Terminally Ill Adults (End of Life) Bill
Ben Spencer Excerpts(1 month ago)
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Dr Ben Spencer (Runnymede and Weybridge) (Con)
I rise to speak to amendments 18, 30, 31, 17 and 32, which stand in my name.
I will start with amendment 18. Many moral arguments on the need for the Bill have been proposed both inside and outside this place. Some of those arguments have addressed the desire for greater control at the end of life, but the vast majority have focused on the prevention of irreversible suffering. The principle of bodily autonomy—which I strongly support in the context of full decision-making capacity, with certain important caveats—is used to justify the rights that the Bill will grant. However, let us put aside the debate surrounding the Bill and focus on the text of the clauses, which is the task that we face on Report.
The provisions are silent on suffering, silent on control and silent on all but a terminal illness with a prognosis of fewer than six months. If the principle is that we must prevent irreversible suffering, all those suffering irreversibly should be able to seek physician-assisted suicide. If the principle is that we should give people control—another level of expression of bodily autonomy—all adults who truly and freely consent with full decision-making capacity should be able to seek physician-assisted suicide. If those principles are circumscribed to an arbitrary definition of “terminal illness”, the inexorable conclusion must be that those patients’ suffering or autonomy are more important than those of others, or that their lives have less value. We have seen that position subtly imported into this debate. When requesting an assisted death is not framed as suicide because some perceive it as understandable, the underlying argument is, “If you’re terminally ill, of course you want to die—that’s understandable.”
We must ensure that we do not, by accident or otherwise, enshrine in our statute book value judgments on the worth of the lives of the terminally ill or on the protections that they should enjoy like everyone else. I tabled amendment 18 to expand the scope of the Bill as much as I can to reduce the discrimination inherent within it. The maximum I could do was to remove the six-month restriction, but I wish the amendment could go further. I know that some Members will wince at this provision, but I ask them to ask themselves what the principles and values in the Bill are, how they are being applied and whether they are being applied equally. I believe that the Bill as drafted is incoherent and discriminatory. My amendment would introduce some moral clarity to the Bill. If we do not do so, the courts will.
I turn to amendments 30 and 31. If we are to rely on the principle of autonomy to authorise physician-assisted suicide for terminal illness, the expressed choice must be true and free. Autonomy needs help, though. A true and free choice needs to be informed; a true and free choice cannot be made under coercion; a true and free choice requires decision-making capacity. I believe that, if we are to rely on the principle of autonomy for the most grave of decisions, there needs to actually be a choice. In the absence of relevant and available palliative care options, where is the choice? How can we rely on autonomy in the absence of choice? The prospect of people choosing physician-assisted suicide not because it meets their needs, but because their needs are unmet owing to a failure in the provision of palliative care, is a moral outrage. My amendments 30 and 31 would ensure that that does not happen.
Neil O’Brien (Harborough, Oadby and Wigston) (Con)
Will my hon. Friend give way?
Dr Spencer
I am sorry but I really cannot, given the time restrictions.
Amendment 17 pertains to the test of decision-making capacity. In English and Welsh law, we use the Mental Capacity Act 2005 to define capacity, and I believe it is right that the functional test of capacity is used in this Bill. We have common law tests of capacity in some circumstances, which arose before we had the Mental Capacity Act. However, the decision to end one’s own life was not permitted in the early case law leading up to that Act. There is no jurisprudence background or guidance. These capacity tests have not been done before. This test needs a bit more of a framework of support.
Amendment 17 lays out the minimum information that needs to be understood as part of the functional test of capacity. Critically, that would include information about the current treatment options, about doing nothing and about proceeding under this legislation. It would make clear that physician-assisted suicide is not a medical treatment, but a personal choice about life and death. Without amendment 17, this Bill will fundamentally undermine the doctor-patient relationship. Doctors do not prescribe death, and this Bill must make that clear.
I turn finally to my amendment 32. There has been some discussion about the inadequacies of the decision-making capacity test as gatekeeper. In effect, there may be circumstances in which, despite having capacity, the person is otherwise recognised as vulnerable. That is how our courts operate. The impact of depression or personality disorder on decision-making capacity can be subtle and elusive. I know, as I used to be a consultant liaison psychiatrist and did research in the area of decision-making capacity. This is tricky stuff to do, especially in the context of a request for an intervention, rather than a refusal.
We should have trained psychiatrists at an early stage assessing capacity. They are expert at picking up these subtle cues and all the other stuff that is going on. A request for physician-assisted suicide should not be taken in isolation, and that needs to be understood and supported. We need someone who knows how to use the Mental Health Act, because if a doctor is doing the assessment, and they have a patient in front of them with a mental disorder, expressing a desire to end their life, they need to make sure that that patient gets the right and appropriate treatment. That may well be using the Mental Health Act. We need to make sure that this happens; I hope it would happen as part of the process as usual, but there is no safeguard in the Bill to make sure that it does. Psychiatrists turning up on the panel at the end is not good enough; they need to be there from the start.
Finally, there are broader issues about the interaction with protections to save life, article 2, and a doctor’s duties. I will cover those in the debate on the second grouping, along with the incredible importance of the Bill’s interaction with the suicide prevention strategy.
Daniel Francis
I rise to speak to amendment 24 in my name, and I will start by thanking my hon. Friend the Member for Spen Valley (Kim Leadbeater) for inviting me to be a member of the Bill Committee.
I accept the principle that somebody given the devastating news that they have six months left to live should be able to choose the moment that they die, with their loved ones around them, but this is not a vote on the principle. We are not being asked to make an arbitrary yes or no choice, for we are legislators, and my experience on the Bill Committee tells me that this Bill, as written, still requires additional safeguards to address the concerns of so many people in this country.
For me, it was death, and my thoughts and concerns about what happens when I die, that drew me to my conclusions on this matter.
Stephen Kinnock
I thank the hon. Lady for her intervention. She may have noted the comment from the hon. Member for Bexhill and Battle: approximately 500 amendments were tabled in Committee, and approximately one third of them were accepted. There was a pretty robust process for looking at whether amendments were acceptable, and the Government were involved in commenting and advising on all of them.
Stephen Kinnock
I will make some progress, if I may.
Amendment 87 would require the co-ordinating doctor to “take all reasonable steps” to establish whether a first declaration had previously been made, so it may slow down the process for accessing assisting dying.
Amendment 45 would significantly impact the operability of the Bill. It would duplicate the role of the assisted dying review panel, and place an additional burden on the co-ordinating doctor to convene the clinical panel. It would also require additional NHS and social care resources, particularly palliative care consultants. That could slow down a person’s access to an assisted death, because there is no requirement on when the panel must be convened, and it could take some time to set up, given the demands on health and social care professionals. The amendment does not specify who is to be on the clinical panel in situations where the co-ordinating doctor is neither a GP nor a consultant. Similarly, there is no provision for whether the clinical panel is to make its decisions unanimously or by majority.
Amendment 48 would require significant changes to the functions and focus of the bodies that are proposed to present arguments to the panel as to why a certificate of eligibility could not be granted. Where an official solicitor acts as an advocate to the court, their purpose is to assist the court on a difficult or novel point of law, not to perform an adversarial function. Similarly, there is no precedent for the Attorney General, His Majesty’s Procurator General or the Treasury Solicitor to intervene in a case in the way that is envisaged, as their roles are to act on behalf of, or provide advice to, the Government, and not to represent a specific argument. In the Government’s view, there are no existing public bodies that are well suited to undertaking this adversarial role.
UK Democracy: Impact of Digital Platforms
Ben Spencer Excerpts(2 months, 2 weeks ago)
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Dr Ben Spencer (Runnymede and Weybridge) (Con)
I thank the Backbench Business Committee and the hon. Member for Lagan Valley (Sorcha Eastwood) for securing this important debate. Digital platforms can both enhance and undermine democracy. Social media can increase awareness of elections and candidates, encouraging participation and voter turnout, but it can also lead to the abuse of democratically elected MPs, councillors and politicians. Even more worrying is the threat of electoral interference from malign international actors. I am grateful to Members from all parties who took part in what was an incredibly thoughtful and interesting debate on such an important issue.
For reasons of time I cannot reflect on everyone’s speech, but I wish to pay particular heed to three Members who have spoken. I thank the hon. Member for Lagan Valley for her incredibly powerful speech, and I am sorry about the abuse, attacks and threats she has experienced. Any attack or abuse to an MP is an attack on our democracy. We have brilliant representatives in this place. I am proud to be a Member of this, the greatest Parliament in the world, and there is a duty on us to stand up for our fellow colleagues, Members across the House, and elected representatives at all levels. I particularly thank her for mentioning Jo Cox and David Amess. I was elected after Jo Cox was murdered, but I did get to meet David Amess before he was murdered, and I still have a letter that he sent me when I was elected as a new MP. I know that he and Jo Cox are very much missed by us all. Sadly, what happened to them clearly drives home the importance of ensuring that we deal with these problems and get this right.
Later in my speech I will pick up on one of the points that the hon. Member for Lagan Valley raised about disinformation and misinformation, as well as digital watermarking. She also raised important points about how social media operates. I have often thought that we need to think about anonymity and privacy separately in terms of people using a platform and its content.
I pay tribute to the right hon. Member for Oxford East (Anneliese Dodds), who used her speech, in part, to make some comments regarding her resignation. Principles are not principles unless we act on them, and I hope she has the opportunity to serve in His Majesty’s Government again at some point in the future. There have been so many brilliant speeches, and I would like to reference everybody but cannot due to time. However, some remarks by the hon. Member for East Kilbride and Strathaven (Joani Reid) jumped out at me, particularly the quote that she read out in this Chamber, and those vile comments. I would be grateful if the Minister commented on that when she winds up the debate, and said what reassurance she can give the House that the issue is being dealt with appropriately by the digital online platforms.
Protecting the integrity of our elections and stopping the influence of malign and foreign actors is a critical role for the Government, and it is the Government’s responsibility to work closely with the Electoral Commission, and others, to protect the integrity, security and effectiveness of UK referendums and elections. The Electoral Commission has a wide range of investigatory and civil sanctioning powers, and the Government are able to refer more serious matters to the police or the National Crime Agency. As outlined in the previous Government’s response to the report on Russia by the Intelligence and Security Committee, the UK’s adversaries adapt a whole-of-state approach to hybrid and malign activity. Therefore, tackling it requires a cross-Government, cross-society response.
To respond effectively, the Government need to draw on the skills, resources and remits of different Departments, agencies and non-governmental organisations. Considering the current geopolitical landscape, it is essential that the Government keep all aspects of their approach to protecting democracy under review so that they can quickly adapt to any new threats that emerge.
The UK is not alone in facing this issue; democracies across the western world are facing the same issue. Political parties are successfully harnessing the impact of social media to reach cohorts of voters who are normally uninterested or disillusioned. That is a good thing, but countries are facing interference from other states, including Russia and China, so how should Governments respond?
The previous Government were resolute in defending our country from hostile state activity. The Elections Act 2022, which they brought forward, restricts third-party campaigning to UK-based groups and eligible overseas electors, so that only those with legitimate interests in UK elections can campaign at UK elections. It also contains new measures requiring digital imprints on online campaign material and greater transparency in political funding. The previous Government also passed the world-leading Online Safety Act, to which many Members have referred. Its provisions have only recently come into force and I hope this Government will continue to actively monitor what Ofcom is doing to ensure the Act is working appropriately.
There are also threats from artificial intelligence and disinformation, particularly the ability of AI to create realistic videos and images impersonating trusted public figures, including political and religious leaders. The risks of that are clear for all to see. In Committee, we tabled an amendment to the Data (Use and Access) Bill that would have set up a technological standard on digital watermarks. In part, it was about helping to solve some of the issues around AI and copyright, but it was also about ascribing authenticity to what people are putting on social media. I suspect that, like me, many colleagues from across the House would like to have the ability to put a digital watermark on the material they put out, so that people can be sure that the content they are seeing is from the person who purports to have created it. The Government voted our amendment down, but I hope Ministers will work with us to support such measures going forward.
To conclude, we must ensure that regulations are effective and up to date with the latest technology. We must ensure that the public are made aware of the risks of AI-generated content and deliberate misinformation, and we must tackle foreign interference in our elections. Digital platforms can enhance democracy and it is important that we do not lose sight of that. Like it or not, traditional media is no longer the primary news source for many people; Twitter, Facebook, TikTok and Snapchat are all part of the news ecosystem. If we, as politicians, want better participation in democracy— I believe that all of us want that—we cannot vacate social media, although if I am honest I am very jealous of the people who do not use it, or vacate the online space. Instead, we must ensure that it works for all of us.
Oral Answers to Questions
Ben Spencer Excerpts(2 months, 2 weeks ago)
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Mr Peter Bedford (Mid Leicestershire) (Con)
Dr Ben Spencer (Runnymede and Weybridge) (Con)
The Minister of State, Foreign, Commonwealth and Development Office (Stephen Doughty)
As we and Mauritius have repeatedly said, including in joint statements on 20 December and 13 January, both sides remain committed to concluding a deal on the future of the Chagos archipelago that protects the long-term effective operation of the joint UK-US base on Diego Garcia. Once the treaty is signed, it will be put to Parliament for scrutiny before ratification in the usual way.
Stephen Doughty
I have answered those questions on a number of occasions, including earlier. I have been very clear that a financial element is crucial to protect the operation of such a vital base for our security and for the security of our allies. Once the treaty is signed, it will be put before the Houses for scrutiny before ratification in the usual way, and that will include costs. We will not scrimp on security: protecting our interests and those of our allies is the most important thing.
Dr Spencer
Politics is about choices, and the speculation about how much the Government want to hand over to Mauritius starts at £9 billion. That money would go a long way as official development assistance, so does the Minister regret that choice?
Stephen Doughty
As I have said, a financial element—let us remember that this is over 99 years—was crucial to protect the operation of the base. If we do not pay for our security, somebody else might attempt to get in there. That is one crucial reason we have worked closely with Mauritius, the United States and other allies and partners, including India, to protect our base on Diego Garcia.
Frozen Russian Assets: Ukraine
Ben Spencer Excerpts(5 months, 1 week ago)
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Dr Ben Spencer (Runnymede and Weybridge) (Con)
Debates such as this, about the horrors now happening in Ukraine, are always very important and very difficult to speak in. I very much appreciated listening to some of the harrowing stories, to remind myself just what the Ukrainians are experiencing, but also why all of us must push back Putin’s war machine.
I am most proud of the leadership that our country has shown over the past few years in the international response to support the Ukrainians to stand up against Putin. A key part of that was bringing together the international community to multilaterally, not unilaterally, support the Ukrainians in their plight. Early in this conflict we saw the weaponisation of oil and gas prices. We saw, and continue to see, hybrid warfare, which has been going on for some time. I very much supported, at every stage, the full-fat embargo of Russian oil and gas. Indeed, this House strongly supported the sanctions, which have been an important part of our support for the Ukrainians.
As tempting as this motion is—and it is very tempting when we read it—I must say that, like Members on both sides of the House, I am cautious and have some concerns and reservations about it. It is important to consider the impact on the international financial order and the rule of law. What differentiates us from Putin and the Russian state is that we do consider and debate this—we have this place where we can consider the rules-based order. Putin thinks that makes us weak, but he is wrong; it makes us strong, and it is what we stand for and what we believe in.
If we are to look at seizing assets, there are two important considerations. First, this focuses on state assets, as opposed to those of individuals and companies, as there is currently no judicial process for individuals and companies who have had their assets frozen, and to go ahead with seizing those assets is a much bigger step. Members have mentioned individuals and companies as well as the state, but the focus has to be specifically on Russian state assets, for which the legal framework is stronger.
Secondly, as with how we led from the beginning of the conflict, there has to be a multilateral approach. This has to be linked through the G7 and our partners in Europe. It has to be done together in unison, and we have a history of doing that. I say to the Minister that I am very proud of how we have done that. If we are to do this, we must do it multilaterally.
We also need to look at these assets being used for military use, as opposed to just general economic support. My understanding is that the interest money that has now been freed up has been restricted from use for military interventions, and this also needs to be considered as part of the process.
Finally, we also need to ensure that our current sanctions are effective. Just before Christmas I mentioned my concerns about the oil and gas embargo, particularly the idea that crude oil derivatives could be finding their way into the UK economy despite the embargo. I am grateful to the Minister for responding to some of my specific questions on that, but I hope he will look carefully at the effectiveness of the proofs of origin under the rules of origin, particularly when it comes to petrochemical derivatives such as plastics and other products that can be manufactured through the use of Russian oil and gas. We must ensure that, in our economy, our oil and gas embargo of Russia is as effective as possible before we even start looking at the next measures to take.
Foreign, Commonwealth and Development Office
Ben Spencer Excerpts(4 years, 9 months ago)
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Dr Ben Spencer (Runnymede and Weybridge) (Con)
Following the creation of the new FCDO, will my right hon. Friend reaffirm that tackling poverty and gender inequality will remain priorities of the Department?
Dominic Raab
I thank my hon. Friend and constituency neighbour. He is absolutely right. As I made clear in relation to the ODA review and the force for good agenda, tackling inequalities through, for example, our campaign to deliver a minimum of 12 years’ education for every girl, no matter what their background, and in relation more generally to prioritising the least developing countries and the bottom billion, the priorities that are dear to his heart will remain at the very centre—they will be the heartbeat—of the new FCDO.
Oral Answers to Questions
Ben Spencer Excerpts(5 years, 1 month ago)
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Wendy Morton
This is an important point. We know that for every percentage point contraction in global GDP from covid-19 we would expect to see as a result, sadly, up to an additional 4 million stunted children, and acute malnutrition is likely to increase. Between 2015 and March 2019, DFID reached 50.6 million women, adolescent girls and young children with nutrition services in 25 countries, and this includes life-saving treatment for acute malnutrition.
Dr Ben Spencer (Runnymede and Weybridge) (Con)
Siobhan Baillie (Stroud) (Con)
The Parliamentary Under-Secretary of State for International Development (James Duddridge)
Keeping supply chains open is essential for British consumers to access what they need. It will also help British business to bounce back quickly. We must protect the lives and livelihoods of people in developing countries who work in those supply chains, so we are working across Government within the G20, the World Trade Organisation and the World Bank on development-focused trade support, including flows of medical supplies. We are also working with British business to support vulnerable communities overseas that provide goods to the UK.
Dr Spencer [V]
Domestic and international supply lines will clearly be crucial to the economic recovery of both ourselves and the world as we bounce back from coronavirus. Is the Minister working with colleagues from the Department for Transport and the Department for Business, Energy and Industrial Strategy to also support logistics firms such as those in my constituency and the vital role that they perform in keeping our country running and open for international business?
James Duddridge
I thank the logistics firms across the country, particularly those in Runnymede and Weybridge, for the work that they do. This ministerial team will continue to work with the Department for International Trade to keep supply chains open so that firms can restart exporting as soon as the operating context allows. We will also work with the Department for Transport and BEIS to understand the impacts on UK logistics firms and the critical role that they play in facilitating trade.