New Forest East MP Sir Julian Lewis debates assisted dying in the House of Commons 29th November 2024 (parliament.tv)
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00:00In the past, I have voted against this type of measure for one overriding reason, namely
00:09the impracticability of effective safeguards. Even if, I have always felt, practical safeguards
00:18could be erected against external coercion, there was no prospect whatsoever of having
00:27effective safeguards against internal pressures on someone to request assisted dying or even
00:35euthanasia. For example, as we have heard, an elderly person in a care home, knowing
00:42that the legacy they could bequeath to their children was being reduced by tens of thousands
00:47of pounds every few weeks, would be highly likely to feel obliged to ask to die. I cannot
00:55conceive of any safeguard against self-sacrifice of this sort, whether for financial reasons
01:03or in order no longer to be a burden on one's nearest and dearest relatives and friends.
01:09However, there is an additional point I wish to inject into the debate. In my opinion,
01:18the key to this dreadfully difficult conundrum about end-of-life care, pain and the possibility
01:26of assisted dying lies, or should lie, in the ability of medical personnel to administer
01:34effective pain relief even if it shortens the patient's remaining time. In my view,
01:43there should be no bar on the use of pain-killing medication if that is the only way to ease
01:49human suffering, even if it leads to a speedier death. Hence the frequent references to putting
01:57dying people on an appropriate pathway. It was therefore most alarming to me to read
02:06a very important paragraph in a letter sent to me in favour of changing the law and voting
02:14for this Bill by my constituent, the distinguished broadcaster Dame Esther Ramson, in which she
02:22explained that doctors no longer feel able to follow this humane course of action since
02:30the atrocious Harold Shipman case, which was briefly alluded to by my right hon. Friend
02:37for Gould and Pocklington. If there has been such a change in regulations as Dame Esther
02:45believes, it is imperative that it should be reversed. This is something positive that
02:52could come out of the imminent debate.
02:57Another thing that has been touched on more than once is the uncertainty and the postcode
03:04lottery surrounding effective palliative care. Dame Esther's view is that there are some
03:11people who have some conditions for whom palliative care never can be effective. Other people
03:18express the view that there is always a way in which pain-killing medication can be used
03:25in order to prevent suffering, but I suspect the answer to this riddle lies in the fact
03:32that that pain-killing care in some cases might lead to a shortening of life.
03:39Therefore, I conclude that there are three issues that should be in our minds. Can safeguards
03:46be effective? My answer to that, I am sorry to say, is still no. Can pain be alleviated
03:54sufficiently by palliative care? I think the balance of the argument is in favour of saying
04:01probably yes, but it is too uneven across the country and would certainly need the sort
04:07of investment that would be necessary to set up a system that would work for assisted dying.
04:13But above all, have doctors the freedom to administer pain relief which may shorten life?
04:22We need to know the answer to that last question, because if, since Shipman, they have been
04:28prevented from taking such merciful measures, then that is a classic case of hard cases
04:36making bad law. Doctors need to be able, humanely, to ease people on their last journey, and
04:45the country needs to know where the medical profession stands on that central matter to
04:53this debate.