Norman Lamb MP writes: I want us to lead the way in Parliament to allow assisted dying

For many years, I opposed attempts to legalise assisted dying.  I had concerns, shared by many, that the risk to the most vulnerable individuals outweighed the benefits.  Equally, I respect those with deeply held religious concerns.
 
But my views have been challenged in recent years. As an MP and in my role in the last Parliament as a health minister, I have spoken to many terminally ill patients, and the families of those who suffered slow deaths in great pain.
 
So many of them were convinced, when someone is suffering intolerably, and when they are reaching the end of their life, they should be allowed to end their suffering with dignity, and with the support of those closest to them.
 
These testimonies have forced me to think again. Would I want the right to decide for myself, when faced with terminal illness, when I wished to die? And would I want it for loved ones? The answer is unequivocally, yes. 

 
Every few months, we hear about a case where someone who is terminally ill is faced with an impossible dilemma.  Either they must accept a slow and painful deterioration and death, or they must endure the indignity of travelling to another country to end their life – risking criminalisation of the relatives or friends who support them. And they only have this option if they can afford it, which many simply cannot.
 
The current legal situation is not just a messy compromise; it is cruel, and it is wrong.  
 
Although the DPP has issued guidelines which limit the types of case where a prosecution would actually be brought, we still leave families in an invidious position. How can we possibly put families through the nightmare of seeing their home become a crime scene and then wait for months to hear whether they will be prosecuted? That, surely, is intolerable. The time has come for us to show leadership on an issue that matters to so many people.
 
As Liberals, we believe that it is for people to choose how they live their lives, whom they marry, and the faiths or communities to which they belong. So how can we argue that it is for the state to decide how they die?
 
A Bill was proposed by Lord Falconer in the last parliament which aimed to legalise assisted suicide for some terminally ill adults.  Lord Falconer’s Bill proposed legalising assisted suicide for terminally ill patients who are mentally competent and have six months or less to live.  
 
It included important safeguards to prevent abuse, and a poll last year by YouGov found that 76% of adults in England and Wales supported the proposals.  
 
As a Liberal, I have reached the view that, while there must be the most rigorous of safeguards, it is right that people should have the choice about how they end their lives when they are terminally-ill and suffering.
 
In the coming parliament, I want us to lead the way on this issue, whilst respecting the views of those who disagree.  So today, yes, we must condemn outrageous plans to scrap the Human Rights Act, and to take away our ability to use the internet in privacy.  But let’s go further too, and finally confront a failing of our liberal society that has been glossed over for far too long.
 
I do not know what decision I would make as a terminally-ill patient myself. But I am certain that it should be my choice to make.

* Norman Lamb is MP for North Norfolk and was Liberal Democrat Minister of State at the Department of Health until May 2015. He now chairs the Science and Technology Select Committee

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31 Comments

  • Jonathan Pile 27th May '15 - 12:25pm

    I deeply respect Norman’s campaign and opinion. But this is a highly difficult and emotive issue which ultimately comes down to individual personal belief, faith and experience. I really doubt whether this should be a party matter but it is a prime example of a cross-party issue which outside of the remit of party policy and should be subject to a non-party free vote in the commons, or perhaps even a referendum. There are incredibly strong arguments on both sides and not the kind of thing we should attempt to come to a collective view on as a party. A slippery slope.

  • I’m really surprised, and very very pleased, to see this from Norman. I am actually backing Tim in the leadership election, but I have long believed that we should be the first political party to formally take the lead on this issue. I do understand that people have religious and moral concerns, so I would not like to see a party whip on this – and of course we have to get all the safeguards right. But for me there are few issues that speak more directly to the basic liberal values of individual liberty and rights over the power of the state. The public is miles ahead of its politicians on this, and sooner or later one party will break the cosy party political consensus and show a lead. It should be us. Well done Norman. I’m afraid I still won’t be voting for you, but I hope you lead on this as Deputy Leader (or whatever deservedly high profile position you have after 16 July).

  • Keith Redwood 27th May '15 - 12:30pm

    While I have every respect for what Norman has written I still have a visceral antipathy to assisted suicide. A better approach would be to improve end-of-life care for terminally ill people., including having the right to die at home or at least somewhere other than a hospital ward. Palliative care is even more of a Cinderella issue in the NHS than mental health. I would like to see more attention drawn to this so that people can die with dignity without feeling the stress of involving a third party in an assisted suicide.

    This is a deeply complex issue and we perhaps, as liberals, should be looking at it in the round and not be fixated on one particular aspect.

  • How long before a cartoonist or sketch-writer picks upon the fact that one of the two leadership candidates for the Liberal Democrats is writing about “assisted dying” ?

    My money is on a joke along the lines of –
    “When it came to dying in the General Election of 2015, the Liberal Democrats did not need any assistance.”

  • Well said Norman! From the Young Liberals championing of gay rights, through David Steel’s Abortion Act to Lynne Featherstone’s championing of equal marriage ee have a very proud record of standing up for individual rights for people to live their lives as they wish without prejudice and fear. Mental health and death were still taboo subjects. You did a fantastic job as a Health Minister to start the transformation of the first of these and I’m thrilled that you will now lead the way on the second. It has taken courageous individuals and families to educate us all that informed choice and dignity in death is a fundamental human right. Thank-you for speaking out for it

  • Helen Tedcastle 27th May '15 - 12:34pm

    I can’t say how disappointing it is to read that an excellent Care Minister in the last government – someone who knows how depression, fear and anxiety can lead people into taking drastic steps, covering their mental health problems up to others – can be prioritising such a controversial issue.

    Norman says, ‘So how can we argue that it is for the state to decide how they die?’

    The state does not decide how we die. The state safeguards and protects people from the real danger of taking their own lives out of fear of being a burden on others, or from subtle coercion from others. Anyone who knows anything about elder abuse, knows the vulnerability of some patients to emotional bullying from unscrupulous and manipulative individuals.

    The Dying Matters campaign as well as other health groups are campaigning for a better care service, better more universally available palliative care and involvement of the patient in their care plan, so that they are not left in the dark.

    This is what real freedom is – helping people to live their last days well, with great care – not going for a counsel of despair which changes a doctor’s relationship with patients and which offers a one-way ticket out of the world, with no second chances.

  • Caron Lindsay Caron Lindsay 27th May '15 - 12:36pm

    Keith,

    I agree with you about looking at the whole thing in the round. I think we really need to talk more about death and preparing for it. However, I have long been convinced that assisted dying has to be a part of it.

    The Scottish Lib Dems debated this and gave backing to the Scottish bill in March. I hope that we as a party push forward for this and I completely applaud Norman’s stance on it.

  • Helen Tadcastle,

    The concerns you raise are of the utmost importance and I agree that every step must be taken in all cases to ensure that people are helped to live and, ideally, to live in the best manner possible.

    There are certain cases, however, where there are individuals who live in such pain and torment that it becomes cruel to deny them the right to choose to end their own life. Tony Nicklinson is just one upsetting example of someone who desperately wanted to end his life that he resorted to refusing food. This shouldn’t have happened.

    It’s one of the most sensitive subjects that could ever be discussed and for that reason any legislation must be handled with care. If we are going to give each individual their right to choose when they die then we need to ensure that the correct safeguards are put in place. This must seriously take into account the fact that some people will emotionally manipulate others into ending their life for whatever ugly reason. We must also be sensitive to the fact that some people may suffer from a mental health illness which could drive them to a state of despair. However, we must also respect the fact that people who in sound mind and judgement want to end their life must be given the right to do so. It is not for others to deny them that right.

  • ‘As Liberals, we believe that it is for people to choose how they live their lives, whom they marry, and the faiths or communities to which they belong. So how can we argue that it is for the state to decide how they die?’

    Yep, cos, after all, death is a part of life, right?

  • I sat with both of my parents as they died and was privileged to do so. I shared some good and some very distressing last moments with them. They both had exemplary medical care, Dad in the nursing home he had had to spend his last few years and Mum at my house. Despite this excellent care there was a point for both of them where all that was left was unpleasantness and pain or drug induced semi-consciousness. I think that both should have had the choice to avoid this part of their final illness, and I think one of them would have done so.

    For me it is about choice, and whether we as a society should deny the ability to make a choice to people in the last part of their lives. My view is that if appropriate safeguards are in place we should allow the choice to be an individual one.

  • Ben Jephcott 27th May '15 - 1:53pm

    I was very impressed by Norman’s record as Care Minister but I am dismayed to see that he wants to make such a divisive and complex issue a priority if he becomes Leader.

    There is a profound Liberal case to make against a law for Assisted Suicide – a minority position in the party maybe but nevertheless consistent with our philosophy and nothing to do with religion.

    Our backs are against the wall in an existential crisis for Liberal Democracy. I do not see how joining Lord Falconer in pressing for contentious legislation on this emotive and narrow issue is the way to galvanise a Lib Dem fightback against the most rightwing government in recent history.

    This kind of legislation should be kept as an issue of conscience as there are supporters and opponents in all parties. Even if in name that is what Norman does, if he is party leader the effect will be to nail our party colours very firmly to this mast.

    Very disappointed as I was seriously considering voting for him.

  • Trevor Stables 27th May '15 - 2:19pm

    Having been a Nurse for over 30 years, Health Service Manager and Private Sector Manager I agree with all the sentiments but remain deeply troubled.

    What is missing from the debate is a way of ensuring that the vulnerable are protected not only from relatives that may be avaricious but also from medical and clinical rationing that is always looming and prevalent.

    Healthcare has always been ageist and programmes like The Liverpool Care Plan has weakened the trust of many elderly people for institutions to protect the Individual against an overbearing system.

    What is urgently required is a System of “Patients Advocates” to look at the question from the Individual’s perspective and to ensure that the persons needs are held uppermost.

  • Caron Lindsay Caron Lindsay 27th May '15 - 2:22pm

    Unnecessarily emotive, Helen, I think. What is wrong with giving people the choice? Nobody who is in favour of assisted dying is against better palliative care but the reality for some people is that even the gold standard of palliative care won’t stop them suffering.

    Part of being a liberal is allowing people to control their own lives as much as possible, giving them as much say in what happens to them. Not everyone would take the option of assisted dying. I’m not sure I would. But I think we need to treat people like adults and let them decide for themselves what is best for them.

  • Joshua Dixon 27th May '15 - 2:22pm

    Not backing Norman but I agree with him on this.

  • Trevor Stables 27th May '15 - 2:23pm

    I forgot to say…This is not a Party Political Matter and must remain a matter of conscience.

  • Simon McGrath 27th May '15 - 2:56pm

    Not sure I agree with Norman on this but good to see him saying strong positions and admitting to changed his mind

  • Eddie Sammon 27th May '15 - 3:05pm

    This is one of those issues where I “listen to the experts” and I trust Norman has done so and he also makes a very good case here, so I support this proposal, quite strongly, actually.

    Even if the public didn’t support it I think it still looks like something we should be championing. I think the case is clear.

  • Sam Charleston 27th May '15 - 3:29pm

    Hear hear, Norman.

    Terry Pratchett said it best: “As I have said, I would like to die peacefully with Thomas Tallis on my iPod before the disease takes me over and I hope that will not be for quite some time to come, because if I knew that I could die at any time I wanted, then suddenly every day would be as ­precious as a million pounds. If I knew that I could die, I would live. My life, my death, my choice.”

  • Helen Tedcastle 27th May '15 - 3:36pm

    Alex Lewis

    ‘Tony Nicklinson is just one upsetting example of someone who desperately wanted to end his life that he resorted to refusing food. This shouldn’t have happened.’

    The Nicklinson case was indeed extremely sad and arouses strong feelings of empathy and compassion in us all.

    When he took his case to the European court, lawyers argued that he had Article 8 rights under the European Convention on Human Rights (respect for private life and family). In their view, these rights could not be respected unless his life was ended deliberately and intentionally by a doctor. This would be called Voluntary Euthanasia not Assisted-Suicide.

    However – and this is the key point – Article 8 also states that the right to respect for private life and family must, in a democratic society, be balanced with considerations of public safety, the prevention of crime, the protection of health and morals, and the protection of the rights and freedoms of others.

    In classical Liberal terms, a balance must be sought between personal freedoms and other-regarding freedoms.

    It is a coherent Liberal position to argue against Assisted Suicide because it cannot be guaranteed – no matter what the promises are on safeguards – that the other-regarding freedoms will be safeguarded sufficiently rigorously to protect the rights and indeed lives of vulnerable sick, depressed and elderly patients.

    Caron Lindsay – yes this is an emotive issue. On the issue of choice, see my answer to Alex above. Choice for one individual effects all others.

  • Im with Helen on this and I have seen both of my own parents die. Talk about safeguards is breathtakingly naive. If I take my own father as an example, there were times in hospital when he didnt eat because he literally couldnt understand the spoken English of the staff distributing the meals and nurses were not controlling this. We dont even have effective safeguards sometimes to make sure people are properly fed and watered. See what happens in Belgium and the Netherlands. There is an expectation placed on terminally ill people to not be a burden on their families. Couple this with the total lack of coordination you will experience if you try to receieve an infirm relative home from hospital and coordinate with councils for home care. To be terminally ill puts an immense amount of psychological pressure on a person and their carers, to then have the patient see the state health system as not only a caring healing system but also a life termination service is a very conflicting thing.
    I have very great sympathy for those like my mother who are terminally ill over many years and Ill be forever grateful that she didnt ask me to help her end her life, nor did she have doctors suggesting this to her as will be the case if these reforms happen. I dont see why those opposed to this are labelled as emotive when the case for this is often put in an emotive way. Incidentally, palliative care has greatly improved in my experience, its just unfortunate that many are totally ignorant of things like the Liverpool Care Pathway because we dont talk about death as a society.

  • If this included an absolute ban on doctors recomending shortening human life, along with making it a hate crime for anyone to say that another person/people should for any reason choose an assisted death, I would consider supporting it. I feel for those who want to end their lives, but I fear for the religious being crticised for rejecting it, and for the dying and disabled who cannot trust their families to put their wishes first.

  • Helen Tadcastle,

    You are correct to state that “In classical Liberal terms, a balance must be sought between personal freedoms and other-regarding freedoms.” I fully understand your point that any situation in which a person could be coerced into taking their own life by another, and is able to do so with the assistance of the law, would be tragic. It is also clear that any safeguards, however thorough, may not be able to stop such coercion.

    The problem we face by doing nothing, however, is that those who do wish to end their own life but are unable to do so have had that right denied to them by society. I do not think your position is illiberal and I recognise that this is an issue in which it is difficult to distance oneself from emotionally, but to deny the individual the right to choose when they die is denying them a basic human right. We cannot hide from this fact and must appreciate that maintaining the status quo does nothing for those who want the right to choose.

  • The main issue is that the benefits are very easily presented, but the costs are obscure and immeasurable. Eg1 over time, will society look down on people who choose to live – will we be fighting for their right to choose in 100 years? Eg 2. Will assisted dying decentivise pharma research into cure for rare terminal diseases – less need for cures? Eg3. Is suffering a mental state which can be conditioned (hawkings must have thought of suicide many times but trained his brain) as different people have different thresholds? Eg4 is dignity an internal definition? My father died after no long protracted illness, but never “lost his dignity” in my mind Eg5 is there benefit to society by families rallying around as a unit (are families stronger)? Etc etc. Better be sure before going against nature…no living organism commits suicide in the face of adversity.

  • Top post, completely agree with Norman on this issue. If ever there was an area where the state position on personal freedom is ridiculous it’s in death.

  • Helen Tedcastle 28th May '15 - 12:47pm

    Alex Lewis
    ‘ … to deny the individual the right to choose when they die is denying them a basic human right’

    On this point I am with Alison McInnes MSP, a Liberal Democrat and Humanist politician. She argued that there is no such thing as the right to die.

    I agree with her. There is no right to die enshrined in the UN Declaration on Human Rights. It is not in the EU Charter of fundamental human rights.

    It is not a right but a claim to a right by those are campaigning for a change in the law.

    The truth is there is no such thing as complete autonomy and individual freedom because we live in a society.

    Therefore, as Lib Dems we seek to balance competing values of liberty, equality and community. Assisted suicide puts self-regarding freedom above and beyond other-regarding freedom and results in an imbalance of freedoms.

    The cases put forward in the media and supported by the pro-assisted suicide campaign, ratchet up the emotions but we know that hard cases always make bad law.

  • Helen Tadcastle,

    Whilst a right to die is not enshrined in the UN Declaration on Human Rights or in the EU Charter of Fundamental Human Rights, this still offers no comfort for those who want the right to choose when they die. It is because they have been denied this right that an imbalance of freedoms exist. A balance of freedoms, and I recognise that this might come across as idealistic, would allow everyone the freedom to choose. We should ensure that each person has the right to protection, the right to care and the right to choose.

  • Helen,

    I must apologise for spelling your last name incorrectly three times. Please feel free to give a twist to my name at any time you wish.

  • “. There is no right to die enshrined in the UN Declaration on Human Rights. It is not in the EU Charter of fundamental human rights.”

    I guess as our thinking evolves, the right to die may well be enshrined in due course. We have no choice over being born but we can, if Ill-health does not prevent us, choose when to end our life.

    Our thinking on when life ends has not stayed static, after all. Until relatively recently medical thinking was that life ends when our heart stops beating but nowadays we accept that life has ended once the brain has died .

  • Helen Tedcastle 29th May '15 - 4:01pm

    Alex Lewis

    Surely we have to recognise that my freedom to choose, when it impinges on the rights of others, limits their freedom for my gain. In the case of so-called right to die claims, this would mean giving a small number of very determined individuals (if we assume we are discussing those who go to Dignitas) their freedoms over those groups who are currently under the full protection of the law. I include those who suffer from psychological bullying or financial pressure from people who are in positions of trust.

    Phyllis

    The EU Charter of fundamental rights only was published in 2007 so I’m not sure we can claim thinking has ‘evolved’ in the manner described in so short a time-frame. Rather, the right to life and the fundamental dignity of the human person has been reaffirmed by the EU charter and that to me is a more overwhelmingly positive message.

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