Assisted Dying for the Terminally Ill Bill [HL]

My Lords, the opponents of the Bill would like us to believe that the present situation is a logical one and that it puts the preservation of life above all else, but, of course, that is not the reality of the situation. I would like to give three examples of where people are allowed to die who could have been kept alive. One example is where the doctor himself or herself makes that decision—when a person is deeply incapable and suffering and there is no obvious hope, they decide not to keep the person alive any longer. Secondly, there is the case where the person has made a living will which requires that of the doctor. Thirdly, there is the case where, if you are capable, you can insist that you are not resuscitated if you have a heart attack. All those cases break the principle of the preservation of life. The thing which you cannot do, though, if you are capable and in hospital is deliberately to advance your death, either on your own or with assistance, to speak practically. Of course, if you are not so ill and therefore you are at home, you can do it, and if someone assists you, they will not in fact get more than a reprimand. So we have the situation where it is only if you are ill enough to be under 24-hour medical care that you cannot advance your death. I find that extremely illogical. Certainly, it cannot be defended on the ground that we put the preservation of life above everything else in all that we do. You can, in fact, kill yourself unless you are so ill that you need medical help to do it. The majority of people—80 per cent of the electorate—do not agree with that and think that the law should be changed. We should take their opinions very seriously because it is not like an opinion about capital punishment, where you are thinking about what should be done to somebody else; it is an opinion about what you would like to be done to you if you were in a certain situation. The problem that we have—it is a very serious feature of the position that we are in as a House—is that the majority of the medical profession are against the Bill. It is extremely easy to understand their feelings because 99.99 per cent of their patients desperately want to go on living, and it is a prime obligation of doctors—it is their prime job—to satisfy the wishes of those people. That leads, of course, to the development of a professional ethic and an instinctive response that that is the overriding drive. But what if a tiny minority want something different—that is the issue—and they are in no position to bring it about on their own? And what if the vast majority of the population think that those people ought to be legally able to have help in bringing about their end? This is a straightforward issue for political philosophy and in my opinion the people have it. I am a passionate supporter of the medical profession and I want it to have more power in the NHS, but this is a matter of people’s lives and I think that the views of individuals and of the population ought to be paramount. There is the issue of unintended consequences, which my noble friend Lord Turnberg quite rightly raised. For example, would the measure undermine the trust between doctors and patients? I do not see why it should. I note that in Holland that trust is higher than in any other European country, as shown by surveys. Would mistakes be made? Do doctors misdiagnose people as terminally ill? Of course, occasionally, they do. But if the person is in that situation and has no reason to think that they will not have a horrible death, they are in a state of mental distress, and mental distress is at least as important an issue here as physical distress, particularly if the patient says, ““I cannot tolerate this situation””. That is in the end of the overriding issue—should the choice of the patient be decisive, if the patient is capable? In the NHS that is, of course, always the overriding criterion except in the case that we are discussing. Eighty 80 per cent of the population think that people should have this facility, and so do I.