I support the motion in the name of my hon. Friend the Member for Croydon South (Richard Ottaway) and I oppose the amendment in the name of the right hon. Member for Lewisham, Deptford (Dame Joan Ruddock).
Britain has been ranked first in the world for quality end-of-life care in a survey by T he Economist intelligence unit of 40 OECD and non-OECD countries, including the USA, the Netherlands, Germany and France. We should be proud of and support services that are providing care to enable patients to live as well as possible, while accepting natural death and doing everything to keep patients comfortable during dying.
Mr Robert Buckland (South Swindon) (Con): Will my hon. Friend join me in paying tribute to organisations such as the Prospect hospice in my constituency, which offers world-class palliative care, not only in-house but within the community that it serves?
Fiona Bruce: I will, and I pay tribute to the entire hospice movement in this country. The care and treatment of patients provided by such services embodies the culture that we have in this nation of prioritising care at the end of life, and does not prioritise foreshortening life by months or years at the end-of-life stage.
The DPP has said that the guidelines that he operates are working well; indeed they are. Prosecutorial discretion is part of our criminal law and applies across a wide range of crimes. We cannot fetter it in law because each case is different. The law gives a clear message that one person should not encourage or assist another’s suicide.
Robert Halfon (Harlow) (Con): I am proud to be supporting my hon. Friend’s amendment today. Does she agree that this is not about choice, but is about people being forced to make choices? Does she also agree that rather than having debates about assisted dying it would be much better if we had more debates and discussions about how we could improve palliative care?
Fiona Bruce: I do, and that is entirely the intent of my amendment.
Mrs Eleanor Laing (Epping Forest) (Con): Will my hon. Friend give way?
Fiona Bruce: I will continue now, if I may, to allow for the many other speakers who want to speak this afternoon.
If encouragement or assistance is given for others to commit suicide, individuals are answerable for their actions, but when appropriate, the law takes a compassionate approach. Patients at the end of life are very vulnerable to influence, particularly from those providing care. Just yesterday a specialist consultant in palliative care told me of his concerns about any change in the law in this area. He told me of an incident which, he said, was not isolated, but typical. He said: “I had a single male patient who was dying of cancer. Life was difficult for him; he had an estranged daughter who confided in me that her father had asked to be taken to Switzerland because his life was not worth living. His daughter had left home quite early in life and they had lost all contact. I talked with him and he told me how proud he
was that she had become a head teacher, he himself having been a teacher earlier on in his life. I encouraged him to get to know his daughter again, to tell her he loved her, and that he was proud of her. They did so and they spent the last two weeks of his life together in the hospice having these conversations, which meant so much to both of them.” Is not that the approach that we should take towards those at the end of their life?
The consultant continued, “We”—that is, doctors—“have real concerns that it would place us in a very difficult position if the law is changed, since at the heart of what we do is the tenet that we should do no harm to our patients. So for someone to have their life terminated would place our relationship on a very different footing.” Doctors do not want the relationship of trust between doctor and patients fractured. That surely is why the DPP guidelines tend towards prosecution if assistance with suicide is given by a doctor or nurse as part of their clinical relationship with the patient.
Several disability groups have told me that they would be extremely concerned should there be any change in the law—that is, in this relationship—a change which could well occur should doctors, such as the consultant I mentioned, have the “option to kill”—as he put it—their patients as one of their choices.
Unlike Oregon, where assisted suicide was made legal in 1997, we have specialist palliative care in the UK, with a full four-year training programme. Oregon has had a four and a half-fold rise in assisted suicides since it legalised the practice in 1997, a practice that would result in over 1,100 assisted suicides in this country on a population basis. And Oregon’s safeguards are paper-thin. The Royal College of Physicians has stated that physician assisted suicide
“would fundamentally alter the role of the doctor and their relationship with their patient. Medical attendants should be present to preserve and improve life—if they are also involved in the taking of life, this creates a conflict that is potentially very damaging.”
Help the Hospices says:“It is right that actions by a care professional are treated differently from actions by a friend or family member”.
Baroness Campbell of Surbiton, speaking on behalf of disabled groups, has said that a change in the law“wouldn’t just apply to the terminally ill, no matter what the campaigners may say. It would affect disabled people too, not to mention the elderly. A change in the law. . . would alter the mindset of the medical and social care professions, persuading more and more people that actually the prospect of an ‘easy’ way out is what people such as me really want. Well, the vast majority of us do not.”
The motion should keep the DPP guidelines as they are, and support improved care at the end of life.
