Terminally Ill Adults (End of Life) Bill MP Statement - 2nd Reading
Terminally Ill Adults (End of Life) Bill – a statement from Dr Al Pinkerton MP (29/11/2024)
On the 29th of November MPs voted on the second reading of the Terminally Ill Adults (End of Life) Bill – a Private Member’s Bill proposing to grant terminally ill adults in England and Wales greater autonomy in determining how and when they die.
I want to thank everyone from across Surrey Heath who has written to me regarding this Bill over recent weeks. The time and effort that constituents have taken to share personal experiences and insights is indicative of the importance of this issue for all of us.
Since the Bill was published a few weeks ago, I have spoken to and read correspondence from constituents, healthcare professionals, legal experts, fellow parliamentarians, people currently living with terminal illness, and those who have cared for loved ones in their final moments of life. I would like to thank everyone for so generously sharing their thoughts, expertise, and experience.
I have also, inevitably, reflected on my own recent experiences.
Over the past few years, I have seen both my maternal grandparents die of/with dementia. Two lives that were almost equally long and healthy (although my grandmother’s macular degeneration had left her almost totally blind in later years) were marked at the end by the same shared indignities: robbed of their swallow reflexes, they both ultimately died of starvation and dehydration over the course of several agonising days.
Neither of them wanted to die as they did. Having seen friends decline over the years, I remember my grandmother quipping in the way that she did: “Just pop something in my tea when the time comes.” She wasn’t being serious, of course, but the implied wish for a better death than those she saw around her was, I think, a considered one. When the time did come, my grandparents received the most extraordinary palliative care – but there was no tea nor anything to put in it, just a teaspoon of water.
The Terminally Ill Adults (End of Life) Bill does not and will never address the circumstances of my grandparents’ deaths. Dementia is a degenerative condition, rather than a terminal illness, and so falls outside of the Bill’s provisions and scope. Nonetheless, my grandparents’ experiences have informed my thinking on assisted dying. I support the principle of choice and affording those at the end of their lives greater agency over how they will die, but I am also hugely concerned about the current state of palliative care in the UK with all its unevenness, gaps, and deficiencies; the possibilities of coercion; and the effect that fear – of a bad death within a creaking system – might have on the freedom of individual decision-making. Effective safeguards are therefore critical.
The process of deciding how to vote on this Bill has been exceptionally challenging, with powerful and convincing arguments mounted on either side of the debate. This is not a decision that should ever be taken lightly.
One of the inherent challenges for parliamentarians is related to the nature of the Bill itself. As a ‘Private Members’ Bill,’ less parliamentary time and scrutiny is available than if it had been an official ‘Government Bill.’ Today, the debate is expected to last approximately five hours. The recent Budget, by comparison, was debated over five days. Government Bills are also subject to pre-legislative scrutiny and impact assessments to test the feasibility, costs, and consequences of implementation. Those tests have not been applied to The Terminally Ill Adults (End of Life) Bill.
And yet, this is the Bill we have before us. If rejected today, it is unlikely that a similar Bill would be presented again any time soon. If, however, the Bill passes this Second Reading, it will progress onto Committee stage, where it will be subject to line-by-line consideration and the detailed legal, medical, and ethical scrutiny it deserves to receive before returning to the Commons in an amended state for final acceptance or rejection by MPs next year.
After much deliberation, I believe that is the right course of action. I therefore intend to vote for this Bill at second reading today – not out of blind conviction, but from a desire to ensure the deepest possible scrutiny before a final decision is taken.
I will continue to engage with both sides of the debate and encourage any constituent who would like to share their views to email me at: al.pinkerton.mp@parliament.uk. I also recommit to doing everything I can to push the government to improve our patchy and uneven palliative care system in the UK and to address people’s fears about what might befall them at the end of life.
Yours sincerely,
Dr Al Pinkerton MP