Assisted Dying for the Terminally Ill Bill [HL]

My Lords, we all come to this debate with a predisposition to support or oppose the proposals before us. That predisposition is derived from our knowledge, belief, culture and experience. There is a spectrum of opinion, from one end which holds euthanasia to be an acceptable part of caring treatment, through to that for which any intervention is unacceptable. We have heard the shades of that today. For myself, the critical point is the involvement of doctors. Doctors should never be the means by which political, social or economic ends are pursued. The flaw in the proposals of the noble Lord, Lord Joffe, is one to which he drew attention himself—that it is deficient in its strictures about what doctors and other medical practitioners such as nurses can do. On vigilance, which has been mentioned, Clause 12, establishing the monitoring commission, must be extensively examined, not least because of the experience in the Netherlands. Furthermore, the appointment, composition, powers and resources of those monitoring commissions needs to be explicitly on the face of the Bill and not left to regulation. Many noble Lords have talked today about the slippery slope, and others have countered with evidence form other jurisdictions. The problem is that the systems about which we have heard today operate in a context where the healthcare system is different, where the culture is different, and where there is no national health service. I suggest that we need evidence from this country of how the Bill, if implemented, would work in our society. Therefore, I believe that one of the omissions in the Bill is provision for a statutory review of the legislation. I want to see in this country a system where people with conditions such as motor neurone disease can make individual decisions about their treatment and do not have to go abroad in order to exercise that choice. I want to challenge my noble friend Lord Carlile—a perhaps difficult task. I do not believe that his proposal is improper, but I do believe that it is inappropriate. My noble friend has been quite clear. He told the House on 10 November that there is no condition that palliative care cannot address in order to help the individual. Some of us do not have that certainty. Therefore, while he believes that the Bill cannot be made acceptable by amendment, some of us remain unsure. Furthermore, this is exactly the kind of issue that should be subject to the detailed and expert scrutiny that it would undoubtedly receive in your Lordships’ House—a scrutiny which it would be unlikely to receive anywhere else other than in a court. Your Lordships, unelected as we are, can listen, evaluate, and concur with or reject lobby campaigns. We alone are able to act as we see fit. I share the desire of my noble friend to limit the income that lawyers may derive from this legislation and to see that whatever emerges is as clear as possible. At the end of this debate—the fourth debate since the Select Committee chaired by the noble Lord, Lord Walton, and informed by the report of the Select Committee chaired by the noble and learned Lord, Lord Mackay of Clashfern—it is still possible to change one’s mind. Perhaps the most important statement today was that made by the noble Lord, Lord Joffe, when he opened the debate and told the House how he had come to change his mind. Further debate should not necessarily follow public opinion, but it would have a distinct role in informing public opinion. That would be of value. The aim of all of us who have taken part in this Bill in any way is to secure for ourselves, for those whom we love and for those whom we do not know humane treatment and a dignified end to life. I am not sure whether the noble Lord’s Bill as it stands would be able to achieve that. But I do not believe that at this stage we should give up trying to see whether it is possible to produce legislation that continues to safeguard individuals and enables them to make the most difficult decision they will ever have to make.