Assisted Dying for the Terminally Ill Bill: Select Committee Report

Part of the debate – in the House of Lords at 7:45 pm on 10th October 2005.

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Photo of Lord Tombs Lord Tombs Crossbench 7:45 pm, 10th October 2005

My Lords, I first join others in congratulating the noble and learned Lord, Lord Mackay of Clashfern, and his committee on dealing with such a complex and emotional subject in so careful and sensitive a way. I will not repeat the arguments so clearly set out in the report and expanded upon by previous speakers. The issues are by now clearly understood, and personal autonomy plays a major part in the arguments.

For my own part, I believe that regard for personal autonomy has played too large a part in recent developments of society and a growing recognition of this appears in the constant pleas for a recognition of individual responsibilities to accompany discussion of individual rights. But what I believe has gone unrecognised in the general discussion is the role of the law in maintaining the delicate balance on which the stability of society depends. A right, once recognised by law, is unlikely to be withdrawn, and a more likely development is a steady extension by seemingly marginal amendments. Hence the "slippery slope" becomes in practice a "legal ratchet"—a fact well recognised by human rights campaigners and exploited by them with considerable success. The extension is presented as small and so is perceived as unimportant compared with the large, earlier step.

Even more dangerous than this mechanism of gradual extension is what might be described as the background effect of the law in shaping society's values. The fact that something previously illegal becomes legal, albeit under clearly stated conditions, is in a real sense permissive and even encouraging. The general public perception is one of relaxation of previously condemned behaviour and a resulting relaxation of controls without a perceived need for any further legislation. Such a development has occurred in abortion practice, where the legislative safeguards have become steadily eroded in practice, with no resulting enforcement action. This increased disregard of carefully constructed law is unhappily present in Holland, where evidence to the committee showed a substantial number of cases of what is euphemistically termed "involuntary euthanasia", when a doctor has killed a patient without that patient's consent. That is not even assisted suicide, it is quite simply murder, although it has resulted in no prosecutions. This startling development was accompanied by an admission that 46 per cent of cases of euthanasia are not even reported, despite a legal requirement to do so—again with no enforcement action. It is hardly surprising, then, that some elderly patients in Holland choose to go to Germany for medical treatment.

It is clear that the bulk of the medical profession in this country is strongly opposed to this Bill, in spite of the disreputable manipulations of some supporters of euthanasia in the councils of some medical organisations. Happily, the general opposition remains unaffected and I would like to pay tribute to the vocation of healing that underpins that opposition. The UK scene differs from that of most countries in that we are comparatively well provided with hospices for the terminally ill, a provision which is gaining ground worldwide. The founder of the movement, the late Dame Cicely Saunders, pioneered pain management and produced that memorable aim, "dying with dignity". Today, the philosophy of the hospice movement is,

"to enable people to live until they die".

What a wonderful contrast to the bleak notion of assisted dying! Palliative care, too, is an area of medicine in which Britain is a world leader. Many patients have died naturally and with dignity as a result of adequate and supportive palliative care. Unhappily, neither of those initiatives has received adequate government support. The hospice movement remains heavily dependent on voluntary support and palliative care is not readily available in many areas of the country. As the voice of society, the Government bear a heavy responsibility in these areas and I hope that the Minister will address the problems in his closing speech.

Respect for the life of the individual lies at the heart of society, and a departure from that long-held position, at a time when pain control and palliative care are at an all-time high, seems to me perverse in the extreme. The difficulties of reliable prognosis of terminal illness and the pressures which can so insidiously creep into the minds of sufferers should themselves make us reject the proposals of the Bill of the noble Lord, Lord Joffe. I shall do so in the event of its return to this House.