WHY I’VE CHANGED MY MIND ON ASSISTED DYING
The former Tory minister is now campaigning for terminally ill patients to end their lives legally after two bouts of cancer and his father’s ‘wonderful’ death
WHEN the Labour backbencher Rob Marris introduced an assisted dying Bill in the House of Commons on September 11, 2015, it was heavily defeated by 330 votes to 118. Among the 202 MPs who did not vote that day was Nick Boles. The member for Grantham and Stamford freely admits that, given the debate was on a Friday afternoon, he was probably back in his constituency.
But a year later Boles – who had been successfully treated for Hodgkin’s lymphoma in 2007 – was diagnosed with a cancerous tumour in his head. And, as the 18th-century diarist Dr Johnson once said, nothing concentrates the mind like the prospect of death.
“I didn’t really think much about death the first time [I had cancer] because the chances of me being successfully treated were high,” says Boles. “But the second time I definitely did because a) it had returned and b) it was much more aggressive. I had this total horror of the idea that I might lose my mental faculties before being able to make a choice about treatment and when and how and where I wanted to die.”
This got him thinking anew about assisted dying and now Boles, 52, is a crusader for a cause that he describes as “the next great frontier for liberal reform”. Apart from taking on the chairmanship of the All Party Parliamentary Group on Assisted Dying, he has become an energetic writer and broadcaster on the subject.
He is in favour of a Bill drawn up by former Lord Chancellor Lord Falconer that stipulates that a fatal dose of medication – possibly barbiturates – can be legally prescribed only if two doctors agree that the individual concerned is over 18, mentally capable and within six months of death. Their decision would then be reviewed by a High Court judge.
SAYS Boles: “I feel very strongly that it is an important thing to do. I haven’t suddenly come to the conclusion that we should all have the right to stab ourselves in the heart whenever we feel like it just because we’ve had a bad day.
“I haven’t moved in the sense that I still don’t support euthanasia. I don’t support what I call assisted suicide, which is where someone is not terminally ill. But I do feel very strongly that we should take this – what I consider to be limited – step. I think not to do so is a denial of a fundamental human right.
“The key thing is that the individuals concerned are going to die soon because by definition they’ve been judged as both terminally ill and within six months of death. There’s no question about their death and its imminence, the only thing in question is how that death should happen and precisely when. I don’t think the state has the right to deny people that choice.”
Apart from the intimations of mortality prompted by his second bout of cancer, Boles’ thinking on assisted dying was also affected by his own father’s demise.
Sir Jack Boles, a former directorgeneral of the National Trust, died five years ago at his home in Devon at the age of 88.
“He took a decision to withdraw the supply of oxygen that was ultimately keeping him alive and I think it’s wonderful that he was able to make the decision,” says his son. (There is no law against refusing treatment.) “His death would have come within weeks or months anyway but the fact that he was able to do that meant that his death was actually genuinely for him a wonderful experience.”
Because of the control he had over the timing of his end, Sir Jack was able to receive communion from the vicar of the parish where he had been churchwarden for many years and leave his wife and children with poignant words of farewell, before a nurse administered a sedative. “For us his family, while being as heartbreaking and sad as it inevitably would be, it was also wonderful and that was only because he was able to – as it were – point at a button and say, ‘Turn it off’. That option isn’t available to many people and I think it should be made available to more people.”
Boles is thinking in particular of individuals with motor neurone disease or late-stage cancer, who wouldn’t necessarily die just by refusing treatment without an enormous amount of suffering. Opponents argue that a right to die could all too easily become “a duty to die”: the elderly and infirm might feel under pressure to kill themselves so as not to be a burden on their families.
“Such concerns are all the concerns that led me not to support the Marris Bill so I can entirely respect them,” says Boles. “And I have a strong memory of why I felt those arguments were sufficiently strong to cause me to withhold my support a very short time ago. My current feeling is that rather than hypothesise about these things let’s look at the evidence.”
He reckons that there is no better illustration of how an assisted dying law can work in practice than the experience of the US state of Oregon. It introduced a Death With Dignity Act in 1997 after a referendum resulted in 51.3 per cent of the votes in favour and 48.7 per cent against.
“It is 21 years since they introduced it in Oregon and they’ve got a huge amount of data and evidence relating to how it’s actually operated and it is fascinating and very inspiring. First there is no evidence in the sense of some massive increase in numbers that would imply that something like what you suggest is going on.”
That said the number of assisted deaths carried out annually in the state has gone up by a factor of 10: from 14 to 143. “Yeah, yeah, yeah,” says Boles. “But to take two absolute numbers like that and sort of divide one by the other is not a statistically proper way of looking at it. What you have to look at is the percentage of all deaths. It is still a very tiny proportion of all deaths.”
HE MAKES the point that at least part of this rise can be attributed to the fact that it takes time for people to become aware that the law has changed and if and when they qualify under its terms. As things stand, the pressure group Dignity In Dying reckons that about 50 UK citizens a year go to Dignitas, the Swiss organisation that offers an assisted dying service from a clinic near Zurich, and another 300 or so kill themselves at home with the – illegal – help of loved ones.
Against this background, public opinion appears to back a change to the law with one Populus poll conducted in 2015 finding 82 per cent of respondents in favour. While most churches oppose the idea, 80 per cent of those identifying as Christians in the Populus poll supported assisted dying. But medical professionals tend to be less enthusiastic. Doctors’ trade union the BMA is against it but the British Medical Journal has called for a poll of doctors to establish what its membership really thinks.
Boles would like to see an assisted dying Bill debated in the House of Commons before 2022. “If I was a betting man I’d say there is a 50-50 chance of getting a law on to the statute book before the next election,” he says. “I would say there’s 100 per cent chance of getting it on the statute book before the one after that. I think the tide is very firmly turning in our favour.”
LIKE FATHER, LIKE SON: Nick applauds the action his father Jack, with him left, was able to take