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Assisted Dying Divide Persists Among MPs As Debate Gathers Pace

Dame Esther Rantzen’s daughter Rebecca Wilcox handed a box of letters in support of assisted dying to No10 on Thursday (Alamy)

9 min read

MPs are carefully monitoring the national debate and concerns surrounding assisted dying, as some believe the "direction of travel" is moving towards parliamentarians voting in favour of a change in the law.

MPs will debate assisted dying in Westminster Hall on Monday after an e-petition requesting a debate reached more than 100,000 signatures. Although no legislation is currently being considered in UK Parliament, the debate is another sign that the campaign in favour of assisted dying has been gathering pace in recent months. In March, Labour leader Keir Starmer said that he personally supported it and pledged to make time for MPs to have a free vote on the issue in Parliament if Labour gets into government, while the current government’s position is also that any change in the law should be led by Parliament.

A fresh wave of campaigning was sparked when broadcaster Dame Esther Rantzen announced in December that she had joined Dignitas, an assisted dying clinic in Switzerland, after receiving a terminal cancer diagnosis. Rantzen has since advocated for legalising assisted dying across the UK.

In February, the Health and Social Care Committee published a report setting out a “broad body of evidence as a significant and useful resource for future debates”. Legislation to introduce assisted dying for terminally ill people is currently being considered in Jersey, the Isle of Man and Scotland. 

A poll last month, conducted by Opinium on behalf of pro-assisted dying organisation Dignity in Dying, showed 75 per cent of people in the UK were in support of making it legal for a person to seek assisted dying in the UK, compared to 14 per cent opposed.

But despite this momentum, many MPs are yet to be convinced. Ahead of Monday’s debate, PoliticsHome spoke to MPs about the reasons why they support or oppose a change to the law, and what could persuade them otherwise.

“Disabled people are really scared”

protester
Protests were held both in favour and against the assisted dying bill in 2015 (Alamy)

Labour’s Shadow Minister for Disabilities Vicky Foxcroft voted in favour of a bill to legalise assisted dying in a parliamentary free vote in 2015. Nine years later, she has changed her mind, and now holds the opposing view to her party’s leader.

“I've been a bit unsure in the past,” she said, explaining that although she was originally planning to abstain on the vote in 2015, she ended up voting in favour after a moving speech by former MP Madeleine Moon, who spoke about the suffering endured by her husband in the final years of his life.

However, Foxcroft said that she is now very strongly against assisted dying being legalised. Describing it as “a hugely emotive subject”, it was clear she had been personally affected by hearing people's stories on both sides of the debate, pausing to wipe away tears during this interview.

“When I became shadow minister for disabled people, I engaged with a lot of disabled people and charities and they are really scared,” she said.

“I just do not think that you can ever go forward with something like this while you have a large amount of population that are terrified of it. And that is why I'm not in favour of it: because of fear, real fear. 

She said that the disproportionate number of deaths of disabled people from Covid had left many feeling "like an afterthought from this government on so many occasions". 

“I've gone and changed my position, but that really has come about from doing this role and listening to people,” she said. 

Foxcroft doubted that assurances on safeguards as the legislation is developed would lead her to change her position. “It's not about this safeguard or that safeguard, it's about how [disabled people] feel about the legislation and how they feel that it could be that slippery slope," she added. "So unless you removed those fears, then no.”

Foxcroft argued that in 2015, much of the debate against assisted dying had been centred on religious grounds: “But the one thing that was missing from that debate in such a big way in 2015 was actually the voice of disabled people.

“I have heard lots and lots of people express their concern about what might happen, the pressure they might feel, the mental anxiety, and at times already having guilt in terms of having to get support from others and to not feel like a burden on the family and not feel like a burden on the state. 

“Representation matters, and we don't have enough disabled MPs in Parliament.”

“This is about a pure personal freedom”

protest
Protests were held both in favour and against the assisted dying bill in 2015 (Alamy)

MPs overwhelmingly voted against an assisted dying bill in 2015, with 330 to 118 votes counted. While Labour MPs were fairly evenly split on the issue, the vast majority of Conservatives voted against the bill at the time.

Matt Warman, Conservative MP for Boston and Skegness, told PoliticsHome he is strongly in favour of a change in the law.

“I think Parliament should be looking around the world and saying ‘what's the best that we could do’,” he said.

“At the moment, we have a very old fashioned position that says ‘just no’ in this country while not stopping people going to Dignitas, while not stopping people trying to circumvent the law. And that produces the worst kind of discrimination: if you can afford it, you can have the death you want. 

“It is emotive but just as with everything else, Parliament has a really profound duty to try and look above the lobbying… This is about in some ways, a pure personal freedom.”

Cases of people carrying out assisted suicide as a result of mental health problems have emerged from countries such as Denmark, which, according to anti-assisted dying campaigners in the UK, show the danger of a "slippery slope" where assisted dying becomes normalised for non-terminal conditions.

But Warman believed the UK should not be considering the “most extreme” examples as the benchmark for assisted dying and seeing it as a “binary solution”.

Addressing concerns that disabled and vulnerable people could be coerced into signing up for assisted dying when the NHS is under pressure, he said that while this was a “real concern”, Parliament would need to have the conversation to get legislation “to the right place” and doctors and the medical establishment would need to review every individual case to ensure safeguards were in place.

“We should be able to say it's a really high bar just to get to this point,” he said.

“Surely you can't go so far as to say ‘we're going to wait for perfect universal health care for everybody before we'll even consider it’. I think what you should obviously be doing is saying we need as good a palliative care set up in the UK as we possibly can, we need as good a NHS more broadly as we possibly can. 

“There’s no tension between the quality of the healthcare you receive and the availability of an option should you wish to take it, one is not diminished by the other.”

He said it was right that it should not be framed as a “political debate”, but claimed the “direction of travel” among fellow MPs was towards supporting legislative change, as well as public polling showing “this is what people are asking for”.

Warman said that he had not seen “any evidence” that certain groups were being underrepresented in the debate.

“One of the things I struggle with is sometimes people who are explicitly coming from the position that they are against this, and will always be against, raising the legitimate interests of vulnerable groups and saying ‘they're on my side too’,” he said.

“The reality is at best those groups are mixed and many of them have got people who are incredibly passionate in favour of it, because they see that it could be something that affects them very personally.”

“I’m open to being persuaded”

Hospice
Justin Madders said he would need to be assured that high quality palliative care was available to everyone (Alamy)

Other MPs take a middle ground position where they are open to the concept of assisted dying only if certain concerns are addressed.

Labour MP and shadow minister Justin Madders told PoliticsHome that he had initially gone into the vote in 2015 with the view that he was in favour of people being “able to have autonomy over their own lives” – but that once he began to look into the details, he began to have “reservations” and eventually voted against.

“I was concerned about the requirement for two doctors to sign and agree that someone had less than six months to live, because I've known plenty of people who have been told that by doctors but actually ended up living an awful lot longer,” he said.

“So I wanted to really be sure that those medical opinions were more robust and that this didn't end up becoming an option as an alternative to medical and palliative care rather than an end of life choice.”

As former shadow minister for secondary care, he said the “great variability” in the availability and quality care in hospices across the country was relevant to the debate. 

Describing himself as being in the “open to being persuaded camp”, Madders said the most important thing was ensuring assisted dying would not become the “default option for people in very difficult circumstances” and that therefore good quality palliative care would have to be available to everyone. 

“We need very strong safeguards to make sure that people do only do this when they're absolutely sure it's the right thing for them that other alternatives have been discounted and that they truly are towards the end of their lives,” he continued.

“I don't want people to spend those last few months in agonising pain, if they can truly make a choice to avoid that. But we also have to be clear that if we do agree to this legislation, we have to be absolutely certain that it will only apply in those very limited circumstances.”

Madders said he would be watching the debate unfold “very carefully”. 

“If we do get a Private Member's Bill in the next Parliament, if I'm here, I think it's very important that whoever brings it forward works with members across the whole of Parliament to make sure that it is a bill that gets as wide as possible support and has the ability to deal with the many concerns people have on a practical level.”

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