Assisted Dying for the Terminally Ill Bill [HL]

My Lords, I declare an interest: I am a nurse. I know that some nurses, whose opinions I very much respect, support the Bill and even seek to do so from an ethical standpoint, but I cannot agree with them. I cannot support any legislation which will, in my opinion at least, jeopardise the future of the nurse/patient relationship. I am therefore pleased to note that the collective voice of nursing is very much opposed to the Bill. The Bill clearly sees the involvement of nurses in the process of assisting death. We have heard much today about choice and autonomy, but you cannot exercise choice and autonomy without involving doctors and nurses. It is not something you can do on your own. Although there is a clause dealing with conscientious objection, I am of the view that it cannot really work in all the care settings where end-of-life care is delivered. The prospect of encountering a patient wishing to take advantage of physician-assisted suicide will not be restricted to those working in palliative care. I feel very strongly that it is not part of their practice for any palliative care nurse to be involved in any process whatever of obtaining assisted dying. We have already heard about the slippery slope, not least about the cultural shift in the UK since the introduction of the Abortion Act 1967. The situation is self-evidently very different today from that envisaged by the noble Lord, Lord Steel of Aikwood. I make no complaint about that because I firmly believe that women have a right to control their own fertility. Some noble Lords have said that there will not be a slippery slope yet, but I am not so confident. I think that there is bound to be a demand for further legislation to legalise euthanasia. The noble Lord, Lord Joffe, said today that he has changed his mind about the legislation going forward in incremental stages. I greatly respect and welcome his revised position. But others will surely not be so content if the Bill is enacted—they will want to take the matter further. I do not believe that this is what the values of the nursing profession are about. I also believe that if the Bill ever becomes an Act, it will severely damage the development and continuation of palliative care, not least if that inevitable cultural shift takes place and the population becomes conditioned to a cheaper option of physician-assisted dying or euthanasia. The noble Lord, Lord Elton, said that money drives policy. That is fairly hard-nosed, but he is right. We know that that is what happens in the real world. It goes without saying that, wherever possible, death should be pain-free and dignified. If there was universal—I emphasise that word—availability of hospice care, not just for malignancies but for diseases such as motor neurone disease, if there was hospice care at home and good symptom and pain control, a lot of the fear that engenders the demand to be allowed to choose assisted dying might be removed. The lessening of that fear would be materially assisted if there were less media hysteria and misinformation—for example, that people living with motor neurone disease choke to death. That simply is not true. I do not want to damaged in any way the trust of patients in nurses and physicians or the terminally ill in their relatives and carers. I do not believe that the Bill provides sufficient safeguard where someone who appears to be terminally ill feels that they are a burden on their family and carers and where—this is the real world, after all—there might be greed and malice aforethought. The prescribing doctor will not be present when the lethal cocktail is taken. Who is to know who administers the drugs? For me, any doctor or nurse who sets up an intravenous line or nasogastric tube where there is an inability to swallow must come very close indeed to practising euthanasia. For all these reasons, and many others which time does not permit me to give, I will support the amendment in the name of the noble Lord, Lord Carlile of Berriew.