Assisted Dying for the Terminally Ill Bill [HL]

My Lords, I commend the noble Lord, Lord Joffe, for his courage and persistence and offer my support for his Bill. I trust that your Lordships will not accede to the invitation of the noble Lord, Lord Carlile, to apply euthanasia to the Bill, because it is in the tradition of the House to give time and attention to vital issues which merit more scrutiny. The noble Lord, Lord Carlile, accused the Bill of casuistry, an unwarranted description of both the Bill—which I do not believe is disingenuous—and, by implication, perhaps, even the noble Lord, Lord Joffe. He declared that it would put every doctor at risk and enrich many lawyers. The noble Lord may well have the gift of prescience, but Clause 4 will clearly afford protection if it becomes law. How that law will be interpreted is a matter that no doubt will be decided by learned judges. The most reverend Primate the Archbishop of Canterbury—who, unfortunately, is not in his place—said that suffering can be helpful. I would not wish to engage in a dispute with him, but that is a matter for individuals to determine in the course of their life. He then went on to say that we would put everyone at risk and that this would be a substitute for palliative care. Time and again we have heard such allegations made in this debate—but they are assumptions; they are not validated. As has also been said time and again, nothing in the Bill precludes us continuing to be a country which is well respected for its attitude towards palliative care. The right reverend Prelate the Bishop of St Albans—who also is not in his place—made an unfortunate analogy, which seems to presume that all those in favour of the Bill are engaging in some kind of wilful misrepresentation by implying that the words that we use do not really have the meaning that they should have. I reject that. I would not impugn his integrity and I do not understand why he should impugn the integrity of those who support the Bill. I have a huge respect for the noble Baroness, Lady Chapman—it is unfortunate she is not in her place—but our society has moved a long way from failing to acknowledge the rights of the disabled and children. This Bill is not a prelude to euthanasia in such circumstances. The noble Baroness, Lady Emerton, who has just spoken, said that no alternative was offered. It may be that we read Clauses 2 and 3 differently, but they take you through a whole range of alternatives that are put to the individual. She may not agree with my interpretation, but that does not necessarily mean, with due respect, that her interpretation is right. At a meeting in this House on 19 April, Professor Raymond Tallis, a geriatrician and former chair of the Royal College of Physicians Ethics Committee, said:"““I am in support of Lord Joffe’s Bill in its present form. There are several reasons for this. Firstly, the current law is a bad law with negative effects. There are a significant number of people who need, and seek assisted dying because of unbearable suffering which cannot be alleviated by even the best palliative care. The result is either botched suicides, currently illegal practices or the need to travel abroad for assistance.""Secondly, society recognises that the law is unfair and overwhelmingly supports a change in the law. In this, they are supported by many healthcare professionals.""Thirdly, the proposed Bill has more safeguards than any other legislation of its kind. Lord Joffe’s Bill will make the situation safer for both patients and doctors than it is at present where end-of-life decisions are shrouded in medical, legal, and ethical fudge.""My own change of mind about the Bill is, perhaps, instructive. When the Ethics Committee which I chaired at the Royal College of Physicians first considered this Bill, in 2003, we opposed it and I was in support of that opposition. Unfortunately our decision was based on a series of assumptions: that good palliative care would obviate the need for assisted dying; that assisted dying legislation would stunt the development of our current underdeveloped palliative care services; that there would be a slippery slope in which assisted dying would be extended to people who did not want it or could not give informed consent, particularly those vulnerable people who have been my main professional concern; and that it would break down trust between doctors and patients. Every single one of those assumptions has proved to be false in those countries where assisted dying is available. Indeed, the impact of liberalising legislation has proved to be the reverse of what I had assumed.""This, then, was why I changed my mind””." Finally, I agree with the noble Baroness, Lady Williams, that love and respect is what every person deserves. But this can be shown in many ways, and I submit that respecting our loved one’s wishes may be difficult but not necessarily wrong. We will all ultimately be faced with the challenge of death and no doubt rage against the dying of the light. This Bill will allow those who so wish to end the struggle, and to do it on their terms. I commend the Bill and I hope that your Lordships will oppose the amendment.