Assisted Dying

Tonia Antoniazzi Excerpts

Monday 29th April 2024 Westminster Hall

[Tonia Antoniazzi (Gower) (Lab)]

I beg to move,

That this House has considered e-petition 653593 relating to assisted dying.

It is an honour to serve under your chairship, Sir Robert.

It is no secret that I grew up as a Catholic and attended Catholic schools. One of the most engaging lessons was religious education, where topics such as abortion and assisted dying, or euthanasia as some may wish to call it, were hotly debated. I admired my teachers who, with firmly held views, always encouraged debate—that is how I remember it, anyway. I have taken, and still take, the same attitude in my work as a Member of Parliament. For this place to have integrity, we must disagree agreeably and have the skills to debate and amend legislation that we may not agree with. Assisted dying is one such subject.

There is no set definition of assisted dying so let me clarify at the outset that here we are referring to the involvement of healthcare professionals in the provision of lethal drugs intended to end a patient’s life at their voluntary request, subject to eligibility criteria and safeguards. That includes healthcare professionals prescribing lethal drugs for the patient to self-administer, and healthcare professionals administering lethal drugs.

The petition calls for the Government to allocate parliamentary time for assisted dying to be debated in the House of Commons and to give members of this House a vote on the issue. More than 207,000 people have signed the petition so far, 272 of them from my constituency of Gower. The petition remains open, so the numbers are probably ticking up as we speak.

The petition was started by Hanna Geissler, the health editor at the Daily Express, and is supported by Dame Esther Rantzen, who is named in the petition. Hanna and the Daily Express have been campaigning on the issue for about two years, but Dame Esther’s public comments marked a change in the public perception of assisted dying, leading them to launch this petition. I pay tribute to their dedication and tenacity.

As people across the House know, this is not the first time I have opened a debate on this topic on behalf of the Petitions Committee. In July 2022, this House considered e-petition 604383, which asked Parliament to legalise assisted dying for terminally ill, mentally competent adults; that petition had more than 155,000 signatures. The fact that, in less than two years, we have had two petitions debates on this subject clearly indicates to me and to others that this issue is one that our constituents are highly engaged in, and I have no doubt that Dame Esther Rantzen has contributed to the heightened awareness of assisted dying. By her own admission, made in our discussion, she did not realise that speaking out about her personal choice would have had the impact that it has.

Whatever our own views, we must recognise that public opinion on assisted dying has shifted in one direction. Polls by Dignity in Dying have shown overwhelming support for changes to the law, with safeguards in place. Membership of Dignitas held by UK citizens has increased to 1,900, with a 23% rise during 2023.

In preparation for this debate and the previous one, I met a wide range of voices on assisted dying. Before this debate, as well as speaking with Hanna and Dame Esther, I spoke with Dr Matthew Doré, the honorary secretary of the Association for Palliative Medicine of Great Britain and Ireland; Dr Andrew Green, the deputy chair of the British Medical Association’s medical ethics committee; and Jonathan Blay from the Royal College of General Practitioners. Such conversations are always welcome and challenge my stance in this debate. The more evidence and sunlight that we can bring to these debates, the better, and we must never dismiss concerns, but consider them fully.

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

Is not the truth of the matter that the debate will continue whether we have it here or not? My colleague Liam McArthur has a Bill going through the Scottish Parliament at the moment. Similar legislation is being considered in the Isle of Man and in the Channel Islands. This issue will have to be addressed. Either we do that in our own time, with our own measured, reasoned debate, or we risk having decisions made for us.

[Tonia Antoniazzi]

I fully accept the right hon. Gentleman’s point that the law is changing in other countries and in parts of the UK. It is important to consider that, and to look at what is done well and not so well. It is for us in this place to consider this matter fully when the opportunity arises.

“Choice” is a key word for Dame Esther and for many of those who have signed the petition. This is about having the choice to die under their own conditions, with dignity and without struggle.

[Alex Davies-Jones (Pontypridd) (Lab)]

My hon. Friend is making an excellent speech. I was here for the last debate that she introduced on the issue and I am pleased to see this debate overwhelmingly supported today. The fact of the matter is that people can have a good death if they can afford it and are physically able to fly to Switzerland. That is grossly unfair. This is completely out of reach for the vast majority of my constituents in Pontypridd and the vast majority of people in the United Kingdom, so it is absolutely right that we have the debate, because if people can afford it and are physically able to do so, they can have a good death.

[Tonia Antoniazzi]

I thank my hon. Friend for her intervention, particularly because she raises a very valid point about the cost of that option for those who can afford to travel, and the discrepancy that there is in our healthcare system.

[Sir Edward Leigh (Gainsborough) (Con)]

That was a perfectly valid intervention, but surely one way to approach this problem is for us to get much better palliative care in place throughout the country. Everybody should be entitled to a dignified death. On this point, under the law of double effect, it is perfectly proper for a qualified doctor to relieve pain with very large amounts of morphine as long as his or her primary purpose is not to kill the patient.

[Tonia Antoniazzi]

I really value that intervention, because two thirds of palliative care in the United Kingdom is actually funded by charities. It is a postcode lottery. Excellent palliative care is what I would hope to have, but I would like to have the choice to have assisted dying and palliative care. I will go on to discuss that further in my speech.

[Caroline Lucas (Brighton, Pavilion) (Green)]

On that point, will the hon. Member give way?

[Tonia Antoniazzi]

I will, but I am very aware of the time and the contributions that need to be made.

[Caroline Lucas]

I will be very brief; I am grateful to the hon. Member for giving way. Does she agree with me that, actually, assisted dying can be a catalyst for more resources to go into palliative care? That is exactly what we have seen under many Administrations around the world.

[Tonia Antoniazzi]

I thank the hon. Member for her intervention. She makes a valid point.

How your family remember you and those last, dying hours with them is also what worries people such as Esther Rantzen. So often, it is the struggle that sticks in the mind of family members when they lose a loved one.

One thing that we can agree on is that this choice must be the choice of the individual and one that is well informed. There are always intended and unintended consequences to any legislation, and it is perhaps naive to suggest that any change in the law would not have wider consequences in society, beyond the individual making the choice. Safeguarding is a huge issue among the voices who oppose a change in the law. In 2023, the Danish ethics council concluded that the existence of an offer of assisted dying would decisively change ideas about old age, quality of life and dying, and that there was too great a risk that it would become an expectation aimed at certain groups in society. How do we prevent vulnerable people from experiencing coercion at a time when they are afraid and ill? It is about conversations and decision making.

[Sir Julian Lewis (New Forest East) (Con)]

I am so grateful to the hon. Lady, for whom I have the highest regard, for allowing me to intervene. Can she explain one thing to me? I do understand the idea of safeguards against coercion, but this is where I have a problem with the notion of assisted suicide: how do we set a safeguard against the person themselves feeling that they have to accept that they will die by their own request rather than be a burden to others? We can protect them from the pressure of others. We cannot protect them from the pressures that they will put on themselves, even though they do not really want to die.

[Tonia Antoniazzi]

I thank the right hon. Gentleman for his intervention, because those are exactly the conversations that we need to be having. We need to see how this has worked in other countries, look at data, be specific and take our role as legislators seriously. We may fall on a different side of the debate, but we need to consider it and engage in the arguments. The work that has been done in this House by the Health and Social Care Committee reflects the importance of having the debate and taking the evidence. I hope that evidence will emerge if we get to debate the issue on the Floor of the House.

The Association for Palliative Medicine of Great Britain and Ireland and the Royal College of General Practitioners oppose any law changes, while the British Medical Association holds a neutral stance. I was very interested to see what the BMA had suggested. Unfortunately, I do not have time to go into that now, but everyone I spoke to agreed that no medical professional should be forced to assist patients to end their lives. That stance is an interesting one, which we should consider.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

I am grateful to my hon. Friend, who is making an excellent speech. She has pointed out the opinion polls and the international examples—Switzerland, Spain, Portugal, Austria, the Netherlands, Belgium, Luxembourg and so on—and mentioned the BMA’s neutral stance. Does she agree that some of us are massively conflicted on this issue? When it comes to abortion I am very pro-choice, but last time we voted on this subject I actively abstained—voted yes and no—and was relieved that the status quo was upheld. Does my hon. Friend agree that some of us are relieved that there is no vote today? With the Hippocratic oath and other things, we are just massively torn on this one, despite the opinion polls.

[Tonia Antoniazzi]

I appreciate my hon. Friend’s contribution. I am going to make progress, because I said that I was going to speak for only 10 minutes, but she makes a very valid point, which will be noted. I thank her for it. This is not an easy debate to have.

In their response to the petition, the Government said:

“It remains the Government’s view that any change to the law in this sensitive area is a matter for Parliament to decide…If the will of Parliament is that the law on assisting suicide should change, the Government would not stand in its way, but would seek to ensure that the law could be enforced in the way that Parliament intended.”

There has not been a vote on this subject in Parliament since 2015, but that does not mean that this House is ignoring the issue. In February this year, the Health and Social Care Committee published its report on assisted dying, as I mentioned. The report did not make any recommendations on law changes; rather, the aim was for the report to serve as a basis for discussion and further debate in Parliament.

A common theme in the evidence submitted to the Committee’s inquiry was what many respondents called “a good death”. I want to make it abundantly clear that assisted dying should not be discussed as a replacement for palliative care; we must also have frank discussions about how palliative care can be improved, so that we can give people the most comfortable end of life possible. Last Monday, there was an engaging Backbench Business debate in the House on funding for hospices; in the interests of time, I recommend that Members and other interested people read it in Hansard. We have to think about some of the recommendations that the Health and Social Care Committee did make around palliative care. It recommended that the Government

“ensure universal coverage of palliative and end of life services”,

give a funding uplift to hospices that require assistance, commission research into how better to provide mental health support and guidance after a terminal diagnosis, and

“establish a national strategy for death literacy and support following a terminal diagnosis.”

That was a point raised by Dr Doré during our conversation. I was struck by the issue of funding. As I mentioned, about two thirds of the funding for palliative care comes from charitable organisations, and I really do not see how that is good enough.

Should the law on assisted dying change and any services be covered by state funding, what message would that send? Should Parliament vote in favour of a law change, there are important questions to consider, some of which I hope I have highlighted this evening. These questions are difficult, but as legislators it is our job to assess the evidence and to try to answer them. The topic of assisted dying is so broad that there are many areas I simply do not have time to cover, such as the current situation in the Crown jurisdictions, the pursuit of prosecutions for family members, or the many individual stories I have heard.

I have previously spoken about the death of my father, over 12 years ago. My family have been supporting my lovely mum, who has had a very tough year—since December, there have been a few times when we did not expect her to pull through. Many friends and colleagues in the House have offered prayers, and I have to say that my mother is our little Easter miracle—the Catholicness never leaves you—and she continues to make good progress. During this time, I have personally wanted to talk about death and consider how I want my death to be. The experience of being in a hospital where there is death all around makes you reflect. It seems harsh and even simplistic, but when such emotion and heartbreak is all around you, you just want your loved ones to be out of pain, however that looks.

We have been lucky that my mother has gotten better, although her life has changed greatly. In my personal view, if someone has a terminal diagnosis and is mentally sound, should they not have the choice to take themselves out of suffering? That is the choice Dame Esther Rantzen talks about. Whatever comes from today’s debate, I would like everyone to consider bringing up the subject of their death with their loved ones now, before it is too late, because two things are certain in this world: we are born, and then we die.

[Several hon. Members rose—]

--- Later in debate ---

[Tonia Antoniazzi]

I thank the Minister, who has rightly set out a measured response to the petition. Obviously, it is difficult for her to commit to a debate on the Floor of the House, because there is an impending general election and much business to do, so I hope that an incoming Labour Government will have that opportunity.

I also thank the petitioners, the petition’s creator, Hanna, and Dame Esther Rantzen. Today has shown our ability to come to this place with a range of strongly held views and have a debate in an informed manner. I thank the hon. Member for Strangford (Jim Shannon), who has sent me a note commenting on the balanced tone of my introduction to this debate on assisted suicide. His comments mean the world. Haven’t we done a sterling job in this House today? That is what we are here for, and that is why we are voted in. I feel strongly about that, as I have said before.

The hon. Member for Aberconwy (Robin Millar) talked about the voiceless and the people who do not have a voice in this debate. I am very good friends with the Paralympian Baroness Tanni Grey-Thompson and Baroness Ilora Finlay, who hold different views on this matter. They are well informed and well spoken and have been in the media on the matter. That does not mean that this House cannot give any potential legislation the sunlight that it deserves. It is incumbent on us to do so. We do so from a place of privilege, because we are elected to this House.

On that note, I thank everybody. I thank the petitioners and campaigners, and I thank you, Mrs Latham, for chairing the debate.

Question put and agreed to.

Resolved,

That this House has considered e-petition 653593 relating to assisted dying.