Danny Kruger MP: speeches

Speeches

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  My hon. Friend says that the term “ability” is not yet defined, but it is set out quite clearly in new clause 1, tabled by the hon. Member for Richmond Park. It simply says: “The person is to be considered as having the ability to make a decision to request assistance to end their life if they can fully understand, use and weigh the relevant information”. It uses the language of the Mental Capacity Act on understanding and weighing information. The key distinction is that it does not allow for impaired judgment; it requires somebody fully to understand the information in front of them. It is very straightforward, and I do not think that it would be difficult to apply. Does my hon. Friend recognise that the terms are pretty clearly laid out?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  That is absolutely right. I do not think best interests can apply in this case. That is why the Mental Capacity Act is being abused. As the hon. Member for Penistone and Stocksbridge said, it is supposed to be cumulative. We are supposed to consider all aspects of the Mental Capacity Act, and best interests should be part of a consideration—but how on earth does one make a best interests decision about somebody deciding to commit suicide? The hon. Gentleman is right that best interests are excluded in the Bill, so the Mental Capacity Act is not being used, except for this most basic, low-level bar to cross, which is the capacity decision.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  The hon. Lady does not like my terminology.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  Will the hon. Lady give way?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  Is my hon. Friend suggesting—I think his new clause makes it clear, and I think my right hon. Friend the Member for North West Hampshire is making the same point—that it is inappropriate for an advance directive to authorise an assisted death? The Mental Capacity Act authorises somebody to decline treatment at a future point, so my hon. Friend is acknowledging that there is a difference between the principle of declining treatment and the principle of requesting an assisted death. Given his new clause, I do not imagine that my hon. Friend thinks that we should have advance directives that authorise an assisted death. If he acknowledges that, he must recognise that there is a distinction between declining treatment and requesting an assisted death.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Eighth sitting) · Hansard source

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  The hon. Gentleman’s intervention helps me to explain my point more clearly, which is that the new clause tabled by the hon. Member for Richmond Park builds on the terms of the Mental Capacity Act. It recognises the value of the terms, which have been well established in case law through the MCA—the ability to understand, use and weigh the relevant information. The key difference is the word “fully”. The case law around the MCA allows for somebody to be deemed capacitous even though their judgment might be impaired. What is proposed in the new clause is the closing of that lacuna, so that it would not be possible for someone to get an assisted death if their judgment was impaired. That is the key difference. It is also important to exclude the MCA because of the thicket of complications that it would entail. We have heard about the importance of simplification. A much simpler and better way to do the entirely novel thing that we are proposing, which is to authorise assisted suicide by the state, is to have a new definition.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I accept those points. Nevertheless, the Bill itself has broad definitions and large exclusions—people who have more than a six-month prognosis, and so on. The Bill, I am afraid, operates in pretty broad brush strokes in order to try to defend large categories of people, so I think it is appropriate to exclude all people who are currently incarcerated—people who are in prison—whatever the reason or the length of their sentence, until they are released, and then they can start the process if they wish to and if they qualify. On homelessness, yes, we should use the official definition of homelessness, which basically means “in precarious housing”. The purpose of the Bill is to enable people who have full autonomy to make a decision in their own best interest. I think it is legitimate to ask whether people who are living in insecure accommodation, whose lives are in flux, who are experiencing extreme precariousness in their lives, should meet the appropriate criteria for autonomy that we wish to set out.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  rose —

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  It is interesting that my right hon. Friend the Member for North West Hampshire has cited that, and I will look at Hansard. However, what I just heard him say, quoting the doctor from the Royal College, was that if we equate the gravity of the cases, it would be appropriate. That is the equivalent of saying that if the two cases are the same, the mechanism can be the same. Crucially, I do not believe that the Royal College does equate the gravity of the two cases. Its written evidence states that while “a person’s capacity to decide treatment can be reliably assessed, an assessment of a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding.” It regards the two cases as different in principle and therefore requiring different tests.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I am grateful to my right hon. Friend. I particularly applaud his amendment’s aspiration to ensure that the doctors’ conversations are properly recorded.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  Prisoners are denied their liberty, not just their vote. They are treated as a single class of people who the state has specific responsibilities for, because it essentially owns them for the time that they are incarcerated. Prisoners have particular protections, but they are also denied a whole range of human rights and opportunities that the rest of society can have. It is not inappropriate to treat prisoners as a distinct class of people to whom the state has a specific responsibility.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  We are trying to avoid suffering, pain and bad deaths. We all share that view. Indeed, later amendments look explicitly at the purpose of an assisted death and the question of the avoidance of pain. I am simply making the important distinction between the decision to withdraw treatment and the decision to administer fatal drugs, which, as I say, are qualitatively different—different in principle and different in practice.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  On the point of legality, of course a law could be challenged under the European convention on human rights, but Parliament is sovereign. If Parliament decides to exclude a particular category, we in this place have to take this enormous responsibility—we make the law in this country.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  What an interesting debate—I am grateful to all hon. Members who participated. I am interested in what the Minister was saying about the ECHR. Notwithstanding my general point about the sovereignty of Parliament, when Lord Sumption gave evidence to the Committee two weeks ago, he stressed the wide margin of appreciation given to member states on the ECHR. Does the Minister think that that will apply in this case to ensure that the British Parliament could vote to exclude these categories of people? If his view is that the Bill could be subject to challenges on discrimination grounds, however, particularly under article 14, I think we will have a lot of problems in applying the Bill. I wonder whether, in due course, we will be able to tease out how the ECHR will intersect with the Bill. As the Minister says, the crucial point is that any discrimination must be justified on the basis of achieving a legitimate and proportionate aim. My suggestion is that there is an absolutely legitimate aim, and that this is a proportionate means of achieving it. The debate got quite philosophical, which I found very interesting. I observe that my constituency neighbour, esteemed colleague and great Conservative, my right hon. Friend the Member for North West Hampshire, has a vision of our particular political creed that is entirely individualistic. He stresses the absolute importance of individual autonomy, treating everybody as an individual without reference to the context in which they live. I suggest to him, and to the Committee, that our freedom and autonomy depend on our relationships. Our autonomy proceeds from our socialisation. We do not emerge fully formed into the world with all our values and attributes; we acquire them by virtue of the people around us. The crucial thing about the prison experience is that it disrupts the relationships that can make an individual genuinely free. Homelessness does likewise, and it sets up all sorts of new relationships and new socialisations that can often be very negative.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  The hon. Gentleman is absolutely right. Once again, it is a shame that we are feeling our way in the absence of that assessment. Nevertheless, I think we all have experience and we can draw on the evidence. The hon. Member for Bradford West made a very powerful point, and she was absolutely right. I spoke earlier about the evidence on suicide among the male prison population; I have experience of working with women in prison as well. There is a genuine danger of chronic, almost epidemic, self-harm among the female prison population. Likewise—this is a fact that we need to bear in mind throughout the debate—suicide is itself contagious. That is why it is so important to discuss it in a responsible way. The option—I use the term advisedly—of assisted suicide is itself dangerous in the context of a prison population in which these ideas are contagious. My right hon. Friend the Member for North West Hampshire talks about the need to assess each case on its own merits, individually. I recognise that, and in principle of course that is what we should be doing. Nevertheless, that assumes that the safeguards in the Bill are adequate to the challenge of dealing with people in such particularly vulnerable circumstances. I am concerned that they are not adequate anyway. I believe very strongly that they are not appropriate to people in these circumstances and that therefore it is appropriate to have what he calls a blanket ban. As I said in an intervention earlier, we have to treat particular classes of people in the same way. We do that all the time, with respect specifically to the prison population. The fact is that we have to draw the line somewhere. We are drawing the line in all sorts of places in this Bill—around the age limit and around diagnosis and prognosis. I think it would be very appropriate, given the extreme vulnerability of these populations, to draw it around them and protect them from the vulnerabilities and dangers that I think all Members recognise might apply in certain circumstances. They will apply in heightened likelihood to these populations. I do not propose to press these amendments to a vote, but I am grateful to hon. Members for the points that they have made, and I hope that the concerns have been noted. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn. Amendment made : 179, in clause 1, page 1, line 13, after “provided” insert “in England or Wales”.— (Kim Leadbeater.) This amendment limits the assistance that may be provided in accordance with the Bill to assistance in England or Wales.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I am grateful to the hon. Lady; her points are absolutely right. Even if the House concludes that the overall principle is right, as the hon. Member for Spen Valley suggested, if it is not possible to do it safely, we should not do it at all. My great concern is that proceeding with the use of the Mental Capacity Act as it currently stands in the Bill will make the Bill dangerous. Let me conclude my point about the difference between assisted dying and the withdrawing of treatment. To decline treatment is to assent to nature; it is to let one’s body do what it will. To commit suicide is to contradict nature; it is to do something to one’s body that interrupts its own plans. I recognise that the outcome is the same —it is death—but we are considering the process of decision making in the clause, and the decision is fundamentally different.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  My right hon. Friend articulates the point well. I do not think it is a semantic decision: there is a real distinction. The fact is that unplugging the ventilator leads to death, but what kills the patient is not the administration of any treatment or drugs that have been provided. The patient dies naturally, whereas the administration of drugs designed to kill them is a qualitatively different event. I agree that of course the ultimate effect is the same, but the act that is performed is qualitatively different, and indeed the intention of the doctor is different.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  The decisions will be recorded, but the conversations that the hon. Lady stipulates should take place under the Bill need further recording, in my view, with further evidence of what was discussed in order to ensure that the safeguards have been properly applied. I also point out that for the chief medical officer to effectively carry out the review under clause 34, they must have evidence available, not just a few schedules that have been signed off. Likewise, I am glad to say that the opportunity remains for a legal appeal, in so far as we still have a judicial process, but I am concerned that the lack of any documentary evidence makes the application difficult for any external party or the Court of Appeal to review. Currently, there is a great paucity of information that the High Court judge considering the application can request. I think it is important that the High Court judge—or, indeed, the panel, if we move to that approach—should have access to a much fuller range of documentation to ensure that the process has been properly followed.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  The hon. Lady might well be right. I totally take that point. I dare say it is people who are homeless. I think the question put was, “Should those who are homeless simply be able to ask for assisted dying?” People in this country say no. In Canada, asked the same question, a quarter of people say yes. The effect of the law has been to institute this principle of assisted dying being an acceptable choice under any circumstances, which is indeed, I am afraid, what happens. I will end with a powerful quote from Fazilet Hadi, who spoke to us representing disabled people. She said: “This Bill is not an abstract exercise; it will land in a society that is rife with inequality.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 29 January 2025; c. 185, Q242.] She said that the society the Bill will land in is the thing that needs to change, not the Bill. She thinks we need to change our society before we do anything like introducing assisted dying. I agree.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  The hon. Lady has expressed very well her whole purpose for the Bill. In a sense, all the debates we are having about safeguards, protections, process and eligibility are secondary to her purpose, which is to give autonomy to patients. One has to ask about the purpose of the safeguards, particularly the one on people having to administer the drugs themselves. In all jurisdictions where physician-assisted suicide is legal, that is the option that people overwhelmingly opt for—I certainly would if I were in that situation. The hon. Lady is right, and that is what she is trying to do: she simply wants the Bill to go through. I take strong issue with her implied point that our purpose here is simply to work out the Bill’s implementation. We are looking at each clause, line by line, to decide whether it is safe or not. As she said herself at the time, the decision on Second Reading was a vote in principle to continue the discussion, which is what we are doing now. We are closely and minutely examining whether every clause is safe.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I am very puzzled, on two grounds. The first is about the impact assessment. I simply do not understand the argument that the Government have to wait until the end of the Committee stage before they can have a view on the Bill and present it for Report. The fact is that the Bill could change again on Report, and the impact assessment would have to be updated further. Why on earth do we not have an impact assessment, which could advise the members of the Committee and the Government themselves on the appropriateness of the measures? That brings me to my second point of confusion: I simply do not understand what on earth the Minister means when he says that he is neutral about the clauses. He has just given the view, from his position, that he objects to the amendment and that he supports the use of the Mental Capacity Act. He is basing his view— I had understood that, as a neutral member of the Committee, he was not going to express one—on something. What is he basing it on? Secondly, how can he express a view when he is supposed to be neutral?

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  If the hon. Lady would like to intervene on me, I would be happy to give way.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I have just a few points to make. I very much applaud the hon. Member for Broxtowe for her amendment, which would genuinely—demonstrably, I might say—strengthen the Bill. It does not seem in any sense hostile to the principle or purpose of the Bill; it supports it. To make a gentle criticism, I think that there is a concern about the lack, throughout the Bill, of a proper trail of documentary evidence following the applicant through the process. For example, the two conversations with the doctor would take place behind closed doors, and no record of their discussion would be made. I do not think that conducive to trust. There is no way to assess whether the safeguards are actually in operation.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  Me again, I’m afraid. The amendments in my name would exclude from eligibility people who are in prison and people who are classified as homeless. In this debate and in our evidence sessions, we have heard it said quite a lot that most people who opt for an assisted death in countries that have it are advantaged—they are middle-class, in our idiom—but the plan is to offer it to everybody; it would be a universal right. My amendments would address some of the most disadvantaged people in our country. I have had a very privileged life, but for 20 years I have run a charity working in London prisons; I spent about 10 years as full-time chief executive and have spent another 10 years as chairman. I have known hundreds of prisoners and ex-offenders, and I still do. Although I firmly believe in criminal justice—indeed, I think we need to be tougher on certain categories of offender—I recognise from my personal experience the dignity in all prisoners and the absolute necessity of respecting their dignity. In fact, I once wrote a speech for a Conservative leader of yesteryear that made some of those points and got headlined “Hug a hoodie”.

• 11 Feb 2025 · Terminally Ill Adults (End of Life) Bill (Ninth sitting) · Hansard source

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  I will conclude my intervention very quickly. I fear that I may have mischaracterised the hon. Member for Bradford West when I said that she is opposed to the Bill in principle; in fact, I do not think that is the case. I am not sure what the difference is between opposition in principle and opposition to the detail, but I recognise that she is certainly not opposed to the Bill in principle, so I apologise to her. Does the hon. Lady agree that the Bill would take a great leap in the dark by legalising assisted dying? At the moment, that leap lands on the uneven ground of the Mental Capacity Act. Does she agree that, if we want to do this properly, we should prepare a solid, cushioned, safe landing space that is appropriate for the Bill, rather than the inappropriate mess that the Mental Capacity Act would induce?