My Lords, this has been a pretty amazing fortnight of public testament that the time is now right for the Bill to be given serious consideration and, I hope, passed.
For some whose poignant stories we have all heard, it is already too late. This legislation is overdue to ensure that dying adults facing unrelievable and unnecessary suffering at the end of their lives can, if they wish, choose not to go through the last few dreadful days or weeks, but choose the time and manner of their dying. It is a tightly and narrowly defined Bill, with several layers of safeguards. It puts the dying person back in the driving seat, as they should be, to be able to decide how they want to die. The noble Baroness, Lady Campbell, for whose determination I have huge respect, regretted that the Bill is about pity. The Bill is not about pity; it is about power—the power of being in control of one’s own death.
The Bill is also about terminally ill people being able to have proper, advance discussion with their family and, above all, with their healthcare professionals. Evidence given to the Commission on Assisted Dying, on which I had the privilege to sit, showed that under the current law doctors and nurses feel at risk if they discuss the full range of options with their patients. This is not acceptable. As the noble Lord, Lord Gordon, said, we do not talk enough about dying.
I will tackle the issue raised by the noble Baroness, Lady Neuberger, that decisions about the settled, sustained and competent views of dying patients on having an assisted suicide should be decided by a judge. We considered that during the Commission on Assisted Dying, but felt that we were seeking that death and decisions about death should be taken normally and appropriately with families and medical advisers, without the hurdle of an artificial, judicial-level process which would take away the very autonomy of the individual that we are trying to achieve.
Some of those concerned about the Bill worry that dying people may opt for an assisted death because they feel, or are made to feel, that they are a burden. I believe that the ability for the certifying doctors to seek additional evidence, should pressure be suspected, is an important safeguard and should be clarified in the code of practice that the Bill enables. If the law is passed, the ability for patients to have a full and transparent upfront discussion with the certifying doctors about all the options, and the recording of those discussions, would add a further safeguard.
At the moment, under the current legislation, we simply do not know whether pressure is being exerted or not. An estimated 300 people are helped to die each year by friends and family, an estimated 1,000 people are assisted to die by medical practitioners and a number of people travel to Dignitas. We do not, at the moment, under the current legislation, know at all whether they have been put under pressure.
We all consider the impact of any decision we make on those who are close to us. We take it into account in decisions such as choosing which movie we go to with the family or what job we are going to take or deciding whether we are going to move house to a different part of the country. It is appropriate that we take the emotions of the people around us into account when we are making an important decision about our death—that is part of human life. The evidence from Washington is that concerns about loss of autonomy and loss of dignity, and the prospect of a struggling, joyless end, figure far higher in people’s decisions to seek assistance to die than feeling that they are a burden.
If the Bill passes, people will not have to choose assisted dying. I have had to have quite distressing correspondence and e-mails with people who seem to think that, if the Bill goes through, they will have to choose to die. They will not have to choose to die; they will have the right to choose the death that they think best. I commend the bravery and energy of the noble and learned Lord, Lord Falconer, and his team in promoting the Bill and call on the House to allow it to proceed to a full and proper analysis in Committee. That is where our House excels, with its wealth of expertise in tackling these very difficult issues.