As an MP I want to make life better for the people I serve. And as a Conservative I believe that people should be free to make their own choices. But we should also look out for people. The world can be cruel. Not everyone is kind or good.
I support assisted dying in principle. I am lucky that my own experiences of death have not been traumatic, but I know about horrific deaths that no amount of palliative care could alleviate. I have heard from constituents who see a cruel death coming and have asked me to vote for assisted dying for their sake. In that situation I believe I would want the choice of assisted dying for myself.
Despite that, I voted against today’s assisted dying bill. The bill is not good enough. It is not good law. It is not the product of good lawmaking. And crucially, the safeguards are not really safeguards.
What do I see as wrong with it? I will give some examples. One flaw is the definition of Terminal Illness. This is much broader than it might at first appear. It could, for instance, include diabetes, and other diseases which quickly become terminal if someone decides to stop their treatment.
Another problem is the approach to mental capacity. The bill uses the approach in the Mental Capacity Act 2005 which aims to give people as much control as possible over living their lives. It errs on the side of maximising capacity because it was never intended for use when the question is about hastening death.
The bill does not properly safeguard against coercion. A doctor involved could be concerned a patient is being coerced. But if on those grounds they opted not to approve the application for assisted dying, it could just be made to another doctor. No one is under any obligation to investigate whether coercion is occurring. The fact there is a judge involved does not mean any such investigation will take place, as this is not their role.
Some people may opt for assisted dying because they feel they are a burden, or because they are fearful they won’t have access to good palliative care. There is nothing in the bill which would provide a challenge to that. Every step in the bill supports people on the path to an assisted death.
These problems and others have been explored at greater length by people with more legal expertise that me. The point is that I could not vote for this flawed law.
The reason it is so flawed is in part a consequence of the process followed, which has not involved proper consultation or pre-legislative scrutiny.
Some say that the vote on the second reading of the bill today was on the principle of Assisted Dying and the details can be ironed out in the Committee stage. I disagree. Committee stage is for refining a bill that is fundamentally right. But this bill contains fundamental wrongs. And it has not followed a proper process to get to this stage, not least for a change in the law of such importance and with such societal consequences. However, I will remain open minded if the committee stage does address my concerns.
I recognise that Assisted Dying has been much researched and discussed. We have debated it before in Parliament. The Health and Social Care Select Committee did an inquiry into it, to which I responded on behalf of the Government. That committee looked at examples from other countries and those models have informed the legislation before us. But that is not the same as a proper legislative process, which has been developed over many years in Parliament to make better laws.
We can draw lessons from the pandemic when we had to legislate fast to save lives. The Covid Inquiry is considering what we got right and wrong, but I don’t think anyone would claim that we got everything right. By contrast, after the pandemic, I took legislation through Parliament to update the law on care home visiting. To me and those who cared about this, it was an important change to make sure residents in care homes would not be cut off from seeing their loved ones in any but the most exceptional circumstances. In the scheme of things, this was not a big change to the law. Nothing like the introduction of assisted dying. However, the process still took many months from the initial working up of options to achieve this end, then consulting, analysing responses and drafting the legislation, before debating it in Parliament. There was then a further consultation before implementation. That sort of process has not been followed for this bill.
I hear the arguments that issues of conscience like this are often legislated for via a private members bill, with abortion as an example. I support abortion, but I don’t believe our legislation for that is as good as it should be. Yet once these things are done, they are hard to change. The legislative process for assisted dying could and should be thorough.
This is also a moment to talk about palliative and end of life care. We are better at this than many countries, but we are not good enough. I say that as a former minister who had that responsibility under the last Government. Hospices provide wonderful care, but many people don’t receive it. Most end-of-life care is provided by the NHS. But do people know how good that is in their area? As a Minister I was working to get the NHS to publish data on this. We should clamour to see that data and for the NHS in every area – and the Government – to be accountable for how well they do palliative and end of life care.
A final thought. I don’t agree with those who oppose this bill because they foresee a ‘slippery slope’. I don’t. Of course, the law (if it becomes one) could be changed in future. That’s Parliament’s job. For instance, the question is already being asked whether it should be limited to people anticipated to have six months or less to live – which is well known to be difficult to estimate. I can envisage a thoughtful debate about changing the law so that people who have the prospect of living with extreme pain, discomfort or indignity could opt for assisted dying. And it might be right to do so. But that’s not a slope you simply slip down. I would expect that to be a thoughtful debate, like the one we are having now, in which MPs would listen to their constituents and consider the arguments for and against, before reaching a conclusion.
I am grateful to everyone who took the time to contact me about this bill, often sharing your own difficult and personal stories. You argued powerfully both for and against assisted dying.
These are conversations we should be having as a society; these difficult conversations about what we want as we near the end of our lives, about how to have a good death, about what matters. The pleas of people who want the choice to have assisted dying were in my head as I voted. I want that choice to be there for them.
But this law will not just affect those who want it. It will affect everyone, and particularly anyone who may be nearing the end of their life or living with serious illness or disability. The choice will be there whether you want it or not; the choice to continue to live or to opt for an early death. It will change our society and we must get it right. I will be looking to Kim Leadbeater and the bill committee to make the bill better before it returns for third reading.
