Coroners and Justice Bill

My Lords, I wish to explain why I am bringing forward the amendment at this point. As some of your Lordships know, I tabled the amendment for the Committee stage at which another amendment in the name of the noble and learned Lord, Lord Falconer, and others covered a wider basis. I was asked to withdraw my amendment to enable the focus of debate to be clear so that your Lordships’ House could consider it. However, both at the time and on reading Hansard subsequently, it became clear that there were certain important matters in my own consideration of the question which I wished to bring back to your Lordships’ House, not for the purpose of pressing them to a vote but in order that we may facilitate the community as a whole in struggling with a difficult question that is now a matter of national discussion, particularly with the consultations of the Director of Public Prosecutions It seems to me that in general debate and, particularly, when there is a vote in your Lordships’ House and the other place, there is a tendency to polarise and to press the case for one side or another rather than to explore what is involved in complex and difficult moral questions. I look at this issue and see it, in a sense, as a matter of disability rights; for me, that is what the question is about. The terms of the amendment address the situation where someone is suffering from a confirmed incurable and disabling illness which prevents them carrying through their own wish to bring their life to a close. It is always very difficult to put oneself in another person’s place or to put oneself in a context other than the one which one experiences, because we tend to see things from our own perspective. However, we are all rather different in our approach to these matters. A disabled person or a person suffering from an illness can no more speak for all other people who are similarly disabled or suffering from that illness than an able-bodied person can speak for all others who are able bodied, because we see and approach things differently. Let us consider the case of someone who wants to embark on the wholly legal activity of bringing their life to a close—it is no longer illegal, although there was a time when it was. They are living in a state of deep and ongoing distress and have come to a free and settled conclusion that this is what they wish to do, but they are, by the nature of the disorder and its disabling effect on them, unable to carry their own wish through. I ask your Lordships so far as possible to put yourself in that situation and to consider what it would be like to have come to the conclusion that one strongly wished to do that, but to be unable to lift a finger in order to act on one’s own wishes and to be kept in that state of distress, pain and discomfort until one was in torture and quite unable to do anything about it. One’s family and friends would have to endanger themselves in respect of the law in order to render the remotest assistance. We have passed disability legislation—there was a debate on disability during the dinner hour earlier on in your Lordships' House—to make sure that, for example, if someone has a wish to pass a university examination but is in some way disabled from carrying through their studies or implementing the exam questions, the authorities provide assistance to the person. However, in this particular circumstance, not only do we not enable assistance but we make it a crime to assist someone who is living in an utterly tortured state and has come to the conclusion that they wish to end it. That conclusion is critical, because someone who is confirmed to be suffering from an incurable, progressive disabling disorder might come to the completely different conclusion that, whatever happened, they wanted to continue their life, and that, whatever their pain, difficulty or discomfort, they wanted to remain in a relationship with those who were important to them. Of course, such a person should be facilitated in every way to carry on with their life. As someone who works with people who sometimes come to the conclusion that they want to bring their life to a close, I am not speaking in some kind of academic fashion. That is rather important. For me at least, morality and ethics are not some academic debate. That is what one actually does in relationships with real people; it is not a matter of speculation. There are those who find themselves in the kind of context described in the amendment; whatever the odds, whatever the pain, whatever the discomfort, whatever the disability, they want—and I believe that it is the majority of people who find themselves in these circumstances—to sustain themselves and their relationships for as long as is remotely possible. Their doing so must be facilitated. However, to recognise that we are probably talking about the overwhelming majority of people does not mean that one should dismiss that important minority of people who have come to a free and settled conclusion that that is not what they wish to do. It is not that one or other should be forced in any way. That brings me to one of the questions, because it has often been said that the problem about facilitating that minority’s wish to take those steps is that it is the thin end of a wedge and that nasty or unpleasant friends or relatives might push those who did not wish to do such a thing into doing it. That is not an unreasonable concern at all. Then one asks if one should dismiss it because of the possibility, indeed the likelihood, that there would be such circumstances. I do not think so. One could justify that only if one had come to an a priori decision that in no such circumstances would one ever give any assistance to anyone in these circumstances. If not, and if one comes to a conclusion that there might be such circumstances but they need protections, it is an incumbent duty to look at what the protections might be to ensure that nothing malign is happening. In a sense, that is what this debate is about. It is an opportunity for people who say, "This is a worry and a concern, because people might be forced in a direction that they did not want to go, one way or t’other, and here is an alternative way, rather than the one in Amendment 66". I do not regard this as any kind of Holy Writ. It is a set of propositions to see whether we can find a way in which to take a step forward in this important and difficult question, which does not apply to huge numbers of people but nevertheless is important. One question put to me was whether medical practitioners were suitable people. Well, I do not think that they are. If a person is to have the comfort, guidance and opportunity to come to a free and settled conclusion and to have a judgment made as to whether they had been put under pressure or whether it has been free and settled, someone in a judicial office is the right person to do it—preferably someone whose approach is inquisitorial rather than adversarial. That is why I proposed that it should be coroners, because they are used to trying to find out the truth of what is going on rather than what is simply the point of law. A perfectly legitimate argument could be made that someone other than a coroner should be doing this, and I entirely accept that. However, there is a requirement for someone who understands the law, is used to trying to find out the truth of what is going on and is sensitive to people and their families and the understanding of things and who has, by nature of their office, the facility to call people, give reports, explore the question and try to come to a reasonable conclusion. That would be someone who could call a specialist to say, "Is this an incurable disorder, or a progressive disorder?". They could call a psychiatrist—or more than one—to ask, "Is this person suffering from a depressive illness which, if treated, would resolve, and they would no longer have the wish to bring their life to a close? Or is this someone who is not suffering from a mental illness but has come to a clear, settled and thought-through wish to take this action but is not able to do so by nature of their disability?". That is the chain of thoughts. Someone finds himself in this circumstance, wishes to do something, is unable to do so—and the protection is that it is not his own physician or even an independent physician who makes the judgment. It is someone who is legally and by experience qualified to explore these questions. Then, if they certify that this is the case and that the person has come to a free and settled view, they can provide a certificate, which would ensure that anyone who rendered assistance—although that does not mean that assistance has to be rendered—would not be breaking the law. Then we would not have what we are frankly in danger of having, which is an Irish solution to the problem. The Irish solution to the abortion problem is that you pass it on to somebody else and then feel justified; you are glad that somebody else is dealing with the problem. Sometimes we actually need to face the problems, struggle with them and try to come to a reasonable conclusion. In such questions, it is often thought that one should maintain a conservative approach to such matters, and not change because if you do so you jeopardise things and move into danger. That is a serious misjudgment. There was a time when the majority of the medical profession believed that it was ethically wrong to provide chloroform to relieve the suffering of women in labour. That was theologically justified because, of course, a woman was to bring forth her children in pain. That was the view of society and the view of many doctors, although not all, thankfully. Now, we would not only regard that is not appropriate, we would regard it as not a moral position. It was the same with suicide. There was a time when it was regarded as a crime. Now, we do not see it in that way. We try to come to an understanding of it. These positions that we take are not immutable. Indeed, sometimes we come to a view later that is radically different from the one that we had earlier on.