Carys Moseley reflects on the ‘Terminally Ill Adults (End of Life) Bill’ debate which had its second reading in parliament on Friday 29 November
The Terminally Ill Adults (End of Life) Bill passed its second reading last Friday, and now goes on to the Committee Stage. MPs voted for it by a majority of 55, with 330 voting ‘aye’ and 275 ‘no’. You can read the transcript of last Friday’s debate on Hansard here. Over 160 MPs had requested to speak but because it was only given five hours’ debating time, they did not all get the opportunity.
MP is offended by the fact that the bill would legalise assisted suicide
As I warned in my line-by-line analysis of the bill, section 1 is entitled ‘Assisted dying’, but goes to state that a terminally ill person “has the capacity to make a decision to end their own life…may on request be provided with assistance to end their own life in accordance with sections 5 to 22.”
The correct term for ending one’s own life is ‘suicide’, not ‘dying’.
Nevertheless, some MPs vehemently objected to opponents of the bill stating plainly that it would legalise assisted suicide. Take for example Cat Eccles (Labour). When Danny Kruger (Conservative) discussed how the meaning of the bill might be stretched, he said this had happened ‘everywhere that assisted suicide is legal’. Cat Eccles raised a Point of Order with the Speaker of the House of Commons, claiming that Danny Kruger used ‘incorrect language’.
“On a point of order, Mr Speaker. He’s using the incorrect language. It is not suicide. That is offensive. Please correct your language.”
The Speaker said that this was not a Point of Order. Danny Kruger then pointed out that the bill would amend the Suicide Act 1961, and ‘would allow people to assist with a suicide for the first time.’ Kruger would continue this attack on suicide later on in his speech as we shall see below.
Manipulating rhetoric about coercion of patients
Presenting the bill, Kim Leadbeater quoted a Senior KC on the topic of identifying coercion of a patient into assisted suicide:
“There is currently no established system for identifying abuse or coercion in advance of a person’s death or for helping vulnerable people to make end of life decisions.”
Given that she was proposing a bill that would hasten people’s deaths this is extraordinarily cynical. She was immediately challenged by a fellow Labour MP, Kevin MacKenna, an experienced nurse, who said clinicians are trained to spot coercion. Leadbeater tried to deflect from this insight by claiming that at present doctors only check if a patient has been coerced after they have died. However, the exact source of her quote was not given, so we cannot tell whether this is about cases of assisted suicide that have come before the courts, suicide in general, or cases where people have ended up travelling abroad for assisted suicide. Leadbeater went on to claim that the bill would criminalise coercion with up to 14 years in prison, dubbing this ‘an extra level of safeguarding’.
When Richard Burgon MP (Labour) raised the possibility that the elderly in care homes would feel coerced into assisted suicide due to the cost of living, Leadbeater replied by claiming relatives tend to coerce people not to choose assisted suicide.
“Evidence from other jurisdictions shows clearly that coercion tends to happen the other way; what tends to happen is that families try to prevent the person from making the choice of an assisted death.”
Here we see clearly the problem that I warned about in last week’s line-by-line analysis of the bill; relatives of terminally ill people are cast as the problem, as preventing them from exercising an alleged fundamental right to assisted suicide. Again, Kim Leadbeater did not furnish sources for this evidence.
MPs are the safeguard for the vulnerable
Danny Kruger (Conservative) spoke decisively against the bill at length. Indeed, his was the first major speech to oppose the bill. One thing that stands out in his speech is a passage on the role of MPs:
“Let me tell the House: we are the safeguard—this place; this Parliament; you and me. We are the people who protect the most vulnerable in society from harm, yet we stand on the brink of abandoning that role. The Rubicon was a very small stream, but on the other side lies a very different world—a worse world, with a very different idea of human value. The idea that our individual worth lies in our utility, valuable only for so long as we are useful—not a burden, not a cost, not making a mess. Let us not be the Parliament that authorises that idea.”
MPs are the safeguard for the lives of the most vulnerable people in society – this by virtue of them opposing a change in the law. MPs are responsible for upholding the value of human life, and for upholding and promoting what traditional Christian moralists call the common good.
Many of the principles invoked by Kruger were echoed by others. For example, Ruth Jones (Labour) talked about the need for assisted living as opposed to assisted dying, and consequently voted against.
The great cloud of witnesses
Towards the end of his speech Kruger spoke in more substantive moral and Biblical terms:
“I mentioned at the start of my speech the voices of those we cannot hear: the frail and elderly and the disabled. As we are surrounded by such a cloud of witnesses, let us do better than this Bill. Let today be not a vote for despair, but the start of a proper debate about dying well, in which we have a better idea than a state suicide service. Let us have a debate in which we remember that we have intrinsic value; that real choice and autonomy means having access to the best care possible and the fullest control over what happens to us while we live; and that true dignity consists in being cared for to the end.”
His warning that the bill would usher in a ‘state suicide service’ was echoed by other MPs of different parties, such as Dame Meg Hillier (Labour).
His statement about ‘true dignity’ is extremely significant, and rare: being cared for until the end of one’s life, rather than grasping at control. This is a Christian principle, opposing the prioritisation of absolute individual autonomy, a mirage that will always disappoint to some degree.
The framing of his principles in terms of the great cloud of witnesses echoed chapter 11 of the Letter to the Hebrews in the New Testament. It also reminds us of those Christians who founded hospitals and hospices down the centuries. Indeed, there were no hospitals in the Roman Empire; it was Christians who pioneered them in the fourth century AD after Christianity was tolerated and persecution of Christians ceased. Hospitals and hospices are an important legacy of Christendom, of the Christian vision of the common good of society.
Shallow dismissal of comparison with other countries
Jim Shannon (DUP) pointed out that Belgium started off with similar proposals to Leadbeater’s, but by now assisted suicide is available on grounds such as dementia and for under-18s. He asked what guarantees there were for preventing such a situation. Leadbeater replied thus:
“Huge amounts of research has been done by the Health and Social Care Committee, and indeed by myself and others. The model being proposed here is nothing like what happens in Belgium. It is nothing like what happens in Canada. There are strict, stringent criteria, and if the House chooses to pass the Bill, those criteria cannot be changed.”
Now this is simply untrue. Any bill that becomes an act of Parliament can be amended at a later date by another bill. Ministers could draft guidance or pass secondary legislation, which does not require a vote, that would change the criteria involved. There is no doubt that pro-assisted suicide campaigners would go to court to try to widen the criteria. On this count Kim Leadbeater is not just misguided, I think she is dishonest. Besides, she can only get away with saying that the bill is ‘nothing like’ the situations in Belgium or Canada because these did not originally emerge from primary legislation, but from subsequent changes by those means.
Warnings of judicial activism
This is why Sir Oliver Dowden’s question about safeguards against judicial activism in the bill was so important. Leadbeater’s short reply to this was that the courts had repeatedly sent the issue back to Parliament. Surely this is because they currently have little choice in the matter.
Diane Abbott (Labour) spoke against the bill despite not being wholly against assisted suicide. She drew particular attention to warnings about the role given to judges in the bill, from the judiciary itself, citing Sir James Munby, a High Court judge:
“Only those who believe implicitly in judicial omniscience and infallibility—and I do not—can possibly have any confidence in the efficacy of what is proposed.”
In Christian terms this quote is important because we understand that only God is omniscient and infallible. Seen in this light, we can see the sobering truth that there are simply no adequate safeguards in this bill or any other possible bill.
Diane Abbott pressed her point home:
“Is the judge supposed to second-guess doctors? Will the judge make a decision on the basis of paperwork? Or will there be a hearing in open court? Where will be the capacity in the criminal justice system to deal with all this? Far from being a genuine safeguard, the involvement of a judge could just be a rubber stamp.”
Sir John Hayes (Conservative) was more scathing:
“It is certainly true that everywhere it has been introduced, assisted dying has expanded—not always by subsequent legislation, but often through judicial interpretation. The idea that we should put this charming but rather naïve faith in the judiciary to make these decisions subsequent to the House passing the Bill is just that: innocent—that is the most generous way I can describe it.”
Robert Jenrick attacks secrecy of judicial proposals
Shadow Justice Secretary minister Robert Jenrick had very little time for the bill, having turned against assisted suicide after initially voting for it in 2015. He zeroed in on the judicial proposals:
“We have spoken about the role of doctors; let us think about the role of judges. The test to be applied is a low one: the civil law threshold, which is a balance of probabilities. This means that a judge could see real risk of coercion and still sign off an individual for assisted death. If the threshold of 50% or more was not reached, the judge would sign off the individual. The next of kin is not informed. There is no right of appeal, which is extremely unusual in English law, and the process is conducted in secrecy. It could be done on papers alone. Transparency is critical to the law. It is one of the oldest principles in our English legal system. As Jeremy Bentham said more than a hundred years ago, evil can arise in secrecy, and publicity is at the heart of justice. This is not a transparent process and that leaves it woefully open to abuse.”
The deliberate sidelining of next of kin in the bill text is noted here. The lack of right of appeal in the courts should come with a huge warning. Finally, the secrecy of the whole judicial process proposed should warrant great suspicion. As Christians we know the words of Jesus Himself, namely that evils that are currently hidden will in future be shouted from the rooftops (Luke 12:2-3). This much is visible in some of the Christian Legal Centre’s end-of-life cases, such as that of Sudiksha Thirumalesh.
The bill undermines the foundations of the NHS
One of the most stark warnings about the bill came from Carla Lockhart (DUP), whose starting point as a Christian is that ‘life is of inherent value’. She stated baldly:
“The bill undermines the foundations of the NHS.”
This echoes and goes further than the warning given by Jeremy Miles the Welsh Health Secretary in October, that should the bill become law it would have ‘a massive impact on the NHS in Wales’.
Clearly what Carla Lockhart meant was that by permitting assisted suicide, the bill would change the nature of the National Health Service by changing the nature of healthcare to make of some doctors and healthcare workers accomplices in patients’ suicide.
Tim Farron, speaking against the bill utilising liberal rights principles, concluded his speech by pointing out that the government’s suicide prevention officer for England opposes the bill.
The bill lacked an Impact Assessment
As a private member’s bill, the bill lacked an Impact Assessment, something that would normally be published with a government bill. Jess Asato (Labour) pointed out that women are disproportionately affected by assisted suicide across different countries, and opposed the bill.
There was also no impact assessment of the bill published as regards effects on disabled people. The bill text excludes people with disabilities and mental illnesses from being deemed terminally ill. However as international experience shows it is highly likely that some would mount a campaign through the courts if not also at committee stage to remove this restriction. It is important to note that Sian Berry (Green Party) suggested an expansion to other conditions where the suffering is much longer than six months. This is an example of the slippery slope being built during the debate!
The importance of the Committee Stage
Only 49 out of the 160 MPs who wanted to speak were able to do so in the debate. They should have the opportunity once the bill goes to Committee Stage. No date has as of yet been given for the Committee Stage to begin. The committee membership has to be decided first. It is unlikely that it will meet before Christmas. It is striking how many MPs who voted for sending the bill onto Committee Stage were worried about its lack of safeguards, despite starting by saying they did not oppose assisted suicide in all cases on principle. There appeared to be more fear than confidence in the chamber at times. I think this shows that many MPs have a troubled conscience on assisted suicide. Analysis by the Independent suggests that at least 36 of the MPs who voted for the bill could later change their mind. The battle is still therefore very much on to defeat this bill.
As Christians we must not give into the assisted suicide agenda nor to the dishonesty of calling it ‘assisted dying’. We know that fear of the Lord is the beginning of wisdom. We need to be able to discern what kinds of fears are the ones that we and others hold. One of the most important apologetic tasks from now on will be to show how fear of the consequences is morally right – it points not only to a concern about correct legal and administrative procedures, but to the moral foundations of good government and healthcare, and to the One who animates all our lives and makes these possible in a fallen world.
