My Lords, death is not a pretty affair. Thus it was a most humbling experience and a great privilege to have been appointed to your Lordships’ committee in 2005 to take evidence on assisted suicide. Not only did we travel to Europe, including a visit to Dignitas, but we travelled also to the US state of Oregon to examine very carefully the operation of the Death with Dignity Act, which was passed in 1997. I suggest that never has the state of Oregon been mentioned so often in your Lordships’ House. We could almost be forgiven for thinking that we are the Oregon Parliament—but we are not. I mention Oregon for a purpose, and I shall dwell very briefly on a few points.
Seventeen years later, that Act has enjoyed great popular support. There is no evidence of abuse, nor are there calls to extend the law beyond its narrow parameters. Partly as a result of the Oregon example, the states of Washington and Vermont have now followed suit. That must be something for good rather than bad. Despite the hysterical claims of opponents that the numbers of assisted deaths in Oregon have risen fivefold, assisted deaths equate to only 0.25% of all deaths each year. These claims obscure the fact that the initial numbers were understandably very low while residents became aware of the choice and, following a steady increase, numbers have stabilised in recent years.
A small minority of patients—around a quarter—cite concerns about inadequate pain control as one of their reasons for pursuing assisted dying. This does not mean that Oregon is not delivering adequate palliative care; on the contrary, it is among the best states in the USA for end-of-life care. Indeed, more than 88% of hospitals in Oregon deliver specialist palliative care compared with the national average of 60%. The vast majority of patients who have assistance to die—more than 85%—are enrolled in hospice care. There, as here, many dying patients face the choice of either being sedated to the point that they lose lucidity or retaining lucidity with less than complete pain control, allowing them to pass away as they wish with friends and family around them.
The law does not endanger potentially vulnerable people. Research tells us that potentially vulnerable groups—the over-85s, people from lower socioeconomic groups, people with disabilities and people suffering from psychiatric conditions—are in fact underrepresented in assisted dying figures. A study from Oregon found that some patients did show symptoms associated with depression, although the authors pointed out that the indicators used to measure depression are also the side-effects of a typical terminal illness—for example, loss of appetite, fatigue and difficulty sleeping.
Claims that patients may be coerced to ingest the life-ending medication by family members are misguided and are not borne out by any evidence. Furthermore, the Bill before us provides additional safeguards that would ensure a patient had a clear and settled intention to die before taking the medication.
Death is a most distressing affair. We must therefore look at this Bill with great care and compassion but, above all, with good, sound common sense. None of us here today asked to come into this world. Should we therefore not have the choice as to how we might wish to depart from it? A very considerable majority of the public are now clamouring for change. Society at large is on the march. It is our duty to listen and act.