My Lords, many noble Lords have spoken of the quality of the chairmanship of the noble and learned Lord, Lord Mackay of Clashfern. I echo that which has already been said. It was a privilege to sit on the committee and a real education. Our thanks go to him and to all the staff who supported us.
Like the noble Lord, Lord Patel, when I joined the committee I was uncertain as to the way forward and whether to support the Bill and the provisions being put forward by the noble Lord, Lord Joffe. The reason for my doubt was that I did not have a fundamental, faith-based approach that gave a simple answer to this question, such as is manifested in much of the correspondence that we have received on the subject. If you simply believe that when you live or when you die is in the hands of someone else, it is not a matter of debate whether we should envisage legislation such as this Bill. If you do not believe that, and if you believe that living an ethical or moral life and trying to legislate in the best interests of society is often a matter of justifying your inconsistencies rather than of total consistency, it is a difficult question.
I need no persuading that more people at the end of their life would be helped by improvements in palliative care and the availability of those services than would be helped by implementing the Bill as outlined by the noble Lord, Lord Joffe. But, like others who have spoken, I do not find those objectives irreconcilable. Nor is it impossible to believe that passionately; to campaign for it and be willing to work for it, and to understand that for most people their suffering—existential and physical—can be helped by excellent palliative care such as is being developed in this country. That is a given.
Equally, I cannot accept the assertion that has been made today in the Chamber that all suffering is amenable to relief. That was not the evidence that we received on the committee, either from patients or doctors. It is not the evidence that many of us have seen in our own lives among those for whom we have cared very deeply. Some suffering is not amenable to relief. Many professionals will accept that, even with the best palliative care.
Sometimes the perceptions of doctors and patients differ in that area. I always remember a lovely story about the late Queen Mother, who said that she had never appreciated the strength of the sense of humour that her orthopaedic surgeon demonstrated until she read, the day after she came round from an anaesthetic in hospital, his comments to the press that she was comfortable recovering from her operation. Doctors have to accept that people vary. My noble friend Lady David said that we should not say that all those who seek such assistance are controlling personalities, as though that were in some way wrong. Some people find some parts of the symptoms and experience of dying more difficult to cope with than other people do. Some symptoms are more amenable to relief than others.
If we are to accept that that is so, I have to ask myself whether there is a greater danger, in moving the line a little so that those people could gain assistance, that we would prejudice more—that we would create greater harm in society. That was the issue on which the noble Lord, Lord Patel, has just spoke. Would we necessarily cause fear and concern that pressure would be put on patients to die? That was not the experience that we saw in any jurisdiction that we visited. In fact, we heard lots of evidence of families persuading people or trying to persuade people not to take that course of action, but that they in the end did.
I bored the committee rigid by constantly questioning whether we really were crossing a Rubicon if we changed to physician-assisted suicide. For me, the difference between physician-assisted and physician-administered suicide was not clear when I embarked on the matter and became much clearer later. It is important to the medical profession, and I could support one but not the other. From the perspective of a patient who wants to die, what is the difference—what is the Rubicon—between being able to say, "Turn off my life-support machine" and having that enacted, or being able to say, "I don't want to take this medication", and leaving an advance directive to say, "I don't want artificial hydration and nutrition"? From the perspective of the patient who wants to end their life prematurely, what is the difference in being able to say, "I want to do this in a considered, controlled way with the assistance of doctors, when I know that it is going to happen, so that I can say my farewells"? I could never answer that question satisfactorily. I could not see a great danger to society, so I support the sort of Bill that the noble Lord, Lord Joffe, intends to introduce.