My Lords, I echo the congratulations expressed from all sides of the House to the noble and learned Lord who chaired the Select Committee. I also congratulate the members of the committee on producing a thoughtful and balanced report. In giving evidence to that committee, I said that I wholly appreciated and understood the sincere and compassionate reasons why my noble friend Lord Joffe had introduced the Bill. As the noble Baroness, Lady Wilkins, said, I chaired the House of Lords Select Committee on Medical Ethics, which reported in 1994. We produced a unanimous report dealing with issues of exactly this nature. I have not changed my mind, even though I now realise that three members of my committee who, in the end, subscribed to a unanimous report, have done so: the noble Baroness, Lady Jay, and, I believe, my noble friend Lady Warnock and the noble Baroness, Lady Flather.
Having said that, I endorse Clause 15 of my noble friend Lord Joffe's Bill:
"A patient suffering from a terminal illness shall be entitled to request and receive such medication as may be necessary to keep him free as far as possible from pain and distress".
That is the motivation of the hospice movement in the UK, which is increasingly influential in treating individuals with terminal illness of all kinds. Palliative care, of which my noble friend Lady Finlay is such a noted exponent, is not just delivered in hospices, but it is a philosophy of care that extends into a community and is practised by many general practitioners.
The principle of double effect has not been mentioned today. The noble Lord, Lord Russell-Johnston, suggested that many doctors in this country already practised euthanasia. I do not believe that they do. They practise what we in our committee report endorsed as double effect. In effect, it means that, if it is necessary in order to relieve pain, distress and suffering, to give such doses of medication as may have—not invariably—the secondary consequence of shortening life, that is perfectly acceptable in law and in medical practice. I admit that some philosophers regard that concept of double effect as hypocritical, but it has been practised widely for very many years. I believe that the use of that double-effect principle produces death with dignity.
Perhaps I may now raise one or two points from the report produced in 1994. We totally accepted the concept of informed consent to medical treatment and endorsed the right of a competent patient to refuse consent to any medical treatment, even if that ultimately resulted in death. We also confirmed that there was no obligation on the healthcare team to embark on or to continue with futile treatment that added nothing to the well-being of the individual as a person. We endorsed advance directives. I have signed an advance directive, which makes it clear that, if I become incompetent or terminally ill, I would not wish to be subjected to certain forms of life-prolonging treatment.
As the noble Baroness, Lady Wilkins, said, many of us had experience of relatives or friends whose dying days or weeks were less than peaceful or uplifting, or whose final stages of life were so disfigured that the loved ones seemed already lost to us. However, we did not believe that those arguments were sufficient reason to weaken society's prohibition of intentional killing, a prohibition that is the cornerstone of law and of social relationships. It protects each one of us impartially in the belief that all are equal. We did not wish that protection to be diminished, and we therefore recommended that there should be no change in the law to permit euthanasia or physician-assisted suicide. In fact, we found that it would be virtually impossible to ensure that all acts of euthanasia were truly voluntary and that any liberalisation of the law would not be abused. I appreciate that many Members of your Lordships' House have expressed concern about the concept of the slippery slope, but the possible erosion of any such legislation, whether by design or by inadvertence, or by the human tendency to test the limits of any regulation—as has clearly happened with the Abortion Act—gave us concern.
I was gravely concerned by what I found in Holland 14 years ago. The situation was that euthanasia was not legal—it was legalised in 2001. Every year, more than 1,200 individuals were subjected to voluntary euthanasia under certain conditions, but more than 1,000 were subjected to non-voluntary euthanasia because they were neither competent to withhold or to give consent. The Royal Dutch Medical Association now says that doctors can help patients who ask for help to die, even though they may not be ill but simply suffer through living. That is a situation and a recommendation that goes far beyond what I would regard as acceptable. As others have said, our committee was concerned that vulnerable, elderly, lonely, sick or distressed people would feel pressure—whether real or imagined—to request early death.
This is a carefully phrased and well-balanced report, but, having considered it carefully and having looked in detail at my noble friend Lord Joffe's Bill, I have to say, after almost 60 years of medical practice and having looked after many dying patients in the course of my professional career, that even with amendment to remove the voluntary euthanasia section, I cannot support it. In all conscience, I would have to oppose it.