My Lords, I wish to speak on Amendment 67 in the name of the noble Lord, Lord Carlile, but, before doing so, I want to say how much I regret the direction of travel of our Committee stage today. I should have thought it would be more profitable to debate all the amendments in Committee and make decisions on Report. However, noble Lords have decided to take the proceedings in a different direction and we will have to deal with that.
There is no perfection to be found with this Bill or without it. As we have said many times, the Second Reading debate gave an opportunity for a large number of noble Lords to express their views and the compassionate arguments that were expressed throughout that debate were very moving. Indeed, there have been similar contributions today.
I have no complaint about the way that the amendments have been grouped today, but that does mean that certain amendments are more relevant to certain issues than others. That is inevitable. My anxiety, as I expressed at Second Reading, concerns the position of the medical profession. I am not a doctor but a close relative is starting out on that road. We have given insufficient consideration to the impact that the Bill, if it is enacted, will have on the profession. As I see it, it would completely change the status of a doctor and the doctor-patient relationship.
How often have we said that, in order to provide a lethal dose or drug, the best medical person to judge that is somebody who knows the patient because no two patients are the same? Even then, that is no guarantee because you have to have some people who are specialists in the delivery of certain substances. Even then, as we have heard from the noble Baroness, Lady Masham, when people deliberately set out judicially to end a life, it turns out to be a mess. By introducing an independent element, the amendment at least separates out from this process the role of the carer and the medical profession up to that point. That is extremely advantageous. Simply to assume that we can subcontract to a profession that does not want this, against its will and without even having a discussion on it, is presumptuous, to say the least.
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Imagine the implications of this at ground level. Not everyone is capable of having an intellectually balanced debate on the pros and cons of whether they are going to die. As the noble Lord, Lord Deben, said,
for any of us over the years who have had constituents, human nature is, sadly, not perhaps as ideal as we would like. I have seen in my home patch mothers and grandmothers dumped on Christmas morning at a community centre to have their lunch, while the family cleared off to enjoy the rest of the day. This is human nature. To believe that it is anything else and there is a rational family debate on what we do with granny on Christmas morning is nonsense. Life is not like that. We are not perfect. There is no perfection to be found.
The other factor that is not considered is the effect of this on the doctors as individuals. They are carers who have given their lives to a particular profession or calling. The relationship between them and the patient will change. Whenever someone goes to a doctor, if they can be persuaded to do so, they are going for help; they are going to trust that person with intimate details of their lives. Perhaps they would say or convey more to a doctor than perhaps to anyone else. I am sure that the right reverend Prelates on the Bishops’ Bench might agree that they get a lot of that—but so do doctors. If at some point that patient, even reluctantly, goes to the doctor because they are afraid, a new dimension of fear will be added because this is not simply the person who could help them but the person who might switch out the lights. Much as I oppose the principle of the Bill, at least bringing an independent element into the decision provides some protection and begins to separate the role of the doctor-patient relationship from this process. That is important.
There is another factor. Things change and we learn. People in some countries already know the cures for certain things that perhaps we do not know in this country. There are doctors in hospitals in this city who are better than others. There are doctors who know more than others. Therefore, there is no equality of information or professionalism within one city, one country or around the world. If a doctor decided that it was right to terminate or recommend the termination of a patient’s life today, and tomorrow discovered that they had missed or failed to learn something, what would be the downstream consequences for that person? I have seen cases at home; for obvious reasons, sadly, my part of this country has experienced huge reservoirs of post-traumatic stress caused by different things. Are we going to add to that today by this process? Who knows? However, it needs to be discussed and that is what Committee is for.
Therefore, much as I am uncomfortable with this whole process, it is better to have an independent, completely separate relationship between the patient and his or her circle of medical advisers. At least by introducing that independent element, one hopes that that crucial, sacred relationship can be preserved without let or hindrance.