Right to die: MPs reject assisted dying law

by jimmykeogh30

2:59PM BST 11 Sep 2015….http://www.telegraph.co.uk/news/uknews/assisted-dying/11857940/Assisted-dying-vote-in-House-of-Commons.html

MPs have overwhelmingly rejected the legalisation of assisted dying in England and Wales after an impassioned four-and-a-half hour debate in which party lines were set aside.

Members voted by three to one against giving second reading to a bill tabled by the Labour backbencher Rob Marris, to allow terminally ill patients to be supplied with a lethal dose of drugs

It was the first ever serious attempt to change Britain’s assisted suicide laws through the House of Commons and saw calls for the issue to be put to a referendum amid polling suggesting public support running at around 80 per cent.

MPs on both sides lined up to give moving personal accounts of the loss of loved ones arguing both in favour and against.

But they were swayed by a series of warnings, including from fellow MPs qualified as doctors, that a change in the law would fundamentally alter the relationship between doctor and patient.

The bill, based on a system already in place in the US State of Oregon, would have enabled anyone thought to have no more than six months to live in the opinion of two doctors to be given heolp to end their life.

A High Court judge would also have had to rule that the person had voluntarily expressed a clear, settled intention to die.

Assisting a suicide is a crime in the UK punishable by up to 14 years in jail, but guidelines drawn up by the former Director of Public Prosecutions Sir Keir Starmer mean that those who help loved-ones travel abroad to die are unlikely to be charged if they are acting out of compassion.

Dr Peter Saunders, campaign director of the Care Not Killing campaign said the vote was an “unequivocal rejection” of a “dangerous piece of legislation”.

“The current law exists to protect those who are sick, elderly, depressed, or disabled from feeling under pressure to end their lives,” he said.

“It protects those who have no voice against exploitation and coercion, it acts as a powerful deterrent to would-be abusers and does not need changing.

“We hope Parliament will now turn its attention to the real issues facing our country of ensuring that everybody can access the very best care, regardless of whether they are disabled or terminally ill and that we fund this adequately.”

The Roman Catholic Archbishop of Southwark, the Most Rev Peter Smith, said the bill had posed “grave risks” to the most vulnerable people in society.

“There is much excellent practice in palliative care which we need to celebrate and promote, and I hope now the debate on assisted suicide is behind us, that this will become a focus for political action,” he said.

Speaking for the Church of England, the Bishop of Carlisle the Rt Rev James Newcome, said: “The vote in the House of Commons sends a strong signal that the right approach towards supporting the terminally ill is to offer compassion and support through better palliative care. We believe that all of us need to redouble our efforts on that front.”

But Sarah Wootton, chief executive of Dignity in Dying, said: “The vote only goes to show just how ridiculously out of touch MPs are with the British public on the issue.

“By rejecting the Bill Parliament has in effect decided to condone terminally ill people ending their own lives but refused to provide them the adequate protection they need,” she added.

“Suffering will continue as long as MPs turn a blind eye to dying people’s wishes. Dying people deserve better.”

Rabbi Dr Jonathan Romain, one of a group of faith leaders supporting assisted dying said: “We are saddened that it failed to progress, as it dashes the hopes of those who wish to avoid ending their days in pain or incapacity.

“We hope MPs will revisit the issue at a future debate, although it will be too late for those who face dying in distress right now.”

Among MPs who spoke from their own experience in the medical profession, Dr Philippa Whitford, the SNP MP and breast cancer surgeon, gave an impassioned speech urging MPs to allow terminally ill people a “beautiful death” rather than helping them die.

But there were many moving contributions from supporters of the change. Paul Flynn, the Labour MP, read out a heart-rending letter from an elderly man who had sat with his wife as she starved herself to death for three weeks after she begged him to help her die.

“Every day of her life she said prayers for other people but when she pleaded ‘please God help take me now’ for once in that long life she prayed for herself but there was no-one to answer,” the man wrote.

Mr Marris told MPs that the current system amounts to “protection for the dead when it is too late” rather than proper safeguards and choice for those facing the end of their lives.

“The current law does not meet the needs of the terminally ill,” he said. “It does not meet the needs of their loved ones and, to some extent, it does not meet the needs of the medical profession.

“We have amateur suicides going on. We have what would be technically illegal assistance going on and we have those who have means going off to Dignitas in Switzerland and the Supreme Court in the Tony Nicklinson case recognised that there is a problem.”

He went on: “This bill provides protection for the living, what we have at the moment is protection for the dead when it is too late.

“Because it is only after people die in questionable circumstances that an investigation is made by police and the prosecuting authorities and then a decision is made on whether a decision would be in the public interest.

“I make no criticism whatsoever of the prosecuting authorities or the police, they are doing the job that we in Parliament have asked them to do but they are doing it after the fact.

“And the fact is that in many of these cases there are only two witnesses to what happened when that person died and one of those witnesses is dead. There are safeguards in this bill for the living the, the two doctors and the judge.

“In Oregon there is not one documented case of abuse or misuse, there a many rumours and urban myths … no one there has ever been changed with a crime.”

Pointing to the need for the former Director of Public Prosecutions to draw up detailed guidelines, he said: “It is time Parliament grasped this issue and social attitudes have changed.

He was challenged about concerns from doctors who oppose assisted suicide but might feel force d to step in in extreme cases, such as where a patient chokes.

“I appreciate that the medical profession in England and Wales is divided on this bill and that probably a majority are against,” he said.

“However, as far as we can tell, there is a significant minority who are in favour of this bill some of them I suspect because they would themselves like to have the option if they were terminally ill.

“There is no contradiction between this bill and having high quality palliative care – it is not a case of one or the other. “Some patients’ needs cannot be met by palliative care and they remain suffering.”

Amid a debate filled with powerful and at times emotional contributions from both sides of the argument, several MPs who worked as doctors spoke of their experiences.

Dr Whitford, the MP for Central Ayrshire, recounted how seeing one terminally ill woman go from fear to experiencing a “beautiful death” had made her decide to dedicate her career to working with cancer patients.

She spoke of being involved in journey with patients whose cancer comes back.

“That journey can lead to a beautiful death,” she said. “The biggest impact on me as a junior doctor was the death of a lady that I had looked after for many months. When I came onto the ward that night the nurses said I think Lizzie is going.

“She was curled up in her bed obviously quite upset, she said she was frightened, she didn’t know what to do. I said you don’t have to do anything, you just have to relax, you just have to let go.

“We had the family in. The West of Scotland male is not good on emotion or openness so I took her son in and I spoke to her again about what was happening to the point where he could tell her that he loved her, how much he was going to miss her.

“I went for a tea and came back and she was sitting up holding court and I thought Oh no we’ve called it wrong. But she was gone in an hour. And it was beautiful.”

Detailing the transformation in the approach to death within her career, she said: “I think we should support letting people live every day of their lives until the end and recognise that as legislators we provide the means for them to live and die with dignity and comfort not to say when you can’t [bear] it take the black capsule. I think we should vote for life and dignity and not death.”

Ben Howlett, the Conservative MP for Bath, said he had come to the Chamber planning to vote in favour but had been persuaded to change his mind by Dr Whitford’s words.

Among those welcoming the vote, the Roman Catholic Archbishop of Southwark, the Most Rev Peter Smith, said the bill posed “grave risks” to the most vulnerable people in society.

“There is much excellent practice in palliative care which we need to celebrate and promote, and I hope now the debate on assisted suicide is behind us, that this will become a focus for political action,” he said.

“We hope MPs will revisit the issue at a future debate, although it will be too late for those who face dying in distress right now.”

A similar Bill, introduced by Lord Falconer, was granted a second reading by the House of Lords following a marathon and impassioned debate last year. It was subject to two days of detailed committee stage debate but failed to make progress before the election.

Sir Keir, who is now a Labour MP, detailed how he had drawn up the guidelines allowing leeway for relatives and loved-ones to offer help but not medical professionals.

He said he now believed there was an “injustice trapped” in the guidelines – that those who wish to end their lives can in practice receive amateur assistance from loved-ones but not professional help unless they have the ability and the means to travel abroad.

But Nadine Dorries, the Conservative MP and former nurse, said thousands of people with no close relatives who effectively count the state as their only next of kin would find themselves in a unenviable position if the law sanctioned assisted dying.

“That sends a shiver down my spine,” she said.

Dr Liam Fox, the former Defence Secretary gave an impassioned speech against a change in the law which he said would force doctors and nurses into an “ethical trap” in the most difficult circumstances.

Recalling his time as a young doctor in Glasgow Royal Infirmary, he said: “I very often would be sitting with a dying patient and there is a very strong temptation to end their suffering.

“I believe anything that increases this pressure on doctors is an ethical trap which I do not want to see.”

He said the principle of “double effect” – in which strong medication given to reduce pain also hastens a patient’s death – was widely accepted.

“That is very, very different ethically and morally from giving a patient something that is primarily designed to kill them,” he said.

Norman lamb, the Liberal Democrat MP and former care minister, said he had changed his mind to back assisted dying after speaking to terminally ill patients.

“When I think would I want that right I am very clear in my mind that I would want it,” he said. “I don’t know whether I would exercise it but if I would want it for myself how can I deny it to someone else.”

Among them Paul Flynn, the Labour MP, said that the use of double effect was nothing more than a “mind game of self-deception” by doctors and the church and potentially “far more dangerous” than the proposals for assisted dying.

He urged the UK to have a referendum on the issue as had happened in Oregon.

He read the House a moving letter from an elderly man who had sat with his wife as she starved herself to death for three weeks, feeling powerless at not being able to help her die as she had asked.

“Every day of her life she said prayers for other people but when she pleaded ‘please God help take me now’ for once in that long life she prayed for herself but there was no-one to answer,” the man wrote.

He went on to describe how she had become increasingly emaciated and had reached the stage where “the shame and humiliation were no longer an embarrassment”.

“I held her close on the days when I could no longer understand her mumbled words, I could only reply hoping she would hear when I said ‘I love you darling, I understand’.

“I hope she knew that I was there with her. I held her when her eyes no longer opened and when she could no longer see I knew she could hear my words when a tear dropped from the corner of an eye.

“I held her until she had no touch, no sight possibly no hearing and I still said ‘I know darling I love you I understand’. I watched her beautiful face become a skeleton and held her when this poor love finally die.

“I hope she knew I was there but I doubt it. And now for the rest of my life I will remember her poor wrecked body and once so beautiful face become a hallow mask.”

Arguments against

  • Faith groups have led the argument against assisted dying, insisting that it would have serious impacts for the most vulnerable in society.
  • The Church of England believes a change in the law would lead to people either feeling pressured to, or putting pressure on themselves to, end their lives prematurely.
  • The Archbishop of Canterbury described the issue of assisted dying as one of the “biggest dilemmas of our time” but said legalising the act would give rise to a “slippery slope” which could lead to further difficulties.
  • Justin Welby stressed his belief that the current law is working and allows for compassion but society must accept that some situations will never be “neat and clear cut”.
  • His concern was recently echoed by UK faith leaders Dr Shuja Shafi, secretary general of the Muslim Council of Britain, Ephraim Mirvis, chief rabbi of the United Hebrew Congregations of the Commonwealth and Lord Singh of Wimbledon, director of the Network of Sikh Organisations UK in a joint open letter to MPs.
  • Together they warned that the UK would cross a “legal and ethical Rubicon” if Parliament votes to let terminally ill patients end their lives.
  • They are supported by David Cameron, who has made his own opinion on the ethically fraught issue clear. A Downing Street spokesman said the Prime Minister is not in favour of an approach that would “take us closer to euthanasia”.

Arguments for

  • However, an alliance of bishops, priests and rabbis, including former archbishop of Canterbury George Carey, have broken ranks to voice an opposing view.
  • In stark opposition to Archbishop Welby, Lord Carey instead believes allowing doctors to help terminally ill people to die is a “profoundly Christian and moral thing” to do.
  • Proper legal safeguards could be devised to ensure vulnerable people are not pressurised into ending their lives by greedy relatives, he argued.
  • Dr Jonathan Romain, Rabbi of Maidenhead Synagogue and chairman of the group Inter-Faith leaders for Dignity in Dying, was among those who signed an open letter published in the Daily Telegraph which urged: “There is nothing sacred about suffering, nothing holy about agony, and individuals should not be obliged to endure it.”
  • Former director of public prosecutions Keir Starmer said the law needs to be changed to “deal with the problem of people wanting to end their lives in this country, medically assisted, rather than traipse off to Switzerland”.
  • He said the debate is not about legalising euthanasia but addressing in-built limitations in the current guidelines, which mean that there can be “injustice in a number of cases”.
  • Campaign charity Dignity In Dying believes it is time the UK “puts an end to unnecessary suffering and gives dying adults the choice of an assisted death”.