John Pugh MP writes…Why the Marris Bill on Assisted Dying failed

I voted against the Marris Bill and found the result and the debate strangely heartening even though it’s an issue its hard to feel certain about. I will not rehearse the arguments presented but endeavour to offer a different explanation than offered by Norman Lamb for why the Marris Bill failed.

Firstly there was an implicit dishonesty in the proposal. No-one is against assisting the dying but if you arguing for assisted suicide you should call it that. Words ,as George Orwell said, matter. Conflating state-facilitated suicide with care of the dying even if the former is appropriate conflates a distinction which is both morally and legally important.

This is not a pedantic point. Many horrors in this world like bombing civilians or gassing Jews have been masked by words like ‘collateral damage’ or ‘final solution’. I do not think assisted suicide is of that order but let’s use words precisely,truthfully.

The Bill called for assisted suicide only for those who were terminally ill, with 6 months to live with clear mental capacity. The proposers said that was all they wanted – yet repeatedly the bill supporters slipped into talking of and praying in aid other cases where people did not have a terminal disease and 6 months only to live. Keir Starmer the former DPP talked only of these cases.

It’s not the actual irrelevance that I object to, it’s when the same people arguing for the Marris Bill dispute the claim that we are on a slippery slope to further extension of the state’s involvement in suicide. Such an approach is disingenuous,if not dishonest.

Personal stories of dying of relatives ,friends and constituents featured frequently in the debate and were used to argue for and against the proposal. The most rational approach ,given that, is to listen most closely to those who have seen most of this- physicians, hospices etc. So far as I recall every medically qualified member of the Commons -and I commend the awe-inspiring contribution of Dr Phillipa Whitford (SNP) -was against the bill as are most professional bodies.

Troubling deaths is ultimately what concerns people on either side most, but there is a danger here that in a society that has very little direct experience of death and dying we resurrect the medieval concept of “death agony” as the norm. Death for the vast majority of citizens is a gradual closing. However, no-one denies death can be horrible for some.

There are at least two solutions society can adopt . Improve palliative care or assist suicide. In permitting the latter the Marris Bill is silent on the issue of whether the person assisted is likely to suffer a deeply distressing death ( they must simply be terminally ill) and does not permit assistance to those who endure equal distress but have more than 6 months to endure.

What it does is give anyone at all with a life span of only 6 months help with suicide. On that proposal people divided depending on whether they worried about the social consequences of allowing that liberty or they thought axiomatically individuals have a right to such a service.

Norman Lamb for example claims that people have such a right. I see nothing obvious about such a claim and Norman offers little in the way of argument to convince me. The fact that a lot of the public agree with the sentiment probably indicates the same lack of reflection that convinces many that capital punishment is a good idea. Norman’s view is not incidentally the majority view of current Lib Dem MPs

Norman rests his case on John Stuart Mill’s classic, if confused, distinction between acts that impact on others and acts which concern only yourself – “over himself, over his own body and mind, the individual is sovereign”.

One could see this position as the natural mindset of the consumerist, me-generation.

One could take the view that your death, your existence is just the individual’s business ,though in a party that has just witnessed the sad,troubling departure of a former leader, that’s a view hard to sustain.

One cannot though without talking complete bunkum claim that in implicating government, the judicial system and the NHS in you death your request for suicide effects no-one else.

People may wish to think of a request for state run (or privately run) suicide assistance service as ‘just their business’ or perhaps as something that only impacts on other people benignly. I would think they were wrong on both counts.

What is dangerous is to claim there is some sort of inalienable,personal right to such a service. Demands,fair or not are not rights.

* John Pugh was Liberal Democrat MP for Southport until 2017 and was elected as a Councillor for the Dukes ward of Sefton Borough Council on 2 November 2017.

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23 Comments

  • I clearly can’t think John’s argument through in a suitably subtle way, although I appreciate his taking the time to write it, but as he critiques Norman Lamb’s position above, it just seems to me that Norman’s line does make sense in a liberal context. I’d probably rather just hear ‘I’m a church member and can’t support this as it involves suicide’ – unless religion hasn’t had an impact on an individual’s vote.

  • Final thought – the vote does show again how far removed the country’s Parliament is from the rest of us. That might be dangerous IF Corbyn’s anti-politics does somehow catch on, which it might if he takes a Podemos style against the ‘caste’ elites …

  • Helen Tedcastle 12th Sep '15 - 2:57pm

    I agree with John Pugh’s argument here and agree that it is not a sustainable view to simply assert a personal right to a state-sanctioned suicide service, without considering the real social effects and possible real harm to others of such a service.

    I also agree that the speech of Dr Philippa Whitford a breast-cancer surgeon against the Bill, was an outstanding contribution, especially as she shared her extensive knowledge on care of the dying with the chamber.

    I would like to thank all those MPs who voted to oppose the Marris Bill especially the Lib Dem MPs who voted no.

  • We are talking about people who are dying anyway

    The word for them is ‘people’.

  • Richard Church 12th Sep '15 - 5:49pm

    A good law needs to demonstrate that it works. The present law does not. Thousands of people will continue to take that long journey to Switzerland to die, or will quietly try to kill themselves alone at home.

    What do those who opposed this bill propose to do now? Will they seek prevent people leaving this country to die?

    This country will be once again be left behind as other countries adopt a more liberal approach to an individual’s choice over how to end their lives.

  • Toby Keynes 12th Sep '15 - 7:07pm

    I’m rather concerned about the general tone of John Pugh’s piece.

    He starts by stating that the proposal has “an implicit dishonesty”, because it refers to “assisted dying” rather than “assisted suicide”.

    The approach of those who reject his “slippery slope” argument, are, he says, “disingenuous, if not dishonest”.

    Norman Lamb, and all those members of the public who agree with him that there should be a right to die, show “the same lack of reflection that convinces many that capital punishment is a good idea”, with the selfishness that is the “natural mindset of the consumerist, me-generation”.

    And, finally, arguing that involving the state in your death affects no-one else is “complete bunkum”.

    This is a debate on which passions run high, but I do think that it is not too much to ask our MPs to show a modicum of respect for those who happen to hold opposing views.

  • It seems that John Pugh would use the same argument against abortion and therefore to me it seems he is behind the times. The public and parliament accept abortion and cope with the idea that being involved in an abortion may affect others. I don’t see any extra problems with being involved in assisted dying of the terminally ill.

    If he is referring to family and friends then his point is even more ridiculous as the effects on these people will only be when they are affected and not if. I don’t believe there is any evidence that those left behind when someone commits suicide when they are terminally ill and will die anyway are affected in the same way as those when the person who commits suicide is not terminally ill.

  • ‘It’s not the actual irrelevance that I object to, it’s when the same people arguing for the Marris Bill dispute the claim that we are on a slippery slope to further extension of the state’s involvement in suicide. Such an approach is disingenuous,if not dishonest.’ ….
    That’s a new level in arch hypocrisy from those opposed to any form of assisted dying.
    The slippery slope argument is entirely invented by the primarily religious groups opposed to people being able to chose the time of their own death.

  • I generally support John Pugh’s view. Firstly assisted dying/suicide means that someone else has to provide and/or administer the fatal overdose. What about that person? They will always have to live with the fact, which is why doctors on the whole oppose this legislation. The right to die is also the write to take someone’s life (however humanely it is done).

    I also think that if assisted dying became permissible in law some particularly vulnerable ill people might feel they had a ‘duty to die’ because of the upset they were causing to their family. Only the current law protects the dying person.

    Assisted suicide is not the ideal answer to decline and death, but better end-of-life care.

  • George Lund 13th Sep '15 - 8:27am

    That the Lib Dems have MPs so illiberal that they would deny people the help they need to die in the manner of their choosing (given sufficient safeguards) is bizarre. And tragic. This is about rights, because death is part of life, and control of it, when we have the mental capacity to decide, should be an essential human right. In all other areas individuals are allowed to collaborate with others to give effect to our rights. Every argument in this article is wrong.

  • John Pugh makes an interesting point about the choice of words in this debate.

    During the 1960s and 1970s, the term used was “euthanasia”. Then, during the 1980s, this was replaced by “voluntary euthanasia”, then during the 1990s it shifted to “assisted suicide”. Now we are calling it “assisted dying”. There has been a slow but consistent migration from the correct historical term to something that sounds less nasty.

    John Pugh writes:

    “One could take the view that your death, your existence is just the individual’s business ,though in a party that has just witnessed the sad,troubling departure of a former leader, that’s a view hard to sustain.”

    One could, and I suppose that I do. However, the legalisation of what is termed “assisted dying” would have a very direct effect on everyone. It would do so by extending the limited circumstances in which it is lawful to take human life.

    johnmc writes:

    “the vote does show again how far removed the country’s Parliament is from the rest of us. ”

    Oh dear, oh dear. On the several occasions that Parliament has voted against having the death penalty, it has shown itself to be far removed from “the rest of us”.

  • [Apologies if similar comments from me come up twice; not sure if my previous comment got lost or is awaiting moderation].

    There is nothing sinister, hypocritical or dishonest about moving away from a term, “suicide”, which carries centuries of associations of guilt and eternal condemnation – from pretty much the same religious institutions that are still opposing any right to die.
    Meanwhile, the term “euthanasia” was an appalling choice because of its historic associations with mass murder by regimes that treated the right to life with absolute contempt, and we’re well rid of it.
    The term “assisted dying” is perfectly clear, to anyone who is not determined to misunderstand it, but it is neutral and doesn’t carry the same historical baggage.
    Language moves on, just as society does.
    Those who object to “assisted dying” are likely also to object to “sex work” (because they prefer the perjorative connotations of “prostitution”) and “gay” (because it implies that there’s nothing miserable about homosexuality). And don’t let us get started on “same sex marriage”.

  • I’ll take issue with the article and argue that the word association between ‘assisted dying’ and ‘assisted suicide’ is wrong…’dying’ is a ‘physical’ issue; ‘suicide’ is, more often than not a ‘mental’ issue….

  • Jonathan Webber 13th Sep '15 - 1:42pm

    I am dying of terminal cancer, liver cancer. Chemo is over and done and I’m in the interesting position of having been referred to the Mac’s home care team for ‘End of Life Support’ which if nothing else has a certain ring to it. I might die within six months, I might not and my sanity is as suspect as ever in that I’m still a member of the party. My pain – relief has been upgraded to morphine and forward planning is not dissimilar to roulette.

    I find these debates puerile – much as I find Pugh’s posturing and others split-hair terminology to be hypocrisy of the highest order. As for the religious bigots….

    But how much do I or should I care? I’ve made arrangements for an assisted death / assisted suicide (in my shoes, playmates, you don’t tend to give a shit about terminology) and it won’t be abroad, hopefully in my bed maybe a hospice.

    I’d like to think that I’ll be in pretty dire pain before the trigger’s pulled, the plunger pressed, the potion swallowed. Strangely a number of people have offered to help – must be a reflection of my popularity.

    Get over yourselves people.

  • Ben Jephcott 13th Sep '15 - 1:51pm

    I’m very pleased to see that Assisted Suicide, for that is what we are talking about, was thrown out by such a clear majority.

    Many of the very poor and frightened disabled people whom I met demonstrating outside Westminster on Friday would be defined as ‘terminally ill’ under the definition in this Bill. Liberals cannot ignore the other-regarding effects of a culture of expectation and abuse which this proposal would have unleashed, forever changing the way we think of care of the very ill, which is why it was vital to reject it.

    We need to extend good quality palliative care to all, that simply has not been done. The present law is about right, what is not right is the uneven access to good quality end of life care, or access to good quality mental health care for those struggling with chronic conditions or facing terminal illness.

    Disappointing to see Greg Mulholland and Tim Farron claiming other engagements, that really is a bit poor. If life and death is not an important issue to clear your diary for then I don’t know what is.

  • Helen Tedcastle 13th Sep '15 - 2:20pm

    Joe Otten

    ‘ Assisted dying is perfectly reasonable term. Suicide is loaded ‘ and ‘We are not asking for the state to help anybody commit suicide’

    Assisted Suicide is not a ‘loaded’ term, because it is the exact description of what was proposed by the Marris Bill. Assisting a person to take their own lives (suicide) is what Assisted ‘dying’ entails.

    John Pugh MP is right when he notes the poignant Orwellian warning that ‘Words matter.’ Language matters.

    If the proposer of the Bill was so confident that it met the right principle for care of the dying then why not call it what it was?

    It is essential not to conflate state-facilitated suicide with care of the dying even if it is from the best of intentions, because it confuses and conflates a distinction, as John Pugh notes, which is both morally and legally important.

    As Liberal Democrats we must always be mindful, it seems to me, of balancing very carefully the principle of individual freedom with the risks of doing real harm to others – often the most vulnerable groups in society – in the exercise of that freedom. In my view, the Bill was far from getting that balance right.

  • Toby Keynes wrote (see above – cannot quite, because I am told my comment is too long):

    (1)

    You have bundled two issues into one here. You offer a general defense of euphemisms, which you seem to acknowledge are nice words for nasty things. I do consider that euphemisms are dishonest and potentially sinister. You do not. Then you kind of characterise opposition to what you call “assisted dying” as being motivated by religious adherence. Well, I do not practice religion, so my opposition cannot be motivated by religious adherence. Others can speak for themselves.

    (2)

    Perhaps. But the historic associations with mass murder point to where “assisted dying” might lead if allowed. Caring for the terminally ill is hugely expensive. How long before the government started cutting that money off? How long before we arrived at what George Galloway calls “medical cleansing”?

    (3)

    Not quite. It misses out the key point about the intentional taking of human life.

    (4)

    The correct term is “prostitution”. “Sex work” can include things other than prostitution, like participating in pornographic films or working in a strip club. If “prostitution” has pejorative connotations, then that is because prostitution is a terrible thing. Why would you want to replace the term with one that makes it sound less terrible?

    (5)

    The use of the term, “gay”, is now almost universal, mainly because it substitutes a word with one syllable for one with five. I think it can been dated back to Gore Vidal’s 1940s novel, “The City and the Pillar”, but I may be wrong. There is a big difference here, however. Homosexuality, unlike “assisted dying” and prostitution, is neither wrong nor nasty. There is nothing that needs to be made to sound less nasty.

    (6)

    This is not a euphemism, just an accurate description of what the thing is. I see same sex marriage as an administrative, not a moral, issue. It is a legal device for the convenient arranging of one’s domestic affairs. So not a euphemism.

  • As on other sensitive issues, the approach of a Liberal should be: “I have my own views on this, my own morality, which are relevant for me, if I advise a friend or if I engage in a debate on personal choices. But my own view does not necessarily represent what the law should require. Personal choice should be paramount.”

    I have not gone into the provisions of the Bill, but it seems to me a Liberal approach would be to support the Bill unless it had flaws, and if it had flaws, to seek to correct them. For me the political issue is about adequate protection for vulnerable people against being pushed into death by professionals or family and against decisions reached quickly which might soon be reversed (which is why it definitely is not illiberal to haul back a person trying to jump from a bridge). The family argument which I see some MPs used cuts both ways: some family members may be devastated by an assisted suicide and others by their loved one’s continuing painful life.

    I would though hold back from criticising those who voted against the bill. Not only are the personal feelings on this so deep and strong that I think we should be understanding, but there is some force in John Pugh’s thin end of the wedge argument. I’d only point out that we already have acceptance of support systems being turned off and of “do not resuscitate”.

  • @ Jonathan. Really really sorry to hear that.

  • Richard Underhill 14th Sep '15 - 11:46pm

    Accurate language is desirable, especially in matters of life and death. i have not seen the debate in the Commons, just a short interview in the Daily Poliitcs, but the previous debate in the Lords was comprehensive and some of those speaking were older than the average MP or younger with disabilities. There were repeated references to one doctor who had killed many patients. The proposed controls against abuse are clearly inadequate.

  • Richard Underhill 14th Sep '15 - 11:48pm

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