Assisted Dying for the Terminally Ill Bill: Select Committee Report

Part of the debate – in the House of Lords at 5:33 pm on 10th October 2005.

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Photo of Baroness Cumberlege Baroness Cumberlege Conservative 5:33 pm, 10th October 2005

My Lords, in the past, medicine was simple, relatively ineffective and safe. Today it is very complicated, effective and potentially dangerous. We have moved from the time when the family doctor, with great kindness, prepared us for the inevitable. Today, for many, the attitude is quite simply negligent. Curing what was thought to be incurable, successfully operating on the inoperable and striving to achieve what is still unachievable is considered a triumph of progress. But in the end we all die. This evening, we are being asked to consider whether it is right to terminate the lives of those people beyond the extremities of medical progress. Fortunately, we have the excellent report, which is not only beautifully written, but well researched and finely balanced. The skill, wisdom and integrity of the committee's chairman shine throughout.

The committee, through the evidence of the noble and learned Lord the Attorney-General, heard that the Director of Public Prosecutions, when asked whether he should in future publish prosecution guidelines, had decided not to do so but to consider each case on its merits. That values the individual and recognises that every life is different, so three cheers for the DPP. During the summer, at the invitation of the noble Baroness, Lady Finlay, I visited Velindre Hospital in Cardiff. It was one of the most memorable and inspiring days of my life. If ever there were a case for human cloning when it comes to palliative care, it is Professor Finlay. Sadly, I do not have the time to describe that visit and what I learnt. If I have a criticism of the committee, it is that it as a body did not take up the offer to visit a hospice. I am sure that for some it would have been enlightening, and might have modified their support for the Bill.

Once a year, I have the joy of presiding over the graduation ceremony of 100 newly qualified doctors. Those young people are some of the brightest in the land. They are well motivated, see medicine as a vocation and cannot wait to start their real work in healing, treating and curing patients. In unison they make a pledge—it is much too long to recite today; anyway, I did so when we debated the previous Bill. That pledge means a great deal to those aspiring young doctors and their tutors, friends and families—and to me—for it is their contract with society. But we are told, in the section on the outline to the Bill, that,

"medical staff who comply with the terms of the Bill [are] to be immune from both prosecution and breach of any professional oath or affirmation".

Are we to jettison so lightly oaths and affirmations? For some of us, they are important. They guide our lives, behaviours, marital status and thinking. Do the oaths and affirmations made by judges, magistrates, and your Lordships in this House mean nothing?

According to the Bill, an oath or affirmation is simply a matter of words—a mere trifle to be discarded. That underlines one of my deep concerns with the Bill, both in its intention and in its practicality; namely, that inconvenience is to be jettisoned. A life which is deemed inconvenient and to have no value is to be cut short, not by the individual, as is allowed by law, but by others—by physicians.

At the moment, I am chairing a working group at the invitation of the Royal College of Physicians to define the nature and role of medical professionalism in modern society. It is tough. Getting a definition has consumed hours of debate and discussion. We have ended up with a long description and a short definition which states that,

"medical professionalism signifies a set of values, behaviours and relationships that underpin the trust the public has in doctors".

Doctors recognise that it is only by maintaining trust that they can help people to ease their way out of this world with dignity, and their families to be free from anger and guilt. In the report, we are told that,

"the majority of letters received from doctors expressed serious reservations about the impact of the Bill".

They are right. They are, in common parlance, the fall guys—the people to shoulder the burden of the execution of any Bill. Of course a conscience clause is proposed that allows doctors to opt out. But how is a patient to know whether they are dealing with a doctor who has opted out or opted in? It is hardly an appropriate conversation to have at such a vulnerable time.

Finally, I return to the DPP's remarks. Here is a lawyer saying that each case must be taken on its merits—do not try to define what is indefinable. I believe that a law will cause many legal battles adding to confusion, anguish and distress. It will start surrounded with good intentions but will end up being a charter to be exploited by venal relatives, determined to take the waiting out of wanting. A Bill, however well intentioned, will cause more harm than good.