Terminally Ill Adults (End of Life) Bill
(Limited Text - Ministerial Extracts only)
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Lord Frost (Con)
My Lords, I am against the Bill, because it is legally and practically defective in many ways, as many other noble Lords have already said. I am against it for philosophical and religious reasons too. For the first time ever, a Bill seeks to give a person of sound will and mind the right to act contrary to a fundamental element of the ethical tradition that has been fundamental to this country—Judeo-Christian morality, and the view that our life is not our own possession to dispose of as we see fit, nor to be taken from us by others, even at our own request.
Noble Lords may ask, as many have done so already, why this should matter to them. They say that they are not religious and that they do not share that ethical system. We have heard some noble Lords say that they have the right to free choice, autonomy over their own life and to protect the dignity, as they see it, of those close to them. I want to briefly explain why I do not think this argument is sufficient and why even those of no religious belief should still be concerned by the prospect of going down the road set out in the Bill.
As I see it, the problem is that the values used to justify the Bill—those of ensuring dignity and preserving autonomy and personal freedom—are also derived from that Judeo-Christian ethical system. As my noble friend Lord Roberts of Belgravia reminded us last week, there have been in the past, and there still are today, many societies that do not fully share those values. They are not self-evident, however much many of us would wish they were.
The Bill is proposing to dismantle part of that inherited ethical system by allowing the state to engage in killing innocent people at their request. Once we have dismantled one part of that system, because we think we know best, what then is the status of the rest of that moral and ethical system? Once you have introduced utilitarianism into our society’s decisions, where do you stop? The ultimate destination of this journey is a utilitarian society with a utilitarian Government, one where there are no free-standing, inherited moral principles of any kind, only the principles that we think we are clever enough to create.
The problem is that in such a society none of us is really safe. The only protection for any of us then are the collective wishes of society, whatever they are at any given moment. In such a society, the rights of those who are inconvenient—the disabled, the ill, the elderly or maybe those who are just unpopular—have no robust defence and are potentially vulnerable. Any of us might one day fall into any of those categories. At that point, your only protection against the general will of society comes from an appeal to the same ethical system that you have just decided is merely contingent, capable of being disposed of if it is inconvenient. Noble Lords may think, as I do, that human dignity and autonomy and freedom are important, but what if the general will of society does not? What ground do you have to stand on there? That is why it is so dangerous to continue dismantling this ethical code, as the Bill does.
I urge noble Lords to think hard about whether we are really confident that we are the generation that is so sure of its judgment and so wise, knowledgeable and confident that we can create a good society on foundations not that we have inherited but which we ourselves have designed. Are we so sure of all those things that we can casually cast aside 2,000 years of our moral tradition and tell ourselves that it does not matter? Noble Lords should look around our country and ask themselves that question. I do not think so, and this is why I hope the Bill will founder.
Lord Brennan (Non-Afl)
My Lords, on Saturday last week the Times newspaper ran a centre-page editorial with the headline:
“The flaws of the assisted dying bill may prove irreparable”.
The editorial stated:
“It should not have fallen to the Lords to protect the public”.
What follows is, putting it kindly, harsh but, putting it bluntly, necessary to be done by this House or in some other way.
The Bill in its present form is not conducive to the common good, for the following reasons. First, we have no idea of its scope in medical terms. Cancer, cardiac, cerebral, immobility, mental—where is the end? Who is going to be trained in these different specialities? Which one is going to be preferred if preference is suggested by the Government? None of the royal colleges has plainly adopted support for the Bill. The psychiatrists are against it, particularly regarding the mental state of a patient to whom assisted dying is offered and what the effect would be. So the scope is big.
Who is going to pay for it? Is this part of the NHS budget? If so, how much? If it is private, how are the two going to divide? There’s a section in the draft Bill about advertising. Do we want to finish up with a system, private or public, of death clinics?
What do the professions say about this? Are doctors going to sign up to do this task, when they might have thought their job was to cure? Nursing staff who might help, or technical staff who might assist in the preparation of the poison or lethal dose of whatever is given to the patient to kill that person—what are they to do? This is putting people to death, whether they want it or not. In Clause 32, we find that we have to amend the Suicide Act, otherwise we will be legislating for unlawful killing, aiding and abetting the person who wants to die.
So the scope is enormous, the effect on the professions is unknown, and the cost, the effect on palliative care and so on could be deeply damaging to all our communities. This is a topic of in-depth complication and the highest level of importance, in which Parliament’s duty is to serve the people it represents here in these two Chambers, no matter what. We can start with the attempt by the noble Baroness, Lady Berger, to put coherence to it.
What about the Hippocratic oath? Several thousand years ago, Hippocrates said, “First, do no harm”. Doctors, and to a similar extent nurses, take that oath to serve us. How does assisted suicide fit into, “First, do no harm”?
I am concentrating on the difficulty because this is probably one of the most serious matters that can affect the public, brought forward to be considered by Parliament. In the House of Commons, both the Justice Minister and the Health Minister were against the Bill. The system rejected it. How on earth will this be resolved.
Baroness in Waiting/Government Whip (Baroness Taylor of Stevenage) (Lab)
I remind the noble Lord of the advisory speaking time.
Lord Brennan (Non-Afl)
If we vote, let us vote at some further stage when we have something serious, coherent and plausible to consider.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)
My Lords, I start by thanking all noble Lords for an extensive, passionate and insightful debate. As noble Lords have observed throughout this debate, its quality and its conduct have been exemplary, and I believe that that has allowed the expression of differing and deeply held views. I thank my noble and learned friend Lord Falconer for his work in introducing this Bill to the House, and I know that many noble Lords are waiting to hear from him as the sponsor.
We have all heard the debates across the country, in which campaigners on both sides have made their case with conviction and care. We have also heard the debates in the other place, and we know the previous consideration that this House has given to the topic of assisted dying. Now it is our turn to scrutinise this legislation.
I turn first to the important issue of the role of the Government, which relates in some part to the Motion in the name of the noble Lord, Lord Forsyth, and the amendment to it from the noble Lord, Lord Carlile. The Government are neutral on the principle of assisted dying. It is a matter of conscience. Whether the Bill becomes law is a decision for Parliament, and my role, alongside that of my noble friend Lady Levitt, is to help ensure that, if this legislation is passed, it is legally and technically effective and workable. So, as with any legislation, if Parliament chooses to pass the Bill, the Government will be responsible for its implementation.
The noble Lord’s Motion refers to time being made available for consideration of amending stages. Scheduling is of course a matter for my noble friend the Government Chief Whip, who will indeed keep this under review. The Government have a duty of care to the statute book and, as such, my officials and those in the Ministry of Justice have worked with my noble and learned friend Lord Falconer and the Commons sponsor Kim Leadbeater MP to offer drafting support and workability advice. This will continue throughout the passage of the Bill and is and has been usual practice.
Turning to the Motions in the name of my noble friend Lady Berger—
Lord Forsyth of Drumlean (Con)
Can the Minister explain why, despite requests from the sponsors of the Bill, and despite the precedent which has been taken with other Bills which were Private Members’ Bills but matters of conscience, such as capital punishment and abortion, the Government are not prepared to provide time so that this House can ensure that it is properly scrutinised and considered?
Baroness Merron (Lab)
I can only repeat the point I made that the Government Chief Whip will listen to the will of Parliament and will review as necessary.
The Motion and the amendment in the name of my noble friend Lady Berger refer to a Select Committee reporting to the House ahead of Committee of the Whole House commencing. The Select Committee should report by Friday 7 November. The outcome of these Motions and any others are indeed a matter for this House to decide on.
To the points that noble Lords have raised over whether this matter should have been for a Private Member’s Bill or a government Bill, I remind us all that, on matters of societal change, the Private Member’s Bill, with government neutrality, has long been used as the right vehicle to handle matters of sensitivity and importance such as this one. On this point of neutrality, I hope that noble Lords will understand my role and why it is not appropriate or possible for me as the Government Minister responding to respond to every point raised during the debate.
I thank the Delegated Powers and Regulatory Reform Committee and the Constitution Committee for their scrutiny of the Bill. As many noble Lords have highlighted, their recommendations will be important in the consideration. The content of this Bill and any delegated powers are a matter for the sponsor and Parliament. I am grateful to both committees because their recommendations will inform the scrutiny of your Lordships’ House. Noble Lords heard my noble and learned friend Lord Falconer’s opening remarks. He has already considered those reports and will continue to do so.
Many noble Lords have spoken about the importance of high-quality palliative care for all those who need it. I want to be clear that irrespective of any legislation on assisted dying, everyone must be provided with high-quality compassionate care through to the end of their life. While the majority of palliative and end-of-life care is provided by the NHS, we recognise the vital role played by the voluntary sector in supporting people at the end of their life. That is why we are providing the hospice sector with £100 million of capital funding for eligible adult and children’s hospices, to ensure that the best physical environment for care is available.
We recognise that more could be done to support people who need palliative and end-of-life care, as a number of noble Lords said. We are looking at how to improve the access, quality and sustainability of all-age palliative and end-of-life care, in line with the recently published 10-year health plan, and to make the shift from hospital to community, including making that care part of the work of neighbourhood health teams.
I thank noble Lords once again for their engagement, care and thoughtfulness during this debate. As I have said, the Government remain neutral on whether the Bill becomes law. Should Parliament pass this legislation, I can say to your Lordships’ House that it will be our responsibility to ensure that it can be implemented safely and effectively.