriate.

Given the limited time, I shall address two particular points. My hon. Friend the Member for Cities of London and Westminster (Mr. Field) made a case for the “grey area” and for Parliament doing nothing. I am afraid to say that that argument can no longer be made. In the latest case, the judges have made it clear that it is time for Parliament to take up its responsibilities. I was concerned by the alacrity with which the Minister leapt to her feet to confirm for my hon. Friend the Member for New Forest, East (Dr. Lewis) that there have been no cases of imprisonment for assisted suicides. There have been prosecutions; people have been left on bail for murder for months and have then had to go through the judicial process. We are failing people such as the family of Debbie Purdy. They are in a position of doubt because we, as Members of Parliament, are not prepared to take up our responsibilities and make the law clear.

However, the issue is not just about those who are involved in assisting people to commit suicide who would not otherwise be able to do so in circumstances in which a terminally ill person is competent and wants to bring their life to an end; it is about providing the comfort of the knowledge that a terminally ill person will potentially have control at the end of their life over circumstances that they cannot predict. That is the greatest and most striking benefit from the change in the law in the state of Oregon, where 17 per cent. of people who are dying take the opportunity to discuss the possibility of ending their life in circumstances over which they have some control with their family. That simple proposition is overwhelmingly supported by the public and would bring comfort to an increasing proportion of our population who are now dying from diseases in a more drawn-out, longer, undignified way than previous generations. We, as Members of Parliament, have a responsibility to hold a debate and bring this matter to a conclusion. We must bring our laws up to date so that they operate in the interest of those people.

At the moment, we are obviating our responsibility and that is why I profoundly disagree with my hon. Friend the Member for Cities of London and Westminster. The grey area in which we are placing people leaves them in uncertainty and doubt, and we are not doing them any service at all. Medical professionals are now in a position in which they know that it is in the interests of their patient to administer the lethal morphine dose. However, that is cloaked by the law of dual effect, and
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they administer pain relief in the absolute knowledge that their patient will die. In many circumstances, the one thing they are unable to do is to establish the wishes of their patient because as soon as they enter into that discussion, they place themselves in peril of prosecution because we have failed to make the law clear. It is time for us to address that.

Hugh Bayley (in the Chair): There is time for two four-minute speeches before we start the wind-ups.

11.52 am

Chris McCafferty (Calder Valley) (Lab): Like my hon. Friend the Member for Bolton, South-East (Dr. Iddon), I declare an interest: I am the chair of the all-party group on compassion in dying, and so, obviously, I have a specific and opposing view to him. I should like to make the view of the all-party group clear to hon. Members, because there is a great deal of misunderstanding about the views of Members who support the right to a dignified death.

Let us be clear that the law as it stands places an absolute ban on assisting another person to die. Assisting a suicide is an offence under the Suicide Act 1961—the law has not changed—and it is punishable by a possible 14 years’ imprisonment. The law is out of step with public opinion and the morals and values of today. In the recent ruling in the case of Miss Debbie Purdy—I am delighted to see she is with us today; she is a powerful advocate for the issues surrounding assisted dying—the judges acknowledged that the offence of assisted suicide is widely drawn.

Hugh Bayley (in the Chair): Order. I remind the hon. Lady of what I said at the start of the debate: hon. Members can talk about principles, but not about individual cases. It would be inappropriate to discuss what the judge said.

Chris McCafferty: I take that on board entirely, Mr. Bayley. Indeed, the judges ruled that only Parliament can change legislation—a point that I am sure we would all readily accept.

Some opponents of a change in the law on assisted dying argue that the law is not broken so we should not attempt to fix it. However, much evidence shows that, despite those claims, the status quo has many negative consequences. The hon. Member for Oxford, West and Abingdon (Dr. Harris) said that the status quo forces terminally ill people to look for alternatives, to exercise control over the manner and timing of their death when they feel that their suffering has become unbearable. That status quo has a terrible cost. We have already heard that, on average, 16 British citizens travel to Dignitas every year. The Home Office has identified that there are four cases of mercy killing each year, but I suspect that that represents only a small fraction of the real number of cases. Of course, such cases often never reach the courts.

Sadly, each year, a number of terminally ill people resort to what are often violent and botched suicides. A number of people refuse food and water, to exercise control over the time and manner of their death. In addition, every year more than 900 people explicitly request that they receive assistance in dying from their doctor. The consequences for those who help can be
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dreadful, and many terminally ill people are driven to desperate measures, such as violent suicide or starvation. They are unable or unwilling to find someone to help them, because they know that that would involve breaking the law.

Those figures demonstrate that the status quo has an extremely negative impact on a sizeable proportion of terminally ill people. I should like to make it clear that Dignity in Dying campaigns for all terminally ill people to have access to excellent top-class palliative care services, regardless of age, disease, geographical location or any other factor.

[Mr Eric Martlew in the Chair]

Of course, we all know that access to excellent palliative care is not always available. We also know that, for some people, good-quality palliative care cannot address their concerns about losing autonomy, control and dignity at the end of their lives. That is far from being a failure of palliative care. This is person-centred issue and, most frequently, at the heart of a request to die is a concern over a loss of autonomy and a desire for control.

The House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill recognised that there is a group of patients whose demand for medically assisted dying will not be deflected by any circumstance—certainly, not by more and better palliative care. The National Council for Palliative Care, the British Medical Association and Macmillan Cancer Support have all acknowledged that to be the case. Dignity in Dying believes that mentally competent terminally ill adults should be allowed the option—it is an option, because it is a matter of personal choice—of an assisted death within strictly legal safeguards. That would bring an end to the many negative consequences of the status quo for terminally ill people and their loved ones.

As we have heard, there are a number of ways in which individuals will take matters into their own hands—for example, Dignitas deaths, mercy killings, violent and unfortunately botched suicides, people refusing food and water and, in some cases, doctors helping their patients to die. The Swiss organisation Dignitas helps people with incurable illnesses to die and regularly features in the British media. In fact, more than 650 British people are members of Dignitas and, since October 2002, more than 100 British citizens have travelled to Switzerland to have an assisted death. That is an average of 16 citizens a year who go to Dignitas. Those people have travelled with the help of their loved ones, and they fear terribly what the legal consequences will be for their loved ones when they return to the UK.

The lack of legal certainty in respect of prosecution of people who accompany their loved ones leads some terminally ill people to travel to Switzerland alone and often—this is a very important point—much earlier than they would otherwise have wanted to do. People are forced to die in a foreign country, away from familiar surroundings and, in some cases, without their loved ones—without their family.

Mercy killings are slightly different. Under the current law, anyone who ends the life of another can be convicted of murder and receive a life sentence, even if the act is a compassionate response to a dying person’s request for help to die. Despite the risk of being convicted of murder, a number of people resort to mercy killing, and they often regard that as a final act of love towards a
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person—perhaps someone to whom they have been married for 50 or 60 years—who is suffering and has requested help to die.

Home Office records show a total of 57 suspected cases of homicide from 1990-01 to 2004-05 that could be described as mercy killings. I am sure that that is only a fraction of the real number, which can never be discovered. The current situation has incredibly negative effects.

Mr. Eric Martlew (in the Chair): Order. I should like to allow another hon. Member to speak before the start of the winding-up speeches. I ask the hon. Lady to remember that.

Chris McCafferty: I take on board that point, Mr. Martlew. I shall make just a couple of final points. The Law Commission has recommended a review of the way in which mercy killing is treated under the law, but the Government and the Ministry of Justice have not established such a review. In a written answer to me on 24 April, my hon. Friend the Minister said that the Government had no plans to do that, despite the fact that changes proposed by the Ministry of Justice to the law of murder could result in genuine mercy killings resulting in life sentences for murder. Such harsh treatment is unfair and goes against public feeling. I understand why the Government are making the proposed changes, but the effect could be that the benign sentencing that we have come to expect or to know in relation to genuine mercy killings is replaced by long custodial sentences. The whole area is murky, and I ask the Minister to adhere to the Law Commission’s recommendation for a consultation on mercy killing, which would be in everyone’s best interest.

12.2 pm

Dr. Julian Lewis (New Forest, East) (Con): In view of the fact that the hon. Member for Calder Valley (Chris McCafferty) took more than twice as long as the guidance from the Chair advised, I shall be exceedingly brief. I believe that the title Dignity in Dying would be far more appropriate for the hospice movement than for the former Voluntary Euthanasia Society.

I believe that my hon. Friend the Member for Cities of London and Westminster (Mr. Field) was absolutely right when he said that one has to apply common sense in these terribly delicate and sensitive areas. Legislating for situations as extreme as those with which we are concerned today is not the best way to apply common sense. The law and common sense are often poles apart. I believe that the hon. Member for Bolton, South-East (Dr. Iddon) put his finger on the nub of the problem when he said that hard cases make bad law.

My own sole contribution to the debate will be to pick on a single word that has been used by the apologists for voluntary euthanasia—safeguards. They say that, of course, appropriate safeguards must be in place. One cannot, in practical terms, put safeguards in place. One cannot safeguard a vulnerable elderly person from being pressed in private to tell the doctors that he or she wants his or her life to be ended prematurely, and one cannot have a safeguard against a selfless vulnerable person, even without pressure being applied by anyone else, feeling that it is their obligation to ask for euthanasia in order not to be a burden on others. Of course, as the
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hon. Member for Walsall, North (Mr. Winnick) said, there are relatively few tragedies in the present situation. Let us not substitute heavy-handed legislation to make a much larger number of abuses the consequence of ill considered interference by the state.

12.4 pm

Dr. John Pugh (Southport) (LD): This is not the first time that I have debated euthanasia with my hon. Friend the Member for Oxford, West and Abingdon (Dr. Harris). I congratulate him on obtaining the debate. We have debated the issue before, certainly at the Liberal Democrat party conference in Southport—my constituency—in 2004. Then, the party backed assisted dying in principle, subject to important and very detailed safeguards, and called for a royal commission. Subsequently, there have been accusations of backsliding from one MEP in the north-west, but that none the less stands as the current party policy.

I lost that debate. I argued that there should not be a party policy, but my hon. Friend, through his persuasiveness, was able to convince the party otherwise. I must make it clear that our positions have not changed since: we stand on opposite sides of the fence. I feel that it is my destiny in this place to follow my hon. Friend, frustrating his legal innovations. As he is a chairman of the National Secular Society, I am reminded of the first MP who identified himself as an atheist in this place, Charles Bradlaugh, who was followed round by a stupider brother called Henry Bradlaugh. He used to appear at many gatherings at which he spoke in a messianic way about atheism and shouted at the back. I will not do that, because this is a very difficult and emotive issue, which is not helped by demonising or stereotyping proponents and opponents as either knaves or fools. There is clear moral intent and careful thought on both sides.

Clearly, important background views colour and run right through the debate. I acknowledge in the context of the debate that some see life as a gift that should be endured, or enjoyed, and some see it as an amazingly fortuitous random event that should be no more unpleasant than it has to be. For the purpose of the debate, we can park or bracket off the different faith positions and concentrate on a rational analysis of the inherent difficulties of assisted-dying legislation. I shall offer my personal analysis.

Assisted dying is a more inclusive, broader term than assisted suicide, with which it is conceptually confounded—it has been in the debate. It is clearly different from palliative care of the dying, suicide or a patient’s right to refuse treatment. Assisted dying proposals in all nations are designed to authorise and legitimate help given with the positive and primary aim of ending life swiftly—not generally, but subject to specific conditions. The grounds are invariably much the same. Either the individual believes something about their condition or the state believes something about their condition—that it is unbearable, hopeless, profoundly undignified or unnecessary or, as has been cited many times in the debate, lacking in autonomy.

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