Assisted Dying for the Terminally Ill Bill [HL]

My Lords, having had to face up to my own mortality when I was diagnosed with leukaemia last autumn, I can identify with the mental trauma that comes with life-threatening illness—a trauma which can in some circumstances slip over into depression. If, in a moment of self-cynicism, I were to describe myself in some way, I might describe myself as a Trinitarian monotheistic utilitarian—to echo the words of the noble Lord, Lord Carlile, earlier. I shall expand on that for a moment. My particular concern is that the current version of this Bill has weakened the safeguard against assisted dying for people who are depressed. Indeed, a significant proportion of terminally ill people who request euthanasia are suffering from transient depression, as the noble Baroness, Lady Finlay, mentioned earlier. The 2004 Bill required a stringent test of mental capacity to make an informed decision about assisted dying. This involved referral to a psychiatrist or psychologist, who would have to take account of any evidence of impaired judgment. The current Bill ignores the advice offered by the Select Committee and lacks this crucial sanction: it no longer makes an explicit connection between impaired judgment, which someone may have who is depressed but whose mind and brain are working properly, and a lack of mental capacity. Those who care for people nearing the end of their lives, and those of us who have approached that extremity of human experience, can testify that a terminal prognosis very often leads to a period of transient depression, but that most patients recover from this phase and adjust to their new situation. In my own case, it was not depression but the kind of mood swings experienced through four severe courses of chemotherapy, which was enough. I echo the words of the noble Baroness, Lady Symons, earlier. Having been somewhere along that road myself, I could not trust myself to use the kind of freedoms envisaged in the Bill. I say that reluctantly, because I remember vividly the maiden speech of the noble Lord, Lord Joffe, and value his contributions in this House. More importantly, physicians are often poor at suspecting, identifying and diagnosing depression, which is often confused with sadness or adjustment disorders. The Bill is not safe; it does not protect vulnerable people. I, too, am concerned that there has been a tendency in wider debates to neutralise arguments of religious people on the ground that they are religious arguments. I know that not absolutely all religious people oppose the Bill, but I also know that many people who would not associate themselves with any of the faith communities also oppose it. We all have ideologies, and proponents of the Bill in the House would be unwise to marginalise the views that come from these Benches and elsewhere because of who we are, as what we do day by day places us in contact with many, many other people. Time does not permit me to answer, and in part apologise for, some of the material that the noble Lord, Lord Taverne, cited earlier. I could do so in writing, but I utterly respect that. There is a reciprocal relationship between theory and practice; our accustomed habits of behaviour have a decisive impact on our ideals. A change in the law concerning the treatment of terminally ill patients will also have repercussions on society as a whole. It will give a new shape to public opinion or common sense. We are talking not only about assisted dying, but about the basic assumptions by which people value and treat themselves and each other. A further danger stems from the very way in which human rights are often pressed in many other areas of life. ““I can”” so quickly becomes ““I must””, and there is no accompanying doctrine of restraint to reassert the fact that my choices and their effects do not redound on me alone. Finally, in the last few seconds of injury time—the Bishop of Oxford will not be speaking—please permit me as a former patient to elaborate a little further. When I had to contemplate my own death for the first time as a reality, I kept being struck by its wider implications; not just for me, but for my family and friends, to say nothing of the doctors and nurses to whom I so quickly became close. Dying, it could be said, is not an entirely individual matter. It is corporate. In trying very hard, and probably unsuccessfully, to inhabit this very grey area of human experience, I am unable to support the permitted freedom envisaged by this Bill.