The easy thing, for MPs who are personally conflicted on matters of conscience, is to abstain from voting. However, despite supporting the principle of Assisted Dying long before I became an MP, I will be voting against the Terminally Ill Adults (End of Life) Bill.
While I understand the religious arguments on this matter, I don’t agree with them. I also think the arguments about improving palliative care, while correct do not preclude an option of Assisted Dying. I fundamentally believe that giving people a level of control over how they die can be a sacred thing in and of itself, is the right thing to do and something we must get right. Yet, I find myself unable to support this Bill as it stands today. That is because of experience of the state’s ability to deal with this sort of complexity.
During my time as a government minister, it became clear to me that our healthcare system is not able to cope with complex issues requiring serious safeguarding. I learnt this when clinicians, parents, whistle-blowers, and children came to me raising serious concerns of safeguarding failures in our gender identity development service. None of the safeguards purportedly in place did anything to prevent young, often gay or autistic, children from receiving irreversible and damaging treatments. I saw a culture where patients and parents felt unable to challenge medical professionals, and medical professionals were fearful of questioning patients.
As Members of Parliament, it is our first and foremost duty to be good legislators. A lot of this has now been lost in our Parliament. There is a tendency to prioritise good campaigning over good law making. It is not our job to be campaigners, even if there are issues about which we care a great deal. It is our job to ensure the law is robust. There is no-one that can step into the breach if we do not do the hard work.
On a decision this profound, MPs should be going in fully armed with the facts, knowing that the legislative process will be as thorough as it possibly can. Instead, we have had two weeks to consider a bill drafted by campaigners. There has been no formal public consultation. No robust discussion with those that must deliver the policy – neither the NHS nor the doctors. Officials have been blocked from carrying out and providing an impact assessment. It does not even seem that HM Treasury has been properly consulted on cost implications nor that the law officers have considered the interaction with the European Convention on Human Rights.
I do not believe there are effective protections in this Bill for patients who feel they are a burden to their families or are pressured by circumstances. It is not clear how doctors would identify dishonesty or coercion, or how the courts will have scope to inquire into it. The author of the Bill has said we must ‘put our faith in medical professionals and lawyers and judges’ - but that is not good enough.
The moment I knew I could not personally support the Bill was at Prime Minister’s Questions, when Sir Alec Shelbrooke asked the Prime Minister whether he would allow MPs two days of debate to examine the details of the bill and any amendments. The Prime Minister swiftly dismissed him, saying five hours was ‘sufficient time’. I knew that this same bureaucratic indifference to the sincere concerns raised by MPs would be reflected in the judicial and healthcare systems responsible for carrying out assisted dying for the most vulnerable in our society.
This issue is too important to be rushed. Anyone who tells you there is no such thing as a slippery slope in law has not been paying attention to recent legislative and regulatory developments. Without robust safeguards proposed, improved end of life care, and the proper vehicle for serious debate and scrutiny, we are not ready for this legislation.
The second reading is the only chance we have to influence this Bill, and I cannot support it. A vote at second reading is not a vote to ‘continue the debate’. After this reading, it will be too difficult to make the changes necessary to improve safeguarding. The vote at second reading is a vote on legislation that can and may well reach the statute books; it is to say that I am prepared to accept this bill becoming law, in this way, with all the consequences that may bring.
We have been here before: when reasonable concerns about how legislation will work, or is working, have been dismissed.
I firmly believe that assisted dying is something we need to consider properly. It is something that requires a full review, and a vote on the principle ahead of detailed work with all relevant groups. As happened with Brexit legislation and on Net Zero, I have always said that it is a mistake to plough ahead with promises, targets, and campaigns with no plan for delivery. It is no different with this Bill. I know that the NHS is not in a state to deliver this safely. And our legal system is already under significant strain.
We need to recognise that our political system is broken. We cannot keep agreeing to things, however well intentioned, without a clear plan for how they will be delivered in practice - with all the implications fully considered. It’s time for politicians to tell the truth and that means accepting that the first duty of MPs is to get the law right.
Originally published in The Times here.
