Mary Kelly Foy

I could not agree more—these issues have come to light in similar jurisdictions around the world. We know that there is a greater risk of social coercion driven by the inequalities that people face. Under the current proposals, will the panel of experts be able to adequately assess the impact of the wider pressures of life? The truth is that when we talk about choice, the reality of making such a choice is very different for the wealthy than it is for others. Inequality shapes health outcomes throughout our lives, as well as the options available to people at the end of their life. The choices facing someone who is financially secure are very different from those facing someone on a low income, relying on benefits or struggling to make ends meet. As I say, evidence from other countries starkly highlights that such social and economic factors—including inequality in the provision of healthcare—are significant for those who are deemed to have chosen to end their life. We should not ignore that. For more than a decade, we have seen public services come under strain, disability support reduced, and rising hardship for many families. During covid, we witnessed immense pressures on our health system, and I worry that we risk telling people that we cannot always guarantee the support needed to live well, but we can offer greater choice in death. Real choice can only come with high-quality care, strong support services and access to excellent palliative care. That would provide dignity, and it is our job—and a challenge for society—to deliver the chance of real dignity for those facing terminal illness. The people most exposed to the risks within the Bill are often those who already face disadvantage: older people, women, those living in poverty and those with poor mental health. We live in a very unequal society; the wealthy are better protected from hardship, while others face pressures that can profoundly influence their decisions. I cannot be clear enough in saying that poverty should never be the reason for someone to choose to die. I conclude by returning to Maria. While she will not be able to hear my remarks today, I know she would be pleased that I finally got to make my case, and I urge colleagues to bear in mind people like Maria when they cast their votes. If we are serious about dignity and choice, our first duty should be to improve care, strengthen support and tackle the inequalities that shape people’s lives.