Dear Constituents,

Thank you to the hundreds of constituents who have emailed or written to me to share their views on Kim Leadbeater’s assisted dying Private Member’s Bill that passed its second reading on Friday 29 November. Many of you passed on your very personal reasons for either supporting or opposing the Bill, and I am grateful for you doing so. This is an incredibly difficult and emotive issue for many, that will have major ramifications for how we treat the terminally ill in the future, and so I have taken my time deciding how to vote this Friday.

Having considered the Bill, listened to advice from experts, and read the numerous emails, postcards, and letters I have received, I decided to vote in favour of the Bill.

As you likely know, the last time this issue was debated in Parliament, in 2015, I did not support the Bill as I did not believe the safeguards were adequate. I should make clear that from a moral standpoint, I am in favour of being able to give people a choice toward the end of their life, for much the same reasons as many of the supporters of the Bill: I would have liked for my close family members to have had a choice toward the end of their life, and I would like to be able to decide for myself if it ever came to it.

For me, the question has always been the strength of the legislation, and whether it contains the strong, practical safeguards necessary to prevent vulnerable people from coercion.

The Bill proposed by Kim contains a number of safeguards that I believe help make the Bill safe in practice, such as the mandatory periods of reflection, the two-doctor approval, the judicial oversight, and the creation of criminal offences specifically targeting the risk of coercion. It is my view that with these robust safeguards, it is possible to prevent abuse, and to make sure that the decision is taken solely by the terminally ill person.

Assisted dying legislation has already been passed in several countries and US states. Opponents of the Bill have raised the instances where assisted dying has included too many people, in particular jurisdictions who have included those within the vague definition of ‘unbearable suffering’. I view the Bill proposed by Kim as, rightly, very different to the law in those jurisdictions. The provision that the person must be terminally ill with no curative treatment available ensures the law is restrictive to this small group.

As the Health and Social Care Committee reported earlier this year, no jurisdiction which has introduced assisted dying on the basis of terminal illness have expanded their eligibility to include those falling under ‘unbearable suffering’. I want to be clear that assisted dying, in my view, should only ever be an option for the terminally ill.

Many have urged for improvements to palliative care instead of assisted dying. The UK palliative care system has previously been ranked among the best in the world, though chronic underfunding has certainly meant palliative care services have declined. But I don’t believe that this means it should be one or the other, as the Office of Health Economics found that even if everyone received the best possible palliative care, at least 5,000 people per year would die without any effective pain relief in their final three months, and over 50,000 would be dying with some level of pain. This means that palliative care simply does not help everyone.

So I do think that palliative care is a separate but related issue, and it should be improved alongside assisted dying becoming an option. For assisted dying to be a fair option, the option must be either assisted dying or sufficient palliative care.

For me, one of the key reasons I have grown to be in favour of the Bill is reading about the number of people with terminal illnesses who take their own lives each year. A study by the Office of National Statistics found that adults diagnosed with terminal illnesses are twice as likely to die by suicide. This means that a significant number of people each year are dying in an often needlessly violent, unpredictable, and distressing way. This is a tragedy for both the family of the terminally ill person, but also for the ill person themself who shouldn’t have to suffer even more than they already are. It is unimaginably sad to think someone would be drawn to violently ending their own life because we could not provide them with the means to do so peacefully. Legalising assisted dying would remove the need for such distressing attempts.

This has been one of the most difficult decisions I have had to make since being elected as Member of Parliament for Islington South and Finsbury almost twenty years ago, and I completely understand that many of you will be disappointed, and perhaps angry, that I have reached this conclusion. But I do believe that this Bill presents an opportunity to prioritise dignity, compassion, and freedom of choice for those close to death.

Best wishes,

Emily