Assisted dying debate in House of Commons: New Forest East MP ‘alarmed’ by letter from Dame Esther Rantzen

New Forest MP Sir Julian Lewis was one of a few select MPs today (Friday) given the chance to have a say on assisted dying before the vote in the House of Commons.

Commons Speaker Sir Lindsay Hoyle said more than 160 MPs were bidding to debate the Terminally Ill Adults (End of Life) Bill – the first time the issue has been debated in the Commons since 2015.

Five hours had been set aside for MPs to air their views on the Bill, and a vote was called before 2.30pm otherwise the Bill was highly unlikely to make any further progress through Parliament.

The vote to support the Bill was passed 330 to 275. Sir Julian voted against, as did New Forest West MP Sir Desmond Swayne and Christchurch MP Sir Christopher Chope.

Sir Julian told the Commons he was alarmed by a letter sent to him by renowned broadcaster and New Forest resident Dame Esther Rantzen in which she said that since the Harold Shipman case, doctors “no longer feel able to” administer painkilling medication which was “the only way to ease human suffering, even if it leads to a speedier death”.

Dame Esther has stage four lung cancer, and has campaigned in favour of the Bill.

Shipman was estimated to have killed 284 people by administering fatal doses of drugs or prescribing abnormal amounts.

Sir Julian said that, if doctors felt this way “it's imperative it should be reversed”, adding: “This is something positive [which] could come out of the imminent debate.”

The New Forest East MP also highlighted the “postcode lottery” surrounding effective palliative care, and said three issues should be in MPs’ minds before they vote: “Can safeguards be effective? My answer to that, I'm sorry to say, is still no.

“Can pain be alleviated sufficiently by palliative care? I think the balance of the argument is in favour of saying probably yes, but it's too uneven across the country and would certainly need the sort of investment that would be necessary to set up a system that would work for assisted dying.

“But above all, have doctors the freedom to administer pain relief, which may shorten life? We need to know the answer to that last question because if, since Shipman, they've been prevented from taking such merciful measures, then that is a classic case of hard cases making bad law.”

The Bill now goes to committee stage where MPs can table amendments, before facing further scrutiny and votes in both the House of Commons and the House of Lords, meaning any change in the law would not be agreed until next year at the earliest.

The MP behind the Bill, Kim Leadbeater, has said it would likely be a further two years from then for an assisted dying service to be in place.

Sir Julian’s speech in full

“In the past, I have voted against this type of measure for one overriding reason, namely the impracticability of effective safeguards. Even if I have always felt practical safeguards could be erected against external coercion, there was no prospect whatsoever of having effective safeguards against internal pressures on someone to request assisted, dying or even euthanasia.

“For example, as we've heard an elderly person in a care home knowing that the legacy they could bequeath to their children was being reduced by tens of thousands of pounds every few weeks would be highly likely to feel obliged to ask to die. And I can't conceive of any safeguard against self sacrifice of this sort, whether for financial reasons or in order no longer to be a burden on one's nearest and dearest relatives and friends.

“However, there's an additional point I wish to inject into the debate because, in my opinion, the key to this dreadfully difficult conundrum about end-of-life care, pain and the possibility of assisted dying lies – or should lie – in the ability of medical personnel to administer effective pain relief, even if it shortens the patient's remaining time.

“In my view, there should be no bar on the use of painkilling medication if that's the only way to ease human suffering, even if it leads to a speedier death. Hence the frequent references to putting dying people on an appropriate pathway. It was therefore, most alarming to me to read a very important paragraph in a letter sent to me in favour of changing the law in voting for this bill by my constituent, the distinguished broadcaster Dame Esther Rantzen in which she explained that doctors no longer feel able to follow this humane course of action since the atrocious Harold Shipman case. Now, if there has been such a change in regulations as Dame Esther believes, I think it's imperative that it should be reversed, and this is something positive could come out of the imminent debate.

“Another thing that has been touched on more than once is the uncertainty and the postcode lottery surrounding effective palliative care. Dame Esther's view is that there are some people who have some conditions for whom palliative care never can be effective. Other people express the view that there is always a way in which painkilling medication can be used in order to prevent suffering. But I suspect the answer to this riddle lies in the fact that that painkilling care in some cases might lead to a shortening of life.

“Therefore, I conclude that there are three issues that should be in our minds:

“Can safeguards be effective? My answer to that, I'm sorry to say, is still no.

“Can pain be alleviated sufficiently by palliative care? I think the balance of the argument is in favour of saying probably yes, but it's too uneven across the country and would certainly need the sort of investment that would be necessary to set up a system that would work for assisted dying.

“But above all, have doctors the freedom to administer pain relief, which may shorten life? We need to know the answer to that last question because if, since Shipman, they've been prevented from taking such merciful measures, then that is a classic case of hard cases making bad law. Doctors need to be able humanely to ease people on their last journey, and the country needs to know where the medical profession stands on that central matter to this debate.”