I would like to thank all constituents who have written to me about this Bill since its introduction in the House of Commons last year. I have read your letters and emails, and assure you that your views, beliefs and experiences have formed part of my considerations.
I also wish to reiterate my thanks to constituents who have contacted me about this issue since I was first elected in 2015. As I explained in my statement after the Second Reading of the Bill, I have met several families over the years who have wanted to share their very difficult and emotive experiences with me. I thank you sincerely for this insight into your personal grief and anguish; your stories have stayed with me and have also formed part of my considerations.
Throughout the process of this Bill, as well as meeting constituents with views from both sides of the debate I have spoken to medical professionals, legal experts and campaigners from both campaigns as well as reading their campaigns' documentation carefully to reach this decision today.
At Second Reading, I voted to allow the Bill to continue in the House of Commons. I did so because of the matters set out above, as well as the thought-provoking campaigns on both sides of this debate and the fact that a significant proportion of the public want to have this national conversation. I did not want to cut that debate short.
I reserved my position, however, for Third Reading (the final stage in the Commons before it goes to the House of Lords) so that I could make a reasoned decision on the final iteration of the Bill following the Commons’ scrutiny.
The substance of the issue is whether our society wishes to give citizens who are suffering a terminal illness and are assessed as having no more than six months to live, a choice they do not have in law currently: the power to let the illness take its course and die without their own intervention, or the power to end their lives themselves at a time of their choosing in the last six months of life.
Before this Bill, when constituents have written to me, I have made a very finely balanced judgement against a change in the law. During the course of this debate, however, I have been deeply affected by the stories of people who could no longer endure the agonies of their terminal illness and the nightmares they and their loved ones lived in guessing how and when their lives would end. The status quo is that many terminally ill people choose to take their lives but must do so in secrecy, loneliness and uncertainty, with dreadful fears for their loved ones if they are suspected to have assisted in the death.
After much thought and careful consideration, I have decided that that choice should be available to people suffering from a terminal illness and who are at the very end of their lives.
There are many people who cannot countenance using such a power; their right not to do so remains sacrosanct. This Bill does not force anyone to end their lives, including those people who obtain a legal order for their own assisted death. The terminally ill person is the person who decides whether they end their lives - no one else.
At Second Reading, I set out three concerns that have been raised by constituents and to which I have sought answers.
i) What happens if a person is assessed as having only six months to live, obtains an order and outlives that prognosis?
Understandably, many people are concerned about this and I have looked into it carefully. Firstly, the Bill does not and cannot require a patient to use the power once they have secured it. The power is for the patient and the patient alone to use. The practical experience in other jurisdictions shows that some will obtain the power and never use it.
Secondly, the Bill requires two independent doctors to confirm the diagnosis and prognosis. This is not a one-off opinion. Even after approval, the attending doctor must conduct a final reassessment at the point of delivery of the medication. If the patient no longer meets the criteria, or has changed their mind, the process stops.
It is also the case that, at the moment, terminally ill people who decide to travel abroad to end their lives must be able to afford to do so, and well enough to travel. Many are simply not able to afford this choice, and those who can may be forced to make an earlier decision than they wish in order to be well enough for the journey.
ii) How will a “slippery slope” be prevented in the UK?
Comparisons with other legal jurisdictions are difficult as our constitutional arrangements and/ or this Bill are different from those of other countries or states often cited. The title of this Bill restricts it to terminally ill people, in accordance with the criteria set out in the Bill. Any changes to the criteria will require another Act of Parliament.
iii) Are the safeguards sufficient to prevent and detect coercion?
Across the debate, we all want to ensure that vulnerable people are not coerced into ending their lives. At the moment, we simply don’t know whether a terminally ill person is being coerced to end their life unless someone suspects an offence and reports it to the police.
The system as amended during the Bill’s passage in the Commons requires professionals from the fields of medicine, psychiatry, social work and law to be vigilant for signs of vulnerability, including medical eligibility, mental capacity, evidence of coercion and of free will. It will be a criminal offence to coerce someone in these circumstances.
Importantly, the process can be stopped or paused at any point. The patient’s continuation of consent is required throughout – right up until the moment the medication is taken, the person can change their mind and withdraw their consent.
This has been an incredibly difficult decision. I understand and respect the views and concerns of people who oppose the Bill. I hope those who disagree with me will conclude that, even though I have reached a decision contrary to theirs, that I have undertaken this heavy responsibility with care. It was a finely balanced judgement for me. Weighing all of these arguments, I concluded that giving terminally ill people with less than six months to live a choice as to how their lives end will provide some desperately ill people some comfort in their final weeks. That persuaded me to vote for the Bill.