Danny Kruger MP: speeches 2025

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Speeches

18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The hon. Lady is right that there is no other agency that is appropriate. The difficulty is that the MHRA is itself highly conflicted—we will come in due course to discuss the role of the profit motive in this mooted procedure—and the big problem is that it is overwhelmingly funded by the pharmaceutical companies. We have to ensure that there is no hint of corruption in the system, but I agree with the hon. Lady that the only way to do this is through that agency, but perhaps after reform.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Yes. We discussed this briefly this morning. There is an important consideration about the effect on medical staff involved in the administration of assisted suicide, and we have to make sure that those who do not want to participate are properly insulated from any sort of obligation, which I know is the intention of the Bill’s promoter, the hon. Member for Spen Valley. Nevertheless, I am concerned about the knock-on effect of participation in assisted suicide spreading across a practice. I agree with my hon. Friend that we have to be mindful of the impact on doctors. The more we widen the scope—as logic compels us to do, as the hon. Member for Harrogate and Knaresborough suggests—the more it is about not just discretion, but an obligation on doctors to approve. We need to think about the conversation that doctors will be required to have with patients who are expressing that wish. If the Bill is widely drawn, as it would be if we were to accept these amendments, there is more opportunity for a doctor to feel compelled to assent to a request.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Will the hon. Gentleman give way?
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Clearly! Fair enough. Amendment proposed : 463, in clause 18, page 12, line 34, leave out paragraph (c)— (Danny Kruger.) Question put, That the amendment be made.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The hon. Lady is absolutely right. We have heard so many professionals convey their concerns about the Bill. The majority of medical professionals who work with the dying—care workers, palliative care specialists and hospice staff— oppose assisted dying, and it is not right to ask them to take a job knowing that they might be called on to witness, if not directly facilitate, assisted death. My other amendment speaks to the whole range of activities that can lead to an assisted death, not just the provision of assistance at the end. It is important that that amendment is accepted too. The hon. Lady is absolutely right: it is important for staff to have that protection. The amendment tabled by my hon. Friend the Member for Reigate speaks to that as well, and would address that concern. I think we are going to hear from her as well, so that is enough from me.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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My strong suspicion is that this is because the evidence is not being accurately collected or reported. With Dignitas and in all these jurisdictions, as the hon. Lady has acknowledged, there are significant failures of data and record keeping. Obviously, it is very much in Dignitas’s interest not to collect and certainly not to publicise evidence of things going wrong. However, that clearly happens in jurisdictions where data is properly collected.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Well, I think prostitution is actually legal; it is the soliciting of it that is illegal—but others can correct me. The only thing that an owner or occupier of a premises is not allowed to forbid is activity that is covered by the Equality Act 2010 or other equality laws. There is nothing in the Equality Act or other laws to prevent an operator from exercising their right to deny assisted dying. My amendment would clarify that right. My right hon. Friend asks how the collective will of the community would be ascertained. It would not be. I am proposing that the operator of the premises would have the right to determine whether assisted dying could take place there or not. I am suggesting that the likelihood with a care home is that the operator would, on behalf of residents and staff, say, “We’re not doing that here.” If they wanted to—if there was a pro-assisted dying care home—it would then be a question for residents and staff whether they wanted to live or work there. I am simply attempting to insist on the right of property—or the right of occupation, I should say, because it is a question not just for the freeholder but for the occupier of the premises. In the case of a house or a business premises, that would be the tenant. Whoever operates the business or the activity of the premises should have the right to conclude that they are not going to have assisted dying in their premises.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I will press amendments 465 to 467, but not amendment 409. I beg to ask leave to withdraw the amendment. Amendment, by leave, withdrawn.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am absolutely certain that if the amendment had been in the original Bill, the Bill would not have passed Second Reading, because it would have validated the argument that many of us made that the implication of assisted suicide is euthanasia. The distinction between them, while valid in the abstract, does not apply in practice, and that distinction will be quickly overridden in time. I agree with the hon. Gentleman.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am supportive of all the amendments in this grouping, including amendment 255 in the name of the hon. Member for Filton and Bradley Stoke (Claire Hazelgrove) about the importance of recording the means of administration of the substance. We have discussed that a bit, and I think it is important to include it. The amendments tabled by the hon. Member for Bexleyheath and Crayford are also important, as they insist on the actual physical presence of a doctor while the treatment is being carried out. His amendments also suggest that there should be a code of practice about what should happen when things go wrong; I want to go further than that, but I do approve of that measure. On amendments 532 and 533, tabled by the hon. Member for Ipswich, I again support in principle the requirement—although there is a little too much regulation by the Secretary of State, in my view—that we be clear about where the act should take place and make provision about what the co-ordinating doctor is legally permitted to do if they determine that the procedure has failed. That is the point I really want to discuss; the amendments tabled by the hon. Member for York Central (Rachael Maskell), and the amendment that I tabled, would impose an obligation on the co-ordinating doctor to provide assistance if the procedure fails. Let me take a moment to explain to the Committee how important it is that we recognise the genuine risk of that eventuality in the case of assisted suicide being performed. There is significant evidence—even given the lack of adequate data collection and the paucity of record keeping, with over half of assisted deaths not properly recorded at all in many places—that in places such as Oregon, which is one of the worst offenders when it comes to data collection, there are significant rates of complication. These can be difficulty with ingesting the drugs, regurgitation and seizures. As I said, 72% of deaths do not record whether complications have occurred, but among the quarter that do, there are significant rates of complication. Sometimes death can take days, and there can be a long time of unconsciousness. The Committee has heard from me and others in previous debates about the extent to which there is real concern about the actual experience of the administration of assisted death. But it is striking how ill-defined the current Bill is on the point about complications, compared to jurisdictions where such laws are in operation. In other countries, there is clear guidance in law for what should be done. In the Netherlands, euthanasia is recommended when assisted suicide seems to be failing; in Canada, doctors are likewise given licence to administer the death themselves if it fails. The Committee has decided not to proceed down that road. Nevertheless, the question arises as to what on earth patients should do. To the point that we are talking about a small or non-existent population group—those we might have to worry will experience complications after the administration of fatal drugs—I refer back to a previous debate, when the hon. Member for Stroud, referring to me, said: “The hon. Gentleman is bringing up lots of rather horrible stories about assisted death. That is why, in Australia, Switzerland and Holland, they have decided, instead of using the regime that he is talking about, to use pentobarbital…One of the reasons why Dignitas uses it is that it is so effective and it does not have those effects.” –– [ Official Report, Terminally Ill Adults (End of Life) Public Bill Committee, 11 March 2025; c. 925.] Having looked into the issue and consulted other medics, I am afraid that the fact is that the safety of pentobarbital is highly contested. It has been debated in litigation in the United States because of its use as a death penalty drug. The executioners who used it said that the deaths were peaceful and akin to falling asleep, but lawyers for inmates on death row have said that “pentobarbital caused flash pulmonary edema, in which fluid rushes through quickly disintegrating membranes into lungs and airways, causing pain akin to being suffocated or drowned.” That is evidence from professionals who have examined the effect of pentobarbital on deceased people. The anesthesiologist Joel Zivot of Emory University hospital in the United States testified to the Canadian Senate on the subject of assisted suicide drugs. He said that when he researched the autopsies of those executed by lethal injection, he stumbled on an alarming discovery: “When I looked at the autopsies, to my surprise, I found that, in most of the cases, the individuals who had been executed by pentobarbital had fluid congested in their lungs. The lungs of these individuals were twice the normal weight, full of water. Now, the only way that this could have happened would have been as a direct consequence of the pentobarbital that was injected into these individuals.” What is the relevance of that for assisted dying?
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I entirely agree that there is great concern about the lack of evidence in countries on which we are constantly relying for evidence of why this proposal is safe. I have suggested that, from the quite limited evidence we have, that it may not be safe. The hon. Gentleman is absolutely right that if we are to proceed, we need to be extremely strict about data collection. To the hon. Gentleman’s point about making it clear to clinicians what drugs they are permitted to use, we also need to have a proper regime of clearing and approving those drugs. In earlier clauses, we debated the imperative on the NHS, the Medicines and Healthcare products Regulatory Agency and the Department of Health to properly authorise the specifics of what drugs will be used. It is not clear at the moment what those would be, and I very much agree that we need to be clearer on that. I finish with a reference to an earlier debate, in which it was suggested, on the basis of the Australian example, that there is no evidence of complications. The hon. Member for Stroud talked about horrible stories from the United States and Canada. He also referred to Australia, where there is apparently no evidence of problems. In fact, I understand that of the six states, only Western Australia records complications, and it does so in relation only to practitioner administration—when the doctor administers the drug—which we do not propose to do here. It does not record complications in relation to self-administration, which is what the Bill proposes. In Western Australia, complications have been reported in 4.3% of cases involving practitioner administration. Again, we are dealing with the great mystery and enigma of how death happens with assisted suicide, and it is certainly unclear what we should do about it.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Those are the sorts of circumstances in which I envisage an occupier—namely, the manager or the organisation that provides the home—being entitled to state that assisted dying does not take place on their premises. I recognise that that is a challenge for individuals living there, but it is explicitly because they are living in a community of others, supported by members of staff, that it is important to acknowledge the rights of the community as a whole, and particularly the organisation or individuals responsible for overseeing the service. I am thinking explicitly of hospices or care homes, where many people end their days; it is imperative that we give the operators of care homes and hospices the explicit opportunity in law to state that they do not facilitate assisted dying on their premises. I hope I have helped the hon. Gentleman to understand the circumstances in which this provision would apply.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I thank the hon. Gentleman for that intervention, because that is exactly the sort of organisation that I would expect to have an objection to assisted dying taking place in its premises. He invites us to consider the alternative to the amendment, which is that there should be an obligation on a care home provider to facilitate an assisted death if somebody wants one. That would mean, in the case of a care home run by the Sisters of Mercy, that a resident could insist on their right to have an assisted death in a care home that is staffed by people who have strong moral objections to that treatment and that is inhabited by other residents who are also deeply uncomfortable with it taking place in their home. I implore Committee members to expand their scope beyond the single individual who would be the subject of the application, and to consider the community they live in.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am grateful that the Minister is allowing us to push him on this, because it is crucial. This is the moment beyond which there is no return. He thinks that helping a patient to sit up would be within the scope of the clause. Does he think that holding the patient’s hand and tipping a cup of pills into their mouth would be consistent with the clause?
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I beg to move amendment 409, in clause 20, page 13, line 35, leave out from “specify” to “for” and insert— “two or more drugs or other substances with different techniques of administration”. The amendment requires that the Secretary of State specifies two or more drugs or other substances, which have different techniques of administration.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Yes, I do acknowledge the problem with that. My expectation would be—thinking about this in real human terms—that if somebody wanted an assisted death, and they wanted to do it in a particular care home, that would be a conversation they would have with the care home operator. The care home operator might have an absolute blanket objection, for lots of reasons we can imagine, but they might in certain circumstances recognise that Mrs Smith has lived here for some years and wants to have an assisted death, and that would be perfectly acceptable to the care home operator, other residents and staff—in which case, that is fine. To challenge the hon. Gentleman, he suggests that because one resident of the care home wants to have the service, the people who live with, and the staff who support, him or her should be obliged either to facilitate or to co-exist with this enormously impactful event that takes place in their space.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am grateful for that, and I will leave it there, but does the Minister agree that it is incredibly difficult to distinguish who is administering the treatment in that scenario? If both their hands are on the instrument, whatever it is—a cup, a syringe or a button on a computer screen—it is very hard to know who has actually delivered the final act.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I am grateful to the hon. Lady. Let me let me look that up later. I am happy to exchange data, because this is clearly something we should be trying to get right. Nevertheless, I want to try to explain why I am suggesting that we have a problem with the drugs that are used in assisted dying and that it has been suggested we use here. Let me continue the quote from Dr Zivot: “When one watches an execution, it’s not clear that this is happening”— meaning that it looks like a peaceful, painless death. He continues: “There is not much to see. Executions, like, I imagine, medical assistance in dying, are a rather bloodless event; not much can be seen outwardly. But the autopsies revealed a very disturbing and surprising finding.” He makes the point that that is particularly disturbing, given that assisted dying often uses a paralysing drug, which induces the impression of peace and calm in the patient, when in fact something else might be going on below the surface. To conclude my quote from Dr Zivot, he says: “To claim that this is a death that is peaceful, well, it can be nothing else because now a person is unable to move in any way, but whether or not they have any conscious experience of what is happening is unknown…it should be clear to the Canadian public that the kind of death that they will experience…will be something other than the way it is represented. It could be exceedingly painful and more akin to drowning.” I cannot judge whether Dr Zivot is right, but we should be very wary of any claims that there is a simple answer to the question surrounding lethal drugs. To the point made by the hon. Lady, and I think by the hon. Member for Stroud, there is no evidence in the many reports from Dignitas, which has a regime very similar to the one we are imagining here—I will certainly look at the evidence mentioned made by the hon. Lady—that contradicts the concerns raised by Dr Zivot.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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There is great anxiety about the validity of much of the evidence in this space. I have great respect for the work of Dr Zivot, because nothing else gets us close to understanding the actual effect of these drugs, once somebody has died.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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Let me come on to that, because I am not aware of any evidence from Dignitas that disputes the assertion that is being made—certainly none that would meet the concerns raised by the genuine evidence of the effect of pentobarbital on death row patients. Again, the absence of evidence is not evidence of absence. I do not think that Dignitas has supplied evidence to contradict the point that I am making.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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The Minister suggested that there will be a code of practice, but clause 30 says that there “may” be a code of practice. Does the hon. Member accept that there might not be one and that, even if there were, the only obligation on professionals would be to have regard to such a code? There is a big difference between that and a stipulation in the Bill.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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On the hon. Lady’s first point, about the gardener refusing to mow the lawn, the activities that an individual will be allowed to opt out of are clearly specified in the amendment and they are the activities covered under the Bill. It is not about unrelated activities connected with the premises but the provision of assistance—not just at the end but all the way along. I hope that is clear. On her second point, again we have—
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I trust this Secretary of State.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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I beg to move amendment 435, in clause 18, page 13, line 6, at end insert— “(9A) Where the procedure has failed, the coordinating doctor must escalate the care of the person by making the appropriate referral to emergency medical services.” This amendment would require the doctor to escalate the care of the person in cases in which the procedure fails.
18 Mar 2025 · Terminally Ill Adults (End of Life) Bill (Twenty-fifth sitting) · Hansard source
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On a point of order, Sir Roger. I am sorry if I missed it, but are we not going to debate amendment 496?

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