Lord Frost:

Moved by Lord Frost

34: Clause 1, page 1, line 13, leave out “assistance to end their own life” and insert “medical help to commit suicide by provision of lethal drugs”Member’s explanatory statementThis is part of a long series of identical or near-identical amendments which Lord Frost would seek to table at Report Stage should this Amendment find favour. The intention is to provide clarity on the nature of the services provided by this Bill and to avoid euphemism. This is the first occasion in the Bill text at which the phrase “assistance to end their own life” occurs.

My Lords, I have four amendments which constitute the entirety of this group: Amendments 34, 121, 138 and 153. I am very grateful to the noble Baronesses, Lady Fox of Buckley and Lady Lawlor, and the noble Lord, Lord Harper, for putting their name to these amendments.

I will begin by making a purely process point. Were the underlying change I propose to find favour, as the explanatory statement on the Marshalled List makes clear, a large number of textual amendments would in fact be needed to ensure internal coherence within the Bill. For the convenience of the House, I have not tabled all those amendments now. In this sense, my amendments are exploratory and probing. The four specific amendments I have chosen, which are on the Marshalled List, have been chosen because they represent the first occasion on which a particular type of change would be required.

To summarise, Amendment 34 represents the first occasion in the Bill in which the phrase

“assistance to end their own life” occurs; Amendment 121 is similarly the first occasion in which the phrase “voluntary assisted dying commissioner” occurs; Amendment 138 is the first occasion in which the phrase “assisted dying review panel” occurs; and Amendment 153 is the first occasion in which the simple word “assistance” occurs: a word that is not in fact defined in isolation but is taken to be short for the phrase “provision of assistance to a person to end their own life”.

Let me now turn to the substance of these amendments. I put them forward for two major underlying reasons. First, it is bad for us as legislators to attempt to legislate in such ambiguous language. Secondly, such language substantively carries real risks for at least some of those who may wish to avail themselves of the provisions of this Bill or have it put to them that they should.

All these amendments have one thing in common. They would replace phrases including the word “assisted” or “assistance” with something much clearer—an explicit reference to what is actually provided for in the Bill, the provision of

“medical help to commit suicide by provision of lethal drugs”.

I was aware when I tabled these amendments—some noble Lords have subsequently mentioned this to me—that the phrase “commit suicide” raises particular wider issues. I understand that and I will come back to it, but let me first proceed with the text as tabled.

First, it is a well-understood principle in drafting legislation—the noble Lord, Lord Deben, made this point earlier today—that it should be unambiguously clear. In this Bill, we have a phrase which covers a wide range of possible meanings. The core phrase,

“assistance to end their own life”, could be read in a wide variety of ways. It could be read as meaning making somebody comfortable in their last hours. It could be read as withdrawing food and drink in a medical setting. It could even be read as an actual act of killing by another party at the request of the individual concerned. It could be read as many other things too, including of course the thing that is actually provided for by this Bill.

The polling about this Bill and the discussion around it shows there are many misunderstandings about what it does and what it allows. Surveys and experimental research show that public responses to questions about legality and support are very sensitive to the wording chosen. That is why it is important to be clear. My amendment would do that by providing clear language. It is possibly language that would be regarded by some as forceful, but nevertheless it is clear.

I apologise for intervening, but this is quite important to the debate. Is the noble Lord saying that his amendments—I take it they are simply exemplar ones—would change the meaning of the Bill, or are they just for the purposes of, as it were, better public understanding?

Yes, they are intended to clarify what the Bill actually provides for. I will explain further. The provision of medical help to commit suicide by the provision of lethal drugs is what the Bill does. That is what it does and that is what it should say that it does. I would say in passing that it is particularly important, since the Bill leaves so much to delegated powers, that we should be unambiguous about the particular power that is provided for.

Secondly, this House and this Parliament should always be clear to ourselves what we are doing when we are legislating. We should try and avoid euphemism. Where we deal with difficult topics, I think it is good to avoid distancing ourselves from uncomfortable realities in legislation by using abstractions. I refer to the 2024 guidance to parliamentary draftsmen which says:

“Write in modern, standard English using vocabulary which reflects ordinary general usage”.

It goes on to say you should

“use precise and concrete words rather than vague and abstract words”.

It is noticeable the most common term in this Bill for the activity for which it provides is the single word “assistance”. The common meaning of that word, I think it is fair to say, does not include providing for the death of an individual. In this Bill, that word has become a euphemistic term of art. Indeed, it is easy to imagine it becoming a jargon word in which a practitioner says to a patient, “Have you thought of asking for assistance?”, as a comfortable way to suggest to vulnerable people that taking their own life might not be something to be too concerned about, or even in the worst case, almost hide from them in the initial discussion what is actually being discussed.

We can see the distancing function of this word, the Latinate “assistance”, if we replace it, as my Amendment would, with the Anglo-Saxon “help”. If the Bill used “help”, the jarring nature of the contrast between that word and the action that is provided for by the Bill would, I think, be too great to bear. I will not go into detail for reasons of time, but exactly the same concern arises from the Bill’s use of the phrase, “approved substance” when what is meant is a lethal drug.

Activities involving uncomfortable and even frowned-upon measures, especially when they involve killing, have of course often been subject to euphemism. The inclusion of euphemism in this Bill is, to me, a troubling and worrying sign about the degree to which the Bill’s proponents are genuinely ready to defend in public the specifics of what they advocate in this Bill. I suggest that we should avoid those risks and concerns by being clear and unambiguous about what is involved.

Thirdly, there is a genuine risk of misunderstanding. We have already discussed the importance of informed consent, especially for vulnerable groups. I suggest that, if the language we use in the legislation is not clear, there is a real risk that, for example, non-native English speakers, ESL speakers, vulnerable groups all kinds or people living with autism who perhaps struggle with ambiguity or allusion will also not understand precisely what is involved, especially given the natural human tendency to shy away from realities at moments of real crisis. Again, I will not quote them for reasons of time, but several witnesses at various stages in this process have raised concerns on this point. Once again, the logic points to providing for absolute clarity.

Fourthly and finally, there is the question of the relationship with the existing statute book. There are two angles to this. First is the use of the word “suicide”, which this Bill carefully avoids, except in the sole context of the necessary amendments to the Suicide Act 1961; that is Clause 32. It has been said before, but it bears repeating, that the fact that an amendment to that Act is necessary is surely the clearest evidence that this Bill provides for a means of committing suicide and, therefore, it is appropriate to use that term more generally in the Bill. Of course, Clause 32 attempts to sidestep this problem by distinguishing “suicide” from “assistance” in its proposed amendment to the Suicide Act, and thus introduces the ambiguity that, as I have noted, we should be seeking to avoid. In fact, all that is needed to do what the drafters want is to exclude from the Suicide Act any functions performed under this Bill if it were to become law. That would be the clearest and simplest approach.

The second aspect, to come back to the point I touched on and foreshadowed earlier, is the use of the specific phrase “commit suicide”. It is of course true that perceptions and societal assumptions have moved on since the 1961 Act. It may well be that it would be reasonable to use a slightly different form of words to the specifics in my amendment in order to avoid any impression that we consider suicide as such to be a crime. Even though the Suicide Act is clear on this point when it says,

“The rule of law whereby it is a crime for a person to commit suicide is hereby abrogated”,

I nevertheless understand that other phrases, such a “die by suicide”, could be preferable. That would be a perfectly reasonable discussion to have, but the crucial thing is that the meaning should be clear, the word should be used and the proposed means of carrying out what is provided for in this Bill should be unambiguous. Otherwise, we are retreating from reality.

To conclude, I hope I have set out enough evidence to show that these amendments are more than terminological and more than debating points. They are not put forward to antagonise. They are not put forward to annoy. They are put forward to deal with genuine concerns about the clarity of this legislation and what it will do if it comes into force, and about the way in which euphemism can have a genuine substantive effect on the way the Bill is perceived and eventually used.

I hope that the Bill’s proponents and the sponsor might be open to some reflection on this point and, specifically, to considering whether it would be better to use clearer language; language that is used elsewhere on the statute book; language that could help deal with the points I have touched on and some of the other concerns that we have had about the way the Bill will be implemented in practice.

Forgive me for interrupting; I do not want to take up time. The noble Lord is now giving us a lesson in Anglo-Saxon, Celtic, Latin and indeed Old German, as well as Middle English. We are missing the point. We need to move on, surely. He has been over 12 minutes on this speech, and it is beyond what we would accept at this stage of the day.

I think I am allowed 15 minutes, actually. I do not think I mentioned Celtic either, just on a point of detail.

That aside, I was reaching—in fact, had already delivered—my peroration. I hope, as I said, the proponents might be open to some reflection on this point. Meanwhile, I beg to move.

I point out to the Committee that if Amendment 34 were to be accepted, it would pre-empt Amendment 35, which leads the next group.

The noble Lord, Lord Shinkwin, is taking part remotely, and I now invite the noble Lord to address us.

My Lords, I begin by quickly welcoming back the noble Baroness, Lady Campbell of Surbiton, and thank her for reminding us so eloquently why we have missed her contributions.

I rise to speak to Amendment 34, and I thank my noble friend Lord Frost for tabling it and for his excellent speech. I also thank the noble and learned Lord, Lord Falconer of Thoroton, for his past commitment to ensuring the law is communicated as clearly as possible by removing the Latin names of the prerogative writs through the Civil Procedure (Modification of Supreme Court Act 1981) Order 2004. Can he explain in his closing remarks why, 22 years later, he appears to have changed his mind on the guiding principle, which I assume informed his earlier decision, that the law should be accessible and unambiguous? Perhaps, and maybe he could clarify this in his closing remarks, he now believes it should be accessible only to some, and that for others it is fine for it to be clouded—or shrouded might be more appropriate, given the fatal consequences of an ill-informed decision on assisted death—in euphemism, nuance and even deceit.

After all, those with a learning disability or Down’s syndrome, for example, are only disabled people, are they not? What does it matter if their disability means they cannot quite grasp the enormity, finality and irreversibility of the decision to seek, as my noble friend’s amendment states,

“help to commit suicide by provision of lethal drugs”?

We know that language matters, but do we know how much it matters to those whose disabilities make them understand less or make comprehension challenging, and, in the case of Down’s syndrome, those whose innate desire to please makes them more prone to agreeing with the question, especially when its implications are not fully grasped?

I hope the noble and learned Lord will accept this amendment and thereby protect not only those whose disabilities make full comprehension difficult but the reputation of your Lordships’ House. Let it never be thought that we do not care if those whose disability-related need for the clarity provided in my noble friend’s amendment are somehow misled to death because of nuance. I hope the noble and learned Lord will show, by accepting this amendment, that those whose disabilities make them particularly vulnerable to ambiguity must not be treated as unfortunate collateral damage.

My Lords, I signed the amendments from the noble Lord, Lord Frost, which seek to probe the ways that we can make this Bill more transparent to the public. That is my main driver—I believe in plain speaking. The public deserve to know what this Bill involves.

As it happens, I think the noble Lord’s wording would add clarity. His proposal is to replace

“assistance to end their own life” with

“medical help to commit suicide by provision of lethal drugs”.

That wording is factually accurate, even if it makes you gulp. The reason it makes one gulp is because it is factually accurate, and we do not often recognise what is being advocated here. There is a danger that the Bill’s terminology creates ambiguity rather than clarity, and it is important that we are frank and open.

Why use the word “suicide”? As has already been explained, the Bill needs to amend the Suicide Act precisely to carve out the legal space to allow this type of assisted suicide, as mentioned in the Bill, to be within the law. That is accurate. But I am wary of having a culture war over the word “suicide”—I use the term “assisted dying” all the time, so I do not want to be called out for hypocrisy here—because I am aware of the fact that suicide as an issue is far too serious and tragic to be glib about or to have verbal ping-pong over.

On the other hand, I am worried that avoiding the word “suicide” in this debate, and making it verboten, might desensitise public debate. Let us be honest, language choice can influence opinion. “Assisted dying” sounds softer, palatable and more sympathetic. It is interesting that evidence shows that support for assisted dying changes if you call it “assisted suicide”; it drops significantly when the terms are plainly defined.

Some may flinch at the proposed words used by the noble Lord, Lord Frost—

“medical help to commit suicide by … lethal drugs”.

As I have said, it is hard to accept that. It makes you think. Is there going to be a complete change in the way medicine is operated, so that medics could hand you poison and lethal drugs? The answer is yes. When people hear that phrase, it might hit them what a fundamental shift this will be for medical professionals and so on. That is exactly why a number of us are not prepared to nod this Bill through. It is perfectly reasonable to completely disagree with what I have just said, but I want everyone to know what the Bill is about and why it is a very big change in our society, causing all sorts of ethical discussions. The public deserve to know that, and therefore we should be as clear as possible.

I recall that, on the first day in Committee—and subsequently, but particularly on the first day—there was a lot of tut-tutting and reprimands, with a lot of people being shouted at when Peers used the term “assisted suicide”. A lot of people stood up, saying, “You can’t say that. You’re just being emotional, manipulative and so on”. But clear language promotes public and patient understanding. In a way, I advocate a patient-centric approach rather than a euphemistic approach, which could, arguably, be seen as an act of misinformation in some instances.

Also, I ask noble Lords who support the Bill why they are so defensive because Dignitas actually offers physician-assisted suicide. In fact, the World Federation of Right to Die Societies talks about assisted suicide in terms of describing the distribution of drugs that will cause the death of a person. The term “assisted suicide” is used in Switzerland, Austria and the Netherlands. That is what it is. That is what we should call it.

Finally, we are told that people who are dying are not committing suicide. The noble Baroness, Lady Hayter, has consistently said that suicide is different from assisted dying and that it cannot be assisted suicide because people who want assisted dying are already dying, and, therefore, they cannot commit suicide. That is more or less it: you are dying anyway, so you are not being driven by despair, but this is an active, positive choice—although we would not know that so far in the Bill because we are not allowed to ask about motives. None the less, you are driven by that.

It seems obvious that there are two problems relating to this. If a person is dying and goes to the trouble of organising obtaining and ingesting a lethal substance—poison—that is suicide. That is an accurate use of language. By removing the word “suicide” from the discussion, there is another danger. Advocates of this Bill, without saying the S-word, none the less argue that assistance in ending one’s life can, in certain circumstances, be dignified, a positive choice and a happy release. I am afraid that normalises taking one’s own life. Even if you do not use the S-word, that is the sort of thing I associate with the propaganda on pro-suicide, pro-self-harm sites, rather than with a Bill such as this. I suggest that normalising and even glamourising taking one’s life as a happy end result is not something we should do. Therefore, I would at least like to call it suicide so that people might gulp and think again.

My Lords, to help the Committee, I will interject to say that it has just gone 5 pm. Basically, we have two options. Both involve us finishing at 5.30 pm. We can either carry on this debate, which is absolutely fine. We have recorded the number of Lords who are present, so I can move to adjourn the House at a convenient point around 5.30 pm. Alternatively, if the debate is coming to an end, we can hear the Front-Bench speeches and then adjourn at 5.30 pm. I do not mind what we do, but we are going to adjourn at 5.30 pm. It is in the hands of the Committee.

My Lords, I have added my name to these amendments from the noble Lord, Lord Frost. I agree with what has been said. I agree with the need to avoid euphemism. The noble Lord, Lord Frost, raised the point, and the noble Baroness, Lady Fox of Buckley, came back to it, that some will object to the phrase “commit suicide”, but I will make a stronger case on that point.

With regard to many cases of suicide, these reservations would be justified. “Commit” implies clear intention by the person concerned to take his own or her own life, but, as we have heard throughout this debate on the Bill so far, suicide can be the result not so much of firm, clear intent, but of the perpetrator sliding inexorably into hopelessness about the circumstances of their life or being confronted by a lack of help. If the inability to cope with such misfortune leads to depression and then suicide, I agree that it is misleading to talk of committing suicide, but the cases envisioned in this Bill are quite different. As the Bill makes clear, the person must have a clear, settled and informed wish to commit suicide. Here, then, “commit suicide” is indeed the appropriate phrase.

Moreover, the phrasing in the Bill, in terms of assistance to end one’s own life, carries, as has been said, a risk of confusion between what the Bill proposes—the deliberate action to bring life to an end—and the normal practice of doctors, as the noble Baroness, Lady Finlay, mentioned earlier, which is to ease suffering and sometimes to use palliative measures that might, although this is not their aim, shorten life. The advocates of the Bill have often spoken in a way that blurs this distinction. It is important that the phrasing of the Bill guards against such confusion.

My Lords, I recognise that the noble Baroness, Lady Fox, will have heard this before, as will have many others, but the fact of the matter is that the Bill talks about assisted dying. “Dying” tells you what it is all about, so I do not think that we need to have the word “suicide”. I say this because I have spoken with the families and loved ones of people who wish to have an assisted death; those who wished that their loved ones had had an assisted death, because they could see the suffering endured by the person who died and the people who were caring for them; and those who are left behind. I have had many conversations and those people all feel strongly that those who want to have an assisted death are not committing suicide; they want to regain some control and want to live for the last few months of their life with some comfort. Just because they ask for an assisted death does not mean that they are actually going to fulfil that, but it gives them and their families comfort. So, please, can we not talk about suicide? We are talking about dying and that is absolutely fine. I do not wish for the people who are already suffering or the people who are caring for them to have more distress in their lives.

My Lords, I find it strange that the noble Baroness, Lady Royall, should be making the argument that the word “dying” tells us all that we need to know. If that were so, we would not need the Bill. The Bill is about a very specific thing, which is choosing to end your own life and getting help with it. The importance of clarity and frankness in language in the making of law is very great. It must be distinguished from perfectly legitimate what I shall call political language.

Take, for example, the right to life, which is one side of the argument in another matter, and the right to choice. Those are both perfectly good phrases about the subject of abortion, but they were not suitable phrases for law. When you talk about law, the word that should be used is “abortion”. That is what is actually happening. I am not saying that there is any dishonesty here, but it is inappropriate for the making of law.

I strongly support what the noble Lord, Lord Frost, said about possible ambiguities and misunderstandings. I give an example, which is nothing whatever to do with assisted dying, but it just illustrates the point. As we ran up to the 1983 General Election, Labour had a policy of unilateral disarmament. The Tories were against unilateral nuclear disarmament and attacked it. Somebody wrote a letter to the Daily Telegraph saying, “I do not think people know what the word ‘unilateral’ means, and if you call it ‘one-sided disarmament’, people will understand what this is about”. The Tories seized that, suddenly changed all their propaganda to talk about one-sided disarmament and the polls shifted very dramatically against one-sided disarmament. The importance of normal English is very significant. Again and again, we can see public confusion, which must be avoided, about what is actually proposed in the Bill.

Finally, there is a contradiction in the arguments made by supporters of the Bill—I think that the noble Baroness, Lady Royall, was in this situation. Since the greatest thing that is being argued for by supporters of the Bill is autonomy, it is important to have a word or phrase that embodies that autonomy and shows who is making this decision and whose agency it is. The phrase “committing suicide” exactly establishes the agency and exactly shows the autonomy. It is contradictory to advocate for autonomy and then to take refuge in euphemism.

Many years ago, the noble and learned Lord, Lord Falconer of Thoroton, introduced a similar Bill. I, very misguidedly, introduced an Amendment to the title of the Bill; I suggested that the word “euthanasia” should be in the Bill. I did this without believing either that the Bill should pass or that it should fail—I was genuinely uncertain—but, earlier that week, I had talked to a 16 year-old schoolgirl in a school. In the short conversation we had, she asked, “Do you think we always feel that we have to go for and strive for perfection?” I found that very difficult to answer, so I pondered on it.

One of the issues here is exactly what the noble Lord, Lord Frost, has just shown. He tried to demonstrate that there are no absolute meanings of words. In that case, I used Greek, but this is something that we need to go beyond now. These words will mean different things to different people. We waste a lot of time doing this sort of meddling with language when it is unnecessary and when there is no issue with the legal quality of the Bill, which, of course, must be paramount. It is clear that the language we have at the moment is undoubtedly intelligible and largely workable.

My Lords, let my start by picking up the point that was just made by the noble Lord, Lord Winston. We should be plain and simple in saying what is going on. In effect, the Bill’s central purposes are to amend the Suicide Act and to legalise somebody’s ability to assist someone else in killing themselves. We should be frank about that; that is what we are doing. If people find us being clear and speaking plainly about what we are doing either uncomfortable or distressing, that should make us pause and ask ourselves whether what we are doing is the right thing. We should not change the language to make the thing that we are doing more palatable. We should speak plainly about it then judge accordingly.

There are some real consequences. One of them was set out by my noble friend Lord Shinkwin when he referred to people with learning disabilities. The noble and learned Lord, Lord Falconer, will correct me if I have got this wrong, but I think that, when he gave evidence to the committee, he was clear that he wanted someone with a learning disability to have the same ability to access assisted suicide as anybody else, assuming that they meet the other eligibility criteria. My noble friend Lord Shinkwin put it very well when he said that people with learning disabilities need to have things explained in clear and straightforward language. That is really important.

In an earlier debate, my noble friend Lord Markham talked about relying on the experts, but we cannot do that because we know that they do not always make the right decision. We know that, during the Covid pandemic, many people with learning disabilities were given “Do not resuscitate” notices because some people had made the decision that their lives were not as worthwhile as others. People made decisions about them that they would not have made about somebody who did not have a learning disability. It is important that we make sure that the language we use about this decision, which could not be more important, is understandable and that the consequences are understandable for everybody who will be impacted by such a decision. My noble friend Lord Shinkwin made that point well.

My noble friend Lord Frost has already made the point about the use of the phrase “committing suicide”; I reflected on it before I signed his Amendment. Personally, I do not like using that phrase—the “commit” piece, not the “suicide” piece—so I paused before I signed his amendment. However, I thought that having a debate and pressing on clarity was important. Obviously, we are in Committee. If my noble friend were to bring forward these amendments on Report, I would want to work with him on the language. I think that removing “commit” would be better because, as my noble friend correctly said, the Suicide Act has removed that vocabulary.

But using the word “suicide” is accurate. Just because somebody has a terminal illness, that does not mean that in taking their own life they are not committing suicide. It is important because it gets through to people the consequence of what we are doing here and the fundamental reshaping we are doing to the way in which society looks at this. That is why so many of us are concerned about it.

Before confronting this, everything we do is about prevention of suicide. The Government have a suicide prevention strategy, and there was all that debate in this House on the Online Safety Act. The noble Baroness, Lady Fox, referred to some of the online sites that promote suicide and make it sound like an okay thing to do. Your Lordships’ House was very exercised during the passage of the Online Safety Act by that sort of online content. There has been a general presumption in society that if someone wishes to die by suicide, we should take every step possible to persuade them not to do so. This legislation is a profound change to that, enabling people to assist someone to die by suicide, and that is why we should be clear and straightforward about the language to confront people with the enormity of that change.

If, having confronted the public with the enormity of that change, they still think that is a good idea, I might not agree but that would be fine. But we should not allow these significant changes to go by because we obfuscate what they are actually about by using language that is not clear and straightforward, and that is the thrust of my noble friend’s amendments. That is why I was happy to put my name to them, and why at least a form of them would be an improvement to the Bill were they to be accepted.

Might I respectfully suggest to the Committee that we now hear from the Front-Bench spokesman so that we can finish this line of amendments by 5.30 pm?

It may be helpful for the Committee if I simply read, very briefly, for the assistance of considering this Amendment, what the former Chief Coroner of England and Wales, Justice Teague, said about the background to the decriminalisation of suicide when giving evidence to the Select Committee. I think the Committee would want to consider it. He said that

“the reason the change was made was not a change in the public policy towards suicide; it was a change in the criminal law to decriminalise it, because the situation had developed where you could not effectively prosecute the person who successfully committed suicide. What the law was doing was prosecuting people who failed. It was manifestly improper and unjust that people should, in effect, be punished for failing to achieve suicide, but it was always made clear at the time of the debate in Parliament that it would remain an offence to assist a suicide, and that it would be the policy of the law that suicide was not something to be approved of”.

In that context, the Committee may wish to consider whether, given that the act being considered here is the assistance of a suicide, it should be plainly named as such, as the noble Lord, Lord Frost, proposes in his amendment.

My Lords, I will take just a minute or two. Words matter. In America, in legislation similar to that which we are entertaining, it is known as “medically assisted suicide”. Similar terminology is used in Switzerland. Those are both jurisdictions that have informed this debate. Recently, in the British Medical Journal, a physician who works in Scotland made this compelling point:

“The phrase ‘assisted dying’ creates confusion and is poorly understood … just 43% of respondents” in opinion polling

“thought ‘assisted dying’ involved the provision of lethal drugs to end somebody’s life”.

Fewer than half of the public understood what was meant by this legislation. He went on:

“The Majority believed the term meant withdrawing life-prolonging treatment or providing hospice-type care”.

If so many of the public have the wrong view of this legislation, how can it possibly not be of assistance for us to use plain language on a matter of such moment?

My Lords—

Noble Lords:

front bench!

My Lords, I have been very clear throughout this debate that any noble Lord who wants to speak and participate should be allowed to do so.

As I said earlier, it is absolutely fine to break mid-group on these amendments.

My Lords, thank you. If there is one place where language matters, it is in the Bill before us. As a young disabled person, I used to interchangeably use “person with a disability” and “disabled person” and did not understand the importance of that. In later amendments, I will argue that “disabled person” is much better phraseology to use.

Language is the dress of thought. We are all spending many hours working on this Bill, but, if the outside world does not understand what is meant by “assisted dying”, we could be in a situation where somebody with learning disabilities or who uses British Sign Language, who has not spent as much time as we have interrogating the Bill in every single session, might not understand what they are signing up to. Personally, I would prefer something around “died by suicide”—that is something else that can be finessed as we go through the Bill.

The BMJ published an article that showed how poorly understood the phrase “assisted dying” was. This highlights the problem that we are facing: the phrase is poorly understood and creates confusion. Just 43% of respondents thought that “assisted dying” involved

“the provision of lethal drugs to end somebody’s life. The Majority believed the term meant withdrawing life-prolonging treatment or providing hospice-type care”.

That is something we must consider. The noble Lord, Lord Winston, talked about how the Bill should be largely workable. It should be workable, but it should also be safe. Part of that safety is about the public understanding what they might be signing up to.

In other groups, we have talked about doctors and medics, and I have many in my family. There is nothing more medic-like than using very long words and things that the public do not necessarily understand. Not everybody is an expert patient. We must be clear about what we mean in the Bill. We should stop hiding behind phrases that people may choose to use. To be clear, I have used the term “assisted dying”, because I try to be very thoughtful of the people who do not like “assisted suicide”. However, I have used “assisted suicide” today, and I will from now on, because that is what the Bill is going to do to the people who sign up to it.

My Lords, I will speak, given that we are going to continue until 5.30 pm and the noble Baroness, Lady Fox, has mentioned me. The problem with removing the word “dying” is that it does not give to the public the absolutely key bit of information, which is that these people are dying anyway. We are talking only about people who are dying. That is what the Bill is about: people who have less than six months to live. They are dying. We may have a theological belief that we are all dying, and that each day we get nearer to that, but let us put that to one side.

The removal of the word “dying” would be the worst way to tell people what this Bill is about. The Bill is not about assisted suicide for someone who just decides that they want to commit suicide or have a suicide death—I do not like the word “commit”. It is not about people who suddenly say that they want to commit suicide because of this, that or the other. We are talking only about a cohort of people who are dying; remove that from the Bill and it is less likely to be understood.

Does the noble Baroness not share my concerns about the misdiagnosis of six months, when you think of all the people who live for much longer afterwards?

While that is absolutely a legitimate thing to discuss, and I would always defer to doctors on that, it makes no difference to this part of the argument of whether we call it dying. The noble Lord may well want to raise the question of whether we can ever be sure that someone is dying, although I have to say that I cannot be the only one who has been with someone where it is jolly clear that they are not going to live till the end of the week. There are times when you absolutely know that someone is going to die. While he may well be right that there are other cases, that is not the issue of this word. This word in the Bill is to give to the public the understanding that we are talking about whether there is a way of helping either the final timing or the way of those final days. We are not talking about someone who just decides to commit suicide for some other reason; we are talking about people who are dying from some sort of terminal illness.

My Lords, I remind the Committee that I am one of those who are still balancing the arguments on the overall Bill, and where I get put off some arguments is when people heckle those who are trying to make a point. I do not think it helps their cause. On the other side of the argument—I am trying not to sound as if I spend my life sitting on the fence—those who speak much longer than they need to in making a point also make it difficult to support some of the points that are being made. On future Committee days, I would like to see a bit more mutual respect between the different sides of the debate, with shorter points made but also less heckling of those who want to make a point. It is important, if we are going to say that we are doing our job in scrutinising the Bill, that everyone who wants to make a valid point, relevant to the amendments, is allowed to make it.

I thank my noble friend Lord Frost for tabling the amendments in this group. I recall that at Second Reading my noble friend Lord Moylan spoke about the importance of language. Language is important, especially clarity of language, so I understand my noble friend’s intentions in tabling these amendments. One could argue that there is a distinction to be made between the terms “assisted dying” and “assisted suicide”. “Assisted dying” on its own, before you even consider the Bill, does not necessarily mean consent on the part of the person whose life is being ended. The Bill introduces that element of consent, but “assisted dying” on its own does not mean consent, whereas it could be argued that the term “assisted suicide” conveys some form of intent—that it is a person seeking to end their own life, they want to do so and are not being assisted to die, regardless of whether or not they want to die. That may seem to be a philosophical point, but it is important that there is a distinction between assisted dying and assisted suicide. As the Official Opposition, we have no collective view, but it is a legitimate challenge by my noble friend to the language of the Bill, seeking clarity or, as the noble Baroness, Lady Fox, said, transparency.

Noble Lords have argued that people in this country should be able to access the services that people can access from Dignitas in Switzerland. However, Dignitas is described as offering physician-assisted suicide. Looking at the Dignitas website—not because I have lost the will to live after trying to get through a day of debates, but to look at the language—I see that it uses the phrase:

“Legal assistance for suicide with DIGNITAS”.

So we have to ask ourselves: if we are trying to be consistent with Dignitas, why is it okay for Dignitas to use the language of “suicide” but, when people want that same service in this country, we cannot use that language?

That is exactly because it will take people who are not dying. This is not what this Bill does.

That is a fair point to be made. It is why the question was asked, and I thank the noble Baroness for answering it.

I thank my noble friend Lord Frost for provoking this debate, because there are still other arguments for using the phrase “assisted suicide”, particularly in terms of clarity. I look forward to the consideration of the arguments made by my noble friend Lord Frost from the noble and learned Lord, Lord Falconer, and the Minister.

My Lords, I will be very brief. The amendments tabled by the noble Lord, Lord Frost, do not present significant workability concerns. As noble Lords will be aware, the amendments have not had technical drafting support from officials. Therefore, further revision and corresponding amendments would be needed to provide consistent and coherent terminology throughout the Bill.

The purpose of making the amendments advanced by the noble Lord, Lord Frost, is clarity. We have to look at this not as some pamphlet but as a piece of legislation. The key thing is that it conveys what it means. The relevant words in the Bill at the moment are:

“A terminally ill person in England or Wales … may, on request, be provided in England or Wales with assistance to end their own life in accordance with sections 8 to 30”.

In my view, that could not be clearer. It is saying that the Bill is about providing assistance to end their own life in accordance with Sections 8 to 30.

The noble Lord, Lord Frost, wishes to change the words

“assistance to end their own life” to

“medical help to commit suicide by provision of lethal drugs”.

The language of the noble Lord, Lord Frost, is both more technical and much looser. Simply as a matter of legal drafting, the draft as it is at the moment is much clearer and accurately describes what would happen. It is not my drafting or that of the sponsor in the other place; it is the drafting of a professional draftsman and I strongly urge the Committee to stick with the non-emotional, accurate, clear drafting that is there already.

My Lords, I thank all those who have supported and engaged with the substance of my amendments. I think we have had a good debate. I also thank the Minister for acknowledging that these amendments would not cause significant or major workability issues—I think her words were something like that—at least on a first viewing. That is important.

I am grateful to the noble and learned Lord, Lord Falconer of Thoroton, the sponsor of the Bill, but I think we will have to disagree on what language is clear and what is not. I continue to believe that the form of words in my amendments is much clearer and sharper, whereas the language in the Bill covers a multitude of possible actions.

To conclude, I continue to believe that there is an important and dangerous ambiguity at the heart of the Bill, which we can clear up by focusing on the language. Therefore, we will probably have to return to this—if we ever get that far. I beg leave to withdraw the Amendment.

Amendment 34 withdrawn.

House resumed.

House adjourned at 5.33 pm.