Assisted Dying for the Terminally Ill Bill [HL]

My Lords, I support this Bill, and I express my admiration for the courageous persistence of my noble friend Lord Joffe in this matter. As a psychiatrist and geriatrician, I know how diverse and sometimes contrary patients can be. I recognise the differences in how people approach death, and I respect those very few who would want to take advantage of this Bill’s provisions. It should be their choice, not ours, and a matter of human rights. I have three brief points to make. First, I want to talk about palliative care. According to the recent figures from the National Council for Palliative Care, at present about 70 per cent of all cancer sufferers are referred to palliative care services, and under the age of 50 almost everyone is referred. That is not bad coverage, although I entirely accept that we need a massive expansion of palliative care skills, and I heartily agree that we must campaign for that, but it would make very little difference to this very small group of people. It would be brave and right if palliative care specialists championed the rights of their patients to have their wishes respected. Secondly, there is the issue of undue influence. One of the burdens that older people and those with disabilities face—the noble Lord, Lord Ashley, made this comment—is the often unwanted protective paternalism of those who run their services. Unless they have mental frailty—many older people do have undiagnosed dementia—older people are no more likely to suffer from undue influence from their relatives or carers than younger people. It is a fallacy to think that older people will be persuaded to take their own lives against their better judgment. The paternalistic denial of older people’s right to be treated as others are is an ageist idea. Thirdly, I want to comment on the safeguards in the Bill to prevent hasty decisions being taken by those who have a treatable, reversible depression, which is very common indeed when someone discovers they have a terminal illness, as my noble friend Lady Finlay of Llandaff said, and is usually responsive to timely medication. I was concerned by the earlier drafting of the Bill, and I suggested that there should be clearer wording to ensure that any mental disorder that impacts on capacity should be sought, and those individuals excluded. While legally capacity can readily be impaired by emotional disorder, unfortunately many doctors interpret capacity wrongly to include only intellectual capacity. I wanted to ensure that people with disturbed emotional states were clearly excluded from the Bill. I am now satisfied that the current wording in Clause 2(4) would ensure that. This legislation will strengthen patients’ confidence that at the end their wishes will be respected. I commend this compassionate Bill to the House.