Damian Hinds

For reasons of timeliness, I will speak only to amendment 101, which relates to adults with Down syndrome or a learning disability, although the amendment is directly relevant to new clause 1, as the right hon. Member for Hackney North and Stoke Newington (Ms Abbott) spoke about. Amendment 101 would disallow medical practitioners from initiating a conversation about assisted dying with a person who has Down syndrome or a learning disability. I speak primarily from my experience, along with others, on the all-party parliamentary group on Down syndrome and what we have heard from members of that community: people with Down syndrome and their families, and professionals specialising in the condition. Many strong and deeply heartfelt arguments have been put by colleagues, and indeed to all of us by constituents in favour of the Bill, including by families in the most difficult circumstances to imagine—actually, they are sometimes unimaginable circumstances. Nobody could question the conclusions they have come to individually as a result of their circumstances. Equally deeply held and heartfelt points are made to us by people from the other perspective, also informed by their sometimes unimaginable own or family circumstances. Of the arguments put against the Bill, I am particularly drawn to those around coercion. However, it is important to remember that coercion is not entirely a black-and-white matter. At the sharpest end, there are cases where an individual will directly bring pressure to bear on another for their own ends, but there are many gradations below that, and pressure can be felt differently by different people. It may be felt especially by people who worry they are a burden on their family, on caregivers, on the national health service, or indeed more broadly on society. Once assisted dying is an available option, over and above the question of pressure from others, I worry about the effect of pressure from oneself. The Bill stipulates in clause 36 that the Secretary of State will issue a code of practice to ensure that the practitioner establishes that there is a “clear and settled intention” for the person to end their own life, including assessing that that person has “capacity to make such a decision”. That will have material challenges of its own. However, with regard to amendment 101, I am talking about the initiation, suggesting or raising of the matter specifically with an individual who has a learning disability or Down syndrome.