My Lords, although I speak today from the Opposition Front Bench and in favour of my noble and learned friend’s Bill, I do so from a purely personal perspective. This is not an issue on which the political parties should take a position; nor have they. Members of all three main parties have spoken on either side of the debate today. The subject of the debate is quintessentially one demanding the exercise of individual judgment, touching, as it does, on the most profound concerns—issues of life and death, freedom of choice, responsibility and ethics. Members of your Lordships’ House have demonstrated in this and previous debates a keen appreciation of the complexities which confront our society in contemplating the plight of those suffering from conditions that are not only incurable, but, in the terms of the Bill, terminal. The sincerity and motivation of proponents on either side of the argument justify the confidence which the Supreme Court displayed in its recent call to Parliament to review and clarify the law.
It is just over four years ago to the day that my wife returned to hospital in the last stages of incurable bowel cancer, diagnosed two years earlier, and we are exactly seven weeks short of the fourth anniversary of her death. As I revealed to the House in the debate on the Motion of my noble friend Lord Dubs last December, she had been a nurse, health visitor and counsellor, and the daughter and sister of doctors. She had seen her grandmother, mother and brother die of cancer. From the start of her journey, she made it clear that if the pain became unendurable, she would wish to be helped to die. She lived as fully as possible during those two years, not least by raising awareness about bowel cancer. In the event, she died peacefully, without excessive pain, under sedation in the hospice where she spent those last few weeks. But I know that she would have wanted me to support the Bill. She would have wanted those whose suffering could not be sufficiently alleviated to have the choice which the Bill, with proper safeguards for both patient and clinician, affords.
In that December debate, I mentioned a friend who was suffering much more pain than my wife as the result of a long illness caused by a cancer which had returned years after surgery. She, too, wished for a peaceful end. She died not long after that debate, but would have preferred an earlier release.
Another friend also suffered badly from an incurable cancer which left her extremely weak, causing her to pass out and fall on a number of occasions, leading to her being rushed into hospital many miles from her home. At one stage, she was put on the Liverpool pathway, without being asked, only to be taken off it a day or two later and dying a couple of weeks after that. The Liverpool pathway has its supporters, but it also has its critics. Its use without the consent of the patient is surely a denial of individual choice. Even with the consent of the patient, it is difficult to argue that it is fundamentally different in substance and effect from what the Bill proposes.
We have heard many moving speeches today, and no one who heard the impassioned speeches of the noble Baronesses, Lady Campbell, Lady Grey-Thompson, and Lady Masham, could fail to be moved by their arguments. Their active lives are the most eloquent testimony of the human spirit’s to attain fulfilment, notwithstanding physical impairments with which many of us would struggle to cope. I understand, but do not agree, with their concerns that the Bill would threaten the future of people with a disability; it is specifically addressed to terminal conditions.
Some of the other arguments against the Bill seemed to me also unconvincing. The numbers affected would not generate the significant financial savings to the National Health Service that the noble Lord, Lord Tebbit, suggested—even assuming that clinicians improperly took that factor into account. It seems to me that the suggestion of the noble Lord, Lord Macdonald, that its provisions bypass the need for an inquest into an inflicted death ignores the crucial point: that, under the Bill, death is self-inflicted following a detailed procedure, although I concede that we need to give further consideration to the details of that procedure.
Support for the principles enshrined in the Bill appears to be growing, even from some of those—such as Desmond Tutu, as referred to by the noble Lord, Lord Dholakia, and the noble and right reverend Lord, Lord Carey—whose commitment to their Christian faith is unchallengeable. Although, as we have heard, many of the professional bodies are opposed to the Bill, many individual physicians support it. Last December, I quoted the line from Keats’s Ode to a Nightingale, in which he expressed his aspiration,
“To cease upon the midnight with no pain”— an aspiration which I suspect that we all share. Another line occurs slightly earlier, which might be thought to serve as a symbol of the Romantic movement, in which the poet speaks of being,
“half in love with easeful Death”.
It is not necessary to subscribe to that morbid approach to recognise the legitimacy of the desire of a patient to end, with assistance and after due process, a life which is in any case drawing to a close but in circumstances which are, to the sufferer, unbearable.
Nothing in the Bill reduces the requirement to provide the best possible palliative care for those who need it, for as long as the patient requires it. However, I respectfully suggest to those who oppose the Bill that it would not be right to deny those for whom even the best palliative care is insufficient the mercy of an earlier release, if such is their wish. Ultimately, as my noble friend Lord Elder said, it should be a matter of choice—a choice about one’s own life and not, as the noble Lord, Lord Carlile, seemed to postulate, about the life of others.
I join all those who have spoken in favour of giving the Bill a Second Reading and going on to examine it in detail in Committee, where legitimate concerns about safeguards for both patients and medical and nursing staff can be explored. In that connection, and having regard to my wife’s experience as a counsellor, I suggest that consideration might be given to the potential role of counselling in the safeguarding process. We should definitely look at requiring parliamentary approval of a code of practice, as suggested by the noble Lords, Lord Shipley and Lord Carlile. I also concur with the suggestion of the involvement of a judge that was made by the noble Baroness, Lady Neuberger, and the noble Lord, Lord Shipley, supported again by the noble Lord, Lord Carlile.
Whichever way Members are inclined—and I make the tally of speeches for each side approximately equal, which gives a sense of how important this issue is and how much thought has been given to it—the House today has fulfilled its function well. We should now continue in that vein at the next stage, doing what your Lordships’ House does best: scrutinising and improving legislation that bears, in this case quite literally, on the life of the citizen.