MPs make clear that the issues surrounding end of life care and decisions are as real for them as for all, with moving and often passionate contributions from all sides of the House
Many MPs reflected on messages from and conversations with constituents:
Let me conclude with a letter from Jane, one of my constituents. Her husband, Richard, was diagnosed with cancer in 2012. On 11 September 2013—two years ago today—he passed away. She said:
"I was able to care for him and the last few weeks we had together helped us to come to terms a little with the inevitable…At one stage because I was caring for him seven days a week, Richard began to feel he was a burden to everyone to which I assured him he was not a burden. I can understand totally where he was coming from. I think changing the law would place pressure on vulnerable people. Those who are elderly, disabled, sick or depressed could feel an obligation to agree to end their lives for fear of being a burden on others. From the bottom of my heart, Mr Flello, I would ask that you could be there…to oppose this piece of legislation."
That is one constituent of mine. I know that others have written to me, asking me to support the Bill, but for Jane's case, we cannot let it go through.
I am particularly thinking of situations where people may feel an unbearable pressure to commit suicide for fear of becoming a burden on loved ones. One of my constituents wrote to me on this point and I would like to share her comments with the House. She said:
"If I was unable to be independent, I would immediately be under pressure to go. My only daughter is fully employed and I have been a widow for over 50 years—there is no one else I could call on. As soon as I ask help of my daughter, I put pressure on her already-busy life. She would not deliberately wish me out of the way but adding the burden of mother-care would make it very hard for her to cope."
She goes on to say:
"How could I NOT feel under pressure to get out of the way? I would be unable stubbornly to stay alive when I knew I was being the last straw in her busy life."
If this Bill becomes law there would be hundreds, if not thousands, of people who would feel themselves to be in this position.
A great number of MPs beyond these, however, spoke of their own families' experiences of chronic and terminal illness, and of dying. Many of these illustrated the difficulties of prognosis, and the very real fear of being a burden, with contributions coming from Labour's Lyn Brown (pictured, top) and the Conservatives' Mike Penning having particular resonance:
I am afraid that I cannot support this Bill. My concern is that we will fundamentally change the way that our society thinks about and deals with the terminally ill, severely disabled people and the vulnerable, troubled and elderly.
My mum died suddenly and unexpectedly, riddled by cancer, but I know that my mum, faced with a terminal prognosis in a world where there was the possibility of state-assisted suicide, acceptable and accepted by society, would have tormented herself during her last months with the question of when she should ask for that button to be pressed. She would have worried about the stresses that my 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 that folk would think that 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; and yet I know that the mere existence of legal and assisted suicide would have placed an enormous burden on her. But what of those without a loving family? What of those elderly people—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 priceless gift of life? Would not some of my more vulnerable constituents think that they ought to take a course of action because it is available and despite the safeguards in the Bill, which I acknowledge have been carefully crafted? Can we be absolutely sure that they would not be pressured into it?
It is naive to believe that we can prevent an elderly, expensive or asset-rich relative being encouraged, coerced or emotionally blackmailed into taking their own life. And if just one person makes that decision to end their life as a result of such pressure, that would be a tragedy.
I oppose it most strenuously, because I think it will fundamentally, slowly but inexorably, change our society's attitude to death and the dying, with a creeping invidious expectation that our elderly, infirm or disabled should take themselves out of the igloo of old, and die a dignified death, leaving the young, fit and able unencumbered by their burdensome, difficult, messy, expensive, pain-filled and challenging lives.
Life is precious. But the virtues in a society that set it apart as wholesome, decent and ethical are those which nurture and value that life. They are the qualities of tolerance, understanding, forbearance and, dare I say it, love, which are such precious commodities. They engender and sustain compassion and ensure a growing humanity, a more civilised society for the living, that shields and truly values life.
I should like to give the House a small example... My mother is 83 years of age and has a number of health issues. Last year, she was in and out of hospital, and in April this year she was told by the consultant that she did not have much time to live. In May, she was given about three days. My mother has now recovered and is very healthy again. Before I left home at 5 o'clock this morning, I had tea and biscuits with her, and she was walking about. She has recovered, but when she was suffering, she was saying, "I feel I am a real burden on my family. I can't do this." She was very emotionally distressed, and she still sometimes gets distressed, but she has survived and she is now healthy.
Everyone in the Chamber knows many such examples, and we could cite large numbers of them. I have a friend who has just lost the battle with cancer after 13 years. When she was diagnosed, she was told that she had six to nine months to live, but she defied all the odds. At the time, her son was 11 years old, but she saw him pass exams, learn to drive, graduate and settle down. She saw him grow from a small boy into a bright young man, and she loved life right until the very end. I wanted to tell that story because it is not unheard of, given the pioneering research that is continually being carried out, that cures to many illnesses and diseases will be found, as I have no doubt they will.
When my father was diagnosed with cancer in 1978, the family watched him die a painful death. It was a bad death, and when he died, I said, "Thank God he has died."
...I went to get his last shot of morphine and I am absolutely certain that that was what pushed him over the edge, but at least he did it without unnecessary pain at that final juncture.
We say that people should not be put under undue pressure or feel they are burdens on their family. They should not feel, "Well, I have the choice, perhaps I should exercise that choice." It is almost impossible to say that people with terminal conditions will not be pushed into an earlier death simply because they have that choice. At the moment, they do not. It is impossible to calculate how many people will say towards the end of their lives, "I think I am going to take that poisonous cocktail because I do not want to be a burden on my family and because it is costing them to keep me in a nursing home, with all that that entails."
I pay tribute to Macmillan nurses, Marie Curie nurses and the hospice care in this country. I do not believe that Dignitas brings dignity to death; I think it brings a speedier death, and I ask the best minds that we have in the world: is that the best that we can offer?
Tim Loughton (East Worthing and Shoreham) (Con)
My prime concern, and why I will vote against the Bill, is that we risk engendering guilt among elderly people and those with serious disabilities about being a burden on their families, their carers or society. Bringing a Dignitas-style solution to their doorstep implies that that is what is expected of them and the most unselfish course of action to take. As our population lives longer, that pressure will become greater.
Rather than re-rehearsing the arguments, I want to close on a very personal story. My mother was diagnosed with cancer at the end of 2013. At the beginning of January 2014 she reacted badly to her chemotherapy and became very poorly. She was taken to hospital and after a few days doctors decided that there was little they could do for her and she was transferred to the new St Wilfrid's hospice in Eastbourne. Staff there were brilliant and we cannot thank them enough. As a patron of St Barnabas House hospice in Worthing, I know the fantastic work that hospices do. Doctors told us that our mother would be unlikely to make the weekend. It was a shock that it had happened so quickly when she apparently had been receiving good treatment.
My brother, my sister and I mounted a vigil. She was in great pain and discomfort but my mother kept telling us that she really did not want to be a burden, and that if she had known that things would turn out like this, she would have taken herself off to Dignitas to make sure she was not a burden. I do not know whether she would have gone through with that, but she was convinced that she did not want to be a burden. We will never know what she might actually have done.
The weekend came and, incredibly, my mother was still there. Fortified by a range of exotic fruits and fruit juices to quench her thirst, she actually started to improve. A few weeks later, she was still there. She had rallied sufficiently that she was deemed to be too fit to stay in the hospice and so was evicted. It was a great triumph for her; people are not normally evicted from hospices. We found her the most wonderful nursing home in Eastbourne, the Queen Alexandra Cottage home. Far from being a burden, she played an active role in helping the staff of the nursing home. She was looked after brilliantly. Her quality of life was excellent. My brother, sister and I spent much quality time with her and enjoyed trips out to favourite family places, and at family get-togethers she was surrounded by her grandchildren.
Sadly, my mother died last October, but eight months after leaving the hospice. She died peacefully and comfortably, and with her family around her, a few days short of her 77th birthday. Those bonus eight months were some of the happiest times we enjoyed with my mother, despite her illness and the limitations it placed on her. It was quality time that allowed her and us to prepare for the inevitable, but in a positive and organised way—my mother was very organised.
For my part, those eight months were just a small compensation for the missed opportunities and family neglect that the job of being an MP inevitably entails. If things had gone differently and my mother had chosen another route, completely oblivious of what was actually to happen, and if that alternative option had been readily available and state-approved, she and we would have missed out on a lot. We were lucky to have that valuable extra time, and she valued it greatly.
That is just one example, and I know that many other people's experiences will lead them to other conclusions, but it is a major personal reason why I think that the risks and the potential loss of human experience and sensitivity outweigh the potential advantages that some people might enjoy from a change in the law, and that is why I shall be voting against the Bill.
Ian Paisley (North Antrim) (DUP)
I believe that Parliament should be in the business of giving people reason to live, not of creating laws that facilitate and accelerate people's death. I say that with respect to those who have today given their own personal, trying and solemn examples, but I believe that the balance is all wrong in this Bill and that is why I will vote against it.
I understand what pastoral care is like. I grew up in a manse. People would come every day to my father's manse and witness people with illnesses and sicknesses who needed to be comforted.
I also have a more personal story to tell. A year ago to this day, my father passed away, and tomorrow we will celebrate his anniversary. Eighteen months prior to that, he had been in hospital. He had suffered a very serious illness and ended up on a life support machine. On his fifth day on that life support machine, the doctors indicated to us, "Look, your father's probably going to die in the early hours of the morning. You should prepare yourselves and be ready for the eventuality." We did. We prepared his funeral. We sat as a family and talked about what we should do over the next few days.
That night, amazingly, my dad sat up in bed and demanded a cup of tea. He went on to enjoy another hearty year, and we went on to enjoy his company and lovely presence for another year. We planned his funeral with him, and it was a very different plan—it was noted publicly for being very different—from ours. Some people may say, "We have a right to do this and to tell people, 'It's now time: this person is now a burden on society'," but that is not what we as legislators and as a Parliament should be doing. We should be taking stock and saying, in his voice, "No."
Mike Penning (Hemel Hempstead) (Con)
We have heard some unbelievably passionate speeches.
The House has also shown that it is not just full of lawyers and professional politicians. There are people here who bring experience of their previous professions. Some of them went off to university, some of us went off into the fire service—including me and the hon. Member for Poplar and Limehouse (Jim Fitzpatrick)—and some went into the Army. This debate has shown what we in the Chamber can do when the electorate elect people who are representative of their communities.
When I was 17, I was a young soldier and I had just passed out of training. I got a message from the adjutant that my grandmother had collapsed and that I had been granted compassionate leave because she was terminally ill. People do not get compassionate leave from the armed forces unless the situation is really serious. I went home and Nan was in hospital. She had had a massive stroke and was paralysed from the neck down. I am a man of faith, and that night I prayed that Nan would not make it through the night. She was in great discomfort and she was conscious most of the time. The doctors said they did not think she would make it. She saw me and she cried, as I did.
Nan lived for another 20 years. She was a feisty girl. She smoked 60 a day, which is why she had the stroke, and she had a huge mass on her lungs. She used to cough in a way that I never thought anybody could cough, and she could swear at me when she saw me smoking, even though she smoked 60 a day. The point I am trying to make is that those in the medical profession are simply fantastic people and they do fantastic things for us, day in, day out—we heard much about that from the hon. Member for Central Ayrshire (Dr Whitford), who told us not only about her work, but about the work that has been done in other areas—but they get it wrong, and the will of the human being to decide when it is right for them to go, no matter what pain they are in, is something that we should not take lightly.
Nan was not in pain when she eventually got home. Strokes are horrible things; Nan was bed-bound and my grandfather nursed her for 20 years. Interestingly, I was best man for my grandfather when he remarried at the age of 71, which is also an experience. Sadly, I lost my step-grandmother only a couple of weeks ago, when she was 99. She was just as feisty as Nan, so in many ways he bought silly twice, because she very much ruled the roost.
When Nan was so ill, a group of nurses came in to help her. This was right at the start of the hospice movement, and ever since I have been involved in the hospice movement...
My reasons for voting against this Bill this afternoon are twofold. First, I do not think it should be an excuse that we cannot control pain in the 21st century for people who are so ill. Secondly, I am, frankly, against suicide. I have been to too many suicides... where we have seen the aftermath. People who wish to commit suicide need help—we should help them, not assist in killing them.
NB: There were many very moving stories from MPs on both sides of the debate, and we do not wish to suggest that this is not the case. In highlighting these contributions, our purpose is to reiterate that those who oppose assisted suicide know all too well the realities of incurable and terminal conditions.