THE big news this week at Westminster – despite struggling for the headlines it deserved alongside COP29 and the resignations of a BBC football presenter and the Archbishop of Canterbury – has been the introduction of the Terminally Ill Adults (End Of Life) Bill – a private members’ bill being brought forward by Labour MP Kim Leadbeater.
Although it’s been an issue long talked about, the bill marking this latest attempt at a change in the law was only published on Monday night and, for that reason, MPs on all sides are still developing their understanding of the full implications.
To a large extent, that will only begin to happen during the debate on its second reading on November 29.
However, as it stands, we believe that to be eligible, a person must be aged over 18; resident in England and Wales; terminally ill and expected to die within six months; and have two doctors and a High Court judge willing to verify that they are eligible and have made their decision voluntarily.
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Private members’ bills are the way that individual MPs rather than the Government can promote legislation at Westminster. They don’t often get far – their fate being to get talked out by one of the usual backbench bores at Westminster that no-one would otherwise have heard of.
Although the MP promoting the bill usually doesn’t get to see it reach the statute books, it does give them some valuable parliamentary time to spotlight their chosen issue, perhaps even moving the debate on and speeding the day when a Government brings forward legislation of its own in that area.
Just occasionally, however, they do make it into law, with profound and far-reaching circumstances. Particularly, they can come into their own where a change in the law would involve a decision of personal conscience which Governments simply can’t ever achieve a collective position on.
David Steel’s Abortion Act of 1967 is a prime example of this. So in that context, and given the extent of the discussion and the cross-party opinion on this issue, there’s perhaps a better than average chance that this bill might actually make it into law.
As a Westminster MP, I understand that some of my constituents expect me to represent them in all matters which are voted upon at Westminster.
However, there are some exceptions that I would personally apply to this general mandate, such as in cases where Westminster is voting on a policy for England which has no financial implications for Scotland, and where the equivalent policy area is also devolved.
My reasoning for this is straightforward. In Scotland, we have our own Parliament. If I, rightly, would object to English, Welsh and Northern Irish MPs making laws for Scotland in areas which are devolved and properly the business of the Scottish people and the Scottish Parliament, how can I in all conscience then intervene on their affairs which are exclusively in their domain?
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Clearly, there are moves in Holyrood to pass a bill which would have similar effect, although ministers have concerns about issues relating to lethal drugs being reserved to Westminster.
However, it’s important for me that the decisions for people in Scotland regarding this matter be taken by our representatives in Scotland’s Parliament, and that the public debate and opportunities to engage with it should reflect that.
When it comes to the matter of principle, however, like probably many people I feel a bit conflicted. For sure, there’s a clear argument about being able to be in control of one’s own life and therefore, in the later stages of a terminal illness, one’s own death.
And those arguments are certainly forceful and compelling, especially when they come from those who themselves have a terminal illness, or from anyone who has seen a close relative or friend suffer unnecessarily.
But I also have other things which weigh on my mind from my own experience. Many years ago, I worked in primary care alongside GPs looking after large caseloads that included patients with life limiting illnesses and conditions. On many occasions, even though it was clear to me that a patient was in the last stages of their life, GPs would resist using the words “terminally ill” until perhaps the final two weeks or later.
Perhaps it was because they were dealing with difficult and sensitive family situations; perhaps because not all hope was lost for an extension of life, but it nevertheless taught me a lesson about the way care was handled in these circumstances.
If now we are asking GPs to make judgements about these situations long before they feel able or comfortable to do so, then maybe we are threatening to ask too much of them.
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Secondly, I would have a concern that if the law were to change, that some with a terminal illness may feel that they have an obligation to follow this path so as to avoid being a burden on anyone else.
Without suitable safeguards and ongoing strong support for hospices and palliative care, I would be concerned that taking the assisted dying route could become an expectation for some, rather than a freely entered-into choice.
Thirdly, and I must declare an interest here as a strong supporter and fundraiser for Marie Curie, no-one need die a painful and distressing death if their end of life care is handled properly by trained professionals.
Whatever decision is reached, we should be considering how we can properly fund palliative care and ensuring it is available to all who need it and wish it.
I will of course follow the debate closely in the House of Commons as you would expect me to and I will retain an open mind, fully aware that greater minds that mine are involved.
However, for Scotland, the place where any decision to change the law should ultimately be taken – and the public debate rooted – is in our own National Parliament.
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Callum Baird, Editor of The National
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