THE TERMINALLY ILL ADULTS (END OF LIFE) BILL
To the residents of Lowestoft, Beccles, and the villages,
On Friday, there will be the Second Reading of the Terminally Ill Adults (End of Life) Bill.
This Private Member’s Bill, brought forward by Kim Leadbeater MP, would allow those who are over 18 and who are expected to die within six months to be given medical assistance to end their own life, provided they have made two separate written declarations of intent and received the agreement of two independent doctors and a High Court judge.
I have spent the last few weeks looking into this issue, consulting experts, and listening to the views of constituents. I held a public meeting to discuss the Bill and its contents, and in the best spirit of democracy, I’ve been open to hearing from all sides of the debate on a difficult issue which has no settled academic or medical consensus.
Ahead of Friday’s debate, I am writing today to inform you that I have come to the decision that I will be voting against this Bill.
Prior to being elected as your Member of Parliament, I spent almost a decade working to protect vulnerable women and children from harm. My focus has, and will always be, on safeguarding those who are most vulnerable to coercion and abuse. I have found myself increasingly unable to reconcile that position with legislating for assisted dying. Whilst we all share the desire to reduce the suffering of those at the end of their lives, I am concerned by the very real possibility of vulnerable people being abused or coerced into taking that decision. The provisions in this Bill have not dissuaded me from that view.
We don’t want to think about it, but abuse surrounds us. It’s a very real and present threat. And it’s a complex thing – it can be difficult for professionals to identify without training, victims often don’t realise until they have got free, and it remains incredibly hard to prove in a court of law.
We also tend not to think of older people as victims of abuse, but the reality is that one in six of those over 60 experience it in some form. Almost half of older victims have disabilities and 44% are abused by a family member (compared with 6% of younger victims). We know that older victims tend to be less likely to leave their abusers and are more likely to experience abuse from current intimate partners.
And yet, I’ve heard from proponents of this Bill that because there is no data to suggest that abuse and coercion is happening in countries where assisted dying is legal that no one is being pressured into ending their own life.
But the absence of evidence is not the same as the absence of it happening.
The Monckton Report, for example, found that a third of female suicides could be linked to domestic abuse and the Killed Women campaign group argues that there could be as many as 130 ‘hidden homicides’ every year in the UK where women who are murdered by a partner or relative instead have their deaths recorded as suicide or an accident.
And although, as many have pointed out, there are numerous flaws in the Bill, I am unconvinced that even the best-possible drafted version of the Bill could adequately sift genuine claimants from those being coerced into it. Just one wrong death is too many.
Beyond the very real threat of abuse and coercion, I am concerned that many people will make the decision to end their life for all the wrong reasons – because they feel like a burden or because they worry their life savings will be eaten up by the cost of their care. In Oregon’s 2021 report on the reasons people had for choosing assisted dying, 54% felt a burden and 8% had financial concerns. This should worry us all.
We campaign on the one hand to recognise the value of older and disabled people, but on the other seem to say with this Bill that some lives are of lesser value. When we start to say that the loss of bodily function is ‘undignified’, how can we look at those with, for example, a stoma or incontinence and say that we still believe they have dignity?
I am also concerned by the criteria we set for who is able to access assisted dying. In Canada, assisted dying was originally reserved for the terminally ill, before being loosened to those with a ‘reasonably foreseeable’ death, and now loosened further to those with a ‘grievous and irremediable medical condition’. Even in Oregon, which is much-cited by proponents and which has not altered its legislation since its introduction, people with anorexia, arthritis, and hernias are able to access assisted dying. The concept of ‘six months to live’ included in this Bill likewise opens up scope for subjectivity. I am struck by the number of doctors who thought someone only had months to live, admitting that they are still treating them more than twenty years later.
What is pertinent in any system is the capacity of people to affect its outcome. Human error is unacceptable in a life-or-death situation, and yet it is all too possible. As is malicious interference. With the variety of miscarriages of justice by the state (from Horizon to the Contaminated Blood scandal), NHS scandals like Alder Hey and Shrewsbury Maternity, doctors like Harold Shipman, and police officers like Wayne Couzens, I am not sure how we can be confident in any system’s ability to administer death.
After careful consideration I will, therefore, be voting against the Bill on Friday, but I would like to thank all of those who attended my public meeting or have written to me on this issue. Regardless of whether you agree with me on this Bill, we all share a desire to lessen suffering for those at the end of life and what I think is clear from this debate is the very real need for better investment in palliative care. Currently, hospices are forced to find two thirds of their funding from charitable sources, whether that is legacy donations or cake sales. I will continue to push for better palliative care so that everyone is afforded the most pain-free end to their life possible.
As ever, you can contact me via email at jess.asato.mp@parliament.uk or by post at Jess Asato MP, House of Commons, London, SW1A 0AA.
Kind regards,
Jess