85 MPs bid to speak in landmark 'right to die' Bill debate
An "unprecedented" 85 MPs are bidding to speak on historic backbench legislation which could enshrine the right to die in British law.
Labour MP Rob Marris warned Parliament must be at its best as it wrestles with the controversial Bill, which would allow adults of sound mind and with less than six months to live the right to ask for medical help to die.
He moved the Assisted Dying Bill in a packed House of Commons as the newly elected MPs faced their first key issue of conscience since the General Election.
At the start of the debate, Deputy Speaker Natascha Engel said the demand to speak from the backbenches meant MPs must keep remarks brief to allow as many into the debate as possible.
Mr Marris' Bill is facing passionate opposition ahead of what is likely to be the first vote on the issue in almost 20 years.
He told MPs: "I hope today we can see Parliament at is best, with an open debate and a free vote on a matter of conscience.
"The current law does not meet the needs of the terminally ill, does not meet the needs of their loved ones. And in some way 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. We have those who have the means going off to Dignitas in Switzerland.
"The Supreme Court in the Tony Nicklinson case recognised there was a problem which needs to be addressed by Parliament.
"It is time Parliament grasped this issue."
Mr Marris' Bill must be voted on before 2.30pm to get a second reading and make progress in the legislative path towards the statute book.
As the debate began inside the Commons chamber, protesters outside Parliament urged MPs not to change the law.
But Mr Marris, the Wolverhampton South West MP, said social attitudes to the right to die had changed since the last Commons vote on the issue in 1997.
He told the Commons: "We all know as politicians not to rely too much on opinion polls - however, opinion polling by Dignity in Dying of 10,000 people, carried out independently by Populus, suggested extremely strong support for the kind of measure I am proposing to the House today.
"I respect the views held by people who are strongly opposed to my Bill. I share their motives for a better society and making sure we have a law which protects people.
"When I came in this morning on the Tube, I stood next to a man with a hoodie on saying on it 'understand difference'. I thought that was quite appropriate.
"This debate is not about opinion poll numbers. It's about conscience and ethics and the kind of society in which we live. We need the debate and Parliament should debate this issue."
Mr Marris' Bill faced immediate opposition. Liberal Democrat John Pugh asked why his Bill was not called the Assisted Suicide Bill, while Tory Fiona Bruce insisted he was misreading the Supreme Court view in the case of Mr Nicklinson.
Labour's Gisela Stuart demanded to know what a doctor was supposed to do if a patient handed fatal medication were to choke while they took it, while former Wales Secretary David Jones said it should have included guidance for the High Court judge who would be asked to sign off on any request to die.
Mr Marris said his Bill included many safeguards and a clear process.
Under the terms of the legislation, two doctors and a High Court judge would have to be satisfied of the requesting patient's eligibility - defined as being terminally ill with less than six months to live, mentally fit to make the decision and aware of alternatives - before the right to die would be allowed.
The patient would be given a 14 day cooling off period before the assistance to die would take place. The patient must administer the fatal medication themselves under the rules in the Bill.
Any doctor is allowed to exempt themselves from the process on conscience grounds.
But Labour's Helen Jones (Warrington North) said: "Your Bill is founded on the belief it is possible to predict the time of death up to six month accurately. In fact, most doctors will tell you that is impossible - certainly impossible to predict beyond a week or two. Is that not the case?"
Mr Marris said: "Professionals often give advice on a balance of probabilities. That is the same for medical professionals. In fact, on the gross statistics when errors in prognosis occur for the terminally ill it usually an overestimate of life expectancy."
Clwyd West MP Mr Jones, who was Wales Secretary under David Cameron, said: "Can you say what independent inquiries the Bill provides for that the judge should make?"
Mr Marris said: "Like many Bills, it doesn't fetter the discretion of a High Court judge in what inquiries they feel appropriate to make."
A shout of "that's reassuring" could be heard from the Tory benches.
Mr Marris warned MPs should not be holding terminally-ill people "hostage" until good palliative care can be provided.
He said he appreciated the medical profession in England and Wales is divided on the Bill, adding the majority are probably against it.
He noted, however, a "significant minority" are in favour of his proposal, telling MPs: "Some of them one suspects, and this is what polling indicates, because they would like themselves to have the option were they terminally-ill.
"There's no contradiction between what is proposed in this Bill and having widespread high-quality palliative care. It's not a contradiction, it's not a question of one or the other.
"Some patients, a minority of patients' needs cannot be through palliative care. They remain, despite the best efforts of palliative care professionals, suffering."
Mr Marris added: "What I don't think this House should be doing is holding terminally-ill people hostage until we get good palliative care, and the availability and funding of palliative care is not in my hands at all."
On whether patients will opt for an assisted death because they feel a burden on their loved ones and the health service, Mr Marris said: "I hope patients do not feel that but I cannot guarantee it.
"It can be somewhat patronising to say that for someone who has one of their factors for making this decision, they would feel a burden, that they should be denied the choice, I think that's wrong. I think they should have the choice."
He said the Bill provides "protection for the living" while the existing law offers protection to the dead.
On whether he would choose an assisted death, Mr Marris told MPs: "I don't know if I had a terminal illness with a prognosis of less than six months if I would.
"But I and many other people would find it comforting to know that the choice is available - to have the option of choosing a dignified and peaceful death at a time and place, and in a manner of my own choosing, at my own hand.
"I think there's been a trend in our society, which I support, in many cases that if the exercise of a choice does not harm others in a free society we should allow that choice."
Conservative former minister Caroline Spelman, who represents the Church of England in the Commons, said the Bill challenges respect for life.
She added increasing secularisation of society has contributed to older people feeling they might be a burden on others.
On society's attitude to death and ageing, Ms Spelman said: "Why is it that so many people say 'I don't want to be a burden'?
"In societies which revere the elderly there's less fear among old people that they impose a strain on everyone else.
"One of my constituents put it like this: 'We are born into dependency, we rely on the goodwill of others even when we're in our prime, and dependency is a necessary feature of our senior years'."
She added: "Respect for life is a question that the Bill challenges. This Bill would also be a major shift in the fundamental principle, changing the relationship between the doctor and their patient.
"It would not just legitimise suicide but promote the participation of others and even if we consider assisted dying to be acceptable in some circumstances, in my view, the law should not be changed."
Labour's George Howarth (Knowsley) intervened to say it can be rational in some circumstances for people to decide they do not want to be a burden on others.
Ms Spelman replied: "I put a rational question back to you - how is it in our society that our senior members of our society have come to the point where they feel they may be a burden?
"And I think the increasing secularisation of society has contributed to this because the Christian principle of honouring your father and mother must to some extent have become weakened if our fathers and mothers and grandparents begin to be concerned that they are a burden."
Earlier, Ms Spelman said it was possible to "make dying better" through "sheer humanity", noting assisted dying could threaten funding to hospices.
Conservative former Cabinet minister Cheryl Gillan said a hospice in her Chesham and Amersham constituency had told her they would not be involved in providing assisted dying to people in its care.
She said: "That would lead perhaps to a situation where people who need care in a hospice may not want to go to that hospice, and therefore choice is removed from dying people for the sort of palliative care that they will require."
Labour former minister Jim Fitzpatrick (Poplar and Limehouse) said people with a terminal illness facing pain, suffering and indignity sho uld have the right to choose to die.
He said: "Before being elected to this place many colleagues know I served in London Fire Brigade for 23 years.
"In my time I worked with asbestos as did (Conservative minister Mike Penning). Because of its heat-resistant properties the fire service used it for all manner of things. For example, we used to wear asbestos helmets and gloves.
"I don't know how many people here have seen the terminal stages of asbestos or mesothelioma.
"Not only is it not pretty, it's damned ugly and if that's what lies in store for me, I want to control my own exit."
Former DPP Sir Keir Starmer said he had faced prosecution decisions in scores of assisted dying cases in his former role.
In a lengthy speech, he told MPs about prosecution guidelines he developed but warned they had shortcomings without a change in the law.
He said: "I quite understand those that say we should revert to a position where nobody should be given any assistance at all.
"But we have arrived at a position where compassionate amateur assistance from nearest and dearest is accepted but professional medical assistance is not unless you have the means of physical assistance to get to Dignitas.
"That, to my mind, is an injustice we have trapped within our current arrangements.
"The second limitation in my guidelines is the only safeguard I could put into the guidelines was an after the event investigation by the police into what had happened."
He added: "I have heard the comments about the safeguards in the Bill and I know how hard it was to come up with the right safeguard in my guidelines. It took me time to arrive at safeguards, I think, could be generally accepted."
Sir Keir was interrupted by points of order as his speech ran past 10 minutes but deputy speaker Eleanor Laing said his "unique position" meant he should get "leeway".
Sir Keir concluded: "In my view, the same and appropriate thought is necessary for the guidelines in this Bill."
Conservative Crispin Blunt (Reigate) spoke in favour.
He said: "Whilst some people might believe that suffering is a grace filled opportunity to participate in the passion of Jesus Christ, which euthanasia selfishly steals that opportunity, I am afraid please count me out.
"To die well is a simple concept and one that would not have shocked Socrates. However, an aversion or allergy or proper weighted consideration of what a good death is or should look like is a shibboleth of a society that has been shaped by Christian concepts of the sanctity of life.
"Like many supporters of this act, it is through my own personal experience. I watched my two parents but most particularly my father-in-law die of cancer.
"Watching the death of my father-in-law, who had conversations with his children, that had he ever found himself in this situation please would they take care to trip over the cables in order if he was on a life support machine that it would be switched off.
"To find himself dying in circumstances where he did not even have the possibility of controlling the time of his own death I found truly appalling."
Labour's Lyn Brown (West Ham) took the reverse position.
She said: "My concern is we will fundamentally change the way our society thinks about and deals with the terminally ill, severely disabled people, the vulnerable, troubled and elderly.
"My mum died suddenly and unexpectedly riddled by cancer. But I know my mum faced with a terminal prognosis in a world where there was a possibility of state assisted suicide, accepted and acceptable, would have tormented herself during her last and final months with the question of when she should ask for that button to be pressed.
"She would have worried about the stresses her sister and I would have endured, she would have worried about the weight of her care being shouldered by the nurses and the doctors. And she would have been anxious folk would think she was consuming too many resources, selfishly staying alive costing money when she could and should just die.
"My mum was not vulnerable. She was not alone or a depressive, she was dearly loved.
"But what of those without a loving family? What of those elderly people - and let's face it they do exist - with families more interested in the cost of care and its impact on their dwindling inheritance than the precious gift of life?"
Conservative Fiona Bruce (Congleton), a prominent right-to-life campaigner, said the Bill omitted many key details and was "legally and ethically totally unacceptable".
She said: "This Bill would authorise doctors to provide a lethal substance for people to kill themselves with. Not a medicine, as the Bill disingenuously describes it. But, and let's put it as it is, a poison.
"No wonder doctors oppose it and we in this House should do so too."
The MP added: "We will have crossed the rubicon from killing people being illegal to killing people being legal.
"That is not doing justice. We are here to protect the most vulnerable in our society not to legislate to kill them."
Conservative Nadine Dorries (Mid Bedfordshire), a former nurse, cautioned against the measures as she drew on personal experiences.
She told how she held the hand of a gay man when he was diagnosed with Aids in the 1980s.
Ms Dorries explained he was given 12 weeks to live but is still alive, adding: "We've now reached the point where somebody today diagnosed with Aids is far more likely to die from something else than they are of Aids - but we would never have thought that in the 1980s."
She went on: "Aids was not something which we knew was going to arrive in the 1980s and we don't know what's down the road tomorrow, what new viral disease, and it will probably be a virus given the information we have, will land and what will be the new Aids of tomorrow.
"So six month diagnoses worry me because no doctor can accurately predict someone's life at six months."
Ms Dorries also told MPs how one of her closest friends was given 14 days to live last August, noting the final fortnight was "wonderful until the very end when she was fast asleep and unknowing".
Ms Dorries said: "That is the beauty of palliative care today."
Democratic Unionist Jim Shannon (Strangford) opposed the Bill, telling the Commons: "I don't see tangible evidence for assisted suicide. I still find myself very much in line with the majority of Christians in this thinking."
He warned the legislation could be a "slippery slope", adding doctors in his constituency feared people will feel pressurised into ending their lives early "so as not to be financial or a care burden" on loved ones.
Mr Shannon also said a law change could also, in future, allow "voluntary euthanasia or it gradually changes attitudes to include non-voluntary and then involuntary euthanasia".
Conservative former Cabinet member Liam Fox, who worked as a GP before he was elected, said the Bill would "open a Pandora's box" which would not benefit future generations.
He warned it would fundamentally change the doctor-patient relationship, telling MPs: "We're talking about overturning 2,000 years of the Hippocratic Oath."
Speaking against the Bill, he also said: "I believe that anything that increases those pressures upon doctors is an ethical trap which is opening up and we should not want to see."
Mr Fox said the law allows patients who are suffering to be given medication which has a main aim of relieving the suffering even if the effect will overall shorten their lives.
He added it is impossible to differentiate between assisted dying and euthanasia.
Mr Fox concluded: "If you have one you will inevitably, because of the failures of process, get another. I don't believe that's an improvement to our society.
"However well-meaning the proponents of this Bill may be they will open a Pandora's box which will fundamentally change who we are and how we are as a society, how we relate to the medical profession, and I believe none of these will be to the benefit of future generations."
Liberal Democrat former care minister Norman Lamb reiterated he had changed his stance on assisted dying and backed the measures after talking to terminally ill people.
He said: "When I ask myself the question what would I want in those circumstances, would I want that right, I'm very clear in my mind that I would want it.
"I don't know whether I'd exercise it but I would absolutely want it for myself and how can I then deny it to others?"
Labour's Sarah Champion (Rotherham) backed the Bill, explaining: "What this legislation will enable is people to have peace of mind.
"We do not know, we only do this once - what our death is going to be like - but I would like to be able to give people that peace of mind that if it becomes intolerable they can make an informed choice about their own life."
Conservative Steve Brine (Winchester) said he would vote against giving the Bill a second reading, adding he was partly surprising himself by doing this as he was "hugely sympathetic" to many of the arguments in favour of the proposal.
But Mr Brine raised concerns about the measures, noting: "It seems to me that today we live in a world obsessed by choice and consumerism. We want to have that career and the perfect family life. We want to shop every hour of the week.
"I find myself agreeing with the Bishop of Bristol who said last month how the supporters of the Bill present it in part as a simple matter of individual choice - choice, he said, being the great God of a consumerised society, and I think he hits the nail on the head.
"I believe that choice creates the burden, it doesn't set you free."
Former Conservative Minister Nick Herbert said: "The language of rights is one we should be very careful of in this space.
"If there is a right to die, then why is it constrained by a six month time period? If there is a right to die, then why is it constrained simply by the fact of having a terminal illness?
"We accept in this country that people do have the right to commit suicide in the sense it is no longer a criminal offence but the the law has always been very clear that should somebody assist that and in particular should a medical professional assist that then a line has been crossed."
Labour's Paul Flynn (Newport West) said: "We will ensure your loved one does not suffer. I think many of us have had that assurances from doctors.
"What they usually mean is they are going to operate the practice of double effect. It means they will give the patient a lethal dose, usually or morphine, that will kill them.
"They play a mind game of self deception pretending that lethal dose is to relieve pain. It is not. It is to kill the patients."
Sir Edward Leigh (Gainsborough), a prominent Catholic member of the Tory benches, said "we are frightened of dying".
He told the Commons: "We don't actually need an assisted suicide or assisted dying bill, what we need is a movement for natural dying.
"We have to come to terms with death as a society and recognise that is a journey we are all going to take. We have to promote the hospice movement, palliative care, put much more resources into it and be honest with people that increasingly intrusive, difficult, painful operations and medications may not be the way.
"In that sense we can resolve this issue and emerge with credit from this moral maze."
Sir Edward added: "Many of us feel that as we embark on this BIll, if it becomes an Act, history will repeat itself.
"For all the controls we are told are going to be there, more and more people will take this route and as they become ill it will be a matter of general question put to them.
"What sort of society do we want to create? Do we want to create a society where we solve our problems by killing?"
Former GP Sarah Wollaston, the Conservative MP for Totnes, said her medical experience told her to oppose the Bill.
She told MPs: "I know myself as a clinician, having had the privilege to sit with many at the end of their lives. There have been often times when people contemplate taking their life, people who ask me to help them take their life.
"They do so because of fear, because of a deep depression. Sometimes a profound sense they are a burden on their families.
"With time, I have seen many, many people come through that to find real meaning in their lives. We need to think very carefully before we take that away."
She added: "We have to consider as a House the harms as well as the benefits, and we have to consider the impacts on wider society."
SNP MP Philippa Whitford (Central Ayrshire), a breast cancer surgeon, said the Bill did not solve what it set out to achieve.
She said: "This is not a tidy up of a small legal anomaly. It is a rubicon. It is changing and legalising the killing of one person by another, regardless of the reasons we would want to carry that out.
"I have been involved in the journey to death of many, many patients. But I have never considered as a doctor that death was a good treatment for anything, no matter what is wrong with you.
"People would choose this for lots of reasons: the fear of being a burden, the fear of dying and most of all the fear of suffering. The responsibility to deal with that lies with us."
She added: "I've not had cancer patients in decades ask me for a quick way out or an escape. What we need to do is ensure that is offered to people who are faced with degenerative illnesses of which we are all afraid.
"When the public support this, they are not actually thinking about the last six months of a terminal illness. They are thinking about Alzheimer's. They are thinking about motor neurone disease, they are thinking about Parkinson's - none of which this Bill will solve.
"Therefore it is inevitable this will migrate. We must support palliative care. We must ensure it is available to people who are dying regardless of the illness. We need to change our tone to the people who live society."