Assisted Dying for the Terminally Ill Bill: Select Committee Report

Part of the debate – in the House of Lords at 8:16 pm on 10th October 2005.

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Photo of Lord Layard Lord Layard Labour 8:16 pm, 10th October 2005

My Lords, we have all had many letters on the subject, and the most interesting one that I had directly addressed whether a doctor would be playing God if he implemented the Bill. The writer argued that, quite to the contrary, a doctor is playing God by denying a dying person their desire. That is the basic issue that we have to address. It is why the public opinion surveys of what people want are so relevant. They are not opinion surveys like those on capital punishment that ask what you would like done to other people; they are about what you would like for yourself, and 80 per cent of people want the Bill. The figure is more than 80 per cent of disabled people, and a majority of elderly people, and of Catholics and protestants, which is very relevant. The central issue is whether we should try to give people what they want in this matter.

I would never say that one should automatically allow people what they want, especially if it affects other people, as has been said many times. I would not say that, even for some purely private matters. But this matter is very private, where the dying person knows so much more than anyone else.

Regarding autonomy, I cannot imagine that any defender of this Bill thinks, as some right reverend Prelates have seemed to imply, that autonomy is the only good. No one I know thinks that. I certainly do not think that. But autonomy is pretty important when you have little else left of your life. I would have thought that the autonomy argument ought to appeal particularly to liberal-minded noble Lords on the opposite side of the House. After all, what is this Bill? It is a Bill of deregulation. At the moment there is a ban—but which is extremely irregularly applied. Today, I learnt a very relevant fact about what would happen if, for example, my mother was dying in pain at home, she asked me to buy 60 paracetamol tablets, I bought them, took them home, she took them home and she died. If I was prosecuted I would get a reprimand. It is only in hospital that I could not perform that act of love. Surely, that is an anomaly that requires some type of remedy such as that proposed in the Bill. It would be absurd to label that remedy a "therapeutic option". That is not what we are talking about. We are talking about doing in a regular way what can happen only irregularly at present.

I end with the "slippery slope" argument. I have been told that in the first six months of this year, the "slippery slope" was referred to 120 times in this House in topics ranging from the Charities Bill to the Speakership of the House. Even so, we must take the argument seriously. Put most generally, if the Bill was enacted, would the system become inured to assisted dying in a manner that led to it becoming more common, perhaps through further legislation or other channels? We do have to look at other places where such legislation has been introduced to look for evidence. Has there, in the case of either Oregon of Holland, been any increased trend in assisted dying? And what has been the impact on involuntary euthanasia which happens when doctors hasten the process of death? We have statistics from some countries, but in Holland there is no evidence that that has become more common over time. Incidentally, in Holland involuntary euthanasia of that kind is low compared with other countries for which there is evidence—probably due to the scope for voluntary assisted dying. That makes sense, does it not?

Trust of patients in doctors is higher in Holland than in any of the 11 countries surveyed, including our own. Doctors in seven countries were surveyed and were asked whether they thought that voluntary assisted dying would increase involuntary euthanasia as a result of the "slippery slope" argument. The majority said, "No". So we can let the slippery slope argument slip to where it belongs and return to the basic issue—respect for the wishes of the patient and for the relief of their suffering. If patients wish to receive life-preserving treatment we grant their desire. That is contrary, I assume, to the teachings of many religions, but we grant it. By the same logic, we should, surely, grant those patients' desire for assisted dying. In fact, would we not be playing God if we refused to do that?