A BILL to legalise assisted dying has been passed in the House of Commons by a narrow majority of 23 votes.
A debate on the Third Reading of the Terminally Ill Adults (End of Life Bill), on Friday, was followed by a free vote, carried by 314 to 291. The Bill will now progress to the House of Lords to be scrutinised by peers.
Before the main debate on the Bill began, MPs considered a number of amendments. Among them were a new clause which would mean that the Bill would not apply to people who had “voluntarily stopped eating or drinking”, which was supported by Ms Leadbeater and passed without a counted vote.
Some changes were rejected, including a new clause which would specify that assisted dying would not be available to people if they were motivated by “not wanting to be a burden”, had a “mental disorder (including depression)”, a disability that was not a terminal illness, “financial considerations”, “lack of access, or delayed access, to treatment”, or “suicidal ideation”.
An amendment that would remove the legal presumption that a person had mental capacity unless shown otherwise was also rejected at a vote.
In the Third Reading debate that followed the consideration of these amendments, Ms Leadbeater argued that it “does not make sense” for it to be legal for people with terminal illnesses to effectively kill themselves by refusing food and drink, but not to request a medically assisted death.
Referring to the stories of several people with terminal illnesses, Ms Leadbeater focused on arguments about autonomy, saying: “Surely we should all have the right to make our own decisions about our own bodies and decide when enough is enough.”
The Conservative MP James Cleverly, a former Foreign Secretary, said that he was confident that all members were “sympathetic” to the underlying motive of the Bill: to reduce suffering.
“I do not come to this from a religious point of view; I’m an atheist, I’m a humanist,” he said; he came to the debate “not from a position of faith, but of ignorance”. He said that he was struck by the number of professional bodies, including the Royal College of Physicians and the Royal College of Psychiatrists, which were neutral on assisted dying as a principle, but had expressed concerns about the particularities of the Bill.
Mr Cleverly urged members to reject the Bill, suggesting that it had not been properly scrutinised, and that neither proponents nor opponents should be comfortable trusting the House of Lords to improve the legislation.
The Labour MP for Bradford West, Naz Shah, also referred to opposition to the Bill by some members of the medical and health-care professions, warning that MPs should be wary of thinking that they knew better than experts.
The Liberal Democrat MP for Richmond Park, Sarah Olney, agreed, saying that this should not be a “political decision” made in an “adversarial” process, but should be handed to a commission of experts.
Responding to points about the lack of consensus from professional bodies, Ms Leadbeater said that there were health-care professionals on both sides of the debate.
“This may be the most fateful Bill we discuss this Parliament. It is literally a matter of life and death,” the Labour MP for Hackney North and Stoke Newington, Diane Abbott, said. “What could be more appalling than losing your life due to poorly drafted legislation?”
Questions of capacity, and privilege, were important, she suggested, and MPs had to be mindful of the fact that they were people who did not have any problem with standing up for themselves; but many people, especially when suffering from a terminal illness, might be less able to exert their autonomy.
The Liberal Democrat MP for Eastbourne, Josh Babarinde, said that there was nobody more voiceless in the process than adults with terminal illnesses, and proponents of the Bill were, like Ms Abbott, concerned with ensuring that those who were vulnerable had autonomy at the end of their lives. “The status quo is completely unacceptable and must be reformed,” he said.
There was an “absolute sanctity of human life”, the Labour MP for Bury St Edmunds and Stowmarket, Dr Peter Prinsley, said; but the question was not about life and death, but “death and death”. His long experience as a doctor had convinced him of the “sanctity of dignity”, he said. He urged members to support the Bill.
The DUP MP for Belfast East, Gavin Robinson, said that he would be voting based on his religious faith, but urged those MPs who were not voting based on a “principled position”, but instead on the specifics of the Bill, to oppose it.
Many had supported the Bill in the expectation that safeguards would be developed at the Committee stage; but, instead, they had been “stripped away”, he said, including the requirement that a High Court judge be involved in the process.
The Labour MP for Worthing West, Dr Beccy Cooper, who is a doctor specialising in public health, disagreed about the levels of protection, as did the Labour MP for Southend West and Leigh, David Burton-Sampson.
Dr Cooper said that caution had been taken through the legislative process to ensure that the legislation included adequate safeguards, and that public-health policy should — and, in this case, would — create a safe environment for people to exercise autonomy over their bodies.
Not all MPs agreed that sufficient care had been taken over the progress of the Bill. Among those to raise concerns was the Conservative MP for North Dorset, Simon Hoare. He observed that about 746 hours had been spent discussing “the death of a fox” when the Hunting Act was being passed, but “about 98 hours discussing the death of fellow humans”. Was this right, he asked.
The Conservative MP for Tonbridge, Tom Tugendhat, said that legislation, if passed, would amount to a “huge shift in the relationship between the individual and the State”, as it would license the State to take a life.
“The truth is that this isn’t assisted dying; assisted dying is what a hospice does already, now: helping people, caring for people, supporting them. This is assisted killing or assisted suicide,” he said.
The language used in the debate has been a source of contention: some opponents of the Bill refer to it as “assisted suicide”, and MPs on the other side object that such language is uncaring (News, 13 June).
The Conservative MP for Droitwich and Evesham, Nigel Huddleston, praised the general tone of the debate, but lamented the “somewhat dismissive attitude expressed towards those with religious beliefs. . . It is perfectly legitimate for religious beliefs to influence one’s views on assisted dying”, and those who articulate them should be “respected, not sneered at”, he said.
In a report published by the think tank Theos, last Friday, Dr Nick Spencer argued that it was fundamentally flawed to demand that “one kind of belief system — the religious one — should be named, outed, and treated like it was a compromising factor, but that other (non-religious) belief systems need not do so” (News, 13 June).
