Assisted Dying for the Terminally Ill Bill: Select Committee Report

Part of the debate – in the House of Lords at 8:01 pm on 10th October 2005.

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Photo of Baroness O'Cathain Baroness O'Cathain Conservative 8:01 pm, 10th October 2005

My Lords, even at the position of speaker number 39, I feel compelled to join everyone else in congratulating the Select Committee under the wise chairmanship of the noble and learned Lord, Lord Mackay of Clashfern. It has done a brilliant job.

Today, we are debating one of the most important issues that could ever come before this House. It is an issue of gravity that affects every single inhabitant of this country; namely, whether we should agree to determining the length of our lives. Its importance is obviously recognised by this House by the very large number of speakers. In my experience, it is a far greater number than for any other non-government issue.

The proposed Bill would be profoundly contrary to the Christian faith and to the basic values shared by British people of all faiths and none. As an aside, I have been advised not to mention the Christian faith in this House. I regard that as almost unbelievable. Over 70 per cent of the population has stated in the last census that they are Christian. As has already been stated, that colours our view. The issue we are addressing is whether there are any circumstances in which we should authorise doctors to help people to end their lives.

I unequivocally oppose the demand for a euthanasia Bill. That is really what we are talking about. Patient-assisted suicide is just the beginning, as has been stated many times. If we start down that road and agree that doctors can help patients to kill themselves, the Voluntary Euthanasia Society would no doubt maintain that we have accepted the principle and that voluntary euthanasia is just an extension of that principle. I pray and hope that this House will reject the call, and most rigorously.

The psychologist Neuhaus, quoted in W J Smith's book Forced Exit published by Random House, New York, in 1997 put the point succinctly and suggested that those who support euthanasia,

"will attempt to guide the unthinkable on its passage through the debatable on its way to becoming the justifiable until it is finally established as the unexceptional".

Our postbags make so many points, but some are made by almost everyone. They include, first, that this is a huge step in the direction of total breakdown of trust between doctor and patient, a point made by doctors and patients; secondly, that elderly people are frightened; thirdly, that the frail fear intimidation; fourthly, that some feel that they would have a duty to remove the burden on their families; fifthly, that those nearing the end of their life feel guilt that they are spending on long-term care the inheritance earmarked for others; and, sixthly, anxiety that the parlous state of the National Health Service's finances could result in pressure being put to end the expense of care. I have just listed those points; the noble Baroness, Lady Wilkins, elaborated on them in a most moving speech.

Interestingly enough, I have had no letters supporting the proposed Bill. The BMA alone wrote to me stating that it was neutral, but how democratic was the vote? Yes, we all had a letter last Saturday trying to justify the stance, but for me it rang pretty hollow.

Briefly, I shall focus on personal autonomy, which is regarded as the kernel of the issue by those who want to see the law changed. Personal autonomy is a highly dangerous concept unless it is properly understood and applied to the right issues. I have always been a believer in people taking charge of their own affairs. Individual choice and personal responsibility are important, and as economic concepts they have served this country well. But one cannot apply economic and political concepts uncritically to the moral and religious sphere. When we try to apply personal autonomy to the transition from life to death we really are trying to play God.

The right reverend Prelate the Bishop of Oxford quoted the statement of Professor Harris, one of the witnesses. I too picked up on it when I read the report. The ending of our lives determines life's final shape and meaning, both for ourselves and in the eyes of others. When we are denied control at the end of our lives we are denied autonomy. The professor implies that if we cannot control our death we are not dying well. I refute that totally. To state the obvious, we are all going to die one day. A good death does not consist of tailoring your departure from this world to your own personal wishes. What determines one's life's final shape and meaning—to use Professor Harris's words—is how one handles the dying process, which involves how one lives spiritually, physically and emotionally during the process rather than how one evades it. To argue for assisted suicide or euthanasia on the grounds of personal autonomy is to oversimplify the problem.

Another witness, Dr Rob George, a consultant in palliative care with a great deal of first-hand experience of people dying, defined autonomy as:

"Self-government rather than self-determination".

He described people who wanted to end their lives as,

"people who are not willing or prepared to engage the issue".

The view of Dr George is on a par with many of the witnesses who had similar experiences of the dying process; namely, that those who want to decide when they die are generally people whose suffering stems more from the fact that they know they are terminally ill than from actual symptoms. We need to recognise that a request for assisted dying, like an attempted suicide, is normally a cry for help, and that is how we should treat it.

Severe depression is often a concomitant of terminal illness. It can be treated effectively, as I know from personal experience. I spoke about that on 25 June 2003 at col. 370 to support my noble friend Lady Knight in the Mental Capacity Bill. Since then, I have had additional sad experiences of the early deaths of my two younger and only siblings. The inevitable deep sadness for me was hugely compensated for by the fact that they both had "good" deaths. Frequently, the dying process is a true period of closeness and an opportunity to show love and respect; a period of reconciliation both with fellow human beings and with God. All of that is of great benefit to both the dying and to those who are ultimately bereaved. Yes, I have witnessed only happy, calm and peaceful deaths, but one cannot overemphasise what solace and good memories result.

The Select Committee's report states that Britain is the world leader in palliative care; however, we know that not enough money is spent on it. It is a disgrace that in a nation blessed with wealth like ours anyone should die in pain. Surely a wish for euthanasia is not a longing for death but a fear of pain and suffering. Barrelling headlong into a euthanasia society is completely the wrong approach. The real, humane solution lies in improving palliative care.

We have day-long debates and three-inch thick reports on a euthanasia Bill. I hope that we shall resoundingly throw out the proposal for such a Bill and hasten the preparation of and investment in just as much time and effort in a palliative care Bill.