Norman Lamb MP writes…Why I support assisted dying

You will have probably heard by now that the Assisted Dying Bill was defeated in Parliament this afternoon by a margin of about three to one.

The scale of victory for opponents of the Bill was almost exactly the same as when it was last debated in 1997. This is remarkable, given the degree of public support for reform – over 80% according to a poll earlier this year. I respect the deeply held convictions of those who oppose assisted dying but I can’t help but reflect on how out of step with public mood Parliament appears to be on this issue of such profound importance.  And before anyone reacts – yes I understand we have a representative democracy and I know that it cuts both ways. I am deeply relieved that Parliament has always rejected hanging!

I used to oppose assisted dying. I shared the concerns of many people about the risk this could pose to vulnerable individuals under pressure from greedy relatives. However, in recent years my views have been challenged.

During my time as a Health Minister and my years as a Member of Parliament I have heard the testimonies of people with terminal conditions, often in great pain, who wanted the right to end their suffering with dignity and in a way of their choosing. Listening to these stories has forced me to confront the principles at stake.

Ultimately, the question surely is: should it be the individual or the state who decides? For me, as a Liberal, there can be no doubt. I know that I would want the right to decide for myself, so I cannot deny it to others.

As Care Minister, I was completely focused on improving end of life care, an area of medicine too often neglected in the past. I had to address really serious concerns about how the Liverpool Care Pathway had been applied in many hospitals as a one size fits all protocol.

What has emerged from the review I initiated is a new approach which focuses completely on the priorities and needs of the individual patient. There is a strong consensus now that, at the end of life, the patient’s wishes come first – on resuscitation, on where to die and so on. How odd then, that when it comes to the most profound question of all, we deny the person the right to decide.

The current legal situation is not just a messy compromise; it is cruel and wrong. We put families into the most invidious position. If they act out of compassion in helping a loved one to die, they still face having their home declared a ‘crime scene’ and then face an investigation which could go on for months, interfering horribly with the process of grieving. The DPP guidelines talk about ‘the suspect’. Surely we can’t put people through this.

Some people, of course, travel to another country to end their life, if they can afford it. But even that is, surely, grotesque – expecting a dying person to travel to an alien clinic in another country, when they could be at home with loved ones. For those who can’t afford to travel, they face the dreadful choice of soldiering on, perhaps in great pain and loss of dignity – or commit suicide. A Labour MP today wrote of how his own father ended his life in this way. Surely, again, this is intolerable.

Another concern people often raise is that giving people the right to die would somehow distract from, or conflict with, steps to ensure excellent palliative care. But good palliative care and assisted dying are in no way incompatible. It is up to Parliament to ensure that we invest enough in palliative care. In Oregon, where assisted dying has been lawful for many years, there is better access to specialist palliative care than in most other states.

John Stuart Mill wrote: “The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.”

I will keep campaigning for that sovereignty to be respected at the end of life, despite the defeat in Parliament today.

* 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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  • George Kendall 11th Sep '15 - 10:10pm

    Norman, I take a different view. But you’re a really good man, following your sincere beliefs, and I’m very glad to be in the same party as you.

  • Peter Bancroft 11th Sep '15 - 10:34pm

    Thank you to Norman for making the case so clearly. If we are not the party of individual sovereignty then we are very little. I can actually understand people who have specific religious objections to the topic, though I would prefer they took the view that they could legalise even things they had objections to. There are of course legitimate problems to raise with assisted dying, but taking power out of people’s hands to determine their own fate is rarely the correct solution.

  • A good clear argument from Norman Lamb.

  • Great to see Norman leading the way on this issue.

  • My father, who was a life-long Liberal, was a keen supporter of “voluntary euthanasia” as it was known then. He convinced me of the case to the extent that when we had to make a 15 minute oral presentation for O-level English, that was what I picked as a topic..

    It does not seem that we are any closer to getting it through parliament than we were in 1970… The Oregon legislation seem sensible and successful, and other than the religious objections I find it hard to understand why anyone objects

  • @Norman. Basically you are saying that people should be allowed to make decisions, even huge decisions like choosing to die for themselves? I can’t believe your party would ever accept this.

    I’d agree people should be allowed to choose to die but I doubt the lib dems would. The lib dems are a social Democratic Party that campaigned at local level to urge Gordon Brown to get tough and ban the sale of cannabis seeds in those grow your own shops that used to exist, if that is unacceptable to them they’re not going allow people to make a really important decisions for themselves like is it time for them to die or not, that’s a whole new level of personal choice that would never be allowed by the liberal democrats.

    This coming century will be a century where people on the whole believe in personal freedom and individual liberty regardless of today’s vote, but the lib dems will not have any place in that I don’t think, because I don’t believe they’re a liberal party nor do I believe they will survive as a mainstream party.

  • John Tilley 12th Sep '15 - 6:58am

    ” As Care Minister, I was completely focused on improving end of life care, an area of medicine too often neglected in the past..”

    Without in any way being impolite, I hope I will be allowed to register a reaction to this statement.

    For many months we were told , especially during the general election and during the leadership campaign, that Norman Lamb’s top priority as a junior minister in was Mental Health.

    Being “completely focused” on too many “top priorities” surely means you are not very focused on any of them?

  • Stephen Hesketh 12th Sep '15 - 7:33am

    Norman makes some compelling points here and is clearly more in tune with public opinion than are the majority of our national parliamentary representatives.

    Yes we must absolutely and unreservedly protect the vulnerable and those who do not agree with it but people who, while in good health, have deposited letters of desire/intent with their doctor and a lawyer must be allowed this fundamental human right.

  • tony dawson 12th Sep '15 - 7:59am

    There is not a very strong lobby for ‘assisted dying’. Some MPs have very firm religious/moral/philosophic positions on this subject – a great many more are ‘straws in the wind’ who have received a large post bag and petitions one way only.

    I am glad that Norman ensures that both sides of this argument are represented within the Liberal Democrats.

  • Helen Tedcastle 12th Sep '15 - 9:21am

    One of the reasons – not the only one of course – that I could not support Norman’s bid for the leadership of the Party was his dogged high profile advocacy of assisted suicide, while being the Care Minister and Minister for the Elderly (although entitled to his personal opinion).

    With the clear defeat of the Marris Bill yesterday, I hope Norman will be able to concentrate on securing a greater focus and much needed debate around quality end of life care and care for the elderly in this society. At the moment it is a postcode lottery.

  • CatherineJane 12th Sep '15 - 9:33am

    I do understand why Norman, and many others, hold this view. But its seems tragic that the phrase “dying with dignity” has come to be understood to mean assisted dying. Should we not be focusing on improving palliative care, so that the terminally ill can be confident that it is possible to die both naturally and with dignity. I worry that if assisted dying became legal, then improving palliative care would be seen as less of a priority.
    Also, Norman says that the right to choose to die is an extension of the liberal principle that the individual, not the state should have the right to make important decisions about their lives. This is a strong argument, and in a way an unanswerable one. But if taken to its logical conclusion, would this not mean that anyone who wished to die, for whatever reason-not just the terminally ill – could request assisted suicide. This, tragically, has begun to happen in countries such as Belgium and Switzerland. These countries began by legalising assisted dying just for the terminally ill, and there were supposed to be safeguards in place. But many of those who have requested, and been given, assisted suicide, have not been terminally ill, but merely suffering from depression. I am sure Norman, with his concern for mental health, would be horrified by this. Some will say that it would not happen here, and could not happen if the right safeguards were in place, but I am sure that is what was originally thought in Belgium and Switzerland.

  • Helen Tedcastle 12th Sep '15 - 9:36am

    Tony Dawson

    ‘There is not a very strong lobby for ‘assisted dying’.’

    That is not the case Tony. The Voluntary Euthanasia Society (re-branded ‘Dignity in Dying’) has been running a high profile and well-funded campaign for a few years now. It is a strong lobby backed by ‘celebrities’ and receives a very sympathetic portrayal via emotional ‘hard cases’ (often not terminally ill ones) on the media.

    I do agree however, that often MPs have strong and clear philosophical and religious principles underpinning and informing their values. It was interesting in the debate yesterday to hear from those of no particular faith also coming out strongly against assisted dying legislation though.

    It was pointed out on more than one occasion that opinion polling is notoriously fickle, given that the answer often depends on the kind of question asked. Fortunately, MPs ignored public opinion when it came to abolishing the death penalty, having the evidence and complex arguments them – unlike the public in most cases.

  • George Kendall 12th Sep '15 - 10:06am

    @AndrewMcC “I find it hard to understand why anyone objects”

    People’s motivations vary, but I think both sides have enormously strong ethical and emotional reasons for taking their position in this debate.

    Those who want assisted dying want to give a choice to those who want to end their suffering but can’t. Opponents believe the safeguards will fail, and the weak and vulnerable will be pressurised into being killed, perhaps even killed without their consent. These are both enormously powerful motivations.

    Those opposed often feel that once implemented, this change in the law would be irreverible. If safeguards were failing, this would often be impossible to prove. How does one prove that an elderly or disabled person felt pressurised into allowing their life to be taken? There is also the fear that if the safeguards failed, and assisted dying of the terminally ill were slowly extended to assisted dying of others, that too would slowly become an accepted practice, even if the law was supposed to prevent it it.

    I think many of those opposed are sceptical that it is even possible to have sufficient safeguards. I have heard people from both sides of the debate claim completely opposite things about what has happened in Holland. One that the safeguards have worked, the other that they haven’t. Perhaps one side is being dishonest. But I think it’s possible each side believes they are being honest, but interpret the same data in opposite ways.

    Both sides, in their way, have liberal motivations. One side want to give someone choice to end their life but can’t, the other to protect someone who is being pressurised to end it.

    I think I can understand the motivations of both. And I think the moral and emotional forces that drive them have a lot in common. Far more than they realise.

  • Trudi Starling 12th Sep '15 - 10:08am

    I totally agree with Norman Lamb. Having watched dear friends struggle through months of pain and suffering with no hope of anything but death, seen the awful trial this put the families through and the dreadful helplessness they felt, I emailed my MP to ask him to support this bill. Even now, I see friends coping with terminal illness or caring for a family member that they know is in distress. When there is no quality of life left, we should have the right to choose. When we are born, we are given life. It’s a gift and therefore ours to do with as we choose. If we put a pet through as much pain and suffering as some people are forced to bear, we’d be prosecuted and rightly so.

  • Graham Martin-Royle 12th Sep '15 - 10:11am

    Excellent article, I agree with every word.

  • It was a superb debate with moving speeches on both sides. Had a little sob when Norman did the quote from Mill it was beautifully delivered and relevant.

  • Thank you, Norman, for articulating my own views in such a clear and cogent manner. I have been a supporter of Dignity in Dying for some years now and this defeat only serves to strengthen my resolve to continue our campaign. To those who claim that the LibDem, as a party, will “never” support assisted dying, I say that I am proud to be a member of a party where liberal and democratic principles are passionately held and debated. Should assisted dying become an issue that most members feel strongly about, it will be put to conference, in one way or another, debated and voted on. I look forward to that day.

  • @Helen Tedcastle

    “The Voluntary Euthanasia Society (re-branded ‘Dignity in Dying’) has been running a high profile and well-funded campaign for a few years now”

    Compared with their opposition? They are like Northern Premier League against Manchester City.

  • Simon Thorley 12th Sep '15 - 2:07pm

    I have no doubt that the opponents of this bill have very deeply-held objections to assisted suicide. However, most of those objections are not liberal, as they seek to impose personal ethics as a standard which others must adhere to. The simplicity of Lamb’s position is its strength – what right does one individual have to force another to die in pain and indignity?

  • Helen Tedcastle 12th Sep '15 - 3:16pm

    Tony Dawson
    ‘ Compared with their opposition? They are like Northern Premier League against Manchester City.’

    Absolutely. The Voluntary Euthanasia society (Dignity in dying) are well-funded, have professional campaigning and PR, are celebrity and media-backed, compared to various loose alliances of disabled groups, charities and faith groups – who were not well-funded in their campaigning or slick or well-staffed.

    Simon Thorley

    ‘ they seek to impose personal ethics’

    Incorrect. They have a clear position which suggests that there needs to be a very careful balance between personal choice and the risk of real harm coming to others by changing fundamentally the doctor-patient relationship.

    They no more ‘impose’ their ethics as those who oppose them do. Also, by stating that those against assisted suicide are forcing people to be in pain, this is a false argument. The argument instead should be for much greater improvements to palliative and end of life care services, (which has already improved greatly in the last decade), so that more people can benefit from a high standard not yet universal in the NHS.

  • Toby Keynes 12th Sep '15 - 5:55pm

    Anna Beria and others:
    The Liberal Democrats have indeed debated assisted dying on two occasions in the recent past and on both occasions voted clearly in support of the right for people who are terminally ill, and with a short life expectancy and have demonstrated a clear and settled wish to die at a time and in a manner of their own, but who are not physically capable of killing themselves, to be assisted – with major safeguards – in other words, very similar to the bills debated yesterday in the Commons and earlier this year in the Lords.
    Both Liberal Democrat motions explicitly made this party policy but treated it as an issue of conscience on which LibDem MPs and peers would not be whipped.

    Helen Tadcastle: “Absolutely. The Voluntary Euthanasia society (Dignity in dying) are well-funded, have professional campaigning and PR, are celebrity and media-backed, compared to various loose alliances of disabled groups, charities and faith groups – who were not well-funded in their campaigning or slick or well-staffed.”

    Helen, are you really saying the funding and campaigning ability of Dignity in Dying is greater than the massed ranks of the Catholic church, the Church of England and all the other orthodox religious institutions?

  • Simon Thorley 13th Sep '15 - 12:15am

    @Helen Tedcastle: “They no more ‘impose’ their ethics as those who oppose them do”. Perhaps. But if both positions are taken as requiring the imposition of views, when one is focussed on restricting personal autonomy and one is concerned with strengthening it, it can easily be seen which position is liberal and which is not.

  • In response to John Tilliey’s comment, I was completely focused on improving end of life care when I was Care Minister. I devoted a massive amount of time to the whole issue of the abuses perpetrated in the name of the Liverpool Care Pathway. I commissioned a review, met with professionals and family members who had concerns and devoted a lot of time to trying to understand the issues. The end result of a long process is that we now have guidelines that focus on the individual priorities of the patient and good communication with loved ones. It is possible to give complete focus to more than one area of policy if you are prepared to put body and soul into it.

  • Richard Underhill 14th Sep '15 - 11:58pm

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