Assisted Dying for the Terminally Ill Bill [HL]

My Lords, I oppose the Bill because I believe that it puts at additional risk an already vulnerable section of the population; namely, the old, the frail and the dying. However, I am chiefly concerned with defending the practice and future development of specialist palliative care as delivered by our hospices, a model which works and which, I believe, is undermined by the provisions of the Bill. I perhaps need to declare an interest in that I was a co-founder of St Mary’s Hospice in Ulverston, Cumbria. I have continuous involvement, and I remain its chairman. The debate has caused distress, and continues to do so, to a significant number of our hospice patients. Such people are fearful as a direct consequence of the Bill and the debate that surrounds it. They are frightened that it is our intention to shorten or terminate their life without their consent. I tell the noble Lord, Lord Joffe, that that is not speculation; that is a fact. The progress that has been made towards reducing suffering in specialist palliative care is well documented. I estimate that 1 per cent of our patients suffer to the degree that the Bill addresses. I would think that, 10 years ago, the figure might well have been nearer 5 per cent The improvement owes a great deal to clinical advances, but by no means everything. Other factors include the success of the hospice model of care and its acceptance by communities in general and by health professionals in particular. Accordingly, patients come to us earlier than before and self-evidently that hugely enhances our ability to give them the best treatment. Of course, pain is not only physical; numerous strands of mental and emotional anguish need to be softened or relieved, and we seek to do that, too. Our work is based on the simple principle that every person has unique physical, emotional and spiritual needs and that treatment must be tailored to those needs. Most of our in-patients admitted for terminal care have, on arrival, an average life expectancy of fewer than 14 days. In normal circumstances, during the first hours and days, pain will be controlled, the fear of pain removed, and, through the ever-growing menu of complementary therapies, quality added to their life. It is deeply wrong, in my view, that, with so few days remaining to these people, the comfort and safety that we seek to provide can be blighted by needless fear and uncertainty. I know of no member of our staff who has come forward in support of the Bill or of any hospice that wants it. Our care professionals can see no improvement in the care they offer, and there have been no demands to alter the time-honoured definition of ““patient autonomy””, which I remind your Lordships provides for patients to stop life-prolonging treatment if they so wish. The other main issue as the Bill affects hospices is what has been described as the ““duty to die”” factor. I will avoid spending time on that much-rehearsed argument, beyond saying that there is substance to the notion that old and ill people, including our patients, increasingly feel growing pressure that they should stop being a burden to their family, their carers, the state and even the institutions charged with their care. I contend that the Bill will lend momentum to that chillingly horrible trend. The problem before us today has been wrestled with for generations. Those who have gone before us saw the recklessness of going down this road for the reasons so eloquently put today and last October by the noble Lord, Lord Phillips of Sudbury. I believe that a touch or arrogance accompanies the belief among a number of contemporary commentators that ours is an enlightened age that has conferred wisdom and intelligence denied to our forebears. I sometimes think that the opposite is true. The future lies not with this Bill but with extending and enhancing the scope of palliative care; introducing justice to its uneven provision; and addressing urgently other conditions for which the model is entirely appropriate. Perhaps the greatest unmet need lies with those suffering from certain heart conditions and end-stage respiratory disease. I believe that palliative care is on course to eliminate the suffering that the noble Lord, Lord Joffe, and his supporters seek to address. I ask only that it be allowed to develop rather than be put at risk.