Assisted Dying for the Terminally Ill Bill: Select Committee Report

Part of the debate – in the House of Lords at 11:10 pm on 10th October 2005.

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Photo of Baroness Neuberger Baroness Neuberger Spokesperson in the Lords, Health 11:10 pm, 10th October 2005

My Lords, it is impossible to make a proper winding-up speech after such a long debate with such excellent speeches. They have been absolutely in the tradition of this House, where passions have been running high but courtesy has nevertheless largely been shown, and even some humour. I, too, congratulate the noble and learned Lord, Lord Mackay of Clashfern, and his committee on their excellent report, and the noble Lord, Lord Joffe, on his Bill and the huge sincerity and unfailing courtesy with which he has brought it forward.

The Select Committee has produced an excellent report, and it has given us a way of taking forward some real concerns. We have heard compelling testimony about the unbearable nature of the suffering of some of those who are terminally ill, and who do not wish to choke to death or die in some other horrible circumstance. We know, from the committee's report and the evidence it heard, that there is a considerable body of opinion, in this House as elsewhere, that believes that people with such conditions should be able to ask for their doctors to help them to die, with all the safeguards discussed.

The committee looked closely at issues of patient autonomy, as has this debate, and examined the growing view that patients have the right to call the tune. This debate has also examined existential questions about the meaning of life, and about suffering as part of life. It has touched on questions of the doctor-patient relationship, and whether a change in legislation will damage that relationship—particularly that between older people and their general practitioners. We have also heard quite a lot about those "weasel words" the slippery slope, as the noble Lord, Lord Griffiths of Burry Port, put it, and the slippery slope argument, with evidence, particularly from the Netherlands, that euthanasia has not been wholly voluntary in all cases, as the noble Lord, Lord Tombs, reminded us.

We have heard that only some 54 per cent of euthanasias are reported to the authorities. In some of these cases, the evidence suggests that euthanasia includes neonates, people in comas and people with a mental illness. Most worryingly of all, according to Irene Keizer from the Dutch Ministry of Health, Welfare and Sport, 25 per cent are people who could have made a request but did not. Then we have had all this firmly rebutted, particularly by my noble friend Lord Taverne.

So where are we? In my view, the Select Committee was right to conclude that assisted suicide should be viewed separately from voluntary euthanasia. I was delighted to hear that the noble Lord, Lord Joffe, is minded to restrict a successor Bill, should there be one, to assisted suicide alone. There are clearly many among us, and I am one, who regard the killing of patients by their doctors, with intent to kill, despite its being at the patient's request, as wholly wrong. I agree completely with the noble Lord, Lord Walton of Detchant, on that.

Furthermore, many regard such killing as utterly incompatible, as do I, with the ethical principles and position of trust which doctors hold. Those who hold such a view would argue that, for societal and moral reasons—pace what the noble Baroness, Lady Hayman, has said, it is not only a religious view—even if a patient is utterly incapacitated by their disease and incapable of killing themselves, they should not be able to get someone else to kill them intentionally. That might be hard, but it may also be right for societal reasons. Unlike the noble Lord, Lord Plant of Highfield, I think there is a difference between commission and omission in these cases.

In the case of assisted suicide, however, the principles are different—even though, in the voluminous correspondence that we have all received, many seem not to think so. If individuals, understanding the consequences, take their own lives—particularly with the safeguards suggested in the original Bill of the noble Lord, Lord Joffe—then that is not unlawful killing committed by doctors or, indeed, nurses. It is arguable that doctors need not be a part of this other than for prescription purposes, as in Switzerland. The Select Committee wisely suggests that,

"if society wishes to legalise acts which run counter to accepted medical ethics, it would be wise to consider whether such acts might not be carried out by other means".

In other words, outside the medical world, as the noble Lord, Lord Lucas, suggested. Two final points at this late hour. If a new Bill is to come before us that can ultimately be debated, as I hope, by a Committee of the whole House, it is important that such a Bill distinguishes not only between assisted suicide and voluntary euthanasia, but between physician-assisted suicide and other means. If doctors are to be involved, the Bill should make provision for them to opt in rather than out, as with other conscience issues. It also needs to make some provision for informing or discussing such issues with family members, as several people have suggested.

Secondly, with all the discussion we have had in this debate about palliative care, real measures need to be taken now for patients to experience good palliative care nationwide, whatever condition they are dying from. It is a disgrace that that is not yet the case, because otherwise people cannot make a real and informed decision.

The Liberal Democrats' spring conference in March last year passed a motion in favour of assisted dying, but, your Lordships will be glad to hear, it left its parliamentarians free on conscience grounds. It is clear that we on these Benches are of mixed views, as is the whole House. Given the extraordinary attacks we have heard on my noble and real friends the right reverend Prelates opposite, I want to say my last bit as a rabbi. I come from what some say is the most life-affirming of all faiths, and we are a pretty life-affirming lot. Our toast when we drink is "lochaim"—not to health, but to life.

I am profoundly opposed to euthanasia. I am in no way convinced that medical involvement in suicide can be right. In a pluralist society, though, I do not necessarily believe that my view should stop all others—provided that doctors and nurses are not involved—and especially that it should stop those very few who genuinely find their pain unbearable, or, as the noble Lord, Lord Turnberg, puts it, "intractable". However, that should only be the case if there is a full and proper informed debate about the social change that might ensue, as the noble and right reverend Lord, Lord Habgood, has put it, and if the fears of those in hospices and the old and vulnerable are thoroughly dealt with, and those experiencing those fears reassured. It should be the case only if equal time is given to the issue of palliative care, and real investment is put into it, so that those hard and moving stories that we have heard today become a rarity, if not completely absent.