Lords Chamber
Friday 12th September 2025
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10:07
Lord Kennedy of Southwark (Labour)
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**** Possible New Speaker ****
My My Lords, My Lords, I My Lords, I regret My Lords, I regret to My Lords, I regret to inform My Lords, I regret to inform the house of the death of the noble Lord Lord Howarth of Newport on Wednesday, 10 September. And on behalf of the house, I extend our condolences to noble Lords family and friends.
**** Possible New Speaker ****
Before we begin the second reading of the debate, I want to remind all noble Lords of a few remind all noble Lords of a few important points. Firstly, there is an advisory speaking time-limit for an advisory speaking time-limit for contributions of four minutes. This reflects the large number of reflects the large number of speakers but also providing a respectable amount of time for everyone to outline their views. This means when the clock reaches three minutes, you should begin to make your concluding remarks and make your concluding remarks and when the clock reaches four minutes, your time is up.
It is designed to ensure that we can arrive at a ensure that we can arrive at a reasonable time. If speakers keep to the four-minute advisory speaking time, we should be able to finish time, we should be able to finish around 5 PM today and next Friday. I would ask all noble Lords to respect the advisory time-limit and all the advisory time-limit and all other noble Lords who are speaking the debate. Openers and winders and the Frontbench speakers from the the Frontbench speakers from the official opposition, Liberal Democrats and a government minister will have longer as per the usual will have longer as per the usual conventions.
Although I am sure those colleagues will also make sure the remarks are considerate of the overall debate. I remind those who have tabled amendments that they should also keep their remarks within the four minutes advisory. I would also like to highlight the general rules to all noble Lords speaking should be here at the beginning, the end, and the best part of the debate as set out in the companion. Finally, noble Lords have sincerely held views both in support and in opposition to this bill.
Please respect that in our debate today and remember courtesy and respect and show those watching the debate the house laws at its best.
Lord Kennedy of Southwark (Labour)
**** Possible New Speaker ****
My My Lords, My Lords, I My Lords, I regret My Lords, I regret to My Lords, I regret to inform My Lords, I regret to inform the house of the death of the noble Lord Lord Howarth of Newport on Wednesday, 10 September. And on behalf of the house, I extend our condolences to noble Lords family and friends.
**** Possible New Speaker ****
Before we begin the second reading of the debate, I want to remind all noble Lords of a few remind all noble Lords of a few important points. Firstly, there is an advisory speaking time-limit for an advisory speaking time-limit for contributions of four minutes. This reflects the large number of reflects the large number of speakers but also providing a respectable amount of time for everyone to outline their views. This means when the clock reaches three minutes, you should begin to make your concluding remarks and make your concluding remarks and when the clock reaches four minutes, your time is up.
It is designed to ensure that we can arrive at a ensure that we can arrive at a reasonable time. If speakers keep to the four-minute advisory speaking time, we should be able to finish time, we should be able to finish around 5 PM today and next Friday. I would ask all noble Lords to respect the advisory time-limit and all the advisory time-limit and all other noble Lords who are speaking the debate. Openers and winders and the Frontbench speakers from the the Frontbench speakers from the official opposition, Liberal Democrats and a government minister will have longer as per the usual will have longer as per the usual conventions.
Although I am sure those colleagues will also make sure the remarks are considerate of the overall debate. I remind those who have tabled amendments that they should also keep their remarks within the four minutes advisory. I would also like to highlight the general rules to all noble Lords speaking should be here at the beginning, the end, and the best part of the debate as set out in the companion. Finally, noble Lords have sincerely held views both in support and in opposition to this bill.
Please respect that in our debate today and remember courtesy and respect and show those watching the debate the house laws at its best.
10:10
10:10
Lord Falconer of Thoroton (Labour)
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Lord Falconer of Thoroton (Labour)
I beg to move this bill be now read a second time. This is an issue which has been debated for years, particularly in this house. The house is full this morning. That house is full this morning. That reflects the seriousness with which your Lordships take this issue. For the first time, we have before us a bill on assisted dying which has come from the other place. I know that we will do what we do so well which is scrutinise.
This is a historic occasion. The current law is confused, causes terrible suffering and lacks compassion and safeguards. People must be at the heart of this debate. The government's own estimate is that if the law was changed to introduce assisted dying, less than 1% of deaths would be assisted after 10 years. But it is right that we allow assisted dying as an option. For those who, despite the best palliative care, still want an assisted death. Palliative care cannot alleviate the pain of everyone.
Lucy Davenport's husband Tom had an agonising death from bile duct cancer despite relieving excellent care and hospice. He died by choking on faecal vomit. Lucy has said the look on Thom's face of terror and horror, that is going to be with us forever. He would be horrified to think that was our last memory of him. For many others, it is not about pain but about alleviating fear or bringing to an end the terrible and continuing loss of dignity and loss of control which has no end accepting death.
If a patient wants to take control of the time of their own death, they are legally entitled to take their own life. But they must do so without any assistance. Often horribly. Many of your Lordships were with me in the archbishops room in Millbank as the widow of a man who had a lethal brain tumour described how she found her husband's body in their garden having stabbed himself in the heart. Others go to dignity as often alone because those who accompany them from England fear the consequences of the criminal law.
Kate's mother Alison had motor neuron disease and died in dignity as in Switzerland. Katie could not join her for fear of police investigation. She found out about the moment her mum had died by text. Katie says we didn't see her go, we didn't hold her hand. The DPP's guidelines make it clear that anyone with medical qualifications who provide assistance will certainly be prosecuted. Where the authorities learned that somebody has provided assistance always suspected of doing so, they do investigate that invariably with compassion, but no matter how kind the process of investigation, it is an agony for the person investigated.
It can go on for months, sometimes over a year. They fear prosecution as they grieve for the person they love. It is right and possible to pass a law which allows those who are terminally ill to die with dignity and at a time of their own choosing without the fear and horror have described. And with appropriate safeguards in law. Not as currently where people in order to have a death at their own choosing seek to evade the law and evade protections.
300 million people in the world live in jurisdictions where there is such a law. There must be safeguards. The bill we are debating today has benefited from those other jurisdictions. It is the most safeguarded assisted dying measure in the world. Particularly in the light of the safeguards inserted in Commons. Key provisions in the bill are as follows. The criteria for requesting assistance is that the person is terminally ill, has the mental capacity to make the decision, is 18 or over, is resident in England or Wales to the last 12 months and is registered with the GP in England or Wales.
The safeguards are designed to ensure that the patient has a clear settled and informed wish to end their life without coercion. Terminally else is defined as having an inevitably progressive disease which cannot be reversed by treatment with a reasonable expectation of death within six months. The bill is for the terminally ill only. It is about how you die when you are dying already. Not for those with unbearable suffering, irrespective of their life expectancy like in some countries such as Canada.
And the bill is clear, a person is not to be considered a person who is terminally ill only if they are a person with a disability or mental person with a disability or mental A layout in the process, as set out in the bill. First, a doctor in a pulmonary care is to set out all of the options including palliative care in the life of the illness and then to doctors independent of each other have to be satisfied that the illness is terminal within six months, that the patient has the mental capacity to make the decision, and, finally, this is her decision, and, finally, this is her firm and settled wish arrived at without coercion.
After that, a panel comprising of the senior judge for Kings Council, psychiatrist and social worker, have to be satisfied of the same things as the two doctors. If they are, then, and only then, can medical assistance be given. I acknowledge that some think the process is too complicated and also excludes too many people. Complicated and as I am very conscious of the words of the Chief Medical Officer, Chris Whitty, give evidence in The Other Place, that we should not create a bureaucratic thing and I very much hope we have avoided that.
But it is vital that we should have a bill that is robust in its safeguards in a matter of this gravity. Disabled groups expressed fears and they may be vulnerable to be over persuaded into an assisted death. I well understand the will of the disabled in dealing with healthcare providers. The evidence strongly suggests that disabled same rights as us and the rest of us when they become terminally ill. This bill gives them excellent protection. There may be risks for them in other interactions in healthcare, but not in relation to this issue.
The multidisciplinary panel which I have referred to was added by a member and committee in the comments replacing the High Court judge alone. The panel provides a better safeguard than the judge alone because of the wider experience of the panel, psychiatrist and social worker, but accompanied by the attention of the judge. Beyond the current safeguards, some people have sought compulsory psychiatric assessment for everybody. I do not believe that as necessary or appropriate. The bill provides that if either of the doctors have the capacity they must refer the patient to a qualified psychiatrist.
Panel includes a psychiatrist and the panel can if they wish, require more psychiatric assessment. No doctor or other person is required to participate in the provision of assistance under the bill. Only those who opt in to participate in the work of the bill can play any part. The bill is explicit in why and making it clear and provides extensive protections for those that do not wish to participate. There are those that argue may be a terminal dispel now and its provisions will be expanded, any such change would require legislation and experience of all jurisdictions is when they start with a terminal spell as this one, that is where the end.
The Health and Social Care Act Select Committee in the comments conducted an inquiry into assisted dying, anything in March 2024. Their inclusion on this issue was as follows. We conclude the jurisdictions in the assisted dying on the basis of terminal and not change the law to include eligibility on the basis of our bill. None of the jurisdictions they said that have introduced a terminal spill have revoked it. And they have been there for as long as 30 years. The bill provides that for England, the Secretary of State must make the regulation, make the provisions on securing the provision of voluntary services, and in Wales Welsh Ministers may make such regulations.
The difference to must and may that respect that settlement when it is in Wales to make their own decisions. And concern is sometimes shown about the cost of an assisted dying service and its effect on the provision. I would draw your Lordships attention to please read the 151 page impact assessment that the Department of Health has produced. The current budget of the National Health Service is £188 billion. On the central estimate as to what the service will cost once it is up and running, the assessment says approximately £25 million, 25 million.
The figure does not take into account the annual savings calculated in the impact assessment which exceed the figure of 25 million. The NHS should have all the time it needs to produce the service properly. They have said they may need up to four years. The bill has a backstop to be brought into effect after four Yaz and we reflect what we have been told in relation to that. The provision of assisted dying is not an alternative to palliative care. The comments Select Committee reported not suggest that the availability of assisted dying is compromised or reduced the availability of palliative care, rather the reverse, their conclusion was we did not see any indications of palliative and end-of-life care in the provision of assisted dying.
Indeed, the introduction of assisted dying in several jurisdictions. The next stage is for this bill to be scrutinised by your Lordships house. I have been intimately involved in the bill since it started its journey. This is a private members bill invariably and inevitably as a matter of conscience. Once the bill passed its second reading in the Commons, the sponsor of the bill in the Commons the honourable member of Spen Valley and your Lordships house has been provided with very substantial support of the civil service regime to ensure that the bill was working.
The Government in providing that support did not enter the neutrality, rather they provided, hence of policy and drafting support /I have long experience of shepherding Government bills through Parliament. This support I have planned in relation to this bill is second to none. The bill passed its third reading in the comments in June after more than 100 hours of debate, including 29 positions in bill committee, two full days of debate at report stage on the floor of the House and the debate at both second reading and third reading and I have to say that is very favourably and is almost double the time scrutiny was given in The Other Place to the children's wellbeing and schools bill which we are dealing with now.
Altogether, the bill committee has debated over 600 amendments, accepting around 1/4 of them, over 100 amendments were made in the sponsor's name and more than 30 amendments that have been tabled voted against the bill were passed. Could I very briefly turned to the motion in the name of the novel Lord Forsyth and Lord Bridges and the amendment in the name of my Noble Friend. The noble Lords Forsyth and Bridges refer to the delegated committee, a report that I considered along with the Constitution Committee.
I will be tabling amendments to deal with many of the points that both committees raised. They always help us in our deliberations. There are some proposed amendments that I will not be able to accept. For example, your Lordships specify the products to be used in the process, medical advances come thick and fast, this legislation is designed to last for the ages. The civil service support as mentioned by the Noble Lord Forsyth and Bridges, I have already dealt with that.
With regards to the availability of Government time which is also raised I and confident that after conversations with the Government that your Lordships will have more than enough time to scrutinise this bill thoroughly, as long, of course, as we start our process of scrutiny in the ordinary courses after they are given a second reading. Could I turn to the Baroness Pidgeon's amendment? It is proposed that the Select Committee that she proposes, unfortunately only got notice for this last night.
And I did not have the opportunity after I received it and she had not discussed it with me. I make no criticism of her, but these are my initial thoughts in relation to it. It is proposed that the Select Committee received the Committee of the whole House and it has been clear for some time that at least seven days will be required to complete the passage of the bill. Four days of committee, two days of report, and a day for third readings. There will then need to be a bond between the two houses if the process cannot start until January which is what Mike Noble Friends amendment suggests and must compete by the spring because spring is when the Government says the session will end.
We will have to fit 75 of these in between 9 January and 31 March. Having regard to recesses, the need for the normal intervals and the fact that other business will be conducted on some of those three days and not every Friday I and afraid it is not possible to do that and I will be therefore opposing that amendment on the basis it is not a workable timetable. That does not rule out the Select Committee running in parallel to the Committee stage and I would be more than happy to discuss subsequent proposals with the Baroness Berridge or anybody else who has such a proposal to make, but we must do our job in this House.
And our job is not to frustrate, it is to scrutinise. My Lords, the bill has been passed by the Commons. The decision on whether to change the law and we should improve where we can and expect, we should respect the final decision of the Commons. There are so many people that have been following the debate that recalled the agonising death of a loved one. Like the people I mentioned at the beginning of the speech that they are what their own death might be like, the public want this.
The elected houses expressed this as well. I am confident that your Lordships will now do what you have done so well in the past. Whatever view we might take on the decision the Commons arrived at, the way that the debate was conducted there enhanced the reputation. I hope that and believe that we can back on our scrutiny in a manner that will reflect just as well on us. This bill before us has already given to those with personal experience of the injustice of the current law.
They will be looking to us to play a proper role if we can improve it further, we should. And we will have done our duty. I
**** Possible New Speaker ****
commend this bill to the House. I beg to move. The question is this bill be now
**** Possible New Speaker ****
The question is this bill be now read a second time.
**** Possible New Speaker ****
read a second time. My Lords, can I thank the Lord for the comprehensive way in which
This is a historic occasion. The current law is confused, causes terrible suffering and lacks compassion and safeguards. People must be at the heart of this debate. The government's own estimate is that if the law was changed to introduce assisted dying, less than 1% of deaths would be assisted after 10 years. But it is right that we allow assisted dying as an option. For those who, despite the best palliative care, still want an assisted death. Palliative care cannot alleviate the pain of everyone.
Lucy Davenport's husband Tom had an agonising death from bile duct cancer despite relieving excellent care and hospice. He died by choking on faecal vomit. Lucy has said the look on Thom's face of terror and horror, that is going to be with us forever. He would be horrified to think that was our last memory of him. For many others, it is not about pain but about alleviating fear or bringing to an end the terrible and continuing loss of dignity and loss of control which has no end accepting death.
If a patient wants to take control of the time of their own death, they are legally entitled to take their own life. But they must do so without any assistance. Often horribly. Many of your Lordships were with me in the archbishops room in Millbank as the widow of a man who had a lethal brain tumour described how she found her husband's body in their garden having stabbed himself in the heart. Others go to dignity as often alone because those who accompany them from England fear the consequences of the criminal law.
Kate's mother Alison had motor neuron disease and died in dignity as in Switzerland. Katie could not join her for fear of police investigation. She found out about the moment her mum had died by text. Katie says we didn't see her go, we didn't hold her hand. The DPP's guidelines make it clear that anyone with medical qualifications who provide assistance will certainly be prosecuted. Where the authorities learned that somebody has provided assistance always suspected of doing so, they do investigate that invariably with compassion, but no matter how kind the process of investigation, it is an agony for the person investigated.
It can go on for months, sometimes over a year. They fear prosecution as they grieve for the person they love. It is right and possible to pass a law which allows those who are terminally ill to die with dignity and at a time of their own choosing without the fear and horror have described. And with appropriate safeguards in law. Not as currently where people in order to have a death at their own choosing seek to evade the law and evade protections.
300 million people in the world live in jurisdictions where there is such a law. There must be safeguards. The bill we are debating today has benefited from those other jurisdictions. It is the most safeguarded assisted dying measure in the world. Particularly in the light of the safeguards inserted in Commons. Key provisions in the bill are as follows. The criteria for requesting assistance is that the person is terminally ill, has the mental capacity to make the decision, is 18 or over, is resident in England or Wales to the last 12 months and is registered with the GP in England or Wales.
The safeguards are designed to ensure that the patient has a clear settled and informed wish to end their life without coercion. Terminally else is defined as having an inevitably progressive disease which cannot be reversed by treatment with a reasonable expectation of death within six months. The bill is for the terminally ill only. It is about how you die when you are dying already. Not for those with unbearable suffering, irrespective of their life expectancy like in some countries such as Canada.
And the bill is clear, a person is not to be considered a person who is terminally ill only if they are a person with a disability or mental person with a disability or mental A layout in the process, as set out in the bill. First, a doctor in a pulmonary care is to set out all of the options including palliative care in the life of the illness and then to doctors independent of each other have to be satisfied that the illness is terminal within six months, that the patient has the mental capacity to make the decision, and, finally, this is her decision, and, finally, this is her firm and settled wish arrived at without coercion.
After that, a panel comprising of the senior judge for Kings Council, psychiatrist and social worker, have to be satisfied of the same things as the two doctors. If they are, then, and only then, can medical assistance be given. I acknowledge that some think the process is too complicated and also excludes too many people. Complicated and as I am very conscious of the words of the Chief Medical Officer, Chris Whitty, give evidence in The Other Place, that we should not create a bureaucratic thing and I very much hope we have avoided that.
But it is vital that we should have a bill that is robust in its safeguards in a matter of this gravity. Disabled groups expressed fears and they may be vulnerable to be over persuaded into an assisted death. I well understand the will of the disabled in dealing with healthcare providers. The evidence strongly suggests that disabled same rights as us and the rest of us when they become terminally ill. This bill gives them excellent protection. There may be risks for them in other interactions in healthcare, but not in relation to this issue.
The multidisciplinary panel which I have referred to was added by a member and committee in the comments replacing the High Court judge alone. The panel provides a better safeguard than the judge alone because of the wider experience of the panel, psychiatrist and social worker, but accompanied by the attention of the judge. Beyond the current safeguards, some people have sought compulsory psychiatric assessment for everybody. I do not believe that as necessary or appropriate. The bill provides that if either of the doctors have the capacity they must refer the patient to a qualified psychiatrist.
Panel includes a psychiatrist and the panel can if they wish, require more psychiatric assessment. No doctor or other person is required to participate in the provision of assistance under the bill. Only those who opt in to participate in the work of the bill can play any part. The bill is explicit in why and making it clear and provides extensive protections for those that do not wish to participate. There are those that argue may be a terminal dispel now and its provisions will be expanded, any such change would require legislation and experience of all jurisdictions is when they start with a terminal spell as this one, that is where the end.
The Health and Social Care Act Select Committee in the comments conducted an inquiry into assisted dying, anything in March 2024. Their inclusion on this issue was as follows. We conclude the jurisdictions in the assisted dying on the basis of terminal and not change the law to include eligibility on the basis of our bill. None of the jurisdictions they said that have introduced a terminal spill have revoked it. And they have been there for as long as 30 years. The bill provides that for England, the Secretary of State must make the regulation, make the provisions on securing the provision of voluntary services, and in Wales Welsh Ministers may make such regulations.
The difference to must and may that respect that settlement when it is in Wales to make their own decisions. And concern is sometimes shown about the cost of an assisted dying service and its effect on the provision. I would draw your Lordships attention to please read the 151 page impact assessment that the Department of Health has produced. The current budget of the National Health Service is £188 billion. On the central estimate as to what the service will cost once it is up and running, the assessment says approximately £25 million, 25 million.
The figure does not take into account the annual savings calculated in the impact assessment which exceed the figure of 25 million. The NHS should have all the time it needs to produce the service properly. They have said they may need up to four years. The bill has a backstop to be brought into effect after four Yaz and we reflect what we have been told in relation to that. The provision of assisted dying is not an alternative to palliative care. The comments Select Committee reported not suggest that the availability of assisted dying is compromised or reduced the availability of palliative care, rather the reverse, their conclusion was we did not see any indications of palliative and end-of-life care in the provision of assisted dying.
Indeed, the introduction of assisted dying in several jurisdictions. The next stage is for this bill to be scrutinised by your Lordships house. I have been intimately involved in the bill since it started its journey. This is a private members bill invariably and inevitably as a matter of conscience. Once the bill passed its second reading in the Commons, the sponsor of the bill in the Commons the honourable member of Spen Valley and your Lordships house has been provided with very substantial support of the civil service regime to ensure that the bill was working.
The Government in providing that support did not enter the neutrality, rather they provided, hence of policy and drafting support /I have long experience of shepherding Government bills through Parliament. This support I have planned in relation to this bill is second to none. The bill passed its third reading in the comments in June after more than 100 hours of debate, including 29 positions in bill committee, two full days of debate at report stage on the floor of the House and the debate at both second reading and third reading and I have to say that is very favourably and is almost double the time scrutiny was given in The Other Place to the children's wellbeing and schools bill which we are dealing with now.
Altogether, the bill committee has debated over 600 amendments, accepting around 1/4 of them, over 100 amendments were made in the sponsor's name and more than 30 amendments that have been tabled voted against the bill were passed. Could I very briefly turned to the motion in the name of the novel Lord Forsyth and Lord Bridges and the amendment in the name of my Noble Friend. The noble Lords Forsyth and Bridges refer to the delegated committee, a report that I considered along with the Constitution Committee.
I will be tabling amendments to deal with many of the points that both committees raised. They always help us in our deliberations. There are some proposed amendments that I will not be able to accept. For example, your Lordships specify the products to be used in the process, medical advances come thick and fast, this legislation is designed to last for the ages. The civil service support as mentioned by the Noble Lord Forsyth and Bridges, I have already dealt with that.
With regards to the availability of Government time which is also raised I and confident that after conversations with the Government that your Lordships will have more than enough time to scrutinise this bill thoroughly, as long, of course, as we start our process of scrutiny in the ordinary courses after they are given a second reading. Could I turn to the Baroness Pidgeon's amendment? It is proposed that the Select Committee that she proposes, unfortunately only got notice for this last night.
And I did not have the opportunity after I received it and she had not discussed it with me. I make no criticism of her, but these are my initial thoughts in relation to it. It is proposed that the Select Committee received the Committee of the whole House and it has been clear for some time that at least seven days will be required to complete the passage of the bill. Four days of committee, two days of report, and a day for third readings. There will then need to be a bond between the two houses if the process cannot start until January which is what Mike Noble Friends amendment suggests and must compete by the spring because spring is when the Government says the session will end.
We will have to fit 75 of these in between 9 January and 31 March. Having regard to recesses, the need for the normal intervals and the fact that other business will be conducted on some of those three days and not every Friday I and afraid it is not possible to do that and I will be therefore opposing that amendment on the basis it is not a workable timetable. That does not rule out the Select Committee running in parallel to the Committee stage and I would be more than happy to discuss subsequent proposals with the Baroness Berridge or anybody else who has such a proposal to make, but we must do our job in this House.
And our job is not to frustrate, it is to scrutinise. My Lords, the bill has been passed by the Commons. The decision on whether to change the law and we should improve where we can and expect, we should respect the final decision of the Commons. There are so many people that have been following the debate that recalled the agonising death of a loved one. Like the people I mentioned at the beginning of the speech that they are what their own death might be like, the public want this.
The elected houses expressed this as well. I am confident that your Lordships will now do what you have done so well in the past. Whatever view we might take on the decision the Commons arrived at, the way that the debate was conducted there enhanced the reputation. I hope that and believe that we can back on our scrutiny in a manner that will reflect just as well on us. This bill before us has already given to those with personal experience of the injustice of the current law.
They will be looking to us to play a proper role if we can improve it further, we should. And we will have done our duty. I
**** Possible New Speaker ****
commend this bill to the House. I beg to move. The question is this bill be now
**** Possible New Speaker ****
The question is this bill be now read a second time.
**** Possible New Speaker ****
read a second time. My Lords, can I thank the Lord for the comprehensive way in which
10:27
Lord Kamall (Conservative)
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Lord Kamall (Conservative)
for the comprehensive way in which they have presented this bill and in the debate for the official opposition let me be clear that as a front bench we have no collective view on either the principle of terminally ill people receiving the conventions of their lives or on the drafting of the bill. The noble Lords on the side of the House will have a free vote, both on the bill and on the motions we are debating. and on the motions we are debating.
Official opposition, so given this fact, I will speak neither in favour nor against the bill but as the noble Lords said, this is a historic occasion. This bill might be one of the most significant pieces of legislation ever entered by this Parliament. With far-reaching implications for our society and the sort of society we want to live in. Noble Lords will appreciate the significance, simply from the shared volume and those speaking and both sides of the debate will be informed by their own experiences, whether that be professional or personal experience.
And we will hear any news stories in these debates and perhaps even shed a few tears, but as in the chamber I know that noble Lords will respect those experiences and reflect upon them. As we work to properly scrutinise and improve the bill where necessary. As the Noble Lord has said, we have received a clear signal from the elected house on the principal. And while that does not prevent noble Lords from opposing the bill, per se, it is a duty of your Lordships has to do its work as a revising chamber diligently.
The bill has received much scrutiny in The Other Place, over 100 hours and more than other private delegations but we must also not forget that 174 members and further amendments were made at third reading. Not all of which have been properly scrutinised. The bill of your Lordships in this House is much changed and is, in need of thorough scrutiny. The argument around this bill are finely balanced and a Noble Friend of mine who is not exactly known for sitting on the fence said that he intended last time that we ended after almost every speech he found himself agreeing with the Speaker.
To this day, he still remains and it just shows how finely balanced these arguments are. So, let me attempt to frame the debate and touch in some areas that noble Lords may wish to touch on at Committee stage. At debating this bill we must have in mind the well-being and dignity of those for whom this bill was originally proposed. The terminally ill who want to end their lives. We were here powerful arguments based on this and compassion. Based on bodily autonomy from the supporters of the bill stop and I understand as the Noble Lord has said he has indicated his openness to amendments to the bill.
These benches welcome their openness. And I expect members will come from the support of this legislation who want to make the best bill possible. We have seen this in some of the emails that noble Lords have shared with each other. And I also think that we saw this at Committee stage in The Other Place. The bill sponsor tabled 142 such amendments. On the other side of the debate there will be noble Lords opposed to the bill on principal grounds. Some based on their faith.
Others who support the principle behind the bill but not the current draft. Either because of insufficient safeguards or because of the limited access to elective care which denies patients care which denies patients They approach this bill with compassion and this is a matter of conscience. We should respect the views of noble Lords who disagree profoundly with this bill just as much as those who are in favour of Bell. Those who oppose the bill will choose to bring amendments to improve the bill despite the overall view, so whether an amendment is tabled by a supporter or opponent of the bill, although Soviet make up their mind, those watching the debate from outside your Lordships house could not mistake amendments for this bill for outright opposition.
A number of organisations include the Law Society, the life and at King's College London, the Royal pathologists and the Royal psychologists who have proposed amendments to address serious concerns over the drafting of the Bill as it stands. And as the noble Lord Faulkner has acknowledged, dedicated powers and the Constitution Committee have recommended amendments to the bill that there are now 42 regulatory powers in this version of the bill in the version that came to this house.
Both Constitution Committee and Private Member's Bill and as the government remains neutral to its purpose, it is unclear how these powers will be used. These are all important challenges which we must take the time to consider carefully. There are noble Lords with strong views on both sides of this debate, but all approach it in good faith. By opening comments are not meant to persuade your Lordships to vote one way the other or to support amendments over others and attempt to frame the overall debate and touch on some of the issues to be probed at Committee stage.
The decisions we take not easy. The consequences are not always clear but I have no doubt that this house, this bill will receive the scrutiny needed. All the emotions and concerns that will be expressed. And no matter how challenging that
**** Possible New Speaker ****
maybe. Examine the bill I am the first LibDem to speak in
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I am the first LibDem to speak in this debate, I am not speaking on behalf of all the Liberal Democrat peers because, like all the other groupings in your Lordships house, there is a divergences views on these issues. The divergences these issues. The divergences between members but is often within between members but is often within each of us that there are dilemmas of an insoluble kind on some of of an insoluble kind on some of these questions. The two previous speakers have addressed some of the technical questions of this bill and technical questions of this bill and address them admirably, and I want to speak in a different way about it.
The first time I had to think it. The first time I had to think about these questions was as a young doctor when I found myself with patients who were suffering a great patients who were suffering a great deal of pain and who want to bring their lives to an end, and the their lives to an end, and the question for me was how should I question for me was how should I help them to manage? I got into conversation with one elderly lady conversation with one elderly lady in her 90s he was suffering from cancer in her gullet which meant she couldn't swallow anything.
And I said well, we have two choices here. One is that we can put a tube down we can keep you alive for as long as possible and relieve your pain as best possible. And before I went to say anything further, she said young man, I am now in my 90s. I have had a fair life with ups and downs. I do not want tubes going down. I just want you to keep me as comfortable as I can, and I know you can't relieve all the pain but keep me as comfortable as you can.
And that is what I did as best I could because however much we wished to rid people of their pain and discomfort, it isn't always possible, even with the best will in the world and the best medication available. But sometimes the situation is much more difficult than that. A close friend who is a very distinguished members in Northern Ireland, and the chairman of the alliance party had a son who was a doctor and a wife who was suffering from an illness from which she would not recover and she was in a terrible state about it and getting worse.
And she made him
Official opposition, so given this fact, I will speak neither in favour nor against the bill but as the noble Lords said, this is a historic occasion. This bill might be one of the most significant pieces of legislation ever entered by this Parliament. With far-reaching implications for our society and the sort of society we want to live in. Noble Lords will appreciate the significance, simply from the shared volume and those speaking and both sides of the debate will be informed by their own experiences, whether that be professional or personal experience.
And we will hear any news stories in these debates and perhaps even shed a few tears, but as in the chamber I know that noble Lords will respect those experiences and reflect upon them. As we work to properly scrutinise and improve the bill where necessary. As the Noble Lord has said, we have received a clear signal from the elected house on the principal. And while that does not prevent noble Lords from opposing the bill, per se, it is a duty of your Lordships has to do its work as a revising chamber diligently.
The bill has received much scrutiny in The Other Place, over 100 hours and more than other private delegations but we must also not forget that 174 members and further amendments were made at third reading. Not all of which have been properly scrutinised. The bill of your Lordships in this House is much changed and is, in need of thorough scrutiny. The argument around this bill are finely balanced and a Noble Friend of mine who is not exactly known for sitting on the fence said that he intended last time that we ended after almost every speech he found himself agreeing with the Speaker.
To this day, he still remains and it just shows how finely balanced these arguments are. So, let me attempt to frame the debate and touch in some areas that noble Lords may wish to touch on at Committee stage. At debating this bill we must have in mind the well-being and dignity of those for whom this bill was originally proposed. The terminally ill who want to end their lives. We were here powerful arguments based on this and compassion. Based on bodily autonomy from the supporters of the bill stop and I understand as the Noble Lord has said he has indicated his openness to amendments to the bill.
These benches welcome their openness. And I expect members will come from the support of this legislation who want to make the best bill possible. We have seen this in some of the emails that noble Lords have shared with each other. And I also think that we saw this at Committee stage in The Other Place. The bill sponsor tabled 142 such amendments. On the other side of the debate there will be noble Lords opposed to the bill on principal grounds. Some based on their faith.
Others who support the principle behind the bill but not the current draft. Either because of insufficient safeguards or because of the limited access to elective care which denies patients care which denies patients They approach this bill with compassion and this is a matter of conscience. We should respect the views of noble Lords who disagree profoundly with this bill just as much as those who are in favour of Bell. Those who oppose the bill will choose to bring amendments to improve the bill despite the overall view, so whether an amendment is tabled by a supporter or opponent of the bill, although Soviet make up their mind, those watching the debate from outside your Lordships house could not mistake amendments for this bill for outright opposition.
A number of organisations include the Law Society, the life and at King's College London, the Royal pathologists and the Royal psychologists who have proposed amendments to address serious concerns over the drafting of the Bill as it stands. And as the noble Lord Faulkner has acknowledged, dedicated powers and the Constitution Committee have recommended amendments to the bill that there are now 42 regulatory powers in this version of the bill in the version that came to this house.
Both Constitution Committee and Private Member's Bill and as the government remains neutral to its purpose, it is unclear how these powers will be used. These are all important challenges which we must take the time to consider carefully. There are noble Lords with strong views on both sides of this debate, but all approach it in good faith. By opening comments are not meant to persuade your Lordships to vote one way the other or to support amendments over others and attempt to frame the overall debate and touch on some of the issues to be probed at Committee stage.
The decisions we take not easy. The consequences are not always clear but I have no doubt that this house, this bill will receive the scrutiny needed. All the emotions and concerns that will be expressed. And no matter how challenging that
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maybe. Examine the bill I am the first LibDem to speak in
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I am the first LibDem to speak in this debate, I am not speaking on behalf of all the Liberal Democrat peers because, like all the other groupings in your Lordships house, there is a divergences views on these issues. The divergences these issues. The divergences between members but is often within between members but is often within each of us that there are dilemmas of an insoluble kind on some of of an insoluble kind on some of these questions. The two previous speakers have addressed some of the technical questions of this bill and technical questions of this bill and address them admirably, and I want to speak in a different way about it.
The first time I had to think it. The first time I had to think about these questions was as a young doctor when I found myself with patients who were suffering a great patients who were suffering a great deal of pain and who want to bring their lives to an end, and the their lives to an end, and the question for me was how should I question for me was how should I help them to manage? I got into conversation with one elderly lady conversation with one elderly lady in her 90s he was suffering from cancer in her gullet which meant she couldn't swallow anything.
And I said well, we have two choices here. One is that we can put a tube down we can keep you alive for as long as possible and relieve your pain as best possible. And before I went to say anything further, she said young man, I am now in my 90s. I have had a fair life with ups and downs. I do not want tubes going down. I just want you to keep me as comfortable as I can, and I know you can't relieve all the pain but keep me as comfortable as you can.
And that is what I did as best I could because however much we wished to rid people of their pain and discomfort, it isn't always possible, even with the best will in the world and the best medication available. But sometimes the situation is much more difficult than that. A close friend who is a very distinguished members in Northern Ireland, and the chairman of the alliance party had a son who was a doctor and a wife who was suffering from an illness from which she would not recover and she was in a terrible state about it and getting worse.
And she made him
10:37
Lord Alderdice (Liberal Democrat)
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Lord Alderdice (Liberal Democrat)
promise that if it got to the point where she could not with it anymore, where she could not with it anymore, that he would assist her to pass away. And when the time came, 1/9, away. And when the time came, 1/9, he put a pillow over her face, she he put a pillow over her face, she passed away, and he went straight out and drowned himself in a nearby out and drowned himself in a nearby lake. He could not discuss it with his son who was a doctor because his son who was a doctor because that would have implicated his son and as we've heard before, that would have been a difficult thing.
The point about raising these questions is that they are not academic questions. They are real academic questions. They are real human challenges which can only be engaged in rules and regulations and protocols, with people in terrible protocols, with people in terrible dilemmas. The only way we can really understand what we're trying to do here today and next week is to put here today and next week is to put ourselves in the same position. For some of us, we will say whatever the pain and discomfort, I simply want to be around as long as possible.
Some may even say I want to be around another month because my first great-grandchild is going to be born but after that, it's a different story, and others will say this is intolerable. It is excruciating. It is dreadful. I desperately wish to be relieved of it. And I suspect that most of us, in those circumstances, would want to help to do what we wanted to do and be relieved of the excruciating pain emotional or physical.
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Amendment to the motion that the bill be read a second time.
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bill be read a second time. I beg to move the amendment standing in my name on the Order standing in my name on the Order Paper. The effect of this amendment is simply to implement the advice which is given by the cabinet
The point about raising these questions is that they are not academic questions. They are real academic questions. They are real human challenges which can only be engaged in rules and regulations and protocols, with people in terrible protocols, with people in terrible dilemmas. The only way we can really understand what we're trying to do here today and next week is to put here today and next week is to put ourselves in the same position. For some of us, we will say whatever the pain and discomfort, I simply want to be around as long as possible.
Some may even say I want to be around another month because my first great-grandchild is going to be born but after that, it's a different story, and others will say this is intolerable. It is excruciating. It is dreadful. I desperately wish to be relieved of it. And I suspect that most of us, in those circumstances, would want to help to do what we wanted to do and be relieved of the excruciating pain emotional or physical.
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Amendment to the motion that the bill be read a second time.
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bill be read a second time. I beg to move the amendment standing in my name on the Order standing in my name on the Order Paper. The effect of this amendment is simply to implement the advice which is given by the cabinet
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10:39
10:39
Lord Forsyth of Drumlean (Conservative)
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Lord Forsyth of Drumlean (Conservative)
bringing in changes to legislation which were matters of conscience, like, for example, the abortion bill or the end of capital punishment or or the end of capital punishment or the decriminalisation of homosexuality. And the advantage of homosexuality. And the advantage of that course is that it means that government time is made available and all the resources of the government and the civil service are made available for purpose. And I'm made available for purpose. And I'm most grateful to the noble Lord for his assurances that he has been given some help.
I'm not so sure of given some help. I'm not so sure of his assurances about the time needed his assurances about the time needed for this. There are four days allocated between now and Christmas, I understand. The employment rights I understand. The employment rights bill has a total of 15 days. These are Fridays. There are other Private are Fridays. There are other Private Members' Bills and it is really important that this is discussed properly which is why have tabled this amendment.
And anyone who has this amendment. And anyone who has read this will realise there is much to do in terms of amending the bill. to do in terms of amending the bill. My father died in agony, and when I went to see him, I said I'm so sorry that your cancer is causing you this distress, and he said to me, Michael, you are to blame. I was completely perplexed by that. He said because you have consistently voted to prevent me getting what I want which is having the opportunity to decide how and when I can die.
Now, I have thought about that long and hard. As a Christian, I thought about it long and hard and come to the conclusion that my father was right and I was wrong, and therefore, I support the principle of this bill absolutely. But I do have some problems with it. If you look at page 7 of the very excellent paper produced on the expatriates of the bill, it sets out a table there on what is actually required. I suspect that people will get to the stage where they just don't want to go on longer.
They will do their best to hang on but they will get to the stage where it is just too much like my father. But under the provisions of this bill, you have to see a GP. Then you to see another GP. Then you gotta see a panel and then there's a holding period of no less than three weeks. Before you can actually get to the position where you are given what you want. That to me is completely impractical and impossible. Some people will say we are doing that in order to provide protection.
But whom are we protecting? Surely the patient should come first before anything else. And one thing more that worries me about this bill is the worries me about this bill is the provisions in the bill gives four years to delay the implementation of the bill. The noble Lord response from the bell said that this is giving hope to people. There's not much hope with the possibility of a bill not actually coming into effect until well after the next Parliament.
So, I say to the house that we need time. We need every resource available in government, and we need government time so that we can get this absolutely right because there won't be a second opportunity for a very long time. And anyone who has read the letters will try to amend it so that the other place can make it worthy of their hope.
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I beg to move the amendment that the noble Lord.
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The original question was at the bill be now read a second time. bill be now read a second time. Since when amendment has been moved, at the end, to insert the words set
I'm not so sure of given some help. I'm not so sure of his assurances about the time needed his assurances about the time needed for this. There are four days allocated between now and Christmas, I understand. The employment rights I understand. The employment rights bill has a total of 15 days. These are Fridays. There are other Private are Fridays. There are other Private Members' Bills and it is really important that this is discussed properly which is why have tabled this amendment.
And anyone who has this amendment. And anyone who has read this will realise there is much to do in terms of amending the bill. to do in terms of amending the bill. My father died in agony, and when I went to see him, I said I'm so sorry that your cancer is causing you this distress, and he said to me, Michael, you are to blame. I was completely perplexed by that. He said because you have consistently voted to prevent me getting what I want which is having the opportunity to decide how and when I can die.
Now, I have thought about that long and hard. As a Christian, I thought about it long and hard and come to the conclusion that my father was right and I was wrong, and therefore, I support the principle of this bill absolutely. But I do have some problems with it. If you look at page 7 of the very excellent paper produced on the expatriates of the bill, it sets out a table there on what is actually required. I suspect that people will get to the stage where they just don't want to go on longer.
They will do their best to hang on but they will get to the stage where it is just too much like my father. But under the provisions of this bill, you have to see a GP. Then you to see another GP. Then you gotta see a panel and then there's a holding period of no less than three weeks. Before you can actually get to the position where you are given what you want. That to me is completely impractical and impossible. Some people will say we are doing that in order to provide protection.
But whom are we protecting? Surely the patient should come first before anything else. And one thing more that worries me about this bill is the worries me about this bill is the provisions in the bill gives four years to delay the implementation of the bill. The noble Lord response from the bell said that this is giving hope to people. There's not much hope with the possibility of a bill not actually coming into effect until well after the next Parliament.
So, I say to the house that we need time. We need every resource available in government, and we need government time so that we can get this absolutely right because there won't be a second opportunity for a very long time. And anyone who has read the letters will try to amend it so that the other place can make it worthy of their hope.
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I beg to move the amendment that the noble Lord.
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The original question was at the bill be now read a second time. bill be now read a second time. Since when amendment has been moved, at the end, to insert the words set
10:42
Lord Carlile of Berriew (Crossbench)
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at the end, to insert the words set out in the Order Paper. Amended to the amendment in the name of Lord Forsyth .$$NEWLINE I do apologise
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Forsyth .$$NEWLINE I do apologise to the Lord Speaker. I beg to move the amendment in my name to Lord the amendment in my name to Lord Forsyth's amendment as being opposed to this brilliant principle, but I'm opposed to this bill because in my view, it is not an adequate bill to deal with all the issues raised and does not provide anything like sufficient protection for those vulnerable people who might be persuaded against their real well to accept assisted suicide.
I agree with Lord Forsyth's words in his amendment. Apart from his bold bid that, in effect, this Private Member's Bill should be treated as a government bill. That was not what the noble and learned Lords Lord Falconer said was happening and indeed, I'm sure that Lord Faulkner would confirm that they are insisting on neutrality being maintained, even when looking at the feasibility of this bill. I see him nodding in agreement. Lord Forsyth asks for full support at ministerial and official level for the in charge of the bill.
That would put the noble Lord in the position of a minister. I would suggest your Lordships that such support is inappropriate for a Private Member's Bill of this kind. It is not pretend for one 2nd to be neutral or for one 2nd to be neutral or evenhanded. If the last 27 words of Lord Forsyth's amendment were removed, I would agree with it completely. But he seeks to take the steps that I have just described. Indeed, despite the large resources supporting the purposes of this bill, and the involvement of many experts including the noble and learned Lord Faulkner, one of our most respected and knowledgeable legislators, this bill earns a D- for its craftsmanship, even after those committee stage meetings in the next place.
The bell needs to be dismantled if it is to be an effective and proper bill to give it what I would call legislative legitimacy. What evidence is there for the propositions I make? I will cite two pieces of evidence that emerge from your Lordships in the last two days. Firstly, the committee chaired by the noble Baroness Lady Ramsay be delegated to the reform committee produced a report a couple of days ago which there is no time to read out. I will simply summarise that, by the calm standards of that committee, their criticism is excoriating.
I was on that committee for a considerable period and I never saw any bell being criticised that extent. They say the bill is simply not fit for purpose, breaking several standard rules of draughtsmanship. It is incompetently drafted after all the time spent on it with the Then yesterday the Constitution Committee reported and endorsed the views expressed by the other committee and said the bill was not fit for purpose and effect. We must remember that this bill would allow a citizen deliberately to perform acts which are intended to cause the death of another citizen.
Since the end of capital punishment, no such act is allowed under Iowa law to any citizen other than in war. That is the change, the weight of the change, that this bill seeks to make. And I believe that we must be given time and the space and the methods to amend this bill if that can possibly be done, hence my support in due course for the Noble Lady Baroness Berger system amendment that would allow a Select Committee to hear evidence that the Commons committee chose not to hear and would have been very persuasive.
So, I beg to move my amendment.
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The original question was that this bill be now read a second time. Since when an amendment has been removed is set out on the order paper and further amendment has been moved to that amendment. The moved to that amendment. The question I therefore have two put is that the amendment in the name of
Lord Carlile of Berriew (Crossbench)
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at the end, to insert the words set out in the Order Paper. Amended to the amendment in the name of Lord Forsyth .$$NEWLINE I do apologise
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Forsyth .$$NEWLINE I do apologise to the Lord Speaker. I beg to move the amendment in my name to Lord the amendment in my name to Lord Forsyth's amendment as being opposed to this brilliant principle, but I'm opposed to this bill because in my view, it is not an adequate bill to deal with all the issues raised and does not provide anything like sufficient protection for those vulnerable people who might be persuaded against their real well to accept assisted suicide.
I agree with Lord Forsyth's words in his amendment. Apart from his bold bid that, in effect, this Private Member's Bill should be treated as a government bill. That was not what the noble and learned Lords Lord Falconer said was happening and indeed, I'm sure that Lord Faulkner would confirm that they are insisting on neutrality being maintained, even when looking at the feasibility of this bill. I see him nodding in agreement. Lord Forsyth asks for full support at ministerial and official level for the in charge of the bill.
That would put the noble Lord in the position of a minister. I would suggest your Lordships that such support is inappropriate for a Private Member's Bill of this kind. It is not pretend for one 2nd to be neutral or for one 2nd to be neutral or evenhanded. If the last 27 words of Lord Forsyth's amendment were removed, I would agree with it completely. But he seeks to take the steps that I have just described. Indeed, despite the large resources supporting the purposes of this bill, and the involvement of many experts including the noble and learned Lord Faulkner, one of our most respected and knowledgeable legislators, this bill earns a D- for its craftsmanship, even after those committee stage meetings in the next place.
The bell needs to be dismantled if it is to be an effective and proper bill to give it what I would call legislative legitimacy. What evidence is there for the propositions I make? I will cite two pieces of evidence that emerge from your Lordships in the last two days. Firstly, the committee chaired by the noble Baroness Lady Ramsay be delegated to the reform committee produced a report a couple of days ago which there is no time to read out. I will simply summarise that, by the calm standards of that committee, their criticism is excoriating.
I was on that committee for a considerable period and I never saw any bell being criticised that extent. They say the bill is simply not fit for purpose, breaking several standard rules of draughtsmanship. It is incompetently drafted after all the time spent on it with the Then yesterday the Constitution Committee reported and endorsed the views expressed by the other committee and said the bill was not fit for purpose and effect. We must remember that this bill would allow a citizen deliberately to perform acts which are intended to cause the death of another citizen.
Since the end of capital punishment, no such act is allowed under Iowa law to any citizen other than in war. That is the change, the weight of the change, that this bill seeks to make. And I believe that we must be given time and the space and the methods to amend this bill if that can possibly be done, hence my support in due course for the Noble Lady Baroness Berger system amendment that would allow a Select Committee to hear evidence that the Commons committee chose not to hear and would have been very persuasive.
So, I beg to move my amendment.
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The original question was that this bill be now read a second time. Since when an amendment has been removed is set out on the order paper and further amendment has been moved to that amendment. The moved to that amendment. The question I therefore have two put is that the amendment in the name of
10:47
Baroness May of Maidenhead (Conservative)
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Baroness May of Maidenhead (Conservative)
that the amendment in the name of Lord Forsyth be agreed to.
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My Lords, as I rise to speak on this bill I declare my interest as ambassador for the hospice. The views I express today are my own. And I say that I recognise across this House that there will be very this House that there will be very firmly held views on both sides of this argument, some coming from real this argument, some coming from real personal experience as we heard from my Noble Friend Lord Forsyth. But I my Noble Friend Lord Forsyth.
But I oppose this bill and I wish to set out main reasons. First, I do not believe that the safeguards in this bill will prevent people from being pressurised to end their lives. pressurised to end their lives. Sometimes for the benefit of others. Sometimes for the benefit of others. I also worry that as we have seen in countries where there is such a law, countries where there is such a law, that people will feel that they must end their lives simply because they feel they are a burden on others.
I worry about the impact it will have worry about the impact it will have on people with disabilities, with chronic illness, with mental health chronic illness, with mental health problems, because there is a risk to legalising assisted dying that reinforces the dangerous notion that some lives are less worth living than others. And again as we have seen in other countries, once a law like this is past, the pressure then grows to extend the scope of it. I also oppose it because I believe that in the absence of, by supplying the default of the coroner's report there is a danger that this could be used as a cover-up.
A cover-up for mistakes made in hospital or for perhaps a hospital-acquired illness, infection, which has led to an increased likelihood of death. I have a friend who calls it the licence to Kill Bill. And finally, my Lords, this is not an assisted dying bill. It is assisted suicide bill. As a society, we believe that suicide is wrong. The Government has a national suicide prevention strategy. We bemoan the number of young people who are lowered into committing suicide by social media and what they read on the internet.
This week is world suicide awareness week. Suicide is wrong. But this bill effectively says suicide is OK. What message does that give to our society? Suicide is not OK, suicide is wrong, says the bill is wrong, and, in my opinion, should not pass.
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My Lords, as I rise to speak on this bill I declare my interest as ambassador for the hospice. The views I express today are my own. And I say that I recognise across this House that there will be very this House that there will be very firmly held views on both sides of this argument, some coming from real this argument, some coming from real personal experience as we heard from my Noble Friend Lord Forsyth. But I my Noble Friend Lord Forsyth.
But I oppose this bill and I wish to set out main reasons. First, I do not believe that the safeguards in this bill will prevent people from being pressurised to end their lives. pressurised to end their lives. Sometimes for the benefit of others. Sometimes for the benefit of others. I also worry that as we have seen in countries where there is such a law, countries where there is such a law, that people will feel that they must end their lives simply because they feel they are a burden on others.
I worry about the impact it will have worry about the impact it will have on people with disabilities, with chronic illness, with mental health chronic illness, with mental health problems, because there is a risk to legalising assisted dying that reinforces the dangerous notion that some lives are less worth living than others. And again as we have seen in other countries, once a law like this is past, the pressure then grows to extend the scope of it. I also oppose it because I believe that in the absence of, by supplying the default of the coroner's report there is a danger that this could be used as a cover-up.
A cover-up for mistakes made in hospital or for perhaps a hospital-acquired illness, infection, which has led to an increased likelihood of death. I have a friend who calls it the licence to Kill Bill. And finally, my Lords, this is not an assisted dying bill. It is assisted suicide bill. As a society, we believe that suicide is wrong. The Government has a national suicide prevention strategy. We bemoan the number of young people who are lowered into committing suicide by social media and what they read on the internet.
This week is world suicide awareness week. Suicide is wrong. But this bill effectively says suicide is OK. What message does that give to our society? Suicide is not OK, suicide is wrong, says the bill is wrong, and, in my opinion, should not pass.
10:50
The Lord Bishop of London (Bishops)
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The Lord Bishop of London (Bishops)
As Lord Kamall has already wanted out, we in this chamber's share the same goal, for people to die with dignity and compassion. There are critical concerns for those like me who believe that this bill is deeply flawed. And you will know that I am a former Government Chief Nursing Officer and I Chair the UK bereavement commission, but as a nurse, a priest, as a daughter, and as a granddaughter, I have had the privilege to be with many people as they die, most people die well.
Although, as we have heard, and will continue to hear, that is not always the case. And most people die well. I have known people to experience some of the most valuable days of their life as it comes to an end. Including those with terminal illnesses. As Baroness May has just pointed out, to change the law is to change society. Any law that introduces choice for a fuel is not limited in its effect to only that feel. If passed, this bill would seek that we are a society that believes that some lives are not worth living.
This bill would become our state endorsed position and our NHS will be active in its delivery. It is the role of the House to scrutinise, but there are no amendments to this bill that can safeguard us completely from its negative effects. I am concerned for those that will face internal and subtle pressure to end their lives in the absence of adequate palliative and social care, or to avoid being a burden to their families. I understand the fear of many that they may be offered free assisted death before they are offered fair chance that they might live.
I am concerned we are still in the dark about how this bill will be integrated into a struggling Health and Social Care Act system. As the delegated power committee report has shown. I am concerned that the bill is unequal to the task of preventing avoidable deaths due to the existing problems of discrimination, inequality, and abuse. I am deeply concerned that so many in this Parliament are not heeding the voices of professional and representative bodies that are raising the alarm.
Above all, this bill fails in its central claim that it delivers choice. A meaningful choice would see the measures in this bill set alongside equally available fully funded palliative social care services. Without the choice offered, this choice is an illusion. It may not be that will of the House to take the decision on the principle of this bill today, but I firmly hope that we will do that in the third reading. If it is necessary, I will table the amendment myself.
Till this House is given the same opportunity as The Other Place to decide. Until then, I have no doubt that the scrutiny given to this bill in the coming stages will make plain its advocacy. As we have heard much of the debate is about fear to loss of control. Two fear of dependency. To someone being somehow unrecognisable to yourself and to others. The challenge is that life is not something to be managed or limited when it becomes difficult.
Life is often more than we can ever understand it to be. I believe in a God whose very being is life. And in that gift we can discover meaning even if we are dying. To speak of God as to speak of the one that never is indifferent to human fragility, but who holds it and tends it. And I believe there is always hope. And what looks like an ending is not the last word. Hope that with proper care, support, dignity and compassion is still possible.
It is this firm belief
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that compels me to resist this bill. My Lords, whilst I respect the
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My Lords, whilst I respect the views of the Bishop of London, I speak in support of the bill. Not only in support of the principal of only in support of the principal of assisting people to die with
Although, as we have heard, and will continue to hear, that is not always the case. And most people die well. I have known people to experience some of the most valuable days of their life as it comes to an end. Including those with terminal illnesses. As Baroness May has just pointed out, to change the law is to change society. Any law that introduces choice for a fuel is not limited in its effect to only that feel. If passed, this bill would seek that we are a society that believes that some lives are not worth living.
This bill would become our state endorsed position and our NHS will be active in its delivery. It is the role of the House to scrutinise, but there are no amendments to this bill that can safeguard us completely from its negative effects. I am concerned for those that will face internal and subtle pressure to end their lives in the absence of adequate palliative and social care, or to avoid being a burden to their families. I understand the fear of many that they may be offered free assisted death before they are offered fair chance that they might live.
I am concerned we are still in the dark about how this bill will be integrated into a struggling Health and Social Care Act system. As the delegated power committee report has shown. I am concerned that the bill is unequal to the task of preventing avoidable deaths due to the existing problems of discrimination, inequality, and abuse. I am deeply concerned that so many in this Parliament are not heeding the voices of professional and representative bodies that are raising the alarm.
Above all, this bill fails in its central claim that it delivers choice. A meaningful choice would see the measures in this bill set alongside equally available fully funded palliative social care services. Without the choice offered, this choice is an illusion. It may not be that will of the House to take the decision on the principle of this bill today, but I firmly hope that we will do that in the third reading. If it is necessary, I will table the amendment myself.
Till this House is given the same opportunity as The Other Place to decide. Until then, I have no doubt that the scrutiny given to this bill in the coming stages will make plain its advocacy. As we have heard much of the debate is about fear to loss of control. Two fear of dependency. To someone being somehow unrecognisable to yourself and to others. The challenge is that life is not something to be managed or limited when it becomes difficult.
Life is often more than we can ever understand it to be. I believe in a God whose very being is life. And in that gift we can discover meaning even if we are dying. To speak of God as to speak of the one that never is indifferent to human fragility, but who holds it and tends it. And I believe there is always hope. And what looks like an ending is not the last word. Hope that with proper care, support, dignity and compassion is still possible.
It is this firm belief
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that compels me to resist this bill. My Lords, whilst I respect the
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My Lords, whilst I respect the views of the Bishop of London, I speak in support of the bill. Not only in support of the principal of only in support of the principal of assisting people to die with
10:55
Baroness Hodge of Barking (Labour)
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Baroness Hodge of Barking (Labour)
dignity, but also in firm support of the legislation before us. In my view, we are presented with a straightforward choice. Are we prepared to allow people in this country faced with certain and imminent death to choose how they die? I want that choice for myself. I would have wanted that choice for those close to me whom I have seen die in terrible agony. I wanted for the 650 terminal ill individuals who take their own lives each year for the thousands of terminally ill who attempt suicide each year.
And for the roughly 50 who travel often alone to Dignitas each year and for alone to Dignitas each year and for the many who die in pain each day, even with the very best of palliative care. I would ask each and everyone of you to reflect on with what you want for yourself, you are prepared to deny to others the choice of the choice of how they wish to die. Who are we to deny others their right to choose? Denying choice represents a fundamental attack on the freedom and right of individuals to control their lives at that terrible time when they are dying.
There are those who argue that they are not opposed to the principle of assisted dying that they just want get more time for yet more consideration of yet more changes. I have to say to my noble Lords I have 30 years in the House of Commons and I have never seen such scrutiny, such openness to considering amendments, such attention to detail as I saw when watching the bill make its way through the House of Commons. We are deeply indebted to my honourable friend for the value, for the collaborative and collegiate way in which she steered her bill through the Commons.
My Lords, we have ample time here to fulfil our role to consider further amendments and to improve and revise the bill during consideration of its processes and, sadly, I have come to the view that those who have tabled the motion to delay the passing of the bill are more committed to killing the bill than to improving it. For that what I fear may be the inevitable consequence if we adopt the proposal to establish a Select Committee. We are not elected, so in carrying out our duties, we must look beyond our own interests and views and listen to public opinion on this very personal and very sensitive issue.
We know from the most recent surveys that nearly 3/4 members of the public want us to make it lawful for an individual to seek assistance in dying in the UK. And we also know that nearly 4 out of in the UK. And we also know that nearly 4/5 of those who live with a disability support a change in the law. And that two out of three responded with faith also expressed support for the law. The time has now come to change this law.
Across the world jurisdictions are introducing laws to enable assisted dying. We should proudly be the standardbearers of this important societal change in Britain. And we should demonstrate by our support for this bill the care and compassion for those that need it most. Those that are coming to the end of their lives and dying.
And for the roughly 50 who travel often alone to Dignitas each year and for alone to Dignitas each year and for the many who die in pain each day, even with the very best of palliative care. I would ask each and everyone of you to reflect on with what you want for yourself, you are prepared to deny to others the choice of the choice of how they wish to die. Who are we to deny others their right to choose? Denying choice represents a fundamental attack on the freedom and right of individuals to control their lives at that terrible time when they are dying.
There are those who argue that they are not opposed to the principle of assisted dying that they just want get more time for yet more consideration of yet more changes. I have to say to my noble Lords I have 30 years in the House of Commons and I have never seen such scrutiny, such openness to considering amendments, such attention to detail as I saw when watching the bill make its way through the House of Commons. We are deeply indebted to my honourable friend for the value, for the collaborative and collegiate way in which she steered her bill through the Commons.
My Lords, we have ample time here to fulfil our role to consider further amendments and to improve and revise the bill during consideration of its processes and, sadly, I have come to the view that those who have tabled the motion to delay the passing of the bill are more committed to killing the bill than to improving it. For that what I fear may be the inevitable consequence if we adopt the proposal to establish a Select Committee. We are not elected, so in carrying out our duties, we must look beyond our own interests and views and listen to public opinion on this very personal and very sensitive issue.
We know from the most recent surveys that nearly 3/4 members of the public want us to make it lawful for an individual to seek assistance in dying in the UK. And we also know that nearly 4 out of in the UK. And we also know that nearly 4/5 of those who live with a disability support a change in the law. And that two out of three responded with faith also expressed support for the law. The time has now come to change this law.
Across the world jurisdictions are introducing laws to enable assisted dying. We should proudly be the standardbearers of this important societal change in Britain. And we should demonstrate by our support for this bill the care and compassion for those that need it most. Those that are coming to the end of their lives and dying.
10:59
Baroness Grey-Thompson (Crossbench)
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Baroness Grey-Thompson (Crossbench)
I would claim an interest as the director of living and dying well. While my view on this subject has been publicly expressed, today is about the contents of the terminally ill adults end-of-life bill and the implications for wider society, its pressures and tensions. And we should therefore learn from other jurisdictions. Just as good laws are not made from hard cases, sound do not make watertight bills and we have heard that the bill is the safest in the world. However, during the committee stage and the press judges were replaced with a panel in a contradictory term called George plus.
This change was made after the Minister of Justice and senior judges raised concerns about the impact on court and the Royal College of Psychiatrists said the suggested model is not even possible. The EHRC stated that the impact assessment from The Other Place was published too late for it to be properly utilised to strengthen the bill. And this bill gives the Secretary of State extensive powers. The Henry VIII clauses and the Statutory Instruments to be endlessly rewritten. Specifically, clause 5 and clause 4 requires the provision of adjustments for language and literacy barriers, but there is no requirement for them to find information for those with learning disabilities or additional needs.
Additionally, Doctor only has to ascertain that a person has been coerced, but how? It is not in the bill. Clause 25 so because it allows the coordinated Doctor to assist the person to ingest or otherwise self- administered the substance still displays the line between assisted dying and euthanasia. And in a recent meeting for those who provide voluntary as in, claims were made that all deaths were peaceful and no requirement to report events and no Convocations were left unrecorded in 72% of deaths.
This bill does not sufficiently outline protocol in terms of combo occasions. Approved substances do not explain how a drug will be approved. In Oregon, patients were given experimental drug with one payment being too harsh causing some to scream in pain. Over 27 years, half the patients of Oregon took between 53 minutes and 137 hours today. If this bill is to bring compassion and calm at the end-of-life, how can this be assured when we don't know what lethal drugs will be given? No requirement for reporting this bill could leave to a lack of proper oversight.
There are cases that a post-mortem where there wasn't a physical illness. We would never find out. If there is nothing to fear from this bill, then there is nothing to fear from accurate reporting. Claims are being made that on the statute books, the law cannot be expanded, just as the suicide act fundamentally our role is to scrutinise legislation. Parliament can do anything but it cannot bind its successor and I'm constantly told their has been no expansion and jurisdiction as Oregon. In 2020, there was a removal of the waiting period before administering assisting, and the definition of terminal was expanded by interpretation.
In Victoria, their five year review in February proposed a plethora of improvements which lead to substantial expansion. Our role and what we must endeavour to do is to weigh up the evidence to safeguard the vulnerable and avoid wrongful death.
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My Lords, first, thank you to the many people who have written to me
This change was made after the Minister of Justice and senior judges raised concerns about the impact on court and the Royal College of Psychiatrists said the suggested model is not even possible. The EHRC stated that the impact assessment from The Other Place was published too late for it to be properly utilised to strengthen the bill. And this bill gives the Secretary of State extensive powers. The Henry VIII clauses and the Statutory Instruments to be endlessly rewritten. Specifically, clause 5 and clause 4 requires the provision of adjustments for language and literacy barriers, but there is no requirement for them to find information for those with learning disabilities or additional needs.
Additionally, Doctor only has to ascertain that a person has been coerced, but how? It is not in the bill. Clause 25 so because it allows the coordinated Doctor to assist the person to ingest or otherwise self- administered the substance still displays the line between assisted dying and euthanasia. And in a recent meeting for those who provide voluntary as in, claims were made that all deaths were peaceful and no requirement to report events and no Convocations were left unrecorded in 72% of deaths.
This bill does not sufficiently outline protocol in terms of combo occasions. Approved substances do not explain how a drug will be approved. In Oregon, patients were given experimental drug with one payment being too harsh causing some to scream in pain. Over 27 years, half the patients of Oregon took between 53 minutes and 137 hours today. If this bill is to bring compassion and calm at the end-of-life, how can this be assured when we don't know what lethal drugs will be given? No requirement for reporting this bill could leave to a lack of proper oversight.
There are cases that a post-mortem where there wasn't a physical illness. We would never find out. If there is nothing to fear from this bill, then there is nothing to fear from accurate reporting. Claims are being made that on the statute books, the law cannot be expanded, just as the suicide act fundamentally our role is to scrutinise legislation. Parliament can do anything but it cannot bind its successor and I'm constantly told their has been no expansion and jurisdiction as Oregon. In 2020, there was a removal of the waiting period before administering assisting, and the definition of terminal was expanded by interpretation.
In Victoria, their five year review in February proposed a plethora of improvements which lead to substantial expansion. Our role and what we must endeavour to do is to weigh up the evidence to safeguard the vulnerable and avoid wrongful death.
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My Lords, first, thank you to the many people who have written to me
11:03
Baroness Featherstone (Liberal Democrat)
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Baroness Featherstone (Liberal Democrat)
many people who have written to me to beg me to support this bill and I do. In so many of these letters tell a horrific story of watching a loved ones suffer and the proportion of supporting these letters to those opposed is overwhelmingly in favour by a ratio of 4 to one. But today, I want to speak for myself. For my rights, my autonomy, for what I want to happen should I face the appalling circumstances of an appalling illness.
My right to choose. It is a central principle in ethics and law, autonomy, the right to make your own decisions about your life, and people can refuse life-saving treatment or choose risky medical procedures, consistency suggests that they should also be able to choose when and how they die, and assisted dying does not cause anyone to end their life but simply respects the choice those who want the option. We already recognise the right to live according to one's own values.
Freedom of religion, the reproductive choices, sexual orientation, marriage or not, why not this, the most important decision of our lives. In choosing assisted dying should frame not as a rejection of life but an embrace of dignity. People facing terminal illness or unbearable suffering may wish to avoid the drawnout decline that strips them of control, of independence or even the ability to recognise themselves. And respecting their choice, it acknowledges the humanity in terms of medical care.
And John Stuart Mills philosophy was that individuals should free to make their own choices unless they harm others. Choosing to end one's own suffering does not harm others whereas forcing someone to endure against their will is a harm. And there is a divide. Those with means can travel abroad, creating inequality and a lonely end. Allowing it locally ensures that choices have no need for the wealthy or the privileged, and when assisted dying is illegal, people sometimes take violent steps to end their life.
It gives people peace of mind and reduces traumatic situations. So in conclusion, I want to thank her for her, thoughtful approach for those about coercion, and it seemed to me from seeing that these concerns meant that changes had been made, but I have absolute confidence that should there be any remaining issues that give rise to further concerns, they will be found and addressed in this house. And may I say to those with disabilities who are understandably very nervous and worried, this does not apply to instability.
Disability is not qualification, and those who raise palliative care as the answer, I wish it was the answer, but it isn't a good enough answer in circumstances that people face today. Very lastly, I say to those who may vote against this bill for religious reasons that assisted dying is not compulsory and if your religious convictions require that you do not take advantage of this bill, then please have compassion and enable us who do not have your convictions to have the right to choose.
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Palliative care may not be the answer but it has to be part of the
My right to choose. It is a central principle in ethics and law, autonomy, the right to make your own decisions about your life, and people can refuse life-saving treatment or choose risky medical procedures, consistency suggests that they should also be able to choose when and how they die, and assisted dying does not cause anyone to end their life but simply respects the choice those who want the option. We already recognise the right to live according to one's own values.
Freedom of religion, the reproductive choices, sexual orientation, marriage or not, why not this, the most important decision of our lives. In choosing assisted dying should frame not as a rejection of life but an embrace of dignity. People facing terminal illness or unbearable suffering may wish to avoid the drawnout decline that strips them of control, of independence or even the ability to recognise themselves. And respecting their choice, it acknowledges the humanity in terms of medical care.
And John Stuart Mills philosophy was that individuals should free to make their own choices unless they harm others. Choosing to end one's own suffering does not harm others whereas forcing someone to endure against their will is a harm. And there is a divide. Those with means can travel abroad, creating inequality and a lonely end. Allowing it locally ensures that choices have no need for the wealthy or the privileged, and when assisted dying is illegal, people sometimes take violent steps to end their life.
It gives people peace of mind and reduces traumatic situations. So in conclusion, I want to thank her for her, thoughtful approach for those about coercion, and it seemed to me from seeing that these concerns meant that changes had been made, but I have absolute confidence that should there be any remaining issues that give rise to further concerns, they will be found and addressed in this house. And may I say to those with disabilities who are understandably very nervous and worried, this does not apply to instability.
Disability is not qualification, and those who raise palliative care as the answer, I wish it was the answer, but it isn't a good enough answer in circumstances that people face today. Very lastly, I say to those who may vote against this bill for religious reasons that assisted dying is not compulsory and if your religious convictions require that you do not take advantage of this bill, then please have compassion and enable us who do not have your convictions to have the right to choose.
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Palliative care may not be the answer but it has to be part of the
11:07
Lord Stevens of Birmingham (Crossbench)
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Lord Stevens of Birmingham (Crossbench)
answer and that is just not the case across England and Wales as we speak today. It is estimated today by my colleagues at King's College London that over 100,000 people die each year in this country without the palliative and end-of-life care that they would have benefited from. Two thirds of people report being fearful of the absence of that palliative care that they will not have access to palliative care when they need it and to the extent this bill is about autonomy, you can't have meaningful choice without having palliative care as part of that choice.
I place a high weight on autonomy. My question is how autonomous can you be when you don't have choices. Advocates for this bill make the point that in some countries, palliative care services have improved. I have looked at those instances. That is because when the legislation has been progressing, there has been a matched government effort to increase funding for palliative care. I am not aware of any such effort on offer in this country, and although the assisted dying service is pair the estimate actually, the cost of palliative care would be far greater and makes it far riskier to envisage that this would come about.
Instead, in this bill, we have a report on offer one year after the bill is passed as it does, and another in nine years time. I don't think those reports are worth the paper they are written on. It is the Secretary of State at the time marking their own homework, one-off assessment and it has no consequences because the bill or the act will commence within four years anyway. So what can be done. I know there are some amendments that could improve prospects and I would like to see a triple lock for palliative care.
First, I would like to see station of the two doctors required to attest that there is a comprehensive offer of palliative care and end-of-life support made available to do the scheme. They have to describe the availability or lack thereof of any palliative care in the local area. Secondly, we should see from the statement that genuine offer of palliative care has been made available, and it would also be perverse if the only way you guaranteed access to palliative care was by going through the assisted dying service so we need to see this periodically, that everyone might benefit from end-of-life care has access to it across the country.
Safeguards like that, I think we should take seriously why this is underfunded and in equitably delivered as is currently the place
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brings substantive risk. I want to start by saying that I
I place a high weight on autonomy. My question is how autonomous can you be when you don't have choices. Advocates for this bill make the point that in some countries, palliative care services have improved. I have looked at those instances. That is because when the legislation has been progressing, there has been a matched government effort to increase funding for palliative care. I am not aware of any such effort on offer in this country, and although the assisted dying service is pair the estimate actually, the cost of palliative care would be far greater and makes it far riskier to envisage that this would come about.
Instead, in this bill, we have a report on offer one year after the bill is passed as it does, and another in nine years time. I don't think those reports are worth the paper they are written on. It is the Secretary of State at the time marking their own homework, one-off assessment and it has no consequences because the bill or the act will commence within four years anyway. So what can be done. I know there are some amendments that could improve prospects and I would like to see a triple lock for palliative care.
First, I would like to see station of the two doctors required to attest that there is a comprehensive offer of palliative care and end-of-life support made available to do the scheme. They have to describe the availability or lack thereof of any palliative care in the local area. Secondly, we should see from the statement that genuine offer of palliative care has been made available, and it would also be perverse if the only way you guaranteed access to palliative care was by going through the assisted dying service so we need to see this periodically, that everyone might benefit from end-of-life care has access to it across the country.
Safeguards like that, I think we should take seriously why this is underfunded and in equitably delivered as is currently the place
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brings substantive risk. I want to start by saying that I
11:10
Baroness Primarolo (Labour)
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Baroness Primarolo (Labour)
am very grateful to the hundreds of people who have written to me about their views on this bill, both for and against. Many of the letters make for very difficult reading. Goodness knows how difficult they were to write. And we all have personal experiences of loved ones painful deaths and circumstances in which they were denied the choice of how they died and when. This is of course an important debate for the whole country, and it is right that your lordship balance legal and ethical considerations, the level of public support, and the requirement for practical safeguards in legislation while responding to clear signals from the majority that they support this bill as drafted.
But I believe, and the point I want to make, above all the considerations that we discuss, there is one towering point. It is the fundamental right of the individual to exercise agency and autonomy over their own lives, and those choices are hard indeed and not taken easily. Denying the ultimate right to end one's life in peace and dignity in the manner and circumstances of one's choosing when the alternative is so scary and appalling.
That is not incompetent. We need to facilitate this bill. I am reminded of when I was held minister, of the complex interactions and how we try to legislate. Particularly when we undertook reforms in the embryology Bill. We took on the challenge, we got the detail right and we did not delay or deny the choice of those who seek this bill. The bill is not a reckless attempt of unchecked freedoms. Far from it.
It provides measures that will offer carefully measures that will offer carefully regulated parts to ensure only those with confirmed diagnoses are covered by this bill. The imperative here for me is to respect human agency and autonomy. And it is a travesty and ultimately wrong for the state or any other agency and civil society to intervene with or impose their values above the right of the individual to self-determination in circumstances where there is no perverse impact on community.
Democracy and in democracy, we must trust individuals to make informed decisions about their own bodies and lives. We must exist imposing our values on others when we have no right to intervene. To deny agency today is seeking freedom to end their lives on their own terms is wrong. The greater good is not served by sacrificing the few to the pain and suffering they face. My Lords, I support this bill. I support it as it is drafted and I will vote to resist any attempts to delay its passage through this.
But I believe, and the point I want to make, above all the considerations that we discuss, there is one towering point. It is the fundamental right of the individual to exercise agency and autonomy over their own lives, and those choices are hard indeed and not taken easily. Denying the ultimate right to end one's life in peace and dignity in the manner and circumstances of one's choosing when the alternative is so scary and appalling.
That is not incompetent. We need to facilitate this bill. I am reminded of when I was held minister, of the complex interactions and how we try to legislate. Particularly when we undertook reforms in the embryology Bill. We took on the challenge, we got the detail right and we did not delay or deny the choice of those who seek this bill. The bill is not a reckless attempt of unchecked freedoms. Far from it.
It provides measures that will offer carefully measures that will offer carefully regulated parts to ensure only those with confirmed diagnoses are covered by this bill. The imperative here for me is to respect human agency and autonomy. And it is a travesty and ultimately wrong for the state or any other agency and civil society to intervene with or impose their values above the right of the individual to self-determination in circumstances where there is no perverse impact on community.
Democracy and in democracy, we must trust individuals to make informed decisions about their own bodies and lives. We must exist imposing our values on others when we have no right to intervene. To deny agency today is seeking freedom to end their lives on their own terms is wrong. The greater good is not served by sacrificing the few to the pain and suffering they face. My Lords, I support this bill. I support it as it is drafted and I will vote to resist any attempts to delay its passage through this.
11:15
Lord Lamont of Lerwick (Conservative)
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Lord Lamont of Lerwick (Conservative)
I speak with hesitation on this very complex issue. Any second reading of the bill must inevitably discuss the principle behind them. I acknowledge the principal choice and acknowledge the argument by changing the rule that brings unnecessary the rule that brings unnecessary pain. Has to be consideration the legislators say because it is not just the immediate consequences and not just the intended consequence but the unintended consequences as well. And we have to take into account the patient doctor Assisted dying is not a treatment and sits with the National Health Service.
Regardless of the stands we take on the principal, any act that is passed must function as a workable framework that protects the interests of patients and professionals and ensures that the safeguards really are proper safeguards. I have struck by the concerns that we have expressed by medical practitioners and also the evidence from several prestigious medical organisations including several Royal colleges which, while remaining neutral have expressed specific concerns about the bill. It's that need to be addressed in committee including these.
Why does the bill not require the person that wants to end their life to be asked why they wish to do so? It is of paramount importance that we avoid a situation in which anyone that wants unassisted death does so because they fear they are becoming a burden. That is a crucial point that people should not be forced to consider there becoming a burden. Would it not be better if pain and suffering were written into the bill as the exclusive reason for allowing assisted dying? Another unanswered question is how will the regulation for legal drug speak carried out? for legal drug speak carried out? This system seems to bypass the MHRA and the approval process? How are we going to judge the capacity that is the capacity of the individual to make the decision about whether to end their life or not? Should there not be similar prohibition as there is in certain countries where people are not allowed, sorry, but in Belgium and New Zealand medical practitioners are prohibited from initiating discussion about the possibility of assisted dying.
Should there not be a similar prohibition in our legislation? On the capacity, one of the Royal colleges has criticised the use of the Mental Health Act as an inappropriate reference point by which to judge the individuals capacity. That is a point that I think needs to be explored in committee. The Secretary of State has made it clear that there will be no extra resources to cope with the bill. Lord Faulkner has assured us that there will be minimal, but we shall see where we are going to be in the curious situation where we may end with a situation in which palliative care is funded by 30% while the state assisted dying will be financed at 100%.
The crucial point I think about this tilt is so much as the delegated Select Committee has pointed out that has yet to be decided, to be decided over time. Delegated into other decisions by Ministers. This is an unsatisfactory position and we need to more detail. For this reason, I think many amendments need to be made in committee and we do need intense scrutiny and the bill as it is at the moment is not
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satisfactory. I acknowledge with deep respect
Regardless of the stands we take on the principal, any act that is passed must function as a workable framework that protects the interests of patients and professionals and ensures that the safeguards really are proper safeguards. I have struck by the concerns that we have expressed by medical practitioners and also the evidence from several prestigious medical organisations including several Royal colleges which, while remaining neutral have expressed specific concerns about the bill. It's that need to be addressed in committee including these.
Why does the bill not require the person that wants to end their life to be asked why they wish to do so? It is of paramount importance that we avoid a situation in which anyone that wants unassisted death does so because they fear they are becoming a burden. That is a crucial point that people should not be forced to consider there becoming a burden. Would it not be better if pain and suffering were written into the bill as the exclusive reason for allowing assisted dying? Another unanswered question is how will the regulation for legal drug speak carried out? for legal drug speak carried out? This system seems to bypass the MHRA and the approval process? How are we going to judge the capacity that is the capacity of the individual to make the decision about whether to end their life or not? Should there not be similar prohibition as there is in certain countries where people are not allowed, sorry, but in Belgium and New Zealand medical practitioners are prohibited from initiating discussion about the possibility of assisted dying.
Should there not be a similar prohibition in our legislation? On the capacity, one of the Royal colleges has criticised the use of the Mental Health Act as an inappropriate reference point by which to judge the individuals capacity. That is a point that I think needs to be explored in committee. The Secretary of State has made it clear that there will be no extra resources to cope with the bill. Lord Faulkner has assured us that there will be minimal, but we shall see where we are going to be in the curious situation where we may end with a situation in which palliative care is funded by 30% while the state assisted dying will be financed at 100%.
The crucial point I think about this tilt is so much as the delegated Select Committee has pointed out that has yet to be decided, to be decided over time. Delegated into other decisions by Ministers. This is an unsatisfactory position and we need to more detail. For this reason, I think many amendments need to be made in committee and we do need intense scrutiny and the bill as it is at the moment is not
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satisfactory. I acknowledge with deep respect
11:19
The Lord Bishop of Southwark (Bishops)
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I acknowledge with deep respect those arguing for the passage of this bill are often speaking from this bill are often speaking from personal experience of the pain and suffering of someone's final illness. Yet along with many other speakers I have deep concerns about legislating to the practice of assisted dying. I caution the House against a remedy of choice in this area. My concern is that the most vulnerable and those who are most vulnerable in society will become more vulnerable should this bill find its way onto the statute.
Related to this I wish to say something on the subject of life which I believe we much consider in any will making provisions for its termination. In the old Testament the principle that life is the Hebrew word, a plural noun. This expression signifies both our expression signifies both our physical life and our source in God who is the source of all life. It is a relational term and like most societies up until our own age it reflects a view of life as gift and one with others.
It is a sign of the deep richness of the journey of life which, of course, encompasses mortality. And the finality which takes us to our very last breath. Indeed to be immensely careful in supporting the departure from the practice and wisdom of centuries. The consumer age in which we now live presents as with a technology with built in obsolescence on a narrowing timescale. It tells us that choice will make us free. Choice needs itself to be examined closely.
Humanity acknowledges instead define a chewed which gives our life meaning for we are all mortal and each of our lives in due course comes to an end, but in this life and that words of the general Thanksgiving we give thanks for our creation, preservation, and all the blessings of this. That is not to ignore the imperative of compassion and assistance for those who are suffering. The Christian conviction retains a belief that life is of intrinsic value at all stages.
There is never a point at which it may be said it is not worth it, or life is not worth living. Assisted dying would dangerously introduce the concept of limited worth of human life into our medical practice and into our relationships. We are signing up to essentially a consumerist understanding of life with many potential perils. Life is to be cherished. And for those of faith we acknowledge life to be sacred. That is why it is imperative that we address the chronic underfunding of palliative care and resource our hospices to do the work they do with such care and designation for those that need their services.
This provision would enhance the dignified dying and should be our first priority. I cannot, in all conscience, support this bill.
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I declare an interest as Chair of the Equality and Human Rights Commission speaking in a personal capacity. This is particularly pertinent today because the H RC
The Lord Bishop of Southwark (Bishops)
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I acknowledge with deep respect those arguing for the passage of this bill are often speaking from this bill are often speaking from personal experience of the pain and suffering of someone's final illness. Yet along with many other speakers I have deep concerns about legislating to the practice of assisted dying. I caution the House against a remedy of choice in this area. My concern is that the most vulnerable and those who are most vulnerable in society will become more vulnerable should this bill find its way onto the statute.
Related to this I wish to say something on the subject of life which I believe we much consider in any will making provisions for its termination. In the old Testament the principle that life is the Hebrew word, a plural noun. This expression signifies both our expression signifies both our physical life and our source in God who is the source of all life. It is a relational term and like most societies up until our own age it reflects a view of life as gift and one with others.
It is a sign of the deep richness of the journey of life which, of course, encompasses mortality. And the finality which takes us to our very last breath. Indeed to be immensely careful in supporting the departure from the practice and wisdom of centuries. The consumer age in which we now live presents as with a technology with built in obsolescence on a narrowing timescale. It tells us that choice will make us free. Choice needs itself to be examined closely.
Humanity acknowledges instead define a chewed which gives our life meaning for we are all mortal and each of our lives in due course comes to an end, but in this life and that words of the general Thanksgiving we give thanks for our creation, preservation, and all the blessings of this. That is not to ignore the imperative of compassion and assistance for those who are suffering. The Christian conviction retains a belief that life is of intrinsic value at all stages.
There is never a point at which it may be said it is not worth it, or life is not worth living. Assisted dying would dangerously introduce the concept of limited worth of human life into our medical practice and into our relationships. We are signing up to essentially a consumerist understanding of life with many potential perils. Life is to be cherished. And for those of faith we acknowledge life to be sacred. That is why it is imperative that we address the chronic underfunding of palliative care and resource our hospices to do the work they do with such care and designation for those that need their services.
This provision would enhance the dignified dying and should be our first priority. I cannot, in all conscience, support this bill.
**** Possible New Speaker ****
I declare an interest as Chair of the Equality and Human Rights Commission speaking in a personal capacity. This is particularly pertinent today because the H RC
11:22
Baroness Falkner of Margravine (Crossbench)
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Baroness Falkner of Margravine (Crossbench)
pertinent today because the H RC itself has briefed the bill and I must stress, therefore, that my remarks are entirely personal and to my own circumstances and knowledge. Some colleagues will know that I was found to have advanced stage III ovarian cancer last summer. After seven months of an unsuccessful diagnosis at an NHS teaching hospital, my experience in that distressing. Was disregarding and, at best, incompetent NHS. Finally, I turn to the sector last August and since then I have had two rounds of chemotherapy and three operations.
And I not on relatively debilitating medication up until 2027. So, in this period, I do feel that I have glimpsed the Grim Reaper through my hospital window in a morphine induced haze. We know that 460 people die of cancer everyday in this country. I know that I am not alone. Before going further, I want to acknowledge the great suffering that is caused with several illnesses that may result in applications for assisted dying. But today in our limited time, concentrated council, this is because the data tells us that for every four week delay in treatment a patient is 10% more likely to die.
The EIA on this bill tells us that in New Zealand and California two thirds of those who seek to end their lives this way are cancer sufferers. I recognise the need for disparity and objectivity when one is trying to pass legislation, so let me turn to the floors that I see in this particular bill. The Constitution Committee of this House has also stated that a private member is built on this subject is wholly inadequate. Recognising repeated attempts in my 21 years here to put this kind of legislation in the statute I would have expected Government to take it over the bill and caused it for pre-legislative scrutiny through a Joint committees.
Earnest burgesses amendment may give us that opportunity and I would intend to work for it. The second floor lives in the definitions of the bill. How do we find terminal illness or measure six months? Or calculate monetary equations that measure our lifespans more poorly than they do bands in NHS to railway tunnels? As in this impact assessment. What do we make of the impact of these measures? The lack of compassion for those genuinely concerned about the impact on disabled people, or the questions of mental capacity.
For religious individuals, and, of course, the elderly, who feel unwanted enough as it is. Importantly, the most critical agents in this story other than patients themselves are given an impossible task, GPs and specialist doctors. Doctors dread that inevitable question from a patient, how long do I have. It puts them in an invidious position. This is particularly so in the case of cancer care when management of the illness is the challenge. how well and how long are the critical questions asked on a daily basis.
In England, 1/3 question arises. How much? This is because NHS for some cancer treatment in Scotland and Wales are simply not available here. That is the most cruel aspect of that postcode lottery. There is much to discuss in the scrutiny of this bill. I say this as someone that has supported the assisted dying bill previously. I do wish that we did not have to deal with this bill, but we will do so in good faith.
**** Possible New Speaker ****
My Lords, wherever you may stand on principle, the fact is that on principle, the fact is that assisted dying is already a reality.
And I not on relatively debilitating medication up until 2027. So, in this period, I do feel that I have glimpsed the Grim Reaper through my hospital window in a morphine induced haze. We know that 460 people die of cancer everyday in this country. I know that I am not alone. Before going further, I want to acknowledge the great suffering that is caused with several illnesses that may result in applications for assisted dying. But today in our limited time, concentrated council, this is because the data tells us that for every four week delay in treatment a patient is 10% more likely to die.
The EIA on this bill tells us that in New Zealand and California two thirds of those who seek to end their lives this way are cancer sufferers. I recognise the need for disparity and objectivity when one is trying to pass legislation, so let me turn to the floors that I see in this particular bill. The Constitution Committee of this House has also stated that a private member is built on this subject is wholly inadequate. Recognising repeated attempts in my 21 years here to put this kind of legislation in the statute I would have expected Government to take it over the bill and caused it for pre-legislative scrutiny through a Joint committees.
Earnest burgesses amendment may give us that opportunity and I would intend to work for it. The second floor lives in the definitions of the bill. How do we find terminal illness or measure six months? Or calculate monetary equations that measure our lifespans more poorly than they do bands in NHS to railway tunnels? As in this impact assessment. What do we make of the impact of these measures? The lack of compassion for those genuinely concerned about the impact on disabled people, or the questions of mental capacity.
For religious individuals, and, of course, the elderly, who feel unwanted enough as it is. Importantly, the most critical agents in this story other than patients themselves are given an impossible task, GPs and specialist doctors. Doctors dread that inevitable question from a patient, how long do I have. It puts them in an invidious position. This is particularly so in the case of cancer care when management of the illness is the challenge. how well and how long are the critical questions asked on a daily basis.
In England, 1/3 question arises. How much? This is because NHS for some cancer treatment in Scotland and Wales are simply not available here. That is the most cruel aspect of that postcode lottery. There is much to discuss in the scrutiny of this bill. I say this as someone that has supported the assisted dying bill previously. I do wish that we did not have to deal with this bill, but we will do so in good faith.
**** Possible New Speaker ****
My Lords, wherever you may stand on principle, the fact is that on principle, the fact is that assisted dying is already a reality.
11:27
Baroness Hunter of Auchenreoch (Labour)
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Baroness Hunter of Auchenreoch (Labour)
assisted dying is already a reality. It is available to those that have the means and ability to go abroad. The question before us is whether we continue with this two tier system, or whether people suffering here should be able to die at home in our own country within our own regulated and see framework as set out in this bill. More stringent than any overseas. I am inspired by the experience, the father of my son's close friend. His widow, Christie is with us in the chamber today.
After struggling with generative Parkinson's return years, was wheelchair-bound with double incontinence, seizures, spasms, insomnia, dyskinesia, and depression. He was at the end stage of Parkinson's with a life expectancy of between six and 12 months. He wished to end his life to spare himself and his family. After much research and two months review of his medical records, Michael made the arduous journey to Belgium. Where physical and psychiatric assessments were completed. Then following the requisite cooling off period the family crossed the channel again.
Michael remained calm and resolute as Christine says to the very last second of his life. The drug was administered and Michael died quickly and painlessly. The moment was sad, his son David wrote, but there was also a beauty and so much dignity in it. Everyone worked hard and would say our last words. He seemed so at peace and filled with acceptance. Two days later Christie had to travel back to Belgium to collect her husband's Belgium to collect her husband's ashes.
All that unavoidable travel inevitably added to the families stress and pain. They know that they were lucky. So many in this country do not have their opportunity. This is about equity of choice, for terminally ill people here. But how and the way they die. I urge my noble Lords to support this bill. noble Lords to support this bill.
After struggling with generative Parkinson's return years, was wheelchair-bound with double incontinence, seizures, spasms, insomnia, dyskinesia, and depression. He was at the end stage of Parkinson's with a life expectancy of between six and 12 months. He wished to end his life to spare himself and his family. After much research and two months review of his medical records, Michael made the arduous journey to Belgium. Where physical and psychiatric assessments were completed. Then following the requisite cooling off period the family crossed the channel again.
Michael remained calm and resolute as Christine says to the very last second of his life. The drug was administered and Michael died quickly and painlessly. The moment was sad, his son David wrote, but there was also a beauty and so much dignity in it. Everyone worked hard and would say our last words. He seemed so at peace and filled with acceptance. Two days later Christie had to travel back to Belgium to collect her husband's Belgium to collect her husband's ashes.
All that unavoidable travel inevitably added to the families stress and pain. They know that they were lucky. So many in this country do not have their opportunity. This is about equity of choice, for terminally ill people here. But how and the way they die. I urge my noble Lords to support this bill. noble Lords to support this bill.
11:29
Baroness Goldie (Conservative)
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Baroness Goldie (Conservative)
My Lords, in principle I oppose the assisted dying, I voted against it in Scottish Parliament, and I want to leave sperm and the task before the House today is to scrutinise this bill. That is the process to which I wish to contribute. And I reserve the right to vote against the noble Lords it seems more likely when this arises, but I do accept that the proposals of this bill act with sincerity and with the best of intentions. The genesis of this bill is profound distress which has attended many patients as they approach the end of their lives and prominent in that distress is a management of pain.
The answer to that problem is not assisted dying. It is how we care better for terminally ill patients and how we manage unbearable levels of suffering. And that requires two things. irreversible of chronic underfunding over decades of palliative and terminal care. And a restoration to conditions of their proper clinical discretion and professional obligation to always act in the best interests of their patients without fear of If it takes legislation to provide that reassurance, that Isabella would support.
Specifically within this bill which is literally dealing with life-and-death, we should find explicit detail clarity and certainty. We should know, as legislators, what are we being asked to turn into law? Well, we don't. Detail, clarity and certainty. For example, the attempt to define terminal illness as an inevitably progressive to illness or disease which cannot be reversed by treatment and death reason be expected within six months is incapable of precision. Diagnosis is not an exact science.
Six months is an estimate. Think of the convicted Libyan bomber. The patient will certainly be influenced by that opinion, even if wrong. There is an attempt to spell out the criteria which must apply to the patient with a clear settled and informed wish to end their own life. Not being coerced by any other person. There is a crucial omission in the bill. I can find no definition of a clear and informed wish but what constitutes that? A doctor has to refer to that in the report following the assessment, but what of the criteria? It is grossly inadequate.
Equally troubling is the decoration to be repeated by the coordinating doctor still to be defined by regulations. The decision is made under coercion or pressure. If the coordinating doctor has only met the Dr once, how can that be a basis on which to inform the opinion of a third-party pressure? As many of your lordships will know, such coercion and pressure is not trumpeted from the bedside. It is furtive and covert. It will take a skilful doctor visiting the patient on a regular basis to be able to make any informed judgement on these issues.
On that, the bill is silent. This takes me to the most concerning omission from the bill. Well we should have explicit provisions and primary legislation, we have repeated reliance on delegated hearths, and that is what makes this bill opaque and impossible to understand. On an issue of life and death, that is completely unacceptable. And we should be indebted to the dedicated powers and regulatory reform committee of this house for the objective but deeply disturbing report laying bare the submissions and inconsistencies.
This should be rejected. It is not fit for purpose.
The answer to that problem is not assisted dying. It is how we care better for terminally ill patients and how we manage unbearable levels of suffering. And that requires two things. irreversible of chronic underfunding over decades of palliative and terminal care. And a restoration to conditions of their proper clinical discretion and professional obligation to always act in the best interests of their patients without fear of If it takes legislation to provide that reassurance, that Isabella would support.
Specifically within this bill which is literally dealing with life-and-death, we should find explicit detail clarity and certainty. We should know, as legislators, what are we being asked to turn into law? Well, we don't. Detail, clarity and certainty. For example, the attempt to define terminal illness as an inevitably progressive to illness or disease which cannot be reversed by treatment and death reason be expected within six months is incapable of precision. Diagnosis is not an exact science.
Six months is an estimate. Think of the convicted Libyan bomber. The patient will certainly be influenced by that opinion, even if wrong. There is an attempt to spell out the criteria which must apply to the patient with a clear settled and informed wish to end their own life. Not being coerced by any other person. There is a crucial omission in the bill. I can find no definition of a clear and informed wish but what constitutes that? A doctor has to refer to that in the report following the assessment, but what of the criteria? It is grossly inadequate.
Equally troubling is the decoration to be repeated by the coordinating doctor still to be defined by regulations. The decision is made under coercion or pressure. If the coordinating doctor has only met the Dr once, how can that be a basis on which to inform the opinion of a third-party pressure? As many of your lordships will know, such coercion and pressure is not trumpeted from the bedside. It is furtive and covert. It will take a skilful doctor visiting the patient on a regular basis to be able to make any informed judgement on these issues.
On that, the bill is silent. This takes me to the most concerning omission from the bill. Well we should have explicit provisions and primary legislation, we have repeated reliance on delegated hearths, and that is what makes this bill opaque and impossible to understand. On an issue of life and death, that is completely unacceptable. And we should be indebted to the dedicated powers and regulatory reform committee of this house for the objective but deeply disturbing report laying bare the submissions and inconsistencies.
This should be rejected. It is not fit for purpose.
11:34
Baroness Murphy (Crossbench)
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Baroness Murphy (Crossbench)
Every bill introduces assisted dying in England since 2005, and we will continue to support it. I do hope that this bill will make it through. For me, the principles are guided by the support for the importance of competent people to make their own decisions on their lives, and a matter of compassion that people should be assisted to end their lives when terminal illness and wanting to complement 10 the further existence or the possibility of a difficult death.
As we have heard, there are no areas jurisdiction based on the Oregon model which is a very successful one, tried and tested, and for other jurisdictions, they have gone for another model which I would broadly say the paradigms of it is part of the wider scheme which I would also have supported. But the Oregon model is the one we got here before us, albeit modified, and that is what we need to get right through Parliament. The one approved by the Commons.
We know from good peer- review and research that there are no risks for the vulnerable. They are largely a rallying point and that's all. There is no evidence of any undue evidence acting on the decision. The process can be part of good palliative care services and in many places where services have improved, it makes people focus more on the realities of care. Yes, it will be great to see better palliative care. I would support that all time and always have, but not at the expense of trying to introduce another legitimate arm to it which is part of good palliative care.
My problem with this bill is what the comments have done to it. It is like Lord Forsyth, hedged around with so many safeguards that have been insurgent that it might prove to be unwieldy if not unwieldy. If the notion for psychiatry should be called in to confirm this, it is probably unnecessary. Doctors are trained to assess capacity, and of course, I doubt love psychiatrist because I am one. I think it is unlikely that my colleagues will want to be involved except in very exceptional circumstances.
Frankly, there is too much bureaucracy and oversight in this bill and the less bureaucratic process, the better the experience for patients. The bill is very narrow of eligibility. We go through with this bill and I am one who would like to see in eligibility criteria to support people with criteria to support people with diagnoses, my 100 year old mother decided to starve herself to death when her pain was excessive, and she did have very good palliative care support and a brilliant GP, but that three weeks that she was determined to die were the worst three weeks of my life.
Nevertheless, I want to see this bill go through and hope it becomes legislation as soon as possible. I'm sympathetic to the noble Lord Forsyth and I am very worried that it will create problems for us. So, let's try to get this bill through so we can make some progress. And respect the wishes of the Commons.
As we have heard, there are no areas jurisdiction based on the Oregon model which is a very successful one, tried and tested, and for other jurisdictions, they have gone for another model which I would broadly say the paradigms of it is part of the wider scheme which I would also have supported. But the Oregon model is the one we got here before us, albeit modified, and that is what we need to get right through Parliament. The one approved by the Commons.
We know from good peer- review and research that there are no risks for the vulnerable. They are largely a rallying point and that's all. There is no evidence of any undue evidence acting on the decision. The process can be part of good palliative care services and in many places where services have improved, it makes people focus more on the realities of care. Yes, it will be great to see better palliative care. I would support that all time and always have, but not at the expense of trying to introduce another legitimate arm to it which is part of good palliative care.
My problem with this bill is what the comments have done to it. It is like Lord Forsyth, hedged around with so many safeguards that have been insurgent that it might prove to be unwieldy if not unwieldy. If the notion for psychiatry should be called in to confirm this, it is probably unnecessary. Doctors are trained to assess capacity, and of course, I doubt love psychiatrist because I am one. I think it is unlikely that my colleagues will want to be involved except in very exceptional circumstances.
Frankly, there is too much bureaucracy and oversight in this bill and the less bureaucratic process, the better the experience for patients. The bill is very narrow of eligibility. We go through with this bill and I am one who would like to see in eligibility criteria to support people with criteria to support people with diagnoses, my 100 year old mother decided to starve herself to death when her pain was excessive, and she did have very good palliative care support and a brilliant GP, but that three weeks that she was determined to die were the worst three weeks of my life.
Nevertheless, I want to see this bill go through and hope it becomes legislation as soon as possible. I'm sympathetic to the noble Lord Forsyth and I am very worried that it will create problems for us. So, let's try to get this bill through so we can make some progress. And respect the wishes of the Commons.
11:38
Lord Hunt of Kings Heath (Labour)
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Lord Hunt of Kings Heath (Labour)
Confronted with the death of my mother four years ago, I thought long and hard about this bill. Just days after celebrating her 99th birthday, she suffered a stroke and died three months later. Her final weeks were distressing, prolonged by unnecessary medical intervention. An experience to me showed urgent need for huge improvement in end-of-life care to prevent futile treatments and avoid unnecessary prolonged suffering. But to me, this is very different from assisting suicide at a person's most vulnerable moment.
As I sat with her in these last days, I have course understood why so many noble Lords here today argue that people should have the choice, but I agree with the Right Rev Bishop of Southwark that actually, the preciousness of life is paramount and they have not changed my opposition to the principle of assisted dying. We are going to hear a lot about evidence. There is enough international evidence to suggest that wherever you start, Lord framed expand to cover non- terminal illnesses and even miners, and I do think the Canadian example is very interesting from that point.
I think there is a real risk of people being pressurised to end their life because they feel being a burden. I do think there is a potential impact on the doctor- patient relationship which could have a corrosive impact. And I do worry about the application of the mental capacity act for which it was not designed in terms of judgements on capacity in this bill. On the issue of NHS cost, it is to be underfunded. My Leonard friend Lord Faulkner said it is very small and he is absolutely right.
My concern is we have already referred is that over the years, over decades and there are a collective group of ministers here like me whose partly responsible. We failed completely to ensure the proper funding of palliative care. My worry is not only will we not get palliative care funded, but actually, the money for assisted dying will come out of assisted care. But with all my experience in the NHS, that is how NHS bodies think about funding issues. So, we have two select committees.
They have identified flaws in the legislation. Coming from where I am, I would at least ask the house that we have sufficient time to go through some of these very important questions. My noble friend has said that he is prepared to make changes. Interestingly enough, not until closed 27 which gives the Secretary of State the power to set out the substances used to enable assisted dying to take place, even though the dedicated Powers committee suggested that you could start off in the bill with a list of substances and then amend secondary legislation.
I would ask him to give some further consideration. It is absolutely essential that we have enough time to debate the bill and the government maintains its neutrality. So I go some way with Lord Forsyth. I agree with him that it is insufficient. I am concerned that the position will place on my noble friend and place in the position of the government minister because I hope the house will support Lord Carlile and my noble friend in terms of having a proper discussion as well.
As I sat with her in these last days, I have course understood why so many noble Lords here today argue that people should have the choice, but I agree with the Right Rev Bishop of Southwark that actually, the preciousness of life is paramount and they have not changed my opposition to the principle of assisted dying. We are going to hear a lot about evidence. There is enough international evidence to suggest that wherever you start, Lord framed expand to cover non- terminal illnesses and even miners, and I do think the Canadian example is very interesting from that point.
I think there is a real risk of people being pressurised to end their life because they feel being a burden. I do think there is a potential impact on the doctor- patient relationship which could have a corrosive impact. And I do worry about the application of the mental capacity act for which it was not designed in terms of judgements on capacity in this bill. On the issue of NHS cost, it is to be underfunded. My Leonard friend Lord Faulkner said it is very small and he is absolutely right.
My concern is we have already referred is that over the years, over decades and there are a collective group of ministers here like me whose partly responsible. We failed completely to ensure the proper funding of palliative care. My worry is not only will we not get palliative care funded, but actually, the money for assisted dying will come out of assisted care. But with all my experience in the NHS, that is how NHS bodies think about funding issues. So, we have two select committees.
They have identified flaws in the legislation. Coming from where I am, I would at least ask the house that we have sufficient time to go through some of these very important questions. My noble friend has said that he is prepared to make changes. Interestingly enough, not until closed 27 which gives the Secretary of State the power to set out the substances used to enable assisted dying to take place, even though the dedicated Powers committee suggested that you could start off in the bill with a list of substances and then amend secondary legislation.
I would ask him to give some further consideration. It is absolutely essential that we have enough time to debate the bill and the government maintains its neutrality. So I go some way with Lord Forsyth. I agree with him that it is insufficient. I am concerned that the position will place on my noble friend and place in the position of the government minister because I hope the house will support Lord Carlile and my noble friend in terms of having a proper discussion as well.
11:42
Lord Ahmad of Wimbledon (Conservative)
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Lord Ahmad of Wimbledon (Conservative)
I rise today to speak in opposition to the bill before us today. Not only as a member of your Lordships house but as a person and what other side of the argument you are, deeply committed to the values of compassion and dignity. But I at that about the value of faith and principle on the issue and sanctity and preservation of human life. I had the honour to serve on the human rights Minister for many years, but for me, the most fundamental of human rights that we must and continue to protect is the right to life itself.
The noble Lord says that I cannot lend support to his bill. I acknowledge the deep pain and suffering of many individuals who have had many moving stories. Along with their families faced with terminal illness, we have all been there with parents with families and friends. No one can underestimate the emotional toll of witnessing a loved one ensuring excruciating suffering, or the anguish of being in the state of health where one's life seems to offer no prospect of meaningful recovery.
Yet it is precisely because of this shared humanity and compassion that we are driven and rightly so as a country, as a community, to seek solutions that alleviate suffering in ways that are aligned with our collective values in terms of protecting life. One of the central arguments in favour of this bill is that it provides individuals the opportunity to exercise autonomy and control over their own death. I understand the appeal of that. In a world increasingly that celebrates individual rights, it is only natural that we would seek to extend such autonomy to the ultimate decision in one's life of how one departs from this world.
But we must seek ourselves to ask the question is it truly a sign of freedom when we open the door to a practice that could be used to expedite life's end rather than seeking, as the noble Lord Stephen set on the issues of palliative care, to preserve and enhance life even in its final moments. I believe there is a moral duty along with the legal and legislative duty upon us that we must uphold, a duty to preserve life and offer care and its most fragile stages, not merely through medical interventions but through dignity, compassion, and kindness.
Psychological and emotional pressures that have been mentioned can often cloud one's judgement. We must also therefore ask ourselves if we as a society have done enough to support those who are facing such dire circumstances, not just through palliative care but also through the emotional, psychological and social support that would empower them to live the remaining days of their lives with dignity and peace. Let us be clear that the very essence of this bill, that assisted dying should be available as an option represents a major shift in the values we uphold as a society.
If we say that it is acceptable to take life in certain circumstances, I fear we risk opening a door where consequences go way beyond the current scope of the bill. Canada has been mentioned. The noble Lord mentioned it in his opening but after that, in 2016, in 2021, changes were made. The words terminal illness were removed. One in 70 deaths in Canada now are in 70 deaths in Canada now are And at a time when technology is advancing, pain management methods advancing, pain management methods are improving, we must ask ourselves whether assisted dying is the right approach.
The role of state is to protect life. I have many concerns about this bill. About the lack of family involvement, engagement, the actual reflection of our die first communities are not included within this and, ultimately, we must ask Choices towards the end of life it is certainly my view that we, as a society, that cherishes life, provide the dignity of the individual, provide not only the medical care, but the emotional and social support and the investment that is required, with help when people are seeking and at the time of ending their lives to live with dignity and that the choose life over death.
The noble Lord says that I cannot lend support to his bill. I acknowledge the deep pain and suffering of many individuals who have had many moving stories. Along with their families faced with terminal illness, we have all been there with parents with families and friends. No one can underestimate the emotional toll of witnessing a loved one ensuring excruciating suffering, or the anguish of being in the state of health where one's life seems to offer no prospect of meaningful recovery.
Yet it is precisely because of this shared humanity and compassion that we are driven and rightly so as a country, as a community, to seek solutions that alleviate suffering in ways that are aligned with our collective values in terms of protecting life. One of the central arguments in favour of this bill is that it provides individuals the opportunity to exercise autonomy and control over their own death. I understand the appeal of that. In a world increasingly that celebrates individual rights, it is only natural that we would seek to extend such autonomy to the ultimate decision in one's life of how one departs from this world.
But we must seek ourselves to ask the question is it truly a sign of freedom when we open the door to a practice that could be used to expedite life's end rather than seeking, as the noble Lord Stephen set on the issues of palliative care, to preserve and enhance life even in its final moments. I believe there is a moral duty along with the legal and legislative duty upon us that we must uphold, a duty to preserve life and offer care and its most fragile stages, not merely through medical interventions but through dignity, compassion, and kindness.
Psychological and emotional pressures that have been mentioned can often cloud one's judgement. We must also therefore ask ourselves if we as a society have done enough to support those who are facing such dire circumstances, not just through palliative care but also through the emotional, psychological and social support that would empower them to live the remaining days of their lives with dignity and peace. Let us be clear that the very essence of this bill, that assisted dying should be available as an option represents a major shift in the values we uphold as a society.
If we say that it is acceptable to take life in certain circumstances, I fear we risk opening a door where consequences go way beyond the current scope of the bill. Canada has been mentioned. The noble Lord mentioned it in his opening but after that, in 2016, in 2021, changes were made. The words terminal illness were removed. One in 70 deaths in Canada now are in 70 deaths in Canada now are And at a time when technology is advancing, pain management methods advancing, pain management methods are improving, we must ask ourselves whether assisted dying is the right approach.
The role of state is to protect life. I have many concerns about this bill. About the lack of family involvement, engagement, the actual reflection of our die first communities are not included within this and, ultimately, we must ask Choices towards the end of life it is certainly my view that we, as a society, that cherishes life, provide the dignity of the individual, provide not only the medical care, but the emotional and social support and the investment that is required, with help when people are seeking and at the time of ending their lives to live with dignity and that the choose life over death.
11:46
The Duke of Wellington (Crossbench)
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The Duke of Wellington (Crossbench)
My Lords, I entered this debate with trepidation. I not a professional either in medicine or law. But I do have a view on this complex matter which touches on so many aspects of humanity. Many of us will know relations or friends who have died in pain. Therefore we must do something to alleviate the unacceptable situation that in the 21st-century in a developed country there is still too many people dying in pain or with total loss of dignity.
I am therefore in favour of the principle that something must be done. When considering legislation we are trying to prevent a present or future ROM without inadvertently creating and unintended further wrong. We are all aware that in this bill a possible future ROM could be that a vulnerable person might in some way be or feel pressured into seeking an end of their lives when circumstances do not justify such an action. As far as I can see, there are more than sufficient safeguards in this bill to prevent such a situation.
In fact, I am concerned that the process of seeking assistance has become to owner as, particularly for vulnerable people. The requirement to consult firstly the coordinating doctor that must be appropriately trained, then the independent doctor that must also consult other professionals, then the Commissioner has to refer the case to an assisted dying panel consisting of a psychiatrist, a social worker, and a person that is held high judicial office. After the various consultations there is then another 14 days for further reflection and the second declaration is required.
I am concerned that there is a lengthy and detailed process that will be difficult, particularly for people that might be described as vulnerable. I do have to question whether this bill for trying to create sufficient safeguards has not in fact expose the patient to further anxiety. To properly pay. The bill is drafted to give a patient a choice as to how they wish to die. The current law does not give patients the choice. And I do think that the patient should have the choice and therefore I support the bill.
It would clearly be wrong for a patient to seek an assisted death, but it would be equally wrong for a patient that is terminally ill and in pain to be put off seeking assistance because the process of the application is too complex and lengthy. There are strong arguments on both sides, that I come down in favour to give the terminally ill a choice to end their lives and in a dignified way where there is as little pain as possible.
The alternative is the status quo. Were those who can afford it and are in good enough health go to Switzerland. That cannot be right, and I therefore support the bill. and I therefore support the bill.
I am therefore in favour of the principle that something must be done. When considering legislation we are trying to prevent a present or future ROM without inadvertently creating and unintended further wrong. We are all aware that in this bill a possible future ROM could be that a vulnerable person might in some way be or feel pressured into seeking an end of their lives when circumstances do not justify such an action. As far as I can see, there are more than sufficient safeguards in this bill to prevent such a situation.
In fact, I am concerned that the process of seeking assistance has become to owner as, particularly for vulnerable people. The requirement to consult firstly the coordinating doctor that must be appropriately trained, then the independent doctor that must also consult other professionals, then the Commissioner has to refer the case to an assisted dying panel consisting of a psychiatrist, a social worker, and a person that is held high judicial office. After the various consultations there is then another 14 days for further reflection and the second declaration is required.
I am concerned that there is a lengthy and detailed process that will be difficult, particularly for people that might be described as vulnerable. I do have to question whether this bill for trying to create sufficient safeguards has not in fact expose the patient to further anxiety. To properly pay. The bill is drafted to give a patient a choice as to how they wish to die. The current law does not give patients the choice. And I do think that the patient should have the choice and therefore I support the bill.
It would clearly be wrong for a patient to seek an assisted death, but it would be equally wrong for a patient that is terminally ill and in pain to be put off seeking assistance because the process of the application is too complex and lengthy. There are strong arguments on both sides, that I come down in favour to give the terminally ill a choice to end their lives and in a dignified way where there is as little pain as possible.
The alternative is the status quo. Were those who can afford it and are in good enough health go to Switzerland. That cannot be right, and I therefore support the bill. and I therefore support the bill.
11:50
Lord Dobbs (Conservative)
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Lord Dobbs (Conservative)
That is separate close and supports the hospice amendment and I hope as a conservative and I reject as a matter of principle the idea that state can demand ownership any more than it can own my spirit. The current law is cruel and understandable most of the Supreme Court says it must be reviewed, the police refuse properly to enforce it. The public demands that it be changed. There is the contrary argument that our lives and our deaths are to God.
I understand the strength of the opinion of those that plead their case. But I suggest that you have no right to impose your view on others who do not agree. And with respect I see no hand of any God that I recognise in laws that condemn innocent men and women to die in agony, even when they beg for their pain to stop. Why are we so afraid to change? Do we really believe that there are ruffians waiting to pounce from the shadows? That is the other argument that is good against this bill.
Are we to believe that we have become so cruel that we have turned into a society of casual killers? Is that what we are supposed to believe? What we are supposed to have become? Such a supposition because that is what it is, my Lords, supposition. Let's wear that supposition against actual suffering. Against the reality of the totally unnecessary torments that so many are false to endure. Even when they beg for mercy. Where those things up one against the other.
Measure fear against fact. And there is surely only one compassionate outcome that this bill or something very much like it was all its many safeguards. A nurse wrote to me. I have never met, she said, a nurse or a doctor who is eager to end the life of any patient. But I have known, she goes on, I have known many nurses and doctors who want to end their doctors who want to end their suffering.
I hope and pray that the law will change and that I will not be subjected to the laws dictated by those that do not agree with me. My Lords, I wish I had had the opportunity out of love to help my mother pass peacefully. In my arms. Instead of watching her years of suffering. It would have been her choice, but she had no choice. Instead, I am left with the enduring memory of endless pain. Your body, my Lords, your life, and your choice.
I wish you all long lives and a quiet and gentle and loving amendment.
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This is not the first country in which I have lived and worked during such a debate as we are having such a debate as we are having today. I was a bishop in New Zealand
I understand the strength of the opinion of those that plead their case. But I suggest that you have no right to impose your view on others who do not agree. And with respect I see no hand of any God that I recognise in laws that condemn innocent men and women to die in agony, even when they beg for their pain to stop. Why are we so afraid to change? Do we really believe that there are ruffians waiting to pounce from the shadows? That is the other argument that is good against this bill.
Are we to believe that we have become so cruel that we have turned into a society of casual killers? Is that what we are supposed to believe? What we are supposed to have become? Such a supposition because that is what it is, my Lords, supposition. Let's wear that supposition against actual suffering. Against the reality of the totally unnecessary torments that so many are false to endure. Even when they beg for mercy. Where those things up one against the other.
Measure fear against fact. And there is surely only one compassionate outcome that this bill or something very much like it was all its many safeguards. A nurse wrote to me. I have never met, she said, a nurse or a doctor who is eager to end the life of any patient. But I have known, she goes on, I have known many nurses and doctors who want to end their doctors who want to end their suffering.
I hope and pray that the law will change and that I will not be subjected to the laws dictated by those that do not agree with me. My Lords, I wish I had had the opportunity out of love to help my mother pass peacefully. In my arms. Instead of watching her years of suffering. It would have been her choice, but she had no choice. Instead, I am left with the enduring memory of endless pain. Your body, my Lords, your life, and your choice.
I wish you all long lives and a quiet and gentle and loving amendment.
**** Possible New Speaker ****
This is not the first country in which I have lived and worked during such a debate as we are having such a debate as we are having today. I was a bishop in New Zealand
11:54
The Lord Bishop of Newcastle (Bishops)
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The Lord Bishop of Newcastle (Bishops)
today. I was a bishop in New Zealand ahead of their referendum on a similar bill five years ago. I witnessed the arguments, heard the reassurances about has since followed its implementation. Including the pressures on healthcare professionals for the unseen consequences for a lack of clarity around the process. Only recently New Zealand published its five year review of act, highlighting significant practical challenges. Including that the committee is ineffective as an oversight body and recommending reforms. Five years on from passing a bill much like the one before us, it would be irresponsible not to take its findings seriously.
Most strikingly, the report highlights confused principles for the service. And even recommends that the New Zealand Government establish specific principles to underpin the act. This is no small matter. To be five years in to providing the service without clarity of the principles on which it was built. For legislation where the consequences of poor drafting are so high, it is alarming that such principles were not defined from the outset. And yet almost 1 into the passage of this private members bill, we are still discussing the concepts.
Without sufficient detail on how a state sponsored suicide service would be implemented. That should trouble us all. In that regard, I will support the amendment put forward by noble Baroness to enable at least mobile professional bodies. Whilst such uncertainty remains about how the bill would operate alongside our most important end-of-life care institutions, we should not legislate at this speed or in this way. Our first responsibility must be to ensure palliative and end-of-life care is accessible and effective for all.
Last week, I visited a hospice in Newcastle. I saw and heard first- hand how an affirmation of life and dignity matters for all of us. Proponents of this bill say it is about choice. Yet I cannot see how this is true. When the bill is both unsafe and unworkable in its current form. Within the Judaeo-Christian tradition the idea of being human begins with God, as my Noble Friend the red River and prelate has asserted. The sense of transcendence which informs personhood.
Our obsession with selfhood and individual choice belies our dignity and respect for others. In being human we begin not so much with selfhood but with the idea of the other. And of who we are in the realisation of community and society. Surely the moral imperative is to help people live. I recall the words of my bishop growing up in the North East, David Jenkins, Woods now written on his tomb. God is, as he is, in Jesus, so there is hope.
It is this that deepens and enriches my vision of life and faith. The vision of faith in humanity, shared with those of other faith and none and which are inextricably bound together. I cannot support this bill. And urge other noble lords to
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resist it also. It is the third time in my life I have spoken in this House unassisted have spoken in this House unassisted dying for so the first time was over 20 has ago when it was not very 20 has ago when it was not very prominent at all. And I have been a prominent at all. And I have been a strong supporter of it. But the date and the argument then was the and the argument then was the sanctity of life was so important and the bishops have said this today.
They believe that very strongly. But many of them, many of strongly. But many of them, many of their parishioners do not believe in Diane acted as in my church and my fellow friends are all very keen on fellow friends are all very keen on assisted dying. And he is nodding, I assisted dying. And he is nodding, I see he wants some as well. I would only say there is something that is very extraordinary about this. That recent directors of the prosecution have been most reluctant to charge husbands for killing their wives because they know that when they go because they know that when they go to court and the court hears how the husband has worked not from greed husband has worked not from greed but from love, he has been asked by but from love, he has been asked by his wife constantly to end her life because she cannot suffer any longer, and so they do not convict.
longer, and so they do not convict. And when lords do not convict, they should be changed. That is the reality that the Prime Minister has actually shared. And so I would, this House has always been very supportive of assisted dying. It is much older than the Commons. And I am now one of the older members, I am 90, so I am much closer to death than any of you. And the one thing I would say is wonderful to have a choice of politico but care, it will cost billions in the Conservative party they're going to see in their next manifesto, billions of palliative care, I do nothing that Faraj is man enough to do that.
And it just won't happen. The real choice is I only hope that my father died watching television news and I hope that I might go as quickly. But I do think one may live and the people that, my friends, I visited two palliative care homes. And to meet friends. And they were looked after very well. But they all wanted to go home. They want to get out as quickly as possible to die at home because they wanted to control their own death.
It is not really alternative, apolitical alternative, so it is absurd to think that it is apolitical alternative to spread The other thing I would like to say is I think this bill should be supported because it is compassionate, it wants to prevent suffering. It also wants to protect coercion. I visited some friends, two friends, who were dying, and they were surrounded by family. And there was coercion, but there was coercion to go on living, not to die.
And that is often the pattern. And I believe the safeguards in this bill are quite adequate. And those who wish to destroy the bill or to undermine it or to increase the safeguards so much, that hardly anybody will ever actually die astutely, I think they should consider very carefully, the great indignity of extended old age. I am now aware of it. One thing I would say to you, bit of good advice, it is very costly, save some money for being old, you really do need it, I assure you.
And the other thing I would say, I think people must die in dignity. A simple reason is that you can anaesthetise suffering, you cannot anaesthetise dignity. And many people feel very indignity indeed that they are going to have to suffer for so long. So, I want my death to be my death and I don't want some intruder, who has never intruded upon my life, to intrude
**** Possible New Speaker ****
upon my death. My Lords, is one of the younger
**** Possible New Speaker ****
My Lords, is one of the younger members of your Lordships house, I want to start by first thanking the want to start by first thanking the hundreds of citizens of this nation who have taken time out to write to who have taken time out to write to us all, email us, and I have read some of those very personal letters some of those very personal letters that have been sent to us and I want to thank them all regardless of whether they are in support of this whether they are in support of this bill, or against this bill.
I also want to thank the MP for Spen want to thank the MP for Spen Valley, for introducing this bill, Valley, for introducing this bill, members from the other house, in the other place, who have actually worked on the committee and I see one of them is stood there, my good friend, the MP for Harrogate, Tom friend, the MP for Harrogate, Tom Gordon. For me, the concept of choice is always important. And I speak in favour of this piece of legislation, because it is fundamentally about choice and about compassion.
This bill is not about compassion. This bill is not about compelling anyone to act against their conscience, it is about giving their conscience, it is about giving individuals and families the ability to decide how they spend their final days, whether they have faith or no faith. Let's be clear, my Lords, we have heard from speakers today about, in principle, they are against people being assisted to take their own life, but I would say, that discussion has been held previously.
And people already had that choice and that choice is simply exercised by people who will leave this nation and go to places like Switzerland, an exercise that choice. So therefore, I think it is time that we, in your Lordships house, move on to see how we can assist those people who want to exercise that choice to do so in our nation, rather than those who can afford to travel abroad. And my Lords, let me be clear, I would not, personally, choose assisted dying. I know with any member of my family.
Our faith teaches us to endure life, until it is a natural end and I would respect that. But my personal decision or that of my family should not mean that others, who would hold different beliefs, and make different choices, are denied the ability to act according to their own conscience. As a society, we already grant a great deal of choice of how we treat a person after death. Families decide whether to bury or cremate. And in some faiths including mine, for our Jewish friends, there is a duty to bury as soon as possible.
Others may take more time and some choose a more natural environmentally friendly option and some choose to share a option and some choose to share a grave with a loved one. And in each case, the law allows space for those decisions to reflect the conscience, culture and personal beliefs. So, I ask if we ask such choice after death, why do we withhold choice in the last days of life? Why do we say to those suffering unbearably, that they must endure their final hours in the way that they would not choose.
Even when the medical choose. Even when the medical profession could provide safe and compassionate assistance. The bill does not compel anyone to end their life, it does not diminish the sanctity of life, simply allows those who, after careful consideration and with proper safeguards, wish to have control of a dying and to do so with the dignity and without the fear of dignity and without the fear of criminalisation. I will follow the passage of this bill carefully and I will remain open-minded to amendments at later stages if they are generally enhancing the intentions of the bill.
At its heart, this is a question of individual freedoms. A central pillar of liberalism. The freedom to choose for oneself provided it does no harm to others. As laws should no harm to others. As laws should not foes needless pain, if we honour
**** Possible New Speaker ****
end. If we pass this bill, we choose to go down a particular road. Before to go down a particular road. Before we do that, we ought to ask where the road leads and are there any the road leads and are there any stopping places on the way. First, let me say I very much respect those let me say I very much respect those who have long campaigned for this bill for some of their position rests on two convictions that I rests on two convictions that I share.
Importance of free choice and a desire to relieve human suffering. What I would ask supporters of the bill to think about, however, are those who experience unbearable those who experience unbearable suffering but have many years to suffering but have many years to live. In 2008, 23-year-old Daniel James went to Switzerland, with James went to Switzerland, with Dignitas, as a 16-year-old he played rugby for England. But paralysed from the waist down as a result of from the waist down as a result of an injury, he couldn't bear the thought of a whole life in that thought of a whole life in that situation.
The hearts of all of us go out to the people in that position. It is of course difficult position. It is of course difficult to weigh the intensity of one's to weigh the intensity of one's personal suffering with another, but we can measure time. It is not the thought of having 60 years of hopelessness ahead, worse than six months of pain. In the course of my life, I met many people suffering from acute schizophrenia, a multipolar disorder, who time and again have tried to kill themselves.
Even when they are in a good period, they said they would rather be dead than have to go through the cycle of their illness again. One has to ask, my Lords, whether it is worse to have six months to live or a lifetime of mental anguish. It seems to be clear that if the desire is to relieve people from unbearable suffering, and they have the right to choose whether they live or die, then the logic of the argument, if you like the argument of compassion, is absolutely inescapable.
That a bill more along the lines of the one there is in Canada or the Netherlands is the only one that will do what is needed. So, my Lords, if this bill goes through, there will be inevitable pressure to amend it to include unbearable suffering of many kinds, physical and mental, not perhaps in the next year or two, but certainly within a few years. It is inevitable, my Lords, because of the logic of compassion, it is even stronger in favour of such a bill, than in favour of the present one.
Therefore, I would like to ask the supporters of the bill to think about whether they really want a situation, such as there is in Canada and the Netherlands. Where it is possible to be assisted in dying, for a whole range of causes. Mental, as well as physical. I am not arguing for or against a bill, just asking whether supporters of the present bill, regard that as desirable. My Lords, 20 years ahead, the proportion of the population is much higher than it is now, millions suffering from dementia, and it is difficult to believe there are sources caring for them, already badly stretched, will be adequate.
There is a nightmare scenario of assisted dying becoming the default option. Learn the -- Noble and learned Lord pointed out in Oregon, there is assisted dying that has lasted for 20 years or so and has not been changed like in Canada or the Netherlands. And that is a good point. It is absolutely a fair point. I totally accepted, that is, in principle. But, my arguments, is that the compassion, the argument of compassion based on free choice and the desire to relieve suffering is even stronger for a Canada type a bill that it is in this one, and bill that it is in this one, and therefore it will be inevitable pressure.
This morning, as I was sitting at the bus stop, waiting to go on, a lady asked what I was doing and I said I was going to do this. She immediately said to me, what about those people suffering from incurable suffering with years to live? My Lords, it is safer not to go down this road.
**** Possible New Speaker ****
Earlier this week, this house earnestly discussed in question is earnestly discussed in question is how to reduce suicides. Suicide hasn't been a crime for over six hasn't been a crime for over six decades, but we still think that it is wrong, we still try to prevent it. Until today. Today, we consider it. Until today. Today, we consider crossing the Rubicon. We debate and how to prevent suicide but how to facilitate it, with the support and facilitate it, with the support and resources of the state.
We are told that the purpose of the bill is to that the purpose of the bill is to prevent terrible suffering. There is nothing in the bill which says this. The essential condition is that someone must be terminally ill, not someone must be terminally ill, not that they are suffering. We are told that there are safeguards. In the House of Commons, the bill's proponents relied on what we were proponents relied on what we were told was an internationally unique safeguard. The authority of a High Court judge.
And then that unique but inconvenient safeguard was but inconvenient safeguard was dropped. We are told that only the terminally ill will be permitted to help, to end their lives. If you believe that personal autonomy, the right to choose death, is the overarching principle, why should the law logically stop at the terminally ill? What about the terminally miserable? Why shouldn't it be there right, anyone's right, to be helped to die? My Lords, I am afraid we already know how the elderly are too often regarded in our society.
As a burden, or a
Most strikingly, the report highlights confused principles for the service. And even recommends that the New Zealand Government establish specific principles to underpin the act. This is no small matter. To be five years in to providing the service without clarity of the principles on which it was built. For legislation where the consequences of poor drafting are so high, it is alarming that such principles were not defined from the outset. And yet almost 1 into the passage of this private members bill, we are still discussing the concepts.
Without sufficient detail on how a state sponsored suicide service would be implemented. That should trouble us all. In that regard, I will support the amendment put forward by noble Baroness to enable at least mobile professional bodies. Whilst such uncertainty remains about how the bill would operate alongside our most important end-of-life care institutions, we should not legislate at this speed or in this way. Our first responsibility must be to ensure palliative and end-of-life care is accessible and effective for all.
Last week, I visited a hospice in Newcastle. I saw and heard first- hand how an affirmation of life and dignity matters for all of us. Proponents of this bill say it is about choice. Yet I cannot see how this is true. When the bill is both unsafe and unworkable in its current form. Within the Judaeo-Christian tradition the idea of being human begins with God, as my Noble Friend the red River and prelate has asserted. The sense of transcendence which informs personhood.
Our obsession with selfhood and individual choice belies our dignity and respect for others. In being human we begin not so much with selfhood but with the idea of the other. And of who we are in the realisation of community and society. Surely the moral imperative is to help people live. I recall the words of my bishop growing up in the North East, David Jenkins, Woods now written on his tomb. God is, as he is, in Jesus, so there is hope.
It is this that deepens and enriches my vision of life and faith. The vision of faith in humanity, shared with those of other faith and none and which are inextricably bound together. I cannot support this bill. And urge other noble lords to
**** Possible New Speaker ****
resist it also. It is the third time in my life I have spoken in this House unassisted have spoken in this House unassisted dying for so the first time was over 20 has ago when it was not very 20 has ago when it was not very prominent at all. And I have been a prominent at all. And I have been a strong supporter of it. But the date and the argument then was the and the argument then was the sanctity of life was so important and the bishops have said this today.
They believe that very strongly. But many of them, many of strongly. But many of them, many of their parishioners do not believe in Diane acted as in my church and my fellow friends are all very keen on fellow friends are all very keen on assisted dying. And he is nodding, I assisted dying. And he is nodding, I see he wants some as well. I would only say there is something that is very extraordinary about this. That recent directors of the prosecution have been most reluctant to charge husbands for killing their wives because they know that when they go because they know that when they go to court and the court hears how the husband has worked not from greed husband has worked not from greed but from love, he has been asked by but from love, he has been asked by his wife constantly to end her life because she cannot suffer any longer, and so they do not convict.
longer, and so they do not convict. And when lords do not convict, they should be changed. That is the reality that the Prime Minister has actually shared. And so I would, this House has always been very supportive of assisted dying. It is much older than the Commons. And I am now one of the older members, I am 90, so I am much closer to death than any of you. And the one thing I would say is wonderful to have a choice of politico but care, it will cost billions in the Conservative party they're going to see in their next manifesto, billions of palliative care, I do nothing that Faraj is man enough to do that.
And it just won't happen. The real choice is I only hope that my father died watching television news and I hope that I might go as quickly. But I do think one may live and the people that, my friends, I visited two palliative care homes. And to meet friends. And they were looked after very well. But they all wanted to go home. They want to get out as quickly as possible to die at home because they wanted to control their own death.
It is not really alternative, apolitical alternative, so it is absurd to think that it is apolitical alternative to spread The other thing I would like to say is I think this bill should be supported because it is compassionate, it wants to prevent suffering. It also wants to protect coercion. I visited some friends, two friends, who were dying, and they were surrounded by family. And there was coercion, but there was coercion to go on living, not to die.
And that is often the pattern. And I believe the safeguards in this bill are quite adequate. And those who wish to destroy the bill or to undermine it or to increase the safeguards so much, that hardly anybody will ever actually die astutely, I think they should consider very carefully, the great indignity of extended old age. I am now aware of it. One thing I would say to you, bit of good advice, it is very costly, save some money for being old, you really do need it, I assure you.
And the other thing I would say, I think people must die in dignity. A simple reason is that you can anaesthetise suffering, you cannot anaesthetise dignity. And many people feel very indignity indeed that they are going to have to suffer for so long. So, I want my death to be my death and I don't want some intruder, who has never intruded upon my life, to intrude
**** Possible New Speaker ****
upon my death. My Lords, is one of the younger
**** Possible New Speaker ****
My Lords, is one of the younger members of your Lordships house, I want to start by first thanking the want to start by first thanking the hundreds of citizens of this nation who have taken time out to write to who have taken time out to write to us all, email us, and I have read some of those very personal letters some of those very personal letters that have been sent to us and I want to thank them all regardless of whether they are in support of this whether they are in support of this bill, or against this bill.
I also want to thank the MP for Spen want to thank the MP for Spen Valley, for introducing this bill, Valley, for introducing this bill, members from the other house, in the other place, who have actually worked on the committee and I see one of them is stood there, my good friend, the MP for Harrogate, Tom friend, the MP for Harrogate, Tom Gordon. For me, the concept of choice is always important. And I speak in favour of this piece of legislation, because it is fundamentally about choice and about compassion.
This bill is not about compassion. This bill is not about compelling anyone to act against their conscience, it is about giving their conscience, it is about giving individuals and families the ability to decide how they spend their final days, whether they have faith or no faith. Let's be clear, my Lords, we have heard from speakers today about, in principle, they are against people being assisted to take their own life, but I would say, that discussion has been held previously.
And people already had that choice and that choice is simply exercised by people who will leave this nation and go to places like Switzerland, an exercise that choice. So therefore, I think it is time that we, in your Lordships house, move on to see how we can assist those people who want to exercise that choice to do so in our nation, rather than those who can afford to travel abroad. And my Lords, let me be clear, I would not, personally, choose assisted dying. I know with any member of my family.
Our faith teaches us to endure life, until it is a natural end and I would respect that. But my personal decision or that of my family should not mean that others, who would hold different beliefs, and make different choices, are denied the ability to act according to their own conscience. As a society, we already grant a great deal of choice of how we treat a person after death. Families decide whether to bury or cremate. And in some faiths including mine, for our Jewish friends, there is a duty to bury as soon as possible.
Others may take more time and some choose a more natural environmentally friendly option and some choose to share a option and some choose to share a grave with a loved one. And in each case, the law allows space for those decisions to reflect the conscience, culture and personal beliefs. So, I ask if we ask such choice after death, why do we withhold choice in the last days of life? Why do we say to those suffering unbearably, that they must endure their final hours in the way that they would not choose.
Even when the medical choose. Even when the medical profession could provide safe and compassionate assistance. The bill does not compel anyone to end their life, it does not diminish the sanctity of life, simply allows those who, after careful consideration and with proper safeguards, wish to have control of a dying and to do so with the dignity and without the fear of dignity and without the fear of criminalisation. I will follow the passage of this bill carefully and I will remain open-minded to amendments at later stages if they are generally enhancing the intentions of the bill.
At its heart, this is a question of individual freedoms. A central pillar of liberalism. The freedom to choose for oneself provided it does no harm to others. As laws should no harm to others. As laws should not foes needless pain, if we honour
**** Possible New Speaker ****
end. If we pass this bill, we choose to go down a particular road. Before to go down a particular road. Before we do that, we ought to ask where the road leads and are there any the road leads and are there any stopping places on the way. First, let me say I very much respect those let me say I very much respect those who have long campaigned for this bill for some of their position rests on two convictions that I rests on two convictions that I share.
Importance of free choice and a desire to relieve human suffering. What I would ask supporters of the bill to think about, however, are those who experience unbearable those who experience unbearable suffering but have many years to suffering but have many years to live. In 2008, 23-year-old Daniel James went to Switzerland, with James went to Switzerland, with Dignitas, as a 16-year-old he played rugby for England. But paralysed from the waist down as a result of from the waist down as a result of an injury, he couldn't bear the thought of a whole life in that thought of a whole life in that situation.
The hearts of all of us go out to the people in that position. It is of course difficult position. It is of course difficult to weigh the intensity of one's to weigh the intensity of one's personal suffering with another, but we can measure time. It is not the thought of having 60 years of hopelessness ahead, worse than six months of pain. In the course of my life, I met many people suffering from acute schizophrenia, a multipolar disorder, who time and again have tried to kill themselves.
Even when they are in a good period, they said they would rather be dead than have to go through the cycle of their illness again. One has to ask, my Lords, whether it is worse to have six months to live or a lifetime of mental anguish. It seems to be clear that if the desire is to relieve people from unbearable suffering, and they have the right to choose whether they live or die, then the logic of the argument, if you like the argument of compassion, is absolutely inescapable.
That a bill more along the lines of the one there is in Canada or the Netherlands is the only one that will do what is needed. So, my Lords, if this bill goes through, there will be inevitable pressure to amend it to include unbearable suffering of many kinds, physical and mental, not perhaps in the next year or two, but certainly within a few years. It is inevitable, my Lords, because of the logic of compassion, it is even stronger in favour of such a bill, than in favour of the present one.
Therefore, I would like to ask the supporters of the bill to think about whether they really want a situation, such as there is in Canada and the Netherlands. Where it is possible to be assisted in dying, for a whole range of causes. Mental, as well as physical. I am not arguing for or against a bill, just asking whether supporters of the present bill, regard that as desirable. My Lords, 20 years ahead, the proportion of the population is much higher than it is now, millions suffering from dementia, and it is difficult to believe there are sources caring for them, already badly stretched, will be adequate.
There is a nightmare scenario of assisted dying becoming the default option. Learn the -- Noble and learned Lord pointed out in Oregon, there is assisted dying that has lasted for 20 years or so and has not been changed like in Canada or the Netherlands. And that is a good point. It is absolutely a fair point. I totally accepted, that is, in principle. But, my arguments, is that the compassion, the argument of compassion based on free choice and the desire to relieve suffering is even stronger for a Canada type a bill that it is in this one, and bill that it is in this one, and therefore it will be inevitable pressure.
This morning, as I was sitting at the bus stop, waiting to go on, a lady asked what I was doing and I said I was going to do this. She immediately said to me, what about those people suffering from incurable suffering with years to live? My Lords, it is safer not to go down this road.
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Earlier this week, this house earnestly discussed in question is earnestly discussed in question is how to reduce suicides. Suicide hasn't been a crime for over six hasn't been a crime for over six decades, but we still think that it is wrong, we still try to prevent it. Until today. Today, we consider it. Until today. Today, we consider crossing the Rubicon. We debate and how to prevent suicide but how to facilitate it, with the support and facilitate it, with the support and resources of the state.
We are told that the purpose of the bill is to that the purpose of the bill is to prevent terrible suffering. There is nothing in the bill which says this. The essential condition is that someone must be terminally ill, not someone must be terminally ill, not that they are suffering. We are told that there are safeguards. In the House of Commons, the bill's proponents relied on what we were proponents relied on what we were told was an internationally unique safeguard. The authority of a High Court judge.
And then that unique but inconvenient safeguard was but inconvenient safeguard was dropped. We are told that only the terminally ill will be permitted to help, to end their lives. If you believe that personal autonomy, the right to choose death, is the overarching principle, why should the law logically stop at the terminally ill? What about the terminally miserable? Why shouldn't it be there right, anyone's right, to be helped to die? My Lords, I am afraid we already know how the elderly are too often regarded in our society.
As a burden, or a
12:14
Lord Harries of Pentregarth (Crossbench)
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Lord Harries of Pentregarth (Crossbench)
nuisance. We are less inclined than other cultures to care for our elderly, in our own homes, and more elderly, in our own homes, and more inclined to place them in care. They inclined to place them in care. They will be happier there, they will be better off there, and in these daily acts of purported compassion is acts of purported compassion is portrayed how some will deal with
12:14
Lord Herbert of South Downs (Conservative)
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Lord Herbert of South Downs (Conservative)
the unwanted elderly if they can. It isn't hard to see how, with just a small slip down the slope, the elderly will be dispatched. And of elderly will be dispatched. And of course it will be their choice. They won't want to get in the way, they won't want to get in the way, they won't want to be a burden. And when the vulnerable are encouraged the vulnerable are encouraged towards the view that it is better for them to die, the Orwellian named assisted dying service will be there assisted dying service will be there to step in.
Of course, the stories we have heard about the suffering of we have heard about the suffering of the terminally ill are heartrending. We can't fail to be moved by them. But that surely is a reason to invest more in palliative care. Not to commit resources to assisted suicide. We cannot responsibly legislate simply because we are moved. In truth, we cannot legislate moved. In truth, we cannot legislate away suffering. My Lords, no so- called safeguard will persuade me that this bill is safe all right.
Indeed, the very need for safeguards, for instance, against coercion, should warn us of the profound danger to which we are about to expose the elderly and the vulnerable. I cannot support this bill and I fear for the consequence
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if it passes. I declare an interest. My brother
Of course, the stories we have heard about the suffering of we have heard about the suffering of the terminally ill are heartrending. We can't fail to be moved by them. But that surely is a reason to invest more in palliative care. Not to commit resources to assisted suicide. We cannot responsibly legislate simply because we are moved. In truth, we cannot legislate moved. In truth, we cannot legislate away suffering. My Lords, no so- called safeguard will persuade me that this bill is safe all right.
Indeed, the very need for safeguards, for instance, against coercion, should warn us of the profound danger to which we are about to expose the elderly and the vulnerable. I cannot support this bill and I fear for the consequence
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if it passes. I declare an interest. My brother
12:14
Baroness Keeley (Labour)
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Baroness Keeley (Labour)
is a consultant in palliative care. Today I want to speak in defence of palliative care and hospice support for people with terminal illnesses. It is deeply troubling that this bill and the debate surrounding it, certainly before today, have given so little consideration to palliative care. I opposed assisted suicide in principle and I oppose this bill, it is poorly constructed and was rushed through the Commons with inadequate scrutiny, with many amendments not debated. Crucially, it does not even require that those requesting assisted suicide are offered palliative care assessment first.
Yet specialists tell us that palliative care can help people who wish to die, rediscover reasons to live. At a recent Lords briefing, a care practitioner, Doctor Lucy Thomas stared a story of a patient who consider Dignitas but change their mind after receiving hospice care. Within days of starting that care, they feel valued, rather than abandoned. Sadly, too many terminally ill people feel abandoned by the NHS due to the lack of palliative care. Sarah Jane wrote movingly in the Times about her father, the neuroscientist, and the palliative care he received.
With motor neurone disease, he planned to go to the Netherlands for euthanasia, but he never did that because he was supported by his family and paid to cope to find enjoyment in life. When his wife died, he struggled with depression and feared losing control, a fear echoed in the debate on this bill. But after hospice doctor explained his palliative care options, his daughter says he became optimistic daughter says he became optimistic He went to stay at the hospice after developing a chest infection.
His daughter describes last 10 days of his life when he received a good the most gentle and attentive care from people who had dedicated their lives to end-of-life care. " She acknowledges her father was lucky to live near it to hospice enabling him to have a peaceful dignified death. Head of this debate we have been privileged to hear from leading palliative care experts killing professors Mark Talbot, and others. Those clinicians, with decades of experience, tell us that almost all patients offered high quality palliative care benefit from it.
It is often offered too little and too late, or not at all. We do not provide enough care and is for people with life limiting illnesses or their families. Over 100,000 people dying each year with unmet palliative care needs. Indeed a Marie Curie survey found that over half of expected deaths, did loved ones feel they received adequate support with healthcare in the final three months. We should have invested in palliative care to more people can benefit, as Sir Colin Blake put it.
It is unethical to leave the needs of 100,000 dying people unmet. We must consider those who do not, would not, she is assisted suicide, and ensure they are offered palliative care first. I pay tribute to my colleague, the MP who tabled the amendment in the Commons to ensure that no care home or hospice should be obliged to provide assisted dying. Hospices exist to offer comfort, dignity, and holistic support. Not to facilitate premature death. Introducing assisted dying into hospices risks undermining their purpose, and deterring those who seek life affirming care.
And hospices are a place of hope and compassion but should not become sites of medicalised death. We must protect the integrity of our care institutions. We must safeguard vulnerable and uphold the rights of those who dedicate their live to end-of-life care. This bill is not the solution. Should start with investment in palliative care to make it available to all who need it including care at home.
Yet specialists tell us that palliative care can help people who wish to die, rediscover reasons to live. At a recent Lords briefing, a care practitioner, Doctor Lucy Thomas stared a story of a patient who consider Dignitas but change their mind after receiving hospice care. Within days of starting that care, they feel valued, rather than abandoned. Sadly, too many terminally ill people feel abandoned by the NHS due to the lack of palliative care. Sarah Jane wrote movingly in the Times about her father, the neuroscientist, and the palliative care he received.
With motor neurone disease, he planned to go to the Netherlands for euthanasia, but he never did that because he was supported by his family and paid to cope to find enjoyment in life. When his wife died, he struggled with depression and feared losing control, a fear echoed in the debate on this bill. But after hospice doctor explained his palliative care options, his daughter says he became optimistic daughter says he became optimistic He went to stay at the hospice after developing a chest infection.
His daughter describes last 10 days of his life when he received a good the most gentle and attentive care from people who had dedicated their lives to end-of-life care. " She acknowledges her father was lucky to live near it to hospice enabling him to have a peaceful dignified death. Head of this debate we have been privileged to hear from leading palliative care experts killing professors Mark Talbot, and others. Those clinicians, with decades of experience, tell us that almost all patients offered high quality palliative care benefit from it.
It is often offered too little and too late, or not at all. We do not provide enough care and is for people with life limiting illnesses or their families. Over 100,000 people dying each year with unmet palliative care needs. Indeed a Marie Curie survey found that over half of expected deaths, did loved ones feel they received adequate support with healthcare in the final three months. We should have invested in palliative care to more people can benefit, as Sir Colin Blake put it.
It is unethical to leave the needs of 100,000 dying people unmet. We must consider those who do not, would not, she is assisted suicide, and ensure they are offered palliative care first. I pay tribute to my colleague, the MP who tabled the amendment in the Commons to ensure that no care home or hospice should be obliged to provide assisted dying. Hospices exist to offer comfort, dignity, and holistic support. Not to facilitate premature death. Introducing assisted dying into hospices risks undermining their purpose, and deterring those who seek life affirming care.
And hospices are a place of hope and compassion but should not become sites of medicalised death. We must protect the integrity of our care institutions. We must safeguard vulnerable and uphold the rights of those who dedicate their live to end-of-life care. This bill is not the solution. Should start with investment in palliative care to make it available to all who need it including care at home.
12:18
Lord Blencathra (Conservative)
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Lord Blencathra (Conservative)
I'm not opposed in principle but opposed to this poorly drafted bill. It is a travesty of a private as well. It is a massive 51 pages with 59 clauses and three schedules. It is one of the largest Private Members' Bills ever introduced in Parliament. It is larger and more controversial than many Government bills, and should have proper scrutiny. Since any proper Government bills that make laws on prison sentences, and Ortiz for killing and dangerous driving etc, it is wrong to pass a law on how people should die to the Private Members' Bill procedure.
The Delegated Powers Committee has issued a scathing report on the excessive 38 delegated power including Henry VIII powers. That report itself should be enough to condemn this bill to the scrapheap. Yesterday the Constitution Committee criticised it. If this bill passes, MPs and peers, we will not be writing the law in how we die but civil servant writing up almost 38 delegated power. But to be, I don't trust the Department of Health to write one word on the implementation.
The department has so far failed to permit single set wards for women. It failed to take action on the discredited Liverpool care pathway, with 3% of patients being extradited to death. A department that cannot the difference between men and women is not fit to write guidance on legislation when people should die and the drugs used to kill them. Every year 550,000 people die of terminal illness in the UK. In my 32 years in parliament, I am convinced it is impossible for Parliament to draft a general law, even with thousands of pages of regulation, which can cover every possible individual circumstance relating to those 550,000 people.
We have to realise and accept our limitations. I can draft a full proof law for myself but not for any of your Lordships situations nor half a million others. The variables are too great. There are numerous cases of people that being diagnosed with terminal cancer and making a full recovery and living many years longer than expected. The father of modern medicine said " Medicine is the science of uncertainty and art of probability. " Prognosis uncertainty is one of the reasons why the Royal College of Physicians do not support the bill.
This bill will give lawyers the ultimate power to make the final decisions, not doctors. We have all seen lawyers pursuing fraudulent medical negligence cases, and corrupt immigration lawyers running cases. Almost every clause in this bill could be used by lawyers on all sides of assisted dying applications to take the case to court. Of course those regulations will be a judicial review paradise for lawyers. I will trust my doctor to do what is in my best interests on my deathbed, on the basis of that medical mantra great First Do No Harm.
" I will be done if I let lawyers decide how I die. 2016 I helped pass the medical innovation act. It aims to promote innovation in medical treatment terminally ill patients. I recall a time that most doctors were in favour of it but the lawyers were opposed. Since we removed the ability to sue for treatment perception is most doctors have serious concerns about this bill, and most lawyers are in favour. I do not want lawyers to come within a million miles of decisions about how people should die.
I believe we need to start again, possibly with a Royal commission led by doctors that will set out the principles and safeguards required. Then there will need to be public scrutiny of a draft bill which a joint Parliamentary committee can consider. Finally we need a proper Government bills, we need to see draft of the regulations which will be there and we hope the regulations will be just alright on the night.
The Delegated Powers Committee has issued a scathing report on the excessive 38 delegated power including Henry VIII powers. That report itself should be enough to condemn this bill to the scrapheap. Yesterday the Constitution Committee criticised it. If this bill passes, MPs and peers, we will not be writing the law in how we die but civil servant writing up almost 38 delegated power. But to be, I don't trust the Department of Health to write one word on the implementation.
The department has so far failed to permit single set wards for women. It failed to take action on the discredited Liverpool care pathway, with 3% of patients being extradited to death. A department that cannot the difference between men and women is not fit to write guidance on legislation when people should die and the drugs used to kill them. Every year 550,000 people die of terminal illness in the UK. In my 32 years in parliament, I am convinced it is impossible for Parliament to draft a general law, even with thousands of pages of regulation, which can cover every possible individual circumstance relating to those 550,000 people.
We have to realise and accept our limitations. I can draft a full proof law for myself but not for any of your Lordships situations nor half a million others. The variables are too great. There are numerous cases of people that being diagnosed with terminal cancer and making a full recovery and living many years longer than expected. The father of modern medicine said " Medicine is the science of uncertainty and art of probability. " Prognosis uncertainty is one of the reasons why the Royal College of Physicians do not support the bill.
This bill will give lawyers the ultimate power to make the final decisions, not doctors. We have all seen lawyers pursuing fraudulent medical negligence cases, and corrupt immigration lawyers running cases. Almost every clause in this bill could be used by lawyers on all sides of assisted dying applications to take the case to court. Of course those regulations will be a judicial review paradise for lawyers. I will trust my doctor to do what is in my best interests on my deathbed, on the basis of that medical mantra great First Do No Harm.
" I will be done if I let lawyers decide how I die. 2016 I helped pass the medical innovation act. It aims to promote innovation in medical treatment terminally ill patients. I recall a time that most doctors were in favour of it but the lawyers were opposed. Since we removed the ability to sue for treatment perception is most doctors have serious concerns about this bill, and most lawyers are in favour. I do not want lawyers to come within a million miles of decisions about how people should die.
I believe we need to start again, possibly with a Royal commission led by doctors that will set out the principles and safeguards required. Then there will need to be public scrutiny of a draft bill which a joint Parliamentary committee can consider. Finally we need a proper Government bills, we need to see draft of the regulations which will be there and we hope the regulations will be just alright on the night.
12:23
Lord Kakkar (Crossbench)
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Lord Kakkar (Crossbench)
My Lords, I rise in first thank Lord Falconer for having introduced this bill in your Lordships House. I thank many noble Lords for their thoughtful and deeply insightful contributions to this debate which have helped inform the crux of the matter. That is, this is a very complex and serious issue. It will ultimately change the relationship between the citizen and the state. And indeed between patients and their doctors. But we have also highlighted the important principle that, as a matter of course, we offer our fellow citizens rights, as long as those rights do not result in harm to other fellow citizens.
Therefore I think it is appropriate at this moment in time that we do consider the question of whether citizens should be given the right when terminally ill to consider when and how their lives are ended. In doing so, we need to be deeply sensitive to the many residual anxieties that still exist, and the many issues that have been raised that attends this bill in its current form. The principal consideration here is whether, in introducing a right for the individual, the bill inadvertently creates the opportunity for harm to other individuals.
And whether sufficient steps have been taken to protect against those potential harms. There are a series of other issues as well. But there is precedent when bills of this nature have arrived in your Lordships House, the nature being, bills that have a profound societal impact, that the government of the day has made additional time available. Two examples are, the murder abolition of the death penalty act 1965 and the abolition act of 1967. So at the very least I think it is essential for the government to ensure that time is made available for appropriate scrutiny.
And that appropriate scrutiny must consider a series of issues, any of which have been raised in this debate already. One that has been made to me by many colleagues in active practice is that they are strongly in principle of the provisions in this bill, but, in practice, they are very concerned about how it might be applied in the NHS, and in particular, how the bill might end up in what is described as a substantially protocol eyes fashion, whether thoughtful and insightful application of its provisions to the individual are lost in the way that so much care is now organised in the NHS.
This is something we will need to explore. The other point that I think has been exceedingly well made, are the implications, and the message sent by passing a bill that makes provision for the state to pay for an assisted dying service in its entirety. Whilst not fully funding the provision of palliative care. What are the implications? What message does that send? And indeed what might be the inadvertent consequences of pursuing that approach? Another matter that will need to be considered very carefully during the committee stage of this bill.
Ultimately, if this bill is to pass, it must pass enjoying maximum amount of confidence. Having provided the appropriate safeguards. To pass it in any other way will regrettably result in very serious
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adverse consequences. Over the last 35 years, I have
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Over the last 35 years, I have attended and spoken at most of the debate on euthanasia. One of the features that has always struck me
Therefore I think it is appropriate at this moment in time that we do consider the question of whether citizens should be given the right when terminally ill to consider when and how their lives are ended. In doing so, we need to be deeply sensitive to the many residual anxieties that still exist, and the many issues that have been raised that attends this bill in its current form. The principal consideration here is whether, in introducing a right for the individual, the bill inadvertently creates the opportunity for harm to other individuals.
And whether sufficient steps have been taken to protect against those potential harms. There are a series of other issues as well. But there is precedent when bills of this nature have arrived in your Lordships House, the nature being, bills that have a profound societal impact, that the government of the day has made additional time available. Two examples are, the murder abolition of the death penalty act 1965 and the abolition act of 1967. So at the very least I think it is essential for the government to ensure that time is made available for appropriate scrutiny.
And that appropriate scrutiny must consider a series of issues, any of which have been raised in this debate already. One that has been made to me by many colleagues in active practice is that they are strongly in principle of the provisions in this bill, but, in practice, they are very concerned about how it might be applied in the NHS, and in particular, how the bill might end up in what is described as a substantially protocol eyes fashion, whether thoughtful and insightful application of its provisions to the individual are lost in the way that so much care is now organised in the NHS.
This is something we will need to explore. The other point that I think has been exceedingly well made, are the implications, and the message sent by passing a bill that makes provision for the state to pay for an assisted dying service in its entirety. Whilst not fully funding the provision of palliative care. What are the implications? What message does that send? And indeed what might be the inadvertent consequences of pursuing that approach? Another matter that will need to be considered very carefully during the committee stage of this bill.
Ultimately, if this bill is to pass, it must pass enjoying maximum amount of confidence. Having provided the appropriate safeguards. To pass it in any other way will regrettably result in very serious
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adverse consequences. Over the last 35 years, I have
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Over the last 35 years, I have attended and spoken at most of the debate on euthanasia. One of the features that has always struck me
12:27
Lord McColl of Dulwich (Conservative)
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Lord McColl of Dulwich (Conservative)
features that has always struck me is that the debates have been full of anecdotes, and perhaps we ought to consider the Greek word anecdote means unpublished, which is arguably what most anecdotes should remain. So I will avoid anecdotes and stick to my practice over the last 50 years. Perhaps I can best illustrate that by a lady aged 28, who came in with an inoperable cancer of the throat. She was in pain and in great respiratory distress.
And I said to her that I could relieve all her symptoms with an intravenous injection, analgesic. Would you like to do that, I asked her. She said yes. I put a needle into her vain and started to titrate her as it were. And I was amazed how much I had to inject will stop eventually, all her symptoms went. And she died three weeks later having had three weeks symptom-free. Cicely Saunders, with whom I was a contemporary at St Thomas's and Guy's Hospital, she was the founder of the hospice movement of course.
And she devised this technique of keeping the level of analgesia in the blood at a constant level. She found it was best to prevent pain, rather than wait until it had come. Of course that works. The patient was much more wide- awake, and could enjoy what life remained with this technique. One of the worrying features of this whole subject is that those who are keen on euthanasia have taken it into their heads many of them, to rubbish the hospice movement and spread rumours around that they don't know how to relieve pain.
This is a lie. I have worked in hospices for all these years, and that is not the these years, and that is not the case. They say, we are not allowed to give more analgesia because of the law. There is no law that prevents that. You can give as much as is needed. And that is the thing that Cicely Saunders promoted and did very well. We hear a lot about freedom, and the right to freedom. A man came into a hospice and he had multiple myeloma.
So it was affecting his bone marrow, and releasing large quantities of calcium. That means if you have too much calcium in the blood, the heart stops beating. And he said he wanted euthanasia. And they said that you are having a drug that keeps your calcium down to stop you dying. If you want to die, all you have to do is stop taking the drug. My Lords, he never stopped taking the drug until the day he died. So much for
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I support this bill. Much has
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I support this bill. Much has changed in the many years your logic tells us debating assisted dying and
And I said to her that I could relieve all her symptoms with an intravenous injection, analgesic. Would you like to do that, I asked her. She said yes. I put a needle into her vain and started to titrate her as it were. And I was amazed how much I had to inject will stop eventually, all her symptoms went. And she died three weeks later having had three weeks symptom-free. Cicely Saunders, with whom I was a contemporary at St Thomas's and Guy's Hospital, she was the founder of the hospice movement of course.
And she devised this technique of keeping the level of analgesia in the blood at a constant level. She found it was best to prevent pain, rather than wait until it had come. Of course that works. The patient was much more wide- awake, and could enjoy what life remained with this technique. One of the worrying features of this whole subject is that those who are keen on euthanasia have taken it into their heads many of them, to rubbish the hospice movement and spread rumours around that they don't know how to relieve pain.
This is a lie. I have worked in hospices for all these years, and that is not the these years, and that is not the case. They say, we are not allowed to give more analgesia because of the law. There is no law that prevents that. You can give as much as is needed. And that is the thing that Cicely Saunders promoted and did very well. We hear a lot about freedom, and the right to freedom. A man came into a hospice and he had multiple myeloma.
So it was affecting his bone marrow, and releasing large quantities of calcium. That means if you have too much calcium in the blood, the heart stops beating. And he said he wanted euthanasia. And they said that you are having a drug that keeps your calcium down to stop you dying. If you want to die, all you have to do is stop taking the drug. My Lords, he never stopped taking the drug until the day he died. So much for
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I support this bill. Much has
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I support this bill. Much has changed in the many years your logic tells us debating assisted dying and
12:31
Baroness Noakes (Conservative)
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Baroness Noakes (Conservative)
tells us debating assisted dying and the terminally ill. A public support for it has been constant. A survey has found around 80% in favour and 20% against consistently for the last 30 years. Your Lordships house should certainly not be a slavish follower of public opinion but should at least hesitate for saying that health knows better than the pretty settled view of the vast majority of the public. Especially now that the other place is aligned. I support this bill because it respects personal choice and autonomy.
However good medical care may be, it is a fact that it does not always go with the suffering that comes with terminal. Terminally ill people do have choices at present, beyond accepting the medical treatment on offer. They can choose to refuse medical treatment, they can choose to refuse hydration and nutrition. And they can also commit suicide. But these are rotten choices, usually associated with an unpleasant death. This bill gives another choice, to people facing certain death.
The possibility of a peaceful death or indeed the likelihood of a peaceful death. I completely accept there are dangers for those who are unable to make rational choices or who are pressured to make choices that they do not want to make. That is why this bill is so complicated, the bill goes out of its way to try and ensure the choice is genuine. Now, I am sure we will be debated in committee whether further safeguards are needed. I hope noble Lords will accept that there will never be a way of eliminating all risks without, in practice, denying choice, to those for whom this bill choice, to those for whom this bill is designed.
That is why I think, in many ways, the most important parts of the bill are those relating to the Commissioner and to monitoring a review of the act. If problems emerge, they will be reported and they can be acted on. And that is an important safeguard on the bill. Lastly, my Lords, while I respect the delegated and regulatory view committee, in this instance, I think they have gone a little bit too far. they have gone a little bit too far. Secondary legislation and Henry VIII clauses are not the devil incarnate, they are often the most effective ways of getting the details right on a sustainable basis, to deal with how things evolve over time.
I hope that our approach to delegated and indeed to the whole of this bill, as it moves through the remaining stages, I hope that we will be pragmatic and that we will not let the best become the enemy of the
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good. On Wednesday, we marked world suicide prevention Day. This year, suicide prevention Day. This year, the theme was changing the narrative on suicide, and we were reminded how
However good medical care may be, it is a fact that it does not always go with the suffering that comes with terminal. Terminally ill people do have choices at present, beyond accepting the medical treatment on offer. They can choose to refuse medical treatment, they can choose to refuse hydration and nutrition. And they can also commit suicide. But these are rotten choices, usually associated with an unpleasant death. This bill gives another choice, to people facing certain death.
The possibility of a peaceful death or indeed the likelihood of a peaceful death. I completely accept there are dangers for those who are unable to make rational choices or who are pressured to make choices that they do not want to make. That is why this bill is so complicated, the bill goes out of its way to try and ensure the choice is genuine. Now, I am sure we will be debated in committee whether further safeguards are needed. I hope noble Lords will accept that there will never be a way of eliminating all risks without, in practice, denying choice, to those for whom this bill choice, to those for whom this bill is designed.
That is why I think, in many ways, the most important parts of the bill are those relating to the Commissioner and to monitoring a review of the act. If problems emerge, they will be reported and they can be acted on. And that is an important safeguard on the bill. Lastly, my Lords, while I respect the delegated and regulatory view committee, in this instance, I think they have gone a little bit too far. they have gone a little bit too far. Secondary legislation and Henry VIII clauses are not the devil incarnate, they are often the most effective ways of getting the details right on a sustainable basis, to deal with how things evolve over time.
I hope that our approach to delegated and indeed to the whole of this bill, as it moves through the remaining stages, I hope that we will be pragmatic and that we will not let the best become the enemy of the
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good. On Wednesday, we marked world suicide prevention Day. This year, suicide prevention Day. This year, the theme was changing the narrative on suicide, and we were reminded how
12:35
Lord Morrow (Democratic Unionist Party)
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Lord Morrow (Democratic Unionist Party)
on suicide, and we were reminded how simply being willing to open a conversation, where a person in crisis can open up suicidal thoughts and be given hope. We are bringing legislation that would indeed change the narrative on suicide, but exactly the opposite way, unattended. This " May reduce unattended. This " May reduce societal taboos, with campaigns in that suicide prevention." Since assisted suicide was introduced in Victoria Australia and although assisted suicides have increased by some 50% amongst older people, similar patterns have been observed elsewhere.
I'm conscious the bill supporters feel uncomfortable with the language of assisted suicide but we cannot shy away from the facts of the bill itself. Clause 32 amends the Suicide Act 1961 and to avoid doctors being prosecuted for providing illegal drugs for patients, an act that would otherwise clearly be categorised as in the words of the statute capable of encouraging or assisting the suicide or attempted suicide of another person. The argument is made rather callously, in my view. That terminally ill people are dying anyway.
But why shouldn't the importance of suicide prevention disappear, just because someone is terminally ill and truth, I would go further and say, this time a vulnerability is precisely the time when the protections afforded by the Suicide Act are most needed. As Royal College of Psychiatrists explains, mental disorders, such as depression, are more common in people nearing the end of their life people nearing the end of their life and anxiety can amplify fears of future suffering. My Lords, the tragedy is that under this bill, a person's wish to die could be endorsed before that person could see the benefits of psychological treatment.
Evidence suggests that suicidally, chronic disease often peaks at 90 days. But the assisted suicide process could take less than one third of that time. The requirement in clause 12 for psychiatric referral, if there is any doubt as to that person's capacity, does not resolve the problem. Many people may reach the low threshold of capacity, set out in the Mental Capacity Act will still have their thinking obscured by poor mental health or other disabilities. For this reason, the Royal College of Physicians and the Royal College of Psychiatrists have made clear, vulnerable patients, particularly those with remedial mental health, or other unmet needs, are not adequately protected by the current bill.
Human rights lawyer, Tom Cross, goes further. Warning that, as drafted, the bill unjustifiably discriminates against those persons whose disabilities manifest in the expression of societal ideation and so breaches article 14 of the European on human rights -- The human -- The European Convention on Human Rights. It is in control to me that a doctor might be persuading a terminally ill patient of the value of life one week, only to be effectively managing suicide prevention and endorsing despair. Once he considers there is only six months to live.
The law should not send the message that some lives are not worth living. For that reason, I will be opposing the bill.
I'm conscious the bill supporters feel uncomfortable with the language of assisted suicide but we cannot shy away from the facts of the bill itself. Clause 32 amends the Suicide Act 1961 and to avoid doctors being prosecuted for providing illegal drugs for patients, an act that would otherwise clearly be categorised as in the words of the statute capable of encouraging or assisting the suicide or attempted suicide of another person. The argument is made rather callously, in my view. That terminally ill people are dying anyway.
But why shouldn't the importance of suicide prevention disappear, just because someone is terminally ill and truth, I would go further and say, this time a vulnerability is precisely the time when the protections afforded by the Suicide Act are most needed. As Royal College of Psychiatrists explains, mental disorders, such as depression, are more common in people nearing the end of their life people nearing the end of their life and anxiety can amplify fears of future suffering. My Lords, the tragedy is that under this bill, a person's wish to die could be endorsed before that person could see the benefits of psychological treatment.
Evidence suggests that suicidally, chronic disease often peaks at 90 days. But the assisted suicide process could take less than one third of that time. The requirement in clause 12 for psychiatric referral, if there is any doubt as to that person's capacity, does not resolve the problem. Many people may reach the low threshold of capacity, set out in the Mental Capacity Act will still have their thinking obscured by poor mental health or other disabilities. For this reason, the Royal College of Physicians and the Royal College of Psychiatrists have made clear, vulnerable patients, particularly those with remedial mental health, or other unmet needs, are not adequately protected by the current bill.
Human rights lawyer, Tom Cross, goes further. Warning that, as drafted, the bill unjustifiably discriminates against those persons whose disabilities manifest in the expression of societal ideation and so breaches article 14 of the European on human rights -- The human -- The European Convention on Human Rights. It is in control to me that a doctor might be persuading a terminally ill patient of the value of life one week, only to be effectively managing suicide prevention and endorsing despair. Once he considers there is only six months to live.
The law should not send the message that some lives are not worth living. For that reason, I will be opposing the bill.
12:39
Lord Swire (Conservative)
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Lord Swire (Conservative)
May I, as others have, start by thanking all those who have taken the trouble to write to me, raising some personal stories, a very tragic stories, I have no personal stories, myself, but I very moved by those who have. And actually, it's one of those debates, one of the few debates I wish I was speaking much later on, so I can sit and listen, as I seem to change my mind, with every speaker, with their own personal experience. Here we have a piece of legislation, which raises profound, ethical and moral issues.
profound, ethical and moral issues. Therefore, we oh it to ourselves and the country to spend as much time in a deep dive on many of the issues they raise, and I have to say, I think it's the duty of this House to do that, with no degree of what the noble Baroness, Baroness Hodgson, said, the comments being elect have more rights than we do, I think we have absolutely every right to amend or send it back if we are not happy with what is in it.
My Lords, this bill is currently construed, leaves bill is currently construed, leaves me with an overriding nervousness. What happens next if we pass this legislation? The noble and learned Lord is reassuring on the matter of primary legislation being required, were this to be amended in any way in the future. But the noble Baroness, Baroness Murphy, is honest enough that she will be seeking immediately an extension of eligibility. And you can quite it shall come in a few years time, people will say six months, people change, medical things have changed, should 12 months, shouldn't be those who come into this category, should extend the category, as they have done in Canada, with all the rather profound problems that have arisen in that part of the world, so I'm nervous about that.
I have a deep unease that we are going to be asking part of the NHS, a staff full of dedicated people who are working there on the whole because they wish to preserve and enhance life, we are hypothecated half of it off to create a category of workers within the NHS. Who will be dedicated to ending life. And that leaves me with a sense of profound unease. Surely we should be spending more time, effort and money on palliative care, end-of-life care, and social care, that should be where we should be concentrating all our efforts and energies.
My Lords, we have heard very little about the amazing advances that there are in treatment, an almost daily basis. What is inoperable or life- threatening today very often is incurable or life can be extended tomorrow. I think we should be a little bit more positive about the ability for people to recover from illnesses which now frankly they would die. I'm worried about the asymmetry of this legislation that we would have different regulations, perhaps in different parts of the United Kingdom.
I'm concerned about the Delegated Powers and Regulatory Reform Committee who express their concern that so much of the bill is being left to delegated legislation. I am concerned that the Select Committee on the constitution is concerned about the lack of pre- legislation scrutiny, saying deliberation scrutiny is significantly command assessment, significantly less than would be expected from a government bill. It is why companies about my noble friend, noble Lord, Lord Forsyth, and his amendment, because I think and his amendment, because I think that makes complete sense.
I have not made my mind up finally, and shall not do so until I have heard all the arguments at Vienna, but currently, if the vote were today, -- At the end, but currently, if the
**** Possible New Speaker ****
vote were today, I would not be in a position to support this bill. I have been asked by my long-
profound, ethical and moral issues. Therefore, we oh it to ourselves and the country to spend as much time in a deep dive on many of the issues they raise, and I have to say, I think it's the duty of this House to do that, with no degree of what the noble Baroness, Baroness Hodgson, said, the comments being elect have more rights than we do, I think we have absolutely every right to amend or send it back if we are not happy with what is in it.
My Lords, this bill is currently construed, leaves bill is currently construed, leaves me with an overriding nervousness. What happens next if we pass this legislation? The noble and learned Lord is reassuring on the matter of primary legislation being required, were this to be amended in any way in the future. But the noble Baroness, Baroness Murphy, is honest enough that she will be seeking immediately an extension of eligibility. And you can quite it shall come in a few years time, people will say six months, people change, medical things have changed, should 12 months, shouldn't be those who come into this category, should extend the category, as they have done in Canada, with all the rather profound problems that have arisen in that part of the world, so I'm nervous about that.
I have a deep unease that we are going to be asking part of the NHS, a staff full of dedicated people who are working there on the whole because they wish to preserve and enhance life, we are hypothecated half of it off to create a category of workers within the NHS. Who will be dedicated to ending life. And that leaves me with a sense of profound unease. Surely we should be spending more time, effort and money on palliative care, end-of-life care, and social care, that should be where we should be concentrating all our efforts and energies.
My Lords, we have heard very little about the amazing advances that there are in treatment, an almost daily basis. What is inoperable or life- threatening today very often is incurable or life can be extended tomorrow. I think we should be a little bit more positive about the ability for people to recover from illnesses which now frankly they would die. I'm worried about the asymmetry of this legislation that we would have different regulations, perhaps in different parts of the United Kingdom.
I'm concerned about the Delegated Powers and Regulatory Reform Committee who express their concern that so much of the bill is being left to delegated legislation. I am concerned that the Select Committee on the constitution is concerned about the lack of pre- legislation scrutiny, saying deliberation scrutiny is significantly command assessment, significantly less than would be expected from a government bill. It is why companies about my noble friend, noble Lord, Lord Forsyth, and his amendment, because I think and his amendment, because I think that makes complete sense.
I have not made my mind up finally, and shall not do so until I have heard all the arguments at Vienna, but currently, if the vote were today, -- At the end, but currently, if the
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vote were today, I would not be in a position to support this bill. I have been asked by my long-
12:43
Lord Barber of Ainsdale (Labour)
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**** Possible New Speaker ****
I have been asked by my long- standing friend and TUC colleague to contribute to this debate. Lord Monks is unable to be present today Monks is unable to be present today due to family reasons, and what follows are his remarks, which I am pleased to bring to your Lordships attention. Some of you will be familiar with Daniel's story. Daniel, our son, died just over a year ago. His story was featured in an ITV documentary, titled A Time to Die and also an article in the House magazine.
Daniel was 48 years old. A music teacher, and a popular presence in many situations. When he was 26, he was diagnosed with MS. Almost certainly primary progressive MS, which by early 2024, had wiped out all his movements except for speech. My wife and I had looked after him since 2016. In 2023, an attack of pneumonia left him unable to move any limb and a concurrent attack of Crohn's disease caused a blockage in his bowels. He was then placed in palliative care.
Daniel always maintained a cheerful and positive outlook on life, despite his enormous disabilities, enduring his suffering with good temper and consideration for others. He did not suffer from depression. But he did decide that he had enough. He wanted to die. He registered with Dignitas in 2022 and had explored the Dutch system of assisted dying as he had a Dutch passport. Neither option work for him. So, he did the only thing he could. In the absence of any UK system for assisted dying.
He starved himself to death by not taking anything by mouth and a week later, died in Saint Christopher's Hospice in south London. Who, by the way, were marvellous. So ends Daniel's story. But I ask those of you who are opposed to assisted dying to face the same choices Daniel and our family faced. Would you have helped him? Would you have put obstacles in his way? What you put obstacles in his way? What you This bill does not cover Daniel's type of illness.
That is its major weakness in my view. Nevertheless in due course I shall vote for it. It may not ease the end of life for those suffering from neurological illnesses, but it will help many more, if Parliament has the guts to give them a choice. Please my Lords, do not make exercising that choice a hugely bureaucratic Grand National course that is very difficult to navigate. Put the emphasis where it should be. Trust people to make the right choice for them.
Please pass this bill when the crucial vote comes. My Lords, I speak now very briefly for myself. Daniel was a talented impressive lovely man, and his loss is still deeply felt by a lot of people. I recognise there are concerns for some colleagues. About whether the safeguards currently built into the bill leave uncertainties in some minds, about possible unintended consequences. Issues which we will be debating thoroughly in the bill's detailed scrutiny to come. But what is absolutely certain is, if this bill is not passed, countless people will continue to suffer painful horrific undignified deaths.
Suffering from which they could be relieved if this bill passes. That is why, like the noble Lord, I am strongly supporting this bill.
Lord Barber of Ainsdale (Labour)
**** Possible New Speaker ****
I have been asked by my long- standing friend and TUC colleague to contribute to this debate. Lord Monks is unable to be present today Monks is unable to be present today due to family reasons, and what follows are his remarks, which I am pleased to bring to your Lordships attention. Some of you will be familiar with Daniel's story. Daniel, our son, died just over a year ago. His story was featured in an ITV documentary, titled A Time to Die and also an article in the House magazine.
Daniel was 48 years old. A music teacher, and a popular presence in many situations. When he was 26, he was diagnosed with MS. Almost certainly primary progressive MS, which by early 2024, had wiped out all his movements except for speech. My wife and I had looked after him since 2016. In 2023, an attack of pneumonia left him unable to move any limb and a concurrent attack of Crohn's disease caused a blockage in his bowels. He was then placed in palliative care.
Daniel always maintained a cheerful and positive outlook on life, despite his enormous disabilities, enduring his suffering with good temper and consideration for others. He did not suffer from depression. But he did decide that he had enough. He wanted to die. He registered with Dignitas in 2022 and had explored the Dutch system of assisted dying as he had a Dutch passport. Neither option work for him. So, he did the only thing he could. In the absence of any UK system for assisted dying.
He starved himself to death by not taking anything by mouth and a week later, died in Saint Christopher's Hospice in south London. Who, by the way, were marvellous. So ends Daniel's story. But I ask those of you who are opposed to assisted dying to face the same choices Daniel and our family faced. Would you have helped him? Would you have put obstacles in his way? What you put obstacles in his way? What you This bill does not cover Daniel's type of illness.
That is its major weakness in my view. Nevertheless in due course I shall vote for it. It may not ease the end of life for those suffering from neurological illnesses, but it will help many more, if Parliament has the guts to give them a choice. Please my Lords, do not make exercising that choice a hugely bureaucratic Grand National course that is very difficult to navigate. Put the emphasis where it should be. Trust people to make the right choice for them.
Please pass this bill when the crucial vote comes. My Lords, I speak now very briefly for myself. Daniel was a talented impressive lovely man, and his loss is still deeply felt by a lot of people. I recognise there are concerns for some colleagues. About whether the safeguards currently built into the bill leave uncertainties in some minds, about possible unintended consequences. Issues which we will be debating thoroughly in the bill's detailed scrutiny to come. But what is absolutely certain is, if this bill is not passed, countless people will continue to suffer painful horrific undignified deaths.
Suffering from which they could be relieved if this bill passes. That is why, like the noble Lord, I am strongly supporting this bill.
12:48
Lord Bridges of Headley (Conservative)
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Lord Bridges of Headley (Conservative)
I am opposed in principle to this bill. For a myriad of reasons. Very well articulated by my noble friend Baroness Meyer, and my noble friend Lord Ahmad. We have heard other noble Lords whose principles lead them to support the bill. And I very much respect their views and their position. To those who disagree with me and other noble Lords on matters of principle, and those who support the bill, I'm sure we can all agree on one point, and it is a simple and obvious one but worth saying.
On legislation on an issue as sensitive as this, we cannot and must not rush ourselves. Quite the reverse. On this subject, almost more than any other, indeed more than any other, it is imperative that we set a very high bar in terms of the scrutiny we give this bill. Which is why I support so wholeheartedly what Lord Forsyth has put in his motion. If this bill is to pass into law, that law must not just be merely workable and practical, it must be a law that commands people's trust.
A law which ensures that those who implement its measures could be held to account although I hear the heartfelt points being made today, I do not think this bill in its current state does meet the exacting standards we should demand of it. Day after day, like I am sure many other noble Lords, I have been receiving emails and letters raising specific points of concern about numerous aspects of it. The eligibility criteria, the definition of terminal illness, the suitability of relying on the Mental Capacity Act, the role of doctors, the safeguards to ensure vulnerable people are not coerced into making decisions.
The impact on NHS resources, and palliative care. The list goes on and on. Baroness Grey- Thompson cited others. These concerns are coming from experts and members of the public. And they cannot and must not be brushed aside. But added to these concerns is one other, another that I think unites many of us on all sides of the House. That is the use of delegated power. My Lords, we often bemoan how governments, and I include those I have been part of, produce bills that gives ministers powers to make regulations which receive minimal Parliamentary approval.
On any issue, chipping away at Parliament's ability to hold ministers properly to account is bad enough. But on this, on this issue that is literally related to life and death, it is in my mind unacceptable. The Delegated Powers Committee quite rightly called several clauses highly inappropriate. Let us remind ourselves what they said. They give sweeping unspecified and unjustified powers to government while removing Parliament scrutiny role for the provision that should be in primary legislation. And replacing it with considerably more limited role of scrutinising legislation.
Lord Falconer I'm delighted to hear that he has suggested that he will address this. I'm pleased to hear that. But I'm not surprised by it. Just last year, he gave a lecture in which he talked about "The primary legislation giving huge power to ministers and other bodies which would previously have required either primary or secondary legislation. " Citing the skeleton legislation, Henry VIII powers, legislation powers and disguise legislation. And he concluded by saying that if legislation comes in one of these four ways it is unconstitutional.
This is one reason why this bill is flawed. White needs a complete overhaul. White is laced with ambiguity, riddled with unanswered questions, and its breeding anxiety amongst so many people.
**** Possible New Speaker ****
This is one of the most important bills we will ever see. For centuries we have protected and centuries we have protected and preserved life, which is to me and so many sacred. We are now asked to
On legislation on an issue as sensitive as this, we cannot and must not rush ourselves. Quite the reverse. On this subject, almost more than any other, indeed more than any other, it is imperative that we set a very high bar in terms of the scrutiny we give this bill. Which is why I support so wholeheartedly what Lord Forsyth has put in his motion. If this bill is to pass into law, that law must not just be merely workable and practical, it must be a law that commands people's trust.
A law which ensures that those who implement its measures could be held to account although I hear the heartfelt points being made today, I do not think this bill in its current state does meet the exacting standards we should demand of it. Day after day, like I am sure many other noble Lords, I have been receiving emails and letters raising specific points of concern about numerous aspects of it. The eligibility criteria, the definition of terminal illness, the suitability of relying on the Mental Capacity Act, the role of doctors, the safeguards to ensure vulnerable people are not coerced into making decisions.
The impact on NHS resources, and palliative care. The list goes on and on. Baroness Grey- Thompson cited others. These concerns are coming from experts and members of the public. And they cannot and must not be brushed aside. But added to these concerns is one other, another that I think unites many of us on all sides of the House. That is the use of delegated power. My Lords, we often bemoan how governments, and I include those I have been part of, produce bills that gives ministers powers to make regulations which receive minimal Parliamentary approval.
On any issue, chipping away at Parliament's ability to hold ministers properly to account is bad enough. But on this, on this issue that is literally related to life and death, it is in my mind unacceptable. The Delegated Powers Committee quite rightly called several clauses highly inappropriate. Let us remind ourselves what they said. They give sweeping unspecified and unjustified powers to government while removing Parliament scrutiny role for the provision that should be in primary legislation. And replacing it with considerably more limited role of scrutinising legislation.
Lord Falconer I'm delighted to hear that he has suggested that he will address this. I'm pleased to hear that. But I'm not surprised by it. Just last year, he gave a lecture in which he talked about "The primary legislation giving huge power to ministers and other bodies which would previously have required either primary or secondary legislation. " Citing the skeleton legislation, Henry VIII powers, legislation powers and disguise legislation. And he concluded by saying that if legislation comes in one of these four ways it is unconstitutional.
This is one reason why this bill is flawed. White needs a complete overhaul. White is laced with ambiguity, riddled with unanswered questions, and its breeding anxiety amongst so many people.
**** Possible New Speaker ****
This is one of the most important bills we will ever see. For centuries we have protected and centuries we have protected and preserved life, which is to me and so many sacred. We are now asked to
12:52
Baroness O'Loan (Crossbench)
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Baroness O'Loan (Crossbench)
so many sacred. We are now asked to change utterly and create a way for how people die. The opposition is massive, particularly among medical practitioners and professional associations. This is a profoundly dangerous and flawed bill. The constitutional committee rightly affirms our right to scrutinise Lord was to speak today but was seriously injured last week and cannot travel. He is not permitted to speak rightly. Had he been here, he would have warned against coercion, inadequate safeguards, inevitable incremental is in and human rights.
The consequences of this bill are not known. There was no pre-legislative consultation. No proper impact assessment. The committee was selected by the bill's promoter, witnesses selected who largely supported the bill. The evidence secured did not reflect a wide evidence base. Most amendments tabled that report were not debated and voted on. Many MPs who wanted to speak were not called. Constitution Committee said yesterday the degree of deliberation assessment and scrutiny is therefore significantly less than we would expect to see for any equivalent government bill.
Especially concerning given the subject matter of the bill. The bill is a framework for assisted death, nothing more. There are 42 delegated legislative powers including Henry VIII powers. Powers which the DPRRC described as sweeping and unspecified and unjustified. Eligibility is very uncertain. What is a recently expected death? The definition of terminal illness is unclear. 36% of such diagnosis are recorded after death to be inaccurate. Only 48% of prognoses are accurate for six months. One two prognoses will be wrong.
Is it safe? Capacity is to be assumed under the Mental Health Act. The assessment process involves two doctors, only one of whom must know the patient. How will they determine capacity, especially in those suffering from shock, grief, and illness after diagnosis? How will it be assessed, monitored? Death may take place in hospices, hospices have said it is not safe. In care homes? How could that be say. Will doctors be able to manage the practice of to stay until the patient is dead? Up to 137 hours.
And what if someone does not die? No one has to check why someone wants to die, coercion if someone feels they are a burden to others. And how will we keep our doctors and other clinicians safe? Clinicians are being asked to do no harm and to provide education to terminate a patient's life. Anyone not do it. What will the effect of this be on our doctors? Suicide rates are already higher among doctors than generally. A doctor dies by suicide generally.
A doctor dies by suicide every 10 days the BMJ says. There is a shortage of obstetricians and gynaecologists because of the process around abortion. The president of the Royal College radiologist has said there is a chronic lack of radiologists. The outlook is bleak. What will be the effect of the introduction of assisted death to the situation? And finally it is accountable? 31% of people seek assisted death that will be nearly 6,000 a year. How will the Commissioner find the psychiatrists, lawyers, social workers who constitute powers for 6,000 applications a year at a time when all three professions are understaffed? At only one hour a case it would take 18,000 panel members time each year and internationally the rate is much higher than 1%.
The bill provides little protection and no security of how death comes about. There will be no inquests, no one will ask about coercion or abandonment or anything else. Around 50% of those who die can't get specialist palliative care. Why do we fund 100% of services at the bidding of life but only 30% at the end? Dame Cicely Saunders said, " We don't have to kill a patient in order to kill the pain. " This bill is in conceived, uncertain and unsafe.
It should be rejected.
The consequences of this bill are not known. There was no pre-legislative consultation. No proper impact assessment. The committee was selected by the bill's promoter, witnesses selected who largely supported the bill. The evidence secured did not reflect a wide evidence base. Most amendments tabled that report were not debated and voted on. Many MPs who wanted to speak were not called. Constitution Committee said yesterday the degree of deliberation assessment and scrutiny is therefore significantly less than we would expect to see for any equivalent government bill.
Especially concerning given the subject matter of the bill. The bill is a framework for assisted death, nothing more. There are 42 delegated legislative powers including Henry VIII powers. Powers which the DPRRC described as sweeping and unspecified and unjustified. Eligibility is very uncertain. What is a recently expected death? The definition of terminal illness is unclear. 36% of such diagnosis are recorded after death to be inaccurate. Only 48% of prognoses are accurate for six months. One two prognoses will be wrong.
Is it safe? Capacity is to be assumed under the Mental Health Act. The assessment process involves two doctors, only one of whom must know the patient. How will they determine capacity, especially in those suffering from shock, grief, and illness after diagnosis? How will it be assessed, monitored? Death may take place in hospices, hospices have said it is not safe. In care homes? How could that be say. Will doctors be able to manage the practice of to stay until the patient is dead? Up to 137 hours.
And what if someone does not die? No one has to check why someone wants to die, coercion if someone feels they are a burden to others. And how will we keep our doctors and other clinicians safe? Clinicians are being asked to do no harm and to provide education to terminate a patient's life. Anyone not do it. What will the effect of this be on our doctors? Suicide rates are already higher among doctors than generally. A doctor dies by suicide generally.
A doctor dies by suicide every 10 days the BMJ says. There is a shortage of obstetricians and gynaecologists because of the process around abortion. The president of the Royal College radiologist has said there is a chronic lack of radiologists. The outlook is bleak. What will be the effect of the introduction of assisted death to the situation? And finally it is accountable? 31% of people seek assisted death that will be nearly 6,000 a year. How will the Commissioner find the psychiatrists, lawyers, social workers who constitute powers for 6,000 applications a year at a time when all three professions are understaffed? At only one hour a case it would take 18,000 panel members time each year and internationally the rate is much higher than 1%.
The bill provides little protection and no security of how death comes about. There will be no inquests, no one will ask about coercion or abandonment or anything else. Around 50% of those who die can't get specialist palliative care. Why do we fund 100% of services at the bidding of life but only 30% at the end? Dame Cicely Saunders said, " We don't have to kill a patient in order to kill the pain. " This bill is in conceived, uncertain and unsafe.
It should be rejected.
12:57
Lord Polak (Conservative)
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Lord Polak (Conservative)
In May 2006, prior to the bill for assisted dying came to Parliament, the late Chief Rabbi Lord Sacks published a document saying the Jewish tradition was firmly opposed to assisted dying full stop I quote, " Those who propose the current bill do so from the highest motives. The purity of motive has never ensured rightness of outcome. Often it has been the reverse. To give a dying dignity using all possible means to treat the pain is one thing, to allow medically assisted suicides is another.
If we lose our reverence for human life, we will one day lose much else besides. " The words of Lord Sacks should once again ring loudly and clearly. As loudly and clearly today as they did in 2006. I have no desire to diminish the heartfelt convictions of anyone here in this chamber, or anyone who has written so movingly. But I speak out of a deep and abiding concern for the society we are shaping. For the values we hold, and for the vulnerable who we are duty bound to protect.
And I speak as someone who was given six months to live 37 years ago. The assisted dying bill before us carries risk we cannot and must not ignore. The debate is not about compassion. All of us want to alleviate the suffering. It is a debate about the means by which we do so. About the kind of society we want to be, and the message we send when the law itself offers death as a solution. I fear the bill crosses that moral Rubicon.
Once the state endorses the intentional ending of life, however regulated, however framed, we embark on a journey whose destination is uncertain, and deeply troubling. We are told that safeguards should be in place but what starts with those deemed mentally competent and terminally ill so easily extends gradually and quietly to others. Looking at the jurisdictions where such laws have been passed, the criteria loosened, and the line, once thought so firm, fades. What message to be sent to the elderly, the disabled, the chronically ill, when the law declares their lives potentially not worth living? Were they not begin to feel a quiet obligation to leave their families to save resources, to cease being a burden? That is not compassion.
It is quiet cruelty masked as choice. Rather than offering death, let us commit to better palliative care for top that is train fund and support hospices and homecare so no one is forced to consider death out of fear, loneliness, or despair. Lord Sacks said life is sacred. It is God's gift and not ours. It is the position is responsible at E2 he'll not do harm. Jewish law teaches that every moment of life has meaning and value. Every breath is a blessing.
We are not absolute owners of our lives, and ending a life that someone's request is considered taking what ultimately belongs to God. We all recognise that terrible fear of degenerative illness, the dread of indignity, the anxiety of being a burden. But enshrining this bill in law risks turning the immeasurable sanctity of life into something to be weighed, measured, and judge. Lord Sacks reminded us that life is not ours to end. I urge all lordships to consider the long- term consequences of this bill, not just for the individuals but for moral fibre of society.
In that moment of suffering, to be offer death or do we offer care? I choose
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Lord Campbell savers are taking part remotely and I now invite Lord
If we lose our reverence for human life, we will one day lose much else besides. " The words of Lord Sacks should once again ring loudly and clearly. As loudly and clearly today as they did in 2006. I have no desire to diminish the heartfelt convictions of anyone here in this chamber, or anyone who has written so movingly. But I speak out of a deep and abiding concern for the society we are shaping. For the values we hold, and for the vulnerable who we are duty bound to protect.
And I speak as someone who was given six months to live 37 years ago. The assisted dying bill before us carries risk we cannot and must not ignore. The debate is not about compassion. All of us want to alleviate the suffering. It is a debate about the means by which we do so. About the kind of society we want to be, and the message we send when the law itself offers death as a solution. I fear the bill crosses that moral Rubicon.
Once the state endorses the intentional ending of life, however regulated, however framed, we embark on a journey whose destination is uncertain, and deeply troubling. We are told that safeguards should be in place but what starts with those deemed mentally competent and terminally ill so easily extends gradually and quietly to others. Looking at the jurisdictions where such laws have been passed, the criteria loosened, and the line, once thought so firm, fades. What message to be sent to the elderly, the disabled, the chronically ill, when the law declares their lives potentially not worth living? Were they not begin to feel a quiet obligation to leave their families to save resources, to cease being a burden? That is not compassion.
It is quiet cruelty masked as choice. Rather than offering death, let us commit to better palliative care for top that is train fund and support hospices and homecare so no one is forced to consider death out of fear, loneliness, or despair. Lord Sacks said life is sacred. It is God's gift and not ours. It is the position is responsible at E2 he'll not do harm. Jewish law teaches that every moment of life has meaning and value. Every breath is a blessing.
We are not absolute owners of our lives, and ending a life that someone's request is considered taking what ultimately belongs to God. We all recognise that terrible fear of degenerative illness, the dread of indignity, the anxiety of being a burden. But enshrining this bill in law risks turning the immeasurable sanctity of life into something to be weighed, measured, and judge. Lord Sacks reminded us that life is not ours to end. I urge all lordships to consider the long- term consequences of this bill, not just for the individuals but for moral fibre of society.
In that moment of suffering, to be offer death or do we offer care? I choose
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Lord Campbell savers are taking part remotely and I now invite Lord
13:01
Lord Campbell-Savours (Labour)
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Lord Campbell-Savours (Labour)
part remotely and I now invite Lord Campbell savers to speak.
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My Lords, I do not intend, in a
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My Lords, I do not intend, in a brief intervention, to argue the case of the Belfast support principles behind the bill set out, however, I do harbour some however, I do harbour some reservations of the process of implementation. I want to concentrate my remarks on the process, and in particular, the girls handling, in this House. And hopefully, in an amended form on its hopefully, in an amended form on its return to the Commons. I have learnt a simple lesson, legislate at haste a simple lesson, legislate at haste and repent in leisure, I worry that and repent in leisure, I worry that if we pass the legislation in a single session, it will, during the single session, it will, during the period of implementation, be subject to repeated attack as unforeseen to repeated attack as unforeseen problems arise.
I propose we proceed on the following basis. The on the following basis. The legislation should be the subject of annual renewal. Over a period of three years. There are a number of precedents in primary legislation, for define period renewal. For those who follow proceedings outside the who follow proceedings outside the House, they may well wish to look at the presidents. The Northern Ireland the presidents. The Northern Ireland act 1974 provided for annual orders renewal in Westminster. The renewal in Westminster. The Terrorism Act 1976 provided powers, as indeed did section 13 of the prevention of Terrorism Act Jazlyn five.
Then we have the provisions under the temporary provisions act 1980. We also have section 98 of the coronary virus act which provides that the temporary now devolve provisions to be voted on in Parliament every six months. And I also understand that attempts were also understand that attempts were made to impart it at the sixth terms Parliament act 2011 to introduce annual renewal, which the House later rejected, so the precedent is there. Today, I am arguing that prior to annual renewal, depending on how the renewal notice was drafted, the government could introduce amendments that deal with problems identified during implementation of the legislation.
On each occasion, Parliament could be subject to Statutory Instruments Act approval, have the opportunity to kill the legislation, if it was dissatisfied with any proposed deficiency reforms. Equally, if ministers failed to take renewal orders, the legislation would lapse. If satisfied however, Parliament could renew. Yes, steep hurdle. Yes. But I believe that controversial legislation on this scale need some form of consensus. We need to heed the concerns of those who will only support its provisions in conditions and minimised opportunity for abuse.
Unlike many others, I am not convinced that the annual review Chief Medical Officer and the five year review by the Secretary of State provide sufficient safeguards for Parliament to have a hand in dealing with potential public concerns. I hope to be tabling an amendment the committee stage, dealing with my concerns. I understand that my son, who is in a similar mind, speak to such an amendment in the Commons, if the opportunity were to arise for some
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thank you. -- Were to arise. Thank you. I must begin by saying I was
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My Lords, I do not intend, in a
**** Possible New Speaker ****
My Lords, I do not intend, in a brief intervention, to argue the case of the Belfast support principles behind the bill set out, however, I do harbour some however, I do harbour some reservations of the process of implementation. I want to concentrate my remarks on the process, and in particular, the girls handling, in this House. And hopefully, in an amended form on its hopefully, in an amended form on its return to the Commons. I have learnt a simple lesson, legislate at haste a simple lesson, legislate at haste and repent in leisure, I worry that and repent in leisure, I worry that if we pass the legislation in a single session, it will, during the single session, it will, during the period of implementation, be subject to repeated attack as unforeseen to repeated attack as unforeseen problems arise.
I propose we proceed on the following basis. The on the following basis. The legislation should be the subject of annual renewal. Over a period of three years. There are a number of precedents in primary legislation, for define period renewal. For those who follow proceedings outside the who follow proceedings outside the House, they may well wish to look at the presidents. The Northern Ireland the presidents. The Northern Ireland act 1974 provided for annual orders renewal in Westminster. The renewal in Westminster. The Terrorism Act 1976 provided powers, as indeed did section 13 of the prevention of Terrorism Act Jazlyn five.
Then we have the provisions under the temporary provisions act 1980. We also have section 98 of the coronary virus act which provides that the temporary now devolve provisions to be voted on in Parliament every six months. And I also understand that attempts were also understand that attempts were made to impart it at the sixth terms Parliament act 2011 to introduce annual renewal, which the House later rejected, so the precedent is there. Today, I am arguing that prior to annual renewal, depending on how the renewal notice was drafted, the government could introduce amendments that deal with problems identified during implementation of the legislation.
On each occasion, Parliament could be subject to Statutory Instruments Act approval, have the opportunity to kill the legislation, if it was dissatisfied with any proposed deficiency reforms. Equally, if ministers failed to take renewal orders, the legislation would lapse. If satisfied however, Parliament could renew. Yes, steep hurdle. Yes. But I believe that controversial legislation on this scale need some form of consensus. We need to heed the concerns of those who will only support its provisions in conditions and minimised opportunity for abuse.
Unlike many others, I am not convinced that the annual review Chief Medical Officer and the five year review by the Secretary of State provide sufficient safeguards for Parliament to have a hand in dealing with potential public concerns. I hope to be tabling an amendment the committee stage, dealing with my concerns. I understand that my son, who is in a similar mind, speak to such an amendment in the Commons, if the opportunity were to arise for some
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thank you. -- Were to arise. Thank you. I must begin by saying I was
13:05
Lord Patel of Bradford (Non-affiliated)
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Lord Patel of Bradford (Non-affiliated)
somewhat hesitant to speak today. Not because I don't wish to contribute, I am currently caring for a loved one which brings my time in this chamber and predictable. And at the same time, makes this bill so much more important and personal to me. I have spent much of my professional life working in the Health and Social Care Act system. In mental health services in the community, and working with those affected who have been misusing drugs or alcohol. I have met people at their most vulnerable, often in pain, sometimes in complete despair, ready to take their lives.
I have also seen the extraordinary capacity of compassionate pallor to care. Skill pain management for family and friends to transform a person's final weeks or months. My own family experience gives me reason to tread carefully. When my brother was in his late 20s, due to childhood health issues, he suffered a series of strokes that were not diagnosed at the time. Over just a few months, he went from being intelligent charming and much loved man, to become someone unable to speak, eat or care for himself.
All the clinicians told us that there was no future for him, it was only a matter of time. Caring for him at home took a terrible toll on my mother. And he was eventually placed in an old people's home in his early 30s. Heavily sedated, with drugs for his own good. Years later, by which time I had become a social worker, was convinced more could be done. He was eventually moved to a specialist Leonard Cheshire home, there without sedation and without therapy, with love and attentive care, he lived another 20 years.
He enjoyed life, saw his son grow into a teenager and formed loving friendships. I sometimes wondered, had this bill already been in law, would he have been given a second chance? The prevailing medical view at the time was very clear, there was no future for him. By contrast, I think my mother, who suffered her third stroke, even then, A&E waiting times were poor and she did not receive treatment in time, her condition deteriorated rapidly in hospital. Consultants told me her organs were failing and she was suffering greatly.
She asked me for a do not resuscitate order and I reluctantly agreed that she should be made comfortable. She was given morphine. Never again conscious, and passed away peacefully three days later. I still live with that decision today. These experiences pull being different directions. They show me the danger of making assumptions about the quality or length of life someone may not yet have. But they also remind me that there are Easing suffering and giving them a peaceful death is the least we can do.
In a country as rich and diverse as ours we cannot ignore the influence of faith, culture and tradition in shaping how people view these questions. For some, life as a sacred gift from God, and only God should decide its end. For others, personal autonomy essential to human dignity. The law must tread carefully to respect both positions, without eroding trust in our healthcare, or other legal systems. The bill before us seeks to set out a set of frameworks for assisted dying with safeguards. But there are questions that remain unanswered.
How can we issuer that safeguards work in practice as well as in theory. How can we guarantee that access to high-quality palliative access to high-quality palliative care is right for everyone, how do we avoid unintended consequences for the most vulnerable? The elderly, those with disability, those were struggling with mental health or addiction. We know there is a big mistrust in the system, and rightly so. And we know there is clear evidence of inequality in care. These questions are not barriers to the debate.
They are the debate. It would need time to debate them. That is why approach this bill, neither with a blanket opposition or uncritical support, but with caution and a desire for evidence. We must look carefully at the experience of other jurisdictions, hear from those most affected, patients, families, and the clinicians would be asked to make end-of-life decisions. Whatever the view we hold today, this conversation would not end at this stage of the bill, it will and should continue, and our responsibility is to ensure it continues in a way that is informed by evidence, routine compassion, and respectful to the value of everyday
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life. I am grateful to follow the noble Lord, Lord Patel, because he has
I have also seen the extraordinary capacity of compassionate pallor to care. Skill pain management for family and friends to transform a person's final weeks or months. My own family experience gives me reason to tread carefully. When my brother was in his late 20s, due to childhood health issues, he suffered a series of strokes that were not diagnosed at the time. Over just a few months, he went from being intelligent charming and much loved man, to become someone unable to speak, eat or care for himself.
All the clinicians told us that there was no future for him, it was only a matter of time. Caring for him at home took a terrible toll on my mother. And he was eventually placed in an old people's home in his early 30s. Heavily sedated, with drugs for his own good. Years later, by which time I had become a social worker, was convinced more could be done. He was eventually moved to a specialist Leonard Cheshire home, there without sedation and without therapy, with love and attentive care, he lived another 20 years.
He enjoyed life, saw his son grow into a teenager and formed loving friendships. I sometimes wondered, had this bill already been in law, would he have been given a second chance? The prevailing medical view at the time was very clear, there was no future for him. By contrast, I think my mother, who suffered her third stroke, even then, A&E waiting times were poor and she did not receive treatment in time, her condition deteriorated rapidly in hospital. Consultants told me her organs were failing and she was suffering greatly.
She asked me for a do not resuscitate order and I reluctantly agreed that she should be made comfortable. She was given morphine. Never again conscious, and passed away peacefully three days later. I still live with that decision today. These experiences pull being different directions. They show me the danger of making assumptions about the quality or length of life someone may not yet have. But they also remind me that there are Easing suffering and giving them a peaceful death is the least we can do.
In a country as rich and diverse as ours we cannot ignore the influence of faith, culture and tradition in shaping how people view these questions. For some, life as a sacred gift from God, and only God should decide its end. For others, personal autonomy essential to human dignity. The law must tread carefully to respect both positions, without eroding trust in our healthcare, or other legal systems. The bill before us seeks to set out a set of frameworks for assisted dying with safeguards. But there are questions that remain unanswered.
How can we issuer that safeguards work in practice as well as in theory. How can we guarantee that access to high-quality palliative access to high-quality palliative care is right for everyone, how do we avoid unintended consequences for the most vulnerable? The elderly, those with disability, those were struggling with mental health or addiction. We know there is a big mistrust in the system, and rightly so. And we know there is clear evidence of inequality in care. These questions are not barriers to the debate.
They are the debate. It would need time to debate them. That is why approach this bill, neither with a blanket opposition or uncritical support, but with caution and a desire for evidence. We must look carefully at the experience of other jurisdictions, hear from those most affected, patients, families, and the clinicians would be asked to make end-of-life decisions. Whatever the view we hold today, this conversation would not end at this stage of the bill, it will and should continue, and our responsibility is to ensure it continues in a way that is informed by evidence, routine compassion, and respectful to the value of everyday
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life. I am grateful to follow the noble Lord, Lord Patel, because he has
13:10
Baroness Smith of Newnham (Liberal Democrat)
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Baroness Smith of Newnham (Liberal Democrat)
Lord, Lord Patel, because he has just outlined so many of the issues which are Lordships house need to think about in the context of this bill. We have heard from several noble Lords this is a matter of choice. And certainly the main campaign of those advocating for the present bill is to give people choice. And in particular, we have heard that it would create a sense of equality. That had the moment, if you have the resources, you might be able to go to Dignitas, to end your life in the way that you wish.
But if you don't have those resources you will have to stay in the UK and potentially die a more difficult death. Therefore, the logic of the argument goes. By introducing this bill, we will create a sense of equality. But, my Lords, I would like to suggest that this bill fails like to suggest that this bill fails to do that. The safeguards in it are not adequate at the time being proposed for us to debate and scrutinise this legislation is not adequate.
Why do I say that? In many ways, for reasons that we have already heard in the chamber today. My noble friend, Baroness Falkner, talking about her own medical case the very different situation of whether you have managed to have quick healthcare through private provision or are stuck on an NHS waiting list. There are disparities at all stages. So, those very people who might be able to pay to go to Dignitas may also be the very people who can pay to have private healthcare, to have had their medical treatment brought forward.
Those disparities are inevitably there. So, we need to be very clear about this. Suddenly saying we are equalising provision and opportunities may not be the case. But my Lords, there is also a very clear sense in the bill that ideas are put forward, but not fully defined, as the noble Lady, Baroness Goldie, in particular, noted. The noble Lady suggested there are many, many people who have written to her and I think they were the noble Lords, saying please this bill as it stands, we agree with every word of it.
Really? Much of the legislation is vague. The terms not defined. And I suspect many of the people advocating for it will not have read it line by line. The noble Lord, Lord Lamont, pointed out many of the questions that remain unanswered in the bill. Those questions require very significant scrutiny. And as the noble Lord, the Bridges of Headley pointed out, this is one of the most significant pieces of legislation we have had three are Lordships house.
-- Through your Lordships house. The children's wellbeing act has got 12 days in committee. This bill is scheduled to have four days in committee. Would it be beyond the realms of possibility for the noble Lord, Lord Faulkner, to work with the usual channels to find a way of having more time devoted to this bill? It would have to be nine Fridays in the period between January and March, there could be creative ways of giving this bill time. So it could be fully scrutinised, that the safeguards that are required can be put in place.
And that we can actually do our job of legislating not just for ourselves and the choice we might want, but for the most vulnerable in society. Because at the moment, the bill isn't fit
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for purpose. I cannot support this bill and I
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I cannot support this bill and I am also opposed, in principle, to assisted dying. Those in favour has spoken today of those who face
But if you don't have those resources you will have to stay in the UK and potentially die a more difficult death. Therefore, the logic of the argument goes. By introducing this bill, we will create a sense of equality. But, my Lords, I would like to suggest that this bill fails like to suggest that this bill fails to do that. The safeguards in it are not adequate at the time being proposed for us to debate and scrutinise this legislation is not adequate.
Why do I say that? In many ways, for reasons that we have already heard in the chamber today. My noble friend, Baroness Falkner, talking about her own medical case the very different situation of whether you have managed to have quick healthcare through private provision or are stuck on an NHS waiting list. There are disparities at all stages. So, those very people who might be able to pay to go to Dignitas may also be the very people who can pay to have private healthcare, to have had their medical treatment brought forward.
Those disparities are inevitably there. So, we need to be very clear about this. Suddenly saying we are equalising provision and opportunities may not be the case. But my Lords, there is also a very clear sense in the bill that ideas are put forward, but not fully defined, as the noble Lady, Baroness Goldie, in particular, noted. The noble Lady suggested there are many, many people who have written to her and I think they were the noble Lords, saying please this bill as it stands, we agree with every word of it.
Really? Much of the legislation is vague. The terms not defined. And I suspect many of the people advocating for it will not have read it line by line. The noble Lord, Lord Lamont, pointed out many of the questions that remain unanswered in the bill. Those questions require very significant scrutiny. And as the noble Lord, the Bridges of Headley pointed out, this is one of the most significant pieces of legislation we have had three are Lordships house.
-- Through your Lordships house. The children's wellbeing act has got 12 days in committee. This bill is scheduled to have four days in committee. Would it be beyond the realms of possibility for the noble Lord, Lord Faulkner, to work with the usual channels to find a way of having more time devoted to this bill? It would have to be nine Fridays in the period between January and March, there could be creative ways of giving this bill time. So it could be fully scrutinised, that the safeguards that are required can be put in place.
And that we can actually do our job of legislating not just for ourselves and the choice we might want, but for the most vulnerable in society. Because at the moment, the bill isn't fit
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for purpose. I cannot support this bill and I
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I cannot support this bill and I am also opposed, in principle, to assisted dying. Those in favour has spoken today of those who face
13:14
Baroness Ritchie of Downpatrick (Labour)
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Baroness Ritchie of Downpatrick (Labour)
spoken today of those who face physical pain at the end of their lives, having personal autonomy. That is not a view I share. But I do believe that more needs to be done to address the state of palliative care in the UK to improve the treatment of those at the end-of- life. However, my Lords, of most concern to me is that this bill poses a risk to the elderly and disabled. Decisions to end life are complex and not simply procedural.
They take place in the context of individuals' daily lives. The context of many elderly and disabled people today should raise red flags about how we are caring for them and whether they will face abuse and pressure to end their lives. A context where 46.6% of those who have died in Oregon have decided being a burden. Where 21.1% of those who died in 2023 in Canada, where death was reasonably foreseeable, cited isolation or loneliness as a factor in their decision-making.
Age UK reports that 1.4 million older people in the UK are often lonely. But according to Hospice UK, 90,000 of our citizens die in poverty every year, that is 247 people daily who have faced the financial impact of One where, as disability rights UK have observed, the government sadly does not have a good track record of protecting vulnerable and disabled. And I talk about all governments in the last 30 years. And that this bill poses a danger to disabled people.
The British geriatrics Society says many of its members are not confident that effective legal safeguards could be developed to protect older people from unwarranted harms. Perhaps most worryingly, research from the other half just from June this year says we should repair for one in seven of those being assisted to die in a single year being a recent victim of elder abuse. All of this is especially pertinent in a nation that is rapidly ageing. In 2022, 19% of our population was aged over 65.
This is expected to rise by 27% by 2072. With several millions more elderly and sick to be expected in the coming decades, what will be our message to them? Will it be that we are a burden on our NHS and economy and should therefore consider ending our lives before it gets worse? I believe as a House we have a duty to protect the vulnerable. And should a response to the elders of our nation be to reverently love and support their needs, should it not be to invest in our care and services such that they do not have to suffer alone? I am not persuaded by the apparent procedural safeguards contained in this bill.
None of them do anything to ameliorate the concerns I have raised for the elderly in particular. I will be supporting the amendments in the name of Lord Carlisle, and of my noble friend Baroness Berridge. I believe let us fulfil the duty of the state in protecting the vulnerable are not encouraging them to die.
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My Lords, it is 19 years since I first spoke in your Lordships House. The hugely emotive topic of assisted dying. My view then that, however well-intentioned the legislation may
They take place in the context of individuals' daily lives. The context of many elderly and disabled people today should raise red flags about how we are caring for them and whether they will face abuse and pressure to end their lives. A context where 46.6% of those who have died in Oregon have decided being a burden. Where 21.1% of those who died in 2023 in Canada, where death was reasonably foreseeable, cited isolation or loneliness as a factor in their decision-making.
Age UK reports that 1.4 million older people in the UK are often lonely. But according to Hospice UK, 90,000 of our citizens die in poverty every year, that is 247 people daily who have faced the financial impact of One where, as disability rights UK have observed, the government sadly does not have a good track record of protecting vulnerable and disabled. And I talk about all governments in the last 30 years. And that this bill poses a danger to disabled people.
The British geriatrics Society says many of its members are not confident that effective legal safeguards could be developed to protect older people from unwarranted harms. Perhaps most worryingly, research from the other half just from June this year says we should repair for one in seven of those being assisted to die in a single year being a recent victim of elder abuse. All of this is especially pertinent in a nation that is rapidly ageing. In 2022, 19% of our population was aged over 65.
This is expected to rise by 27% by 2072. With several millions more elderly and sick to be expected in the coming decades, what will be our message to them? Will it be that we are a burden on our NHS and economy and should therefore consider ending our lives before it gets worse? I believe as a House we have a duty to protect the vulnerable. And should a response to the elders of our nation be to reverently love and support their needs, should it not be to invest in our care and services such that they do not have to suffer alone? I am not persuaded by the apparent procedural safeguards contained in this bill.
None of them do anything to ameliorate the concerns I have raised for the elderly in particular. I will be supporting the amendments in the name of Lord Carlisle, and of my noble friend Baroness Berridge. I believe let us fulfil the duty of the state in protecting the vulnerable are not encouraging them to die.
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My Lords, it is 19 years since I first spoke in your Lordships House. The hugely emotive topic of assisted dying. My view then that, however well-intentioned the legislation may
13:18
Baroness Morris of Bolton (Conservative)
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Baroness Morris of Bolton (Conservative)
well-intentioned the legislation may be, the safeguards just are not good enough, and this view has not changed over the intervening years and debates. If anything, my concern for the vulnerable and the frightened has increased. But I also recognise that over these years, opinions have changed, often due to distressing family experiences. And I understand the strength and feeling of those here today and throughout the country who support this bill. As Lord Carlisle of Berry so rightly said, this bill is not adequate.
And however well- intentioned, a promise made in a general election campaign delivered through a Private Members' Bill with all its constraints and time limits, it is not the way to fundamentally change the contract between government and the people. The report of the Select Committee on the constitution completely captures where I stand on this bill. A Private Members' Bill simply cannot undergo the same scrutiny as a government bill. And as they say, this is especially concerning given the subject matter of the bill.
I also agree committee's advocacy for parliamentary pre-legislative scrutiny. If ever there was such a need, it is in this bill. Any legislation which is so profoundly changes that norms of society should only be undertaken after seeking the widest views. That is why I do not think my noble friend Lord Forsyth 25th Amendment make this bill fit for the statute book, however many hours we debate it. We don't need more time to listen to ourselves, we need more time to listen to the voices of others.
We have a chance to do that with the amendment in the name of Lady Berger which I will support. To all those who have written to me, either in favour or against the bill, a huge thank you for sharing your stories. We heard from Lord Faulkner the harrowing story of Tom's death from bowel can. And yet choosing when to die does not guarantee a gentle end. In 2015, I raised the issue of a handful of people who had woken up from the drugs administered.
It is now nine in Oregon. None of whom asked to repeat the experience. And with the drugs taken now with tablets, it is not just one tablet but you have to swallow something like 100. And I thank those who have written to express their concerns around the issues of complicated grief which haunts many relatives of those who have chosen assisted suicide, and of which we here too little. In almost all the letters I received, there was a desire to address the fear and reality of dying in pain.
Which exists. As we have heard so eloquently expressed around the House, any discussion of assisted dying has to go hand in hand with a vision of, and access to, the very best of palliative care. If we could achieve that, then we really would be fulfilling the stated purpose of this bill, of giving those who are ready time a choice over the manner of their death. But as things stand, I wholeheartedly agree with Lady Smith, this bill is not fit for
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purpose. I beat that noble Baroness of
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I beat that noble Baroness of Bolton by two years. It was in 2004 I was appointed a member of the Select Committee of this House to
And however well- intentioned, a promise made in a general election campaign delivered through a Private Members' Bill with all its constraints and time limits, it is not the way to fundamentally change the contract between government and the people. The report of the Select Committee on the constitution completely captures where I stand on this bill. A Private Members' Bill simply cannot undergo the same scrutiny as a government bill. And as they say, this is especially concerning given the subject matter of the bill.
I also agree committee's advocacy for parliamentary pre-legislative scrutiny. If ever there was such a need, it is in this bill. Any legislation which is so profoundly changes that norms of society should only be undertaken after seeking the widest views. That is why I do not think my noble friend Lord Forsyth 25th Amendment make this bill fit for the statute book, however many hours we debate it. We don't need more time to listen to ourselves, we need more time to listen to the voices of others.
We have a chance to do that with the amendment in the name of Lady Berger which I will support. To all those who have written to me, either in favour or against the bill, a huge thank you for sharing your stories. We heard from Lord Faulkner the harrowing story of Tom's death from bowel can. And yet choosing when to die does not guarantee a gentle end. In 2015, I raised the issue of a handful of people who had woken up from the drugs administered.
It is now nine in Oregon. None of whom asked to repeat the experience. And with the drugs taken now with tablets, it is not just one tablet but you have to swallow something like 100. And I thank those who have written to express their concerns around the issues of complicated grief which haunts many relatives of those who have chosen assisted suicide, and of which we here too little. In almost all the letters I received, there was a desire to address the fear and reality of dying in pain.
Which exists. As we have heard so eloquently expressed around the House, any discussion of assisted dying has to go hand in hand with a vision of, and access to, the very best of palliative care. If we could achieve that, then we really would be fulfilling the stated purpose of this bill, of giving those who are ready time a choice over the manner of their death. But as things stand, I wholeheartedly agree with Lady Smith, this bill is not fit for
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purpose. I beat that noble Baroness of
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I beat that noble Baroness of Bolton by two years. It was in 2004 I was appointed a member of the Select Committee of this House to
13:22
Baroness Hayman (Crossbench)
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Baroness Hayman (Crossbench)
Select Committee of this House to investigate the bill brought forward by the noble and much missed Lord. Since then, since that bill, that committee had an extensive program of work. It travelled as far as it would have to travel today to see all the jurisdictions where there is legislation in place, but we legislation in place, but we travelled. Resort Dignitas, we took many many evidence sessions, and listening to the debate today, I just wondered how many members of your Lordships House had actually read that report and seen how these issues come up again and again? And of course there have been other bills, other debates, more in this House actually than the other place, and there have been many reports, most notably I think, the Select Committee of the other place in the health and social care.
We have had a lots more evidence. We have looked at different ways of approaching it. But we have not resolved of course the issue of principle that divides many people in this House. But it seems to me, I had a wry smile when the noble Lord said we should not rush into this. 21 years, I would like to see some progress made. And I think we have to recognise that other jurisdictions have made progress.
That there have been advances in palliative care, and of course, I support that. But I do have to say to the noble Lord, however advanced palliative care is, it does not help everybody. I am still haunted by the last conversation I had last year with someone very close to me who was dying with a London teaching hospital who had cared for him for many years, with wonderful palliative care. The last things he said to me were, " Every night I go to sleep I pray that I won't wake up.
" My Lords, in our visit to Oregon, one of the things that struck me most that was new to me was to learn how many people asked for a prescription for the drugs to end their life. But didn't actually use them. It was around 40%. I think that has been a pretty constant figure, and it has been replicated in other jurisdictions. The right reverend Prelate, the Bishop of London said, absolutely rightly, that if we change the law, it will affect more people than the 1% who have an assisted death.
But I think that is a good thing. I think that would give tremendous comfort and courage to many people with terminal diseases. Knowing that, if the worst comes to the worst, if palliative care can't help them, that there is an option that they could choose to take. I think that would be a good and a compassionate thing, not just for the 1% but for many more of us.
We have had a lots more evidence. We have looked at different ways of approaching it. But we have not resolved of course the issue of principle that divides many people in this House. But it seems to me, I had a wry smile when the noble Lord said we should not rush into this. 21 years, I would like to see some progress made. And I think we have to recognise that other jurisdictions have made progress.
That there have been advances in palliative care, and of course, I support that. But I do have to say to the noble Lord, however advanced palliative care is, it does not help everybody. I am still haunted by the last conversation I had last year with someone very close to me who was dying with a London teaching hospital who had cared for him for many years, with wonderful palliative care. The last things he said to me were, " Every night I go to sleep I pray that I won't wake up.
" My Lords, in our visit to Oregon, one of the things that struck me most that was new to me was to learn how many people asked for a prescription for the drugs to end their life. But didn't actually use them. It was around 40%. I think that has been a pretty constant figure, and it has been replicated in other jurisdictions. The right reverend Prelate, the Bishop of London said, absolutely rightly, that if we change the law, it will affect more people than the 1% who have an assisted death.
But I think that is a good thing. I think that would give tremendous comfort and courage to many people with terminal diseases. Knowing that, if the worst comes to the worst, if palliative care can't help them, that there is an option that they could choose to take. I think that would be a good and a compassionate thing, not just for the 1% but for many more of us.
13:26
Lord Gold (Conservative)
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Lord Gold (Conservative)
My Lords, when I spoke at the second reading debate of the assisted dying bill in 2021, I expressed great concern about hidden persuasion being used by family members encouraging loved ones to take their own lives. This means that, by words or conduct, the patient is made to feel guilty that they continue to live, that they are a burden and expense on the family, but it would be better for everyone if they were no more. This new bill fails effectively to address this issue.
Yes, it outlaws coercion, but it does not deal at all with the issue of hidden persuasion. In the earlier bill, a High Court Judgement would have been required to confirm the patient eligibility for assisted dying. Those involved could be questions and the process tested. The role of the judge is now to be taken by a panel comprising a legal member, psychiatrist, social worker. The lawyer's view could be ignored as decisions are by majority vote. My Lords, removing proper judicial scrutiny is a most worrying developments.
There is no requirement in this bill that the patient must be known to the two doctors who are required to be involved. And the patient will certainly not be known to the panel will stop so determining capacity and intention will be extremely difficult. Inevitably, the patient will be in a vulnerable state. They may be distressed that their families inconvenienced by having to visit, sometimes coming from afar, for those in a care home, there may be concern about the substantial cost being incurred, eating into future inheritance.
Nobody outside the visiting family will know what pressure has been put on the patient. How can we ever be sure that there has not been abuse? Further, the bill expressly provides in section 38 that a death by self administration does not constitute an unnatural death. So there will be no inquest unless a senior coroner has reason to suspect that the deceased died an unnatural death stop no guidance is offered as to what might persuade the coroner to undertake such an investigation.
I have a further major concern about this bill. Which is that, far from ending the debate about assisted dying, it is the beginning of a far bigger debate. Touched on by some of you this afternoon. The replacement of judicial scrutiny by the proposed panel is a warning that safeguards risk being abandoned. Have no doubt, if this bill becomes law, this is that slippery slope to further change with calls for us to introduce euthanasia, which has been the experience of other countries will stop euthanasia is now accepted in Belgium, the Netherlands, Canada, and the state of Oregon.
And in some places, patients have been euthanised for psychiatric conditions including depression. Indeed, the Netherlands has proposed extending the law to elderly people with completed lives. There is already pressure to extend this bill. Some suggesting that doctors should be able to administer the drug, not simply assist, when the patient is too will take it themselves. Is this what we want? I certainly don't. This bill outlines a complicated process before patient will be permitted to receive assistance in dying.
The bill is silent as to how this is to be done. I am concerned that all of this has been sufficiently thought through. I do not believe that our present medical staff can cope with assisted death in addition to that very valuable work they now do, so something different is needed. The NHS is finding it hard enough coping with the patient who wants to live, One possibility is that ministers might create mobile assisted death units, making the option of choosing death far easier vulnerable patients to accept.
Because all the problems of the process will be managed by professionals who know the system, provide the two doctors needed, lies with the panel and assist patients with all the administration and form , this risks a further means of subtle coercion. My Lords, I have only touched on some of the concerns I have about Lisa Melo. It is a really bad measure, and should be rejected. Nobody wants patients to suffer a painful death, was assisting an early death is not the answer.
If this measure is approved and the government has to make it work, the cost and the administration involved would be colossal. It will be far better spending this money and putting our efforts into improving the palliative care that we offer. palliative care that we offer.
Yes, it outlaws coercion, but it does not deal at all with the issue of hidden persuasion. In the earlier bill, a High Court Judgement would have been required to confirm the patient eligibility for assisted dying. Those involved could be questions and the process tested. The role of the judge is now to be taken by a panel comprising a legal member, psychiatrist, social worker. The lawyer's view could be ignored as decisions are by majority vote. My Lords, removing proper judicial scrutiny is a most worrying developments.
There is no requirement in this bill that the patient must be known to the two doctors who are required to be involved. And the patient will certainly not be known to the panel will stop so determining capacity and intention will be extremely difficult. Inevitably, the patient will be in a vulnerable state. They may be distressed that their families inconvenienced by having to visit, sometimes coming from afar, for those in a care home, there may be concern about the substantial cost being incurred, eating into future inheritance.
Nobody outside the visiting family will know what pressure has been put on the patient. How can we ever be sure that there has not been abuse? Further, the bill expressly provides in section 38 that a death by self administration does not constitute an unnatural death. So there will be no inquest unless a senior coroner has reason to suspect that the deceased died an unnatural death stop no guidance is offered as to what might persuade the coroner to undertake such an investigation.
I have a further major concern about this bill. Which is that, far from ending the debate about assisted dying, it is the beginning of a far bigger debate. Touched on by some of you this afternoon. The replacement of judicial scrutiny by the proposed panel is a warning that safeguards risk being abandoned. Have no doubt, if this bill becomes law, this is that slippery slope to further change with calls for us to introduce euthanasia, which has been the experience of other countries will stop euthanasia is now accepted in Belgium, the Netherlands, Canada, and the state of Oregon.
And in some places, patients have been euthanised for psychiatric conditions including depression. Indeed, the Netherlands has proposed extending the law to elderly people with completed lives. There is already pressure to extend this bill. Some suggesting that doctors should be able to administer the drug, not simply assist, when the patient is too will take it themselves. Is this what we want? I certainly don't. This bill outlines a complicated process before patient will be permitted to receive assistance in dying.
The bill is silent as to how this is to be done. I am concerned that all of this has been sufficiently thought through. I do not believe that our present medical staff can cope with assisted death in addition to that very valuable work they now do, so something different is needed. The NHS is finding it hard enough coping with the patient who wants to live, One possibility is that ministers might create mobile assisted death units, making the option of choosing death far easier vulnerable patients to accept.
Because all the problems of the process will be managed by professionals who know the system, provide the two doctors needed, lies with the panel and assist patients with all the administration and form , this risks a further means of subtle coercion. My Lords, I have only touched on some of the concerns I have about Lisa Melo. It is a really bad measure, and should be rejected. Nobody wants patients to suffer a painful death, was assisting an early death is not the answer.
If this measure is approved and the government has to make it work, the cost and the administration involved would be colossal. It will be far better spending this money and putting our efforts into improving the palliative care that we offer. palliative care that we offer.
13:32
Lord McCrea of Magherafelt and Cookstown (Democratic Unionist Party)
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Lord McCrea of Magherafelt and Cookstown (Democratic Unionist Party)
I don't think I have heard such a variety of opinions and I wish to express mine on is the issue of life and death. As a minister, I have been present at the sick and dying beds of so many of my fellow travellers to eternity, it can be a difficult and heartbreaking theories for the individual and their loved ones. At my Lords, sickness is a reality for us all at sometimes in their lives and death is inevitable.
Death passes no dwelling, whether the occupant be rich or poor. It is the great leveller. In my consideration today, I wish to thank those who sent me numerous letters and emails, from deeply concerned individuals, health professionals, and organisations expressing various viewpoints. But we can in this House, must make a decision about the legislation has been presented to us today. I unashamedly state that I believe that human life, that human beings are unique amongst gods creatures, in being made in the image of God.
When they rebelled against the will of God, they chose their own way and nothing has changed. For their accepted opinion of society today is it is my body, my life and nobody can and should tell me what to do. As in the book of Judges, every man did that which was right in his own eyes. And I know that philosophy is very popular today. Not one of us decided when we would be born. And the cardinal question is have we the right to decide when we should die? Again, the word of God says it is appointed unto men once to die, not appointed unto men once to die, not appointed by them.
We live in a society that pushed goes out of its reckonings and it wanders on aimlessly and hopelessly, seeing little reason or meaning in life life itself, each of us mention the harrowing cases of severe struggles enjoying life under pain of death, suffered by our fellow human beings. Some conclude that the answer to these stories of human suffering is to assist the person to end their life, rather than improve the management of the end-of-life. This bill makes it a legal right for patients to access assisted dying.
Does not mandate a comparable right to be able to access other end-of-life services. We are aware that patients with a diagnosis of a terminal this are very vulnerable and weak and elderly people are at serious risk of coercion. I left feel they are only a burden to their families. I have heard that so many times in my ministry. Also estimating how long a patient will survive is, at best, very difficult even for specialists. And I know a patient being given a three or six month prognosis, who are actually still alive today three years later.
Enjoying life, making cherished memories of their loved ones. Were they to act in a similar prognosis using this bill, that decision would be fatal and final. The legislation before us is called the Terminally Ill Adult End-Of-Life but in reality, it is assisted suicide for some even easy is killing, and it is considered murder, even a patient has a terminal, given one category of sick people a legal right to exercise the right to autonomy by killing themselves, logically opens the door in creating legal conditions, to Is being put by some of the group supporting this bill.
It was only last Wednesday, we marked Will Suicide Prevention Day, today we are debating a bill that creates an exception. One day, we tell them, do not give up, but at the same time, we make legislation to allow the NHS to give drugs for people to end their lives. Some years ago, Parliament rejected capital punishment on the basis that if one innocent life was taken, it would be one too many. I asked today how many innocent, elderly or sick people will die through this legislation, if selected.
I have no doubt the number will be great. And I strenuously oppose this bill.
Death passes no dwelling, whether the occupant be rich or poor. It is the great leveller. In my consideration today, I wish to thank those who sent me numerous letters and emails, from deeply concerned individuals, health professionals, and organisations expressing various viewpoints. But we can in this House, must make a decision about the legislation has been presented to us today. I unashamedly state that I believe that human life, that human beings are unique amongst gods creatures, in being made in the image of God.
When they rebelled against the will of God, they chose their own way and nothing has changed. For their accepted opinion of society today is it is my body, my life and nobody can and should tell me what to do. As in the book of Judges, every man did that which was right in his own eyes. And I know that philosophy is very popular today. Not one of us decided when we would be born. And the cardinal question is have we the right to decide when we should die? Again, the word of God says it is appointed unto men once to die, not appointed unto men once to die, not appointed by them.
We live in a society that pushed goes out of its reckonings and it wanders on aimlessly and hopelessly, seeing little reason or meaning in life life itself, each of us mention the harrowing cases of severe struggles enjoying life under pain of death, suffered by our fellow human beings. Some conclude that the answer to these stories of human suffering is to assist the person to end their life, rather than improve the management of the end-of-life. This bill makes it a legal right for patients to access assisted dying.
Does not mandate a comparable right to be able to access other end-of-life services. We are aware that patients with a diagnosis of a terminal this are very vulnerable and weak and elderly people are at serious risk of coercion. I left feel they are only a burden to their families. I have heard that so many times in my ministry. Also estimating how long a patient will survive is, at best, very difficult even for specialists. And I know a patient being given a three or six month prognosis, who are actually still alive today three years later.
Enjoying life, making cherished memories of their loved ones. Were they to act in a similar prognosis using this bill, that decision would be fatal and final. The legislation before us is called the Terminally Ill Adult End-Of-Life but in reality, it is assisted suicide for some even easy is killing, and it is considered murder, even a patient has a terminal, given one category of sick people a legal right to exercise the right to autonomy by killing themselves, logically opens the door in creating legal conditions, to Is being put by some of the group supporting this bill.
It was only last Wednesday, we marked Will Suicide Prevention Day, today we are debating a bill that creates an exception. One day, we tell them, do not give up, but at the same time, we make legislation to allow the NHS to give drugs for people to end their lives. Some years ago, Parliament rejected capital punishment on the basis that if one innocent life was taken, it would be one too many. I asked today how many innocent, elderly or sick people will die through this legislation, if selected.
I have no doubt the number will be great. And I strenuously oppose this bill.
13:37
Lord Meston (Crossbench)
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Lord Meston (Crossbench)
My Lords, I am one of the two survivors of the committee of medical, which reported in 1994, consequent on the case of Anthony Bland, since then, my views have changed. Assisted by the report of the Council on bioethics. While some arguments for and against the bill are finely balanced, it now seems to me the balance comes down in its favour, and I support it. The status quo is unacceptable. At present, it is possible, irrationally, to refuse life-saving treatment.
But not possible, to per shoe independent rational request for life ending treatment. At present the law allows suicide that can criminalise loved ones, for whom they may need help. In favour of those who may have the physical ability in finance to travel abroad or unaided, while allowing other unrelated, covert and sometimes drastic practices to continue. Opponents of the bill really must consider how much of the existing status quo they wish to continue.
I do not accept the more extreme objections to the bill. It extreme objections to the bill. It is indeed not rush legislation, the topic is being sensibly considered in and out of Parliament for years. Ironically, the first bill rejected by this House in 1936 is said to have failed because the safeguards were too cumbersome. I do not expect speculative overstated slippery slope arguments. Good legislation can and should provide firm footholds on any perceived slip. Through unambiguous drafting, clear and specific safeguards and guidelines, including active oversight and proper exploration of realistic ulcerative medical options, including palliative care.
Can and should have control of the clear confines of the new law and the courts and government can be expected to make clear that any further permitted extension of such law, should be for Parliament and require primary legislation. The risk and sources of possible pressure by unscrupulous partners or relatives can be discerned and addressed, by appropriate regulation and procedures and by informed assessment of the family structure, and dynamics and financial implications. The proposed multidisciplinary panel should have an inquisitorial approach to collect and test the necessary evidence and, where necessary, make factual decisions.
Further consideration should be required, should be given to requiring early notification to family and carers and encouraging their participation if wanted. An requiring disclosure of testamentary arrangements. I would like to see a wider role for the independent advocate, authoritative guidance, vital assessment of capacity, and possible protection of anonymity. This bill was improved in another place, it can be further improved here. Finally, I would suggest that perhaps the worst possible outcome would be differing laws, and different jurisdictional parts of the British Isles.
But not possible, to per shoe independent rational request for life ending treatment. At present the law allows suicide that can criminalise loved ones, for whom they may need help. In favour of those who may have the physical ability in finance to travel abroad or unaided, while allowing other unrelated, covert and sometimes drastic practices to continue. Opponents of the bill really must consider how much of the existing status quo they wish to continue.
I do not accept the more extreme objections to the bill. It extreme objections to the bill. It is indeed not rush legislation, the topic is being sensibly considered in and out of Parliament for years. Ironically, the first bill rejected by this House in 1936 is said to have failed because the safeguards were too cumbersome. I do not expect speculative overstated slippery slope arguments. Good legislation can and should provide firm footholds on any perceived slip. Through unambiguous drafting, clear and specific safeguards and guidelines, including active oversight and proper exploration of realistic ulcerative medical options, including palliative care.
Can and should have control of the clear confines of the new law and the courts and government can be expected to make clear that any further permitted extension of such law, should be for Parliament and require primary legislation. The risk and sources of possible pressure by unscrupulous partners or relatives can be discerned and addressed, by appropriate regulation and procedures and by informed assessment of the family structure, and dynamics and financial implications. The proposed multidisciplinary panel should have an inquisitorial approach to collect and test the necessary evidence and, where necessary, make factual decisions.
Further consideration should be required, should be given to requiring early notification to family and carers and encouraging their participation if wanted. An requiring disclosure of testamentary arrangements. I would like to see a wider role for the independent advocate, authoritative guidance, vital assessment of capacity, and possible protection of anonymity. This bill was improved in another place, it can be further improved here. Finally, I would suggest that perhaps the worst possible outcome would be differing laws, and different jurisdictional parts of the British Isles.
13:41
Baroness Monckton of Dallington Forest (Conservative)
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Baroness Monckton of Dallington Forest (Conservative)
My Lords, I declare my interests as Chair of Team Domenico and patron of children's hospices. In 2018, along with two other mothers of young adults with learning difficulties, I took a test case to the High Court to challenge the way that the capacity act was being interpreted for this cohort. Essentially, what it meant is that authorities had no obligation to consult us as parents on so-called best interest decisions for our children. Because they were, logically -- Chronologically adults and therefore, in the eyes of the law, deemed to have capacity.
The High Court judgement, although some pathetic to our case, did not medically change anything. And it is still extremely difficult for parents to become deputies of their own children. I would call this tutorial chips attention to a particularly -- Your Lordships attention to a particularly daunting attention to a particularly daunting aspect of this bill. Most daughter who has Down syndrome would have been advised by a doctor, who she may never have met, that she should consider it would be best to have her life ended, because she was deemed to have a terminal condition.
Not only that but the bill specifically excludes any obligation to discuss this with us, her parents, or any other family members. I can only imagine the fear and terror that would go through my daughter. And a total lack of compression. Yes, she is capable of making decisions. What to wear, what to eat, what to watch on Netflix. But when it comes to something more abstract, she is, at best, extremely confused. Also, like many with Down syndrome, she is highly suggestible.
She is anxious to please those who she perceives to be an authority. I can clearly see where the danger lies. It is regrettable that the other place did not find the time to discuss the amendment cut down by my honourable friend, Damian Hinds. Which would have excluded any person with a learning disability from initial discussions about being given a fatal dose, unless they themselves had raised it. I do not mean to cast aspersions on the medical profession.
We have wonderful examples of it in this House. There is a tendency within it to regard those living with learning disabilities as suffering. We saw this clearly in COVID with a do not resuscitate notices at the end of her hospital beds. People with Down syndrome for example do not suffer, they do not have a disease. Nor do I question the good intentions or the compassion of those who promoted this legislation. And I was startled to see, in a pamphlet, that was circulated to all members of this House, by the campaigning book My Death, My Decision, a paragraph urging us not to contemplate any amendment which would, " Encourage interference from family members." The strained view of the very nature of what a family is.
I will certainly be putting down such an amendment. I urge the House to consider when voting on this bill the most vulnerable among us. The coalition of more than 350 disability organisations have expressed their opposition of this bill. For parents who have spent lifetimes fighting for their children, and I worry about them cruel.
The High Court judgement, although some pathetic to our case, did not medically change anything. And it is still extremely difficult for parents to become deputies of their own children. I would call this tutorial chips attention to a particularly -- Your Lordships attention to a particularly daunting attention to a particularly daunting aspect of this bill. Most daughter who has Down syndrome would have been advised by a doctor, who she may never have met, that she should consider it would be best to have her life ended, because she was deemed to have a terminal condition.
Not only that but the bill specifically excludes any obligation to discuss this with us, her parents, or any other family members. I can only imagine the fear and terror that would go through my daughter. And a total lack of compression. Yes, she is capable of making decisions. What to wear, what to eat, what to watch on Netflix. But when it comes to something more abstract, she is, at best, extremely confused. Also, like many with Down syndrome, she is highly suggestible.
She is anxious to please those who she perceives to be an authority. I can clearly see where the danger lies. It is regrettable that the other place did not find the time to discuss the amendment cut down by my honourable friend, Damian Hinds. Which would have excluded any person with a learning disability from initial discussions about being given a fatal dose, unless they themselves had raised it. I do not mean to cast aspersions on the medical profession.
We have wonderful examples of it in this House. There is a tendency within it to regard those living with learning disabilities as suffering. We saw this clearly in COVID with a do not resuscitate notices at the end of her hospital beds. People with Down syndrome for example do not suffer, they do not have a disease. Nor do I question the good intentions or the compassion of those who promoted this legislation. And I was startled to see, in a pamphlet, that was circulated to all members of this House, by the campaigning book My Death, My Decision, a paragraph urging us not to contemplate any amendment which would, " Encourage interference from family members." The strained view of the very nature of what a family is.
I will certainly be putting down such an amendment. I urge the House to consider when voting on this bill the most vulnerable among us. The coalition of more than 350 disability organisations have expressed their opposition of this bill. For parents who have spent lifetimes fighting for their children, and I worry about them cruel.
13:45
Lord Dubs (Labour)
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Lord Dubs (Labour)
It is a privilege to be able to take part in a debate such as this one. And even if I disagree with some of the views that have been put forward, I do fully respect the sincerity with which they have been put forward. I would like to pay tribute to Kim, she has done a tremendous job, the tenacity, the sensitivity, the campaigning further, I think she deserves a lot of respect even if one does not agree with their views.
I do. I have always felt that I could not vote against the measure which I would, sorry, I have always felt that I cannot deny to others something that I would want for myself and I would certainly want to avail myself of the bill if my health had reached the position where I could fight for it. The present position is surely unsafe, cruel and unworkable and those members of this House who do not want the bill under very circumstances I think are obliged to say what is it that you have to offer or do we simply keep the offer or do we simply keep the People who have the money to go to Switzerland, there are no safeguards at all.
At least here we have built with numerous safeguards. Public opinion is very much on the side of this bill. All surveys show the public want to be able to have a choice, and it is we, the politicians, who are in danger of being out of step with the public. We have had the question of the Oregon experience. My understanding, and I think the noble Baroness Hayman said, people who get palliative care in Oregon also have the right if they want to finish their life, if they qualify under the legislation.
And yet because they can do it at any time, they often don't use it at all. It is a sign that people want some control over their destinies. The bill had extensive coverage in the Commons. We have to be very careful before we challenge an elected House that has been through such long processes of debate and consideration on this particular measure. I think it would be a regrettable step if we were to block something procedural means. Rather than by the principles which are therefore asked to scrutinise legislation.
I think the bill of the Commons has received more scrutiny than virtually any other piece of legislation in the world. And it was very clear, that the Commons in the end were in favour of it. People have talked about pressure. There is also possible to pressure the other way. Might be an individual who wants to take advantage of the bill and his family won't let him or her. The pressure can work in both directions of what we need is adequate safeguards.
I wonder if I could finish by describing an experience, we have all had personal testimonies. Some years ago was a similar attempt to pass legislation in this House. A friend of mine was very ill with motoneuron. And I was to see him quite often. One particular thing from his family was could I be there to talk to him. I got there, his wife and children were there. At that point, all he could do was tap out on a keyboard. On the next visit he could not even do that.
He was in a pretty bad way. But the purpose of my visit, or his intention in visiting, was that he wanted my views on the bill going through. And he wanted me to give a promise that I would support such legislation. I gave him that
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promise. My Lords, I want to address two
**** Possible New Speaker ****
My Lords, I want to address two points. When you read the debates in the other place, you immediately see the other place, you immediately see a strong focus by opponents of the bill on the pain and suffering of the terminally ill individual in the
I do. I have always felt that I could not vote against the measure which I would, sorry, I have always felt that I cannot deny to others something that I would want for myself and I would certainly want to avail myself of the bill if my health had reached the position where I could fight for it. The present position is surely unsafe, cruel and unworkable and those members of this House who do not want the bill under very circumstances I think are obliged to say what is it that you have to offer or do we simply keep the offer or do we simply keep the People who have the money to go to Switzerland, there are no safeguards at all.
At least here we have built with numerous safeguards. Public opinion is very much on the side of this bill. All surveys show the public want to be able to have a choice, and it is we, the politicians, who are in danger of being out of step with the public. We have had the question of the Oregon experience. My understanding, and I think the noble Baroness Hayman said, people who get palliative care in Oregon also have the right if they want to finish their life, if they qualify under the legislation.
And yet because they can do it at any time, they often don't use it at all. It is a sign that people want some control over their destinies. The bill had extensive coverage in the Commons. We have to be very careful before we challenge an elected House that has been through such long processes of debate and consideration on this particular measure. I think it would be a regrettable step if we were to block something procedural means. Rather than by the principles which are therefore asked to scrutinise legislation.
I think the bill of the Commons has received more scrutiny than virtually any other piece of legislation in the world. And it was very clear, that the Commons in the end were in favour of it. People have talked about pressure. There is also possible to pressure the other way. Might be an individual who wants to take advantage of the bill and his family won't let him or her. The pressure can work in both directions of what we need is adequate safeguards.
I wonder if I could finish by describing an experience, we have all had personal testimonies. Some years ago was a similar attempt to pass legislation in this House. A friend of mine was very ill with motoneuron. And I was to see him quite often. One particular thing from his family was could I be there to talk to him. I got there, his wife and children were there. At that point, all he could do was tap out on a keyboard. On the next visit he could not even do that.
He was in a pretty bad way. But the purpose of my visit, or his intention in visiting, was that he wanted my views on the bill going through. And he wanted me to give a promise that I would support such legislation. I gave him that
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promise. My Lords, I want to address two
**** Possible New Speaker ****
My Lords, I want to address two points. When you read the debates in the other place, you immediately see the other place, you immediately see a strong focus by opponents of the bill on the pain and suffering of the terminally ill individual in the
13:49
Lord Grabiner (Crossbench)
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Lord Grabiner (Crossbench)
the terminally ill individual in the period leading to death. That's distress and suffering also impacts the lives of the family and is of the individual. This point has been made by other noble Lords, and was pressed by the noble and learned Lord Lord Faulkner in his opening remarks. The curiosity is that when we examine the conditions or safeguards designed to ensure so far as possible the integrity of the process devised for ending a life prematurely, there is a striking omission from the drafting.
Specifically, no condition has been inserted to the effect that the patient should, still less must, be suffering pain or anguish of a kind which has been emphasised. My Lords, this looks like a mismatch, or a non sequitur. It is a convenient and emotionally appealing argument for those who propose this dramatic change in our law, to stress the suffering of the patient. We all the idea of our nearest and dearest having to live with excruciating pain. For some reason, the bill does not make the existence of that pain one of the conditions that needs to be satisfied before assisted death would be legally permissible.
Perhaps the noble Lord Lord Faulkner will be able to, and will enlighten the House with an explanation for the non sequitur. Alternatively, he may be supportive of a suitable amendment to deal with the point. We shall hear his usually windup. I think that the noble Lord Lord Lamont made a similar point when he made his remarks a little earlier. The other point I want to draw attention to is that the conditions identified in the bill are, in my view, quite inadequate to cope with coercion.
By which I mean, family or social pressure, but on the patient, which impacts or undermines what should genuinely be the free choice of the patient. Where money is involved, people have been known to misbehave, and to do so badly. I think Lord Dobbs took a different view in the course of his remarks. I must say I profoundly disagree. The point is neatly, if rather crudely captured, by the expression, " Where there is a will, there is a relative.
" Google attributes this remark to the comedian Ricky to face but it is a serious point. At first rush, the proposed safeguard, the requirement for an opinion of an attending doctor, plus that of an additional independent doctor supported by a panel which includes a lawyer, why lawyers are said to have any special capacity I don't begin to understand, but my Lords, I ask this, what does any of this means in practice? I'm afraid that years as a lawyer may have made me a bit cynical.
In particular, the reference to the involvement of the panel including a lawyer looks like a piece of window dressing. If two reputable doctors are both in agreement, it is impossible to see what useful function the panel can what useful function the panel can perform. The panel cannot go against the joint view of the medical practitioners, they are the experts. Parity of reasoning, is obvious that if the two doctors have not agreed, the case will ever get the panel. Unsurprisingly, it is not suggested that the panel should have the power to summon witnesses.
Or to satisfy themselves that the patient has been coerced or encouraged in the direction of suicide. I would add, as is the obvious, coercion can be a thing of great subtlety. Even in court where the validity of the will is debated with documentary disclosure, witness statements, and cross-examination, but the truth may never emerge. None of these courtroom safeguards are contemplated by the bill. The reference to the requirements of panel to prove the bill is my view, just a fig leaf calculated to cover the doubters.
On analysis it provides the comfort at all. The safeguards in the bill with respect to coercion are inadequate, and I'm not convinced they can be satisfactorily improved.
**** Possible New Speaker ****
My Lords, I feel humbled by the debate so far. And indeed many people who wrote to me and I thank people who wrote to me and I thank them for doing so. I feel certain nation is looking to us here today
Specifically, no condition has been inserted to the effect that the patient should, still less must, be suffering pain or anguish of a kind which has been emphasised. My Lords, this looks like a mismatch, or a non sequitur. It is a convenient and emotionally appealing argument for those who propose this dramatic change in our law, to stress the suffering of the patient. We all the idea of our nearest and dearest having to live with excruciating pain. For some reason, the bill does not make the existence of that pain one of the conditions that needs to be satisfied before assisted death would be legally permissible.
Perhaps the noble Lord Lord Faulkner will be able to, and will enlighten the House with an explanation for the non sequitur. Alternatively, he may be supportive of a suitable amendment to deal with the point. We shall hear his usually windup. I think that the noble Lord Lord Lamont made a similar point when he made his remarks a little earlier. The other point I want to draw attention to is that the conditions identified in the bill are, in my view, quite inadequate to cope with coercion.
By which I mean, family or social pressure, but on the patient, which impacts or undermines what should genuinely be the free choice of the patient. Where money is involved, people have been known to misbehave, and to do so badly. I think Lord Dobbs took a different view in the course of his remarks. I must say I profoundly disagree. The point is neatly, if rather crudely captured, by the expression, " Where there is a will, there is a relative.
" Google attributes this remark to the comedian Ricky to face but it is a serious point. At first rush, the proposed safeguard, the requirement for an opinion of an attending doctor, plus that of an additional independent doctor supported by a panel which includes a lawyer, why lawyers are said to have any special capacity I don't begin to understand, but my Lords, I ask this, what does any of this means in practice? I'm afraid that years as a lawyer may have made me a bit cynical.
In particular, the reference to the involvement of the panel including a lawyer looks like a piece of window dressing. If two reputable doctors are both in agreement, it is impossible to see what useful function the panel can what useful function the panel can perform. The panel cannot go against the joint view of the medical practitioners, they are the experts. Parity of reasoning, is obvious that if the two doctors have not agreed, the case will ever get the panel. Unsurprisingly, it is not suggested that the panel should have the power to summon witnesses.
Or to satisfy themselves that the patient has been coerced or encouraged in the direction of suicide. I would add, as is the obvious, coercion can be a thing of great subtlety. Even in court where the validity of the will is debated with documentary disclosure, witness statements, and cross-examination, but the truth may never emerge. None of these courtroom safeguards are contemplated by the bill. The reference to the requirements of panel to prove the bill is my view, just a fig leaf calculated to cover the doubters.
On analysis it provides the comfort at all. The safeguards in the bill with respect to coercion are inadequate, and I'm not convinced they can be satisfactorily improved.
**** Possible New Speaker ****
My Lords, I feel humbled by the debate so far. And indeed many people who wrote to me and I thank people who wrote to me and I thank them for doing so. I feel certain nation is looking to us here today
13:54
Lord Johnson of Lainston (Conservative)
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Lord Johnson of Lainston (Conservative)
in this House to deliver on this final liberty, that of being able to decide how, in certain specific circumstances, one leaves this world. I know there are rightly concerned about the bill, how in practice the prospect of giving people this right operates. I do not take this lightly. Obvious and reasonable objections have been well raised today. These concerns must be answered by the body politic. We must be aware that people may feel pushed to end the life early, as we have just heard.
Foldable people must be protected, I'm always sceptical as to how the state can be genuinely compassionate. Safeguarding well-being and other such processes is often a mechanism to protect institutions and faades behind which officials hide. These are not technicalities. We should also not use this, as has been well raised, as an excuse to reduce funding to palliative and careful stop for this to be right and proper it must be a genuine choice. And not a false one. However, in reality, this bill is more about decriminalising those who help me with a choice I want to make, as much as it is giving me the choice in the first place.
As Lord Dubs is adequately just said, we already have that choice but it is absurdly complex and solitary. And those who love us are removed from the processes. This bill changes that. It allows us to have access to proper care in this country. It enables us to have real dignity in our departure. And it ends the absurd situations we currently ensure where a spouse is potentially arrested at Heathrow having taken the partner to Dignitas. The fact this is happening today already in the worst possible way.
In this bill, with however many issues it contains, is fundamentally better than the situation we currently suffer. To this end we must not let complexities defeat us. You should not let the technical means of regulation used as a block on the principle. I dislike fundamentally all forms of regulation, but in this instance support proper clarity for doctors and structure for families around this urgent need. We should be more fearful of failing to deliver this freedom than of the risks that the freedom of choice may entail.
With freedom always comes risk. It behoves us to use all our talents to find a way to deliver on this last and final rights of our citizens. I am an optimist. Legislation can be revised and reviewed. Secretaries of State can take common sense decisions, it is true. And the medical and other professions can pride themselves on really owning the process over which they have control. This is all possible. People often ask, what is the House of Lords for? I say to is precisely for situations like today, when we focus on solving complex highly sensitive problems with a single goal in mind, which is to allow people to live their lives as they want.
Free from pain and suffering, from the moment they are born until the very end. I look forward to working through this bill that single objective in mind.
**** Possible New Speaker ****
My Lords, I was expelling to a group of people last night the virtues were of speaking your virtues were of speaking your Lordships House. And I somewhat controversially perhaps for a former member of the other house fan myself saying that the advantage of having no constituents is that you can look
Foldable people must be protected, I'm always sceptical as to how the state can be genuinely compassionate. Safeguarding well-being and other such processes is often a mechanism to protect institutions and faades behind which officials hide. These are not technicalities. We should also not use this, as has been well raised, as an excuse to reduce funding to palliative and careful stop for this to be right and proper it must be a genuine choice. And not a false one. However, in reality, this bill is more about decriminalising those who help me with a choice I want to make, as much as it is giving me the choice in the first place.
As Lord Dubs is adequately just said, we already have that choice but it is absurdly complex and solitary. And those who love us are removed from the processes. This bill changes that. It allows us to have access to proper care in this country. It enables us to have real dignity in our departure. And it ends the absurd situations we currently ensure where a spouse is potentially arrested at Heathrow having taken the partner to Dignitas. The fact this is happening today already in the worst possible way.
In this bill, with however many issues it contains, is fundamentally better than the situation we currently suffer. To this end we must not let complexities defeat us. You should not let the technical means of regulation used as a block on the principle. I dislike fundamentally all forms of regulation, but in this instance support proper clarity for doctors and structure for families around this urgent need. We should be more fearful of failing to deliver this freedom than of the risks that the freedom of choice may entail.
With freedom always comes risk. It behoves us to use all our talents to find a way to deliver on this last and final rights of our citizens. I am an optimist. Legislation can be revised and reviewed. Secretaries of State can take common sense decisions, it is true. And the medical and other professions can pride themselves on really owning the process over which they have control. This is all possible. People often ask, what is the House of Lords for? I say to is precisely for situations like today, when we focus on solving complex highly sensitive problems with a single goal in mind, which is to allow people to live their lives as they want.
Free from pain and suffering, from the moment they are born until the very end. I look forward to working through this bill that single objective in mind.
**** Possible New Speaker ****
My Lords, I was expelling to a group of people last night the virtues were of speaking your virtues were of speaking your Lordships House. And I somewhat controversially perhaps for a former member of the other house fan myself saying that the advantage of having no constituents is that you can look
13:58
Baroness Debbonaire (Labour)
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Baroness Debbonaire (Labour)
no constituents is that you can look at the evidence and listen to the arguments. I find myself actually in or of the depth and quality of evidence assessed and arguments made today. And of The Listening Post up I intend to use the prism of eating disorders as a way of examining some of the arguments that have not yet been made because I want to stick to my solution not to repeat the points that have already been well made but the lack of choice when there is not sufficient quality of hospice care and so forth.
Other noble peers the arguments well. If you are a young woman, and it is typically women, with an eating disorder, you may have consulted a website about how to do that better. We, in both houses, have tried our best to legislate against the provision of such website for the Online Safety Act and rightly so. You may not have consulted a website about how to commit suicide, but you also may have done. Again, the Online Safety Act rightly seeks to stop that from happening.
Many of us voted for that act, and we did so thinking about what was currently legal but harmful. And I stand by that and I'm committed to it. You have an eating disorder, it is in fact the mental health condition which is not covered by clause two part two of the current Bill as it stands because voluntary suspension of eating and drinking is not the same as an eating disorder. They are two different things. It is important to the singers though.
I do not pretend that this is easy for anybody. I do not pretend it is easy to find us all in this House taking incredibly seriously the fact that if we get this bill wrong, people die we should not die at this stage they will die. That was one of the reasons I think one of my colleagues has expressed why your Lordships House came to the view many years ago that capital punishment was wrong. I hold that same view now about this bill.
And I speak with intense pain actually and love for those who have made the eloquent and heartfelt cases to end the suffering of those who are terminally ill. I understand that. This bill actually there was no specialist treatment. There was none. There were no specialist treatment beds in hospitals where they were needed at the point when that mental illness had become life-threatening. As the noble Baroness said, treatment delayed increases the risk of a terminal and. Do we really want to legislate so that people who cannot get treatment then become terminally oh and seek assisted dying as oh way out of that? We are in danger of doing just that.
I don't think that is the intention by my friend Lord Faulkner or anybody else who is in favour of assisted dying. I don't think that is the intention but that is where we're going to end up. I'm not in favour of assisted dying. I'm here to speak against the bill, however, because we are here to legislate. I wish all noble peers and their thoughts over the coming weeks to consider the specific case of eating disorders and how that does not work in the context of this bill and why that matters, and then to consider that frame for other conditions in which lack of illness.
Other noble peers the arguments well. If you are a young woman, and it is typically women, with an eating disorder, you may have consulted a website about how to do that better. We, in both houses, have tried our best to legislate against the provision of such website for the Online Safety Act and rightly so. You may not have consulted a website about how to commit suicide, but you also may have done. Again, the Online Safety Act rightly seeks to stop that from happening.
Many of us voted for that act, and we did so thinking about what was currently legal but harmful. And I stand by that and I'm committed to it. You have an eating disorder, it is in fact the mental health condition which is not covered by clause two part two of the current Bill as it stands because voluntary suspension of eating and drinking is not the same as an eating disorder. They are two different things. It is important to the singers though.
I do not pretend that this is easy for anybody. I do not pretend it is easy to find us all in this House taking incredibly seriously the fact that if we get this bill wrong, people die we should not die at this stage they will die. That was one of the reasons I think one of my colleagues has expressed why your Lordships House came to the view many years ago that capital punishment was wrong. I hold that same view now about this bill.
And I speak with intense pain actually and love for those who have made the eloquent and heartfelt cases to end the suffering of those who are terminally ill. I understand that. This bill actually there was no specialist treatment. There was none. There were no specialist treatment beds in hospitals where they were needed at the point when that mental illness had become life-threatening. As the noble Baroness said, treatment delayed increases the risk of a terminal and. Do we really want to legislate so that people who cannot get treatment then become terminally oh and seek assisted dying as oh way out of that? We are in danger of doing just that.
I don't think that is the intention by my friend Lord Faulkner or anybody else who is in favour of assisted dying. I don't think that is the intention but that is where we're going to end up. I'm not in favour of assisted dying. I'm here to speak against the bill, however, because we are here to legislate. I wish all noble peers and their thoughts over the coming weeks to consider the specific case of eating disorders and how that does not work in the context of this bill and why that matters, and then to consider that frame for other conditions in which lack of illness.
14:02
Lord Farmer (Conservative)
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Lord Farmer (Conservative)
I want to stand back from this bill and call out the dangers of the wider cultural drift towards hyper- individualism. Freedom to end life on our terms, making death accessible as a personal convenience, HD centralises and cheapens the death, life and humanity itself. Professor Lewis humanity itself. Professor Lewis Appleby warns that are socially remarkable commences consensus that it is right to prevent all types of suicide. He also said that the phrase assisted suicide should not be considered offensive.
At the time of the second reading in the Commons, two of my friends who were suffering terminal conditions, one has since died, both followed the debate and news coverage and told me the subject is very airy and make them feel like they were a burden to their loved ones. Assisted dying is the places -- latest promotion of personal autonomy. It floats the important do no harm principle underlying classical liberalism as well as immediate harms to the disabled, those who fear becoming a burden and those vulnerable to coercion.
There are long-term harms to this bill, typical of what pollster James calls shrouded attributes of policies, costs and liabilities, hidden at point of sale to the public, which inflict a later tale of pain. First the inevitable extension to other groups beyond those catered for in this bill. International examples abound of legal group where mental illness, nocturnal conditions an ever younger sufferers become eligible -- non- terminal conditions. Labour should prioritise sorting out palliative, social and end-of-life care before even thinking about assisted dying.
Less than 1/5 disagreed. Hospice movement needs strengthening first, otherwise there is no genuine choice as we've already heard in this debate. You matter because you are you and you matter to the last moment of your life. We will do all we can not only to help you die peacefully but also to live until you die. Helping patients live until they die is what very many doctors want to keep offering or offer more reliably. Fear of missing out drives calls for assisted dying.
Supporters are significantly more likely than opponents to believe they will be unable to fund their own end-of-life care, and that the government won't pay for it. Third, the cheapening of life and disregard for relationships which flowed from outlawing physical and mental suffering despite these being part of universal human being part of universal human condition. Wells they should be affiliated -- alleviated where possible, taking the escape route of death is intensely painful for many years for close family members and friends when they have had no say in the matter.
When personal autonomy trumps everything, we end up, dare I say, they are fine selfishness -- glorifying selfishness. Western society has all too often been insensitive to the dimension of time, thinking through the long-term unintended consequences of policy changes is imperative. But were short time -- short-term fixes which will inflict lifelong pain on those they target.
At the time of the second reading in the Commons, two of my friends who were suffering terminal conditions, one has since died, both followed the debate and news coverage and told me the subject is very airy and make them feel like they were a burden to their loved ones. Assisted dying is the places -- latest promotion of personal autonomy. It floats the important do no harm principle underlying classical liberalism as well as immediate harms to the disabled, those who fear becoming a burden and those vulnerable to coercion.
There are long-term harms to this bill, typical of what pollster James calls shrouded attributes of policies, costs and liabilities, hidden at point of sale to the public, which inflict a later tale of pain. First the inevitable extension to other groups beyond those catered for in this bill. International examples abound of legal group where mental illness, nocturnal conditions an ever younger sufferers become eligible -- non- terminal conditions. Labour should prioritise sorting out palliative, social and end-of-life care before even thinking about assisted dying.
Less than 1/5 disagreed. Hospice movement needs strengthening first, otherwise there is no genuine choice as we've already heard in this debate. You matter because you are you and you matter to the last moment of your life. We will do all we can not only to help you die peacefully but also to live until you die. Helping patients live until they die is what very many doctors want to keep offering or offer more reliably. Fear of missing out drives calls for assisted dying.
Supporters are significantly more likely than opponents to believe they will be unable to fund their own end-of-life care, and that the government won't pay for it. Third, the cheapening of life and disregard for relationships which flowed from outlawing physical and mental suffering despite these being part of universal human being part of universal human condition. Wells they should be affiliated -- alleviated where possible, taking the escape route of death is intensely painful for many years for close family members and friends when they have had no say in the matter.
When personal autonomy trumps everything, we end up, dare I say, they are fine selfishness -- glorifying selfishness. Western society has all too often been insensitive to the dimension of time, thinking through the long-term unintended consequences of policy changes is imperative. But were short time -- short-term fixes which will inflict lifelong pain on those they target.
14:06
Lord Birt (Crossbench)
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Lord Birt (Crossbench)
I strongly support this bill. Overall, it is well considered. Importantly, it benefits from the experience of many other countries that started this journey well before us. In no sense, would we be pioneers. The carefully designed process that the bill sets out should address the possible risks. For instance, severe coercion, which have been identified. We know from surveys there is overwhelming public support for assisted dying. All of us have received heartrending letters pleading the passage of this bill from individuals who have had harrowing experiences of witnessing loved ones slowly dying in extreme pain or in at the debilitating circumstances.
And this bill confers the right for such an individual facing imminent death not just to avoid anguish and pain and the prospect of their condition progressing intolerably come about to die at the moment of their choosing in the circumstances of their choosing and with dignity. I want that right and anyone who wants it should have it as well. No doubt the bill can be further improved. the bill can be further improved. The committee makes many points we should take on board.
But the explanatory notes remind us of decades of attempts to introduce assisted dying legislation which have simply failed. It is highly unlikely that any government in the foreseeable future will see is the backbone. We must therefore makes -- backbone. We must therefore makes -- make this bill right and pass it. Whilst I entirely see the value of the process setting out two independent assessments, two periods of reflection and an independent peer review panel, there may be risk in the world of constrained resources where it is hard these days to even see your GP, of unwelcome slippage, of prolonged delays, perhaps in August or over the Christmas period that intensifies suffering.
Should be built into this process on the one hand greater certainty on the total time normally taken, and on the other some flexibility on telescoping time when circumstances demand it, particularly for those who may enter the process at a later stage. Finally, for anyone uncertain, harbouring doubts about this bill, I strongly advise they watch the one hour discussion hosted by the healthcare professionals for assisted dying with four Australian practitioners working in this field. Without exception, they came over as people of enormous integrity and humanity, caring, truly dedicated to their work and entirely convincing about the necessity and the effectiveness of a carefully considered assisted dying process.
It is well worth watching and I have no doubt whatsoever that our medical professionals who volunteer, and you have to volunteer, for a role in the assisted dying process will equally rise to the challenge. This is further -- let us further improve and then let us pass this critically important bill.
And this bill confers the right for such an individual facing imminent death not just to avoid anguish and pain and the prospect of their condition progressing intolerably come about to die at the moment of their choosing in the circumstances of their choosing and with dignity. I want that right and anyone who wants it should have it as well. No doubt the bill can be further improved. the bill can be further improved. The committee makes many points we should take on board.
But the explanatory notes remind us of decades of attempts to introduce assisted dying legislation which have simply failed. It is highly unlikely that any government in the foreseeable future will see is the backbone. We must therefore makes -- backbone. We must therefore makes -- make this bill right and pass it. Whilst I entirely see the value of the process setting out two independent assessments, two periods of reflection and an independent peer review panel, there may be risk in the world of constrained resources where it is hard these days to even see your GP, of unwelcome slippage, of prolonged delays, perhaps in August or over the Christmas period that intensifies suffering.
Should be built into this process on the one hand greater certainty on the total time normally taken, and on the other some flexibility on telescoping time when circumstances demand it, particularly for those who may enter the process at a later stage. Finally, for anyone uncertain, harbouring doubts about this bill, I strongly advise they watch the one hour discussion hosted by the healthcare professionals for assisted dying with four Australian practitioners working in this field. Without exception, they came over as people of enormous integrity and humanity, caring, truly dedicated to their work and entirely convincing about the necessity and the effectiveness of a carefully considered assisted dying process.
It is well worth watching and I have no doubt whatsoever that our medical professionals who volunteer, and you have to volunteer, for a role in the assisted dying process will equally rise to the challenge. This is further -- let us further improve and then let us pass this critically important bill.
14:10
Baroness Fraser of Craigmaddie (Conservative)
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Baroness Fraser of Craigmaddie (Conservative)
I have spent some years working to improve care and support for vulnerable people, specifically as chief executive of several -- Cerebral Palsy Scotland. Also as a previous trustee of the Neurological Alliance Scotland. All of us want to ensure compassion and care are assured in services for everyone when they need it. I believe everyone is entitled to make informed choices, to make choices that allow them to live with dignity and as pain-free as possible. Sadly, for too many people, this is not the reality.
Lack of access to condition specific support, lack of access to palliative care, lack of accepted -- lack of access to social care are all reasons why the status quo does not work for many people. Set in the context of clinical backlogs, constrained funding in Health and Social Care Committee people will not make other choices in the context that is equal. Here, in this chamber, we are all in the main healthy, competent come articulate and above all privileged people. I have been asked, "Would I not want an assisted death if I was unable to speak for myself? Dress myself or eat by myself? Postcodes but this is the reality every day for many disabled people.
In seeking to ensure this bill leaves this place fit for purpose, we must consider assisted dying not through the lens of what we think we might want for ourselves, but rather its impact on the most vulnerable in our society. We have been told that this bill gives people choice, but which people and what choices? As it stands, this bill leaves me profoundly uncomfortable. The personal stories of people seeking choice and control over the manner of their death, or the heartrending examples of poor care seem to me not likely to be resolved by the provisions of this bill.
I'm also concerned about the differences between this bill and the bill currently going through the Scottish parliament and the implications of these differences for service provision and regulation across the UK if both bills passed. I gave evidence to the lead committee scrutinising the bill on behalf of Cerebral Palsy Scotland. Both bills leave too many details to be agreed later, speaking -- sweeping across powers such as approving drugs. It will require cooperation and coordination between two administrations and should, I believe, require full transparency in Parliament.
Where these bills use words such as terminal, progressive or's treatment, we need clarity on what those terms mean. Other is, such broad terminology and the lack of detail around the process of assisted dying will result in unintended gaps. I also want to see provisions to ensure mandatory involvement of health professionals who actually know the person and our experts on the condition the person is presenting with. But there are a host of other issues that currently concern me, including greater clarity on how people die, especially if they are unable to use their hands or ingest a substance, direction on what medical professionals are supposed to do or not do in case something goes wrong, stronger protections for conscientious objectors and far, far greater clarity on training and reporting standards and requirements.
The bill presents too many questions and not many answers. I look forward to playing the part during its passage as it is essential that these questions are not brushed aside or dismissed and that clear answers are provided. that clear answers are provided.
Lack of access to condition specific support, lack of access to palliative care, lack of accepted -- lack of access to social care are all reasons why the status quo does not work for many people. Set in the context of clinical backlogs, constrained funding in Health and Social Care Committee people will not make other choices in the context that is equal. Here, in this chamber, we are all in the main healthy, competent come articulate and above all privileged people. I have been asked, "Would I not want an assisted death if I was unable to speak for myself? Dress myself or eat by myself? Postcodes but this is the reality every day for many disabled people.
In seeking to ensure this bill leaves this place fit for purpose, we must consider assisted dying not through the lens of what we think we might want for ourselves, but rather its impact on the most vulnerable in our society. We have been told that this bill gives people choice, but which people and what choices? As it stands, this bill leaves me profoundly uncomfortable. The personal stories of people seeking choice and control over the manner of their death, or the heartrending examples of poor care seem to me not likely to be resolved by the provisions of this bill.
I'm also concerned about the differences between this bill and the bill currently going through the Scottish parliament and the implications of these differences for service provision and regulation across the UK if both bills passed. I gave evidence to the lead committee scrutinising the bill on behalf of Cerebral Palsy Scotland. Both bills leave too many details to be agreed later, speaking -- sweeping across powers such as approving drugs. It will require cooperation and coordination between two administrations and should, I believe, require full transparency in Parliament.
Where these bills use words such as terminal, progressive or's treatment, we need clarity on what those terms mean. Other is, such broad terminology and the lack of detail around the process of assisted dying will result in unintended gaps. I also want to see provisions to ensure mandatory involvement of health professionals who actually know the person and our experts on the condition the person is presenting with. But there are a host of other issues that currently concern me, including greater clarity on how people die, especially if they are unable to use their hands or ingest a substance, direction on what medical professionals are supposed to do or not do in case something goes wrong, stronger protections for conscientious objectors and far, far greater clarity on training and reporting standards and requirements.
The bill presents too many questions and not many answers. I look forward to playing the part during its passage as it is essential that these questions are not brushed aside or dismissed and that clear answers are provided. that clear answers are provided.
14:14
Lord Carter of Haslemere (Crossbench)
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Lord Carter of Haslemere (Crossbench)
The noble Baroness lady men in stated in the house on 4 September last year, and I quote, "The government because my commitment is to ensure that any -- assisted dying is to provide access to high-quality relative and end-of-life care." Here we are having that debate. Has access to palliative care improved so much in the last few months? The experts say not. As we've heard but it bears repeating the evidence shows that 100,000 people die each year in the UK with unmet palliative care needs.
Fewer than 50% have input from a specialist palliative care team and their last three months of life. -- In their last three months of life. The bill sidesteps this crucial issue because, as was pointed out, it contains to requirement that the person suffering the terminal illness must also be suffering intolerable pain -- it contains no ... Regardless of whether they are experiencing pain or not. Of course, some of these people will require policy of care in any event.
But if the focus of the debate was instead on relieving intolerable pain and suffering, then it would be more apparent that we should be legislating for wider access to higher quality palliative care, not a state assisted death regime. As the Health and Social Care Committee heard, patients in countries with assisted dying request help to die frequently change their mind if provided with proper palliative care stuff for example evidence from Oregon showed that 46% of patients who received substantive palliative care changed their minds about an assisted death, compared with just 15% who did not receive such palliative care.
Yet the bill does not require that the person received palliative care before electing an assisted death stop merely that the given the opportunity to discuss it. There is therefore a strong case of a huge sum which would be spent on state assisted deaths to be spent instead on improving access to specialist palliative care. Yet the intention seems to be quite the opposite. The impact statement sets out the tens of million pounds currently spent on care, state pensions and benefits which would be saved if this bill were enacted.
Is this really a relevant consideration? If so, I suggest we need to re-examine our priorities here. We should be encouraging those who are ill, depressed or struggling in anyway to believe that life is a precious gift and worth living. We should be treating them as individuals who never ceased to be important. Even in frailty or decline. And that they deserve to have a dignified life in all its seasons by being cared for to the end with the state meeting the full costs of that.
In speaking on this bill, each of us individually have searched our consciousness and that is exactly how it should be. In searching mind, and taking line I have, I have been guided by my Christian beliefs on life and on how life comes to an end.
Fewer than 50% have input from a specialist palliative care team and their last three months of life. -- In their last three months of life. The bill sidesteps this crucial issue because, as was pointed out, it contains to requirement that the person suffering the terminal illness must also be suffering intolerable pain -- it contains no ... Regardless of whether they are experiencing pain or not. Of course, some of these people will require policy of care in any event.
But if the focus of the debate was instead on relieving intolerable pain and suffering, then it would be more apparent that we should be legislating for wider access to higher quality palliative care, not a state assisted death regime. As the Health and Social Care Committee heard, patients in countries with assisted dying request help to die frequently change their mind if provided with proper palliative care stuff for example evidence from Oregon showed that 46% of patients who received substantive palliative care changed their minds about an assisted death, compared with just 15% who did not receive such palliative care.
Yet the bill does not require that the person received palliative care before electing an assisted death stop merely that the given the opportunity to discuss it. There is therefore a strong case of a huge sum which would be spent on state assisted deaths to be spent instead on improving access to specialist palliative care. Yet the intention seems to be quite the opposite. The impact statement sets out the tens of million pounds currently spent on care, state pensions and benefits which would be saved if this bill were enacted.
Is this really a relevant consideration? If so, I suggest we need to re-examine our priorities here. We should be encouraging those who are ill, depressed or struggling in anyway to believe that life is a precious gift and worth living. We should be treating them as individuals who never ceased to be important. Even in frailty or decline. And that they deserve to have a dignified life in all its seasons by being cared for to the end with the state meeting the full costs of that.
In speaking on this bill, each of us individually have searched our consciousness and that is exactly how it should be. In searching mind, and taking line I have, I have been guided by my Christian beliefs on life and on how life comes to an end.
14:18
Lord Roberts of Belgravia (Conservative)
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Lord Roberts of Belgravia (Conservative)
The measure before us represent the possibility of the greatest alleviation on pain and suffering in this country since Alexander Fleming discovered penicillin 97 years ago. It's no criticism of our excellent hospice movement to point out that no amount of resources given to palliative care can alter the ultimate results or abolish the fearful pain and indignity that terminally ill people have to go through, unless they take so many painkillers that they become prey to weird delusions, essentially becoming different people to those their love ones know.
Families gathered around death beds are presently denied the right to help to end their loved one suffering because of the so-called sanctity of life, even when that life has lost any possible meaning for Stockholm wishes in his first soliloquy that the everlasting had not fixed his Canon against self slaughter -- Shakespeare. But thou shalt not kill can be expended in exceptional circumstances and so it should be in the case of the horrendous pain of an irreversible slow death.
Wanting to avoid it, such excruciating pain, is not selfish, it's a human right. Going back further in history, Going back further in history, beyond Augustin of Hippo and Thomas Aquinas, theologians who prescribed suicide, the ancient Greeks and Romans recognised there was nothing noble in it if the alternative is far worse -- nothing not noble. Along with the doctor and family, protected by robust safeguards and oversight mechanisms, but not of the state, or the church, to decide whether he or she wants to escape pain and suffering in their final days.
The autonomy to die on one's own terms, not on those imposed by others, should not be denied any longer. The defenders of the status quo have been talking about this being the thin end of the wedge but there's hardly any legislation we consider here that can't be seen as the thin end of some word or another. The idea Britain will turn into some kind of heck to more of grannies being killed off by families eager to requests is ludicrous and this bill has safeguards against it anyhow.
This is not about the disabled or about the mentally ill or about those with eating disorders. Few generations will consider us monsters. In people from shortening their death agonies if they wish to, especially as the majority of the population and of the elected House support this bill. People will rightly condemn this House if we refuse a person in desperate pain with only six months to live, the right to choose the time and method of their death. We spent a good deal of time criticising our ancestors for their views on race, sex and class, but those people who come after us will stand aghast that we allowed some of our old people to die in pain akin to torture rather than simply overturn a mediaeval and sadistic practice.
practice.
Families gathered around death beds are presently denied the right to help to end their loved one suffering because of the so-called sanctity of life, even when that life has lost any possible meaning for Stockholm wishes in his first soliloquy that the everlasting had not fixed his Canon against self slaughter -- Shakespeare. But thou shalt not kill can be expended in exceptional circumstances and so it should be in the case of the horrendous pain of an irreversible slow death.
Wanting to avoid it, such excruciating pain, is not selfish, it's a human right. Going back further in history, Going back further in history, beyond Augustin of Hippo and Thomas Aquinas, theologians who prescribed suicide, the ancient Greeks and Romans recognised there was nothing noble in it if the alternative is far worse -- nothing not noble. Along with the doctor and family, protected by robust safeguards and oversight mechanisms, but not of the state, or the church, to decide whether he or she wants to escape pain and suffering in their final days.
The autonomy to die on one's own terms, not on those imposed by others, should not be denied any longer. The defenders of the status quo have been talking about this being the thin end of the wedge but there's hardly any legislation we consider here that can't be seen as the thin end of some word or another. The idea Britain will turn into some kind of heck to more of grannies being killed off by families eager to requests is ludicrous and this bill has safeguards against it anyhow.
This is not about the disabled or about the mentally ill or about those with eating disorders. Few generations will consider us monsters. In people from shortening their death agonies if they wish to, especially as the majority of the population and of the elected House support this bill. People will rightly condemn this House if we refuse a person in desperate pain with only six months to live, the right to choose the time and method of their death. We spent a good deal of time criticising our ancestors for their views on race, sex and class, but those people who come after us will stand aghast that we allowed some of our old people to die in pain akin to torture rather than simply overturn a mediaeval and sadistic practice.
practice.
14:21
Baroness Prentis of Banbury (Conservative)
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Baroness Prentis of Banbury (Conservative)
My Lords, I apologise to giving you three very personal examples. When I was in my late 20s, we had a baby son who died and I almost died giving birth to him. For a few short hours, it looked, while our lives in the balance, it looked as if choices would have to be made. In fact this wasn't the case, there was nothing to decide, but the whole experience gave me deeper understanding of where law and vertical ethics collide.
I learnt that to be kind, nor must be very clear. And I was able to use this in my later practice in coronial law and for example in representing the government in some very high-profile cases on this issue. Secondly, my point is that death within the law can be, and indeed usually is, very good. My parents deaths are examples of this, my mother six years ago, my father 12 days ago, were assisted by excellent palliative care. Drugs were able to help my parents to breathe and ensure that their pain could be managed at the last.
These were good deaths. But my concern is that doctors need to be empowered to be frank and to be honest and to provide holistic care for the person that they are caring for, one of the best things we did for dad was to go round his body disconnecting some of the bleeping machines and some of the syringes that were in him and ask, why do you need that? What is that for? You know he is dying, let's take it away. And those on my side of this debate must be honest as well.
There is a small group of illnesses for which a peaceful death is not a likely outcome. And we need to focus our efforts collectively on these and on managing these, and on managing the law to support these being better deaths. My third concern is that the ill are very vulnerable. I have recently been diagnosed with aggressive cancer and treatment starts this week. My prognosis is excellent. I have every advantage. I have a strong faith, I have a loving family, I have an interesting workplace and good colleagues and supportive community.
And enough money. And underlying good health. And indeed excellent treatment I should say. But there have been some very low moments in the past few weeks when I have realised the burden I am to my family who are currently arguing he should take extra week off to look after me. And also, my concerns about watching them, watching me suffer, as well of course as my own fear frankly of pain and loss of control. I watch that final debate in the Commons and what struck me was that woman after woman, ethnic minority after ethnic minority, disabled people, stood up and said this bill is not good enough for my vulnerable community.
My Lords, please don't write me letters and messages, I'm drowning in kind this. Instead, I ask you to think hard about me with all my advantages feeling like a burden stop just briefly, not all the time, don't worry, I will be back this time next year bouncing around. But I ask you to think instead of messaging me, think about the vulnerable and how easy it is for them to feel their lives are not worth living.
I learnt that to be kind, nor must be very clear. And I was able to use this in my later practice in coronial law and for example in representing the government in some very high-profile cases on this issue. Secondly, my point is that death within the law can be, and indeed usually is, very good. My parents deaths are examples of this, my mother six years ago, my father 12 days ago, were assisted by excellent palliative care. Drugs were able to help my parents to breathe and ensure that their pain could be managed at the last.
These were good deaths. But my concern is that doctors need to be empowered to be frank and to be honest and to provide holistic care for the person that they are caring for, one of the best things we did for dad was to go round his body disconnecting some of the bleeping machines and some of the syringes that were in him and ask, why do you need that? What is that for? You know he is dying, let's take it away. And those on my side of this debate must be honest as well.
There is a small group of illnesses for which a peaceful death is not a likely outcome. And we need to focus our efforts collectively on these and on managing these, and on managing the law to support these being better deaths. My third concern is that the ill are very vulnerable. I have recently been diagnosed with aggressive cancer and treatment starts this week. My prognosis is excellent. I have every advantage. I have a strong faith, I have a loving family, I have an interesting workplace and good colleagues and supportive community.
And enough money. And underlying good health. And indeed excellent treatment I should say. But there have been some very low moments in the past few weeks when I have realised the burden I am to my family who are currently arguing he should take extra week off to look after me. And also, my concerns about watching them, watching me suffer, as well of course as my own fear frankly of pain and loss of control. I watch that final debate in the Commons and what struck me was that woman after woman, ethnic minority after ethnic minority, disabled people, stood up and said this bill is not good enough for my vulnerable community.
My Lords, please don't write me letters and messages, I'm drowning in kind this. Instead, I ask you to think hard about me with all my advantages feeling like a burden stop just briefly, not all the time, don't worry, I will be back this time next year bouncing around. But I ask you to think instead of messaging me, think about the vulnerable and how easy it is for them to feel their lives are not worth living.
14:25
Baroness Cass (Crossbench)
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Baroness Cass (Crossbench)
My Lords, like others I would like to thank the many people on both sides of the debate who have written to me sharing views and deeply personal stories. For the sake of transparency, I will say this on a personal level, I'm supportive of the principle of assisted dying in very narrowly defined circumstances. However I'm deeply concerned about this bill as it stands and do not consider it to be either safe or deliverable. I will focus on just one aspect.
As part of the process the bill requires three different doctors, the one undertaking the preliminary discussion, the coordinating doctor and the independent doctor, to discuss the primary diagnosis, prognosis and treatment options as well as palliative care options including symptom management. The latter two doctors must also assess for coercion, domestic abuse and capacity as well as discussing the assisted dying process. I believe I'm the most recently retired medic in this house, having given up my licence to practice last month. Throughout my recent review I have devoted much time and discussions to thinking about meaningful, informed consent.
Back in the day when I was a junior Haussmann we were expected to take consent that knowing much about the relevant procedure or how to adequately answer patients questions we have come along way since then. Options are explained to patients first hand clinicians who are specialists in the topic they are discussing, because it's impossible for other doctors to be up-to-date with the rapidly involving a range of treatments. You may assume that in the case of those seeking assisted dying this has already been done by the treating doctor.
But when someone in part the serious diagnosis you from blank out everything that is said thereafter and may be fearful of asking additional questions. We know nothing about the background and qualifications of the three doctors who are expected to fill this potential gap. The latter two are at least supposed to be able to examine patients medical records and speak to treating professionals. However, written records are rarely adequate as a basis for such discussion and there are major complexities in doctors external to an organisation accessing electronic records.
Furthermore, the treating doctor may not be available in a timely way. And as for advising on palliative care options, the only professionals who can explain the full range of symptom control measures are palliative care consultants. In other words, the coordinating and independent doctors asked to take on two wholly different roles, the first is to substitute for a full multidisciplinary assessment involving the team managing the primary diagnosis, the palliative care specialist and in some circumstances a psychiatrist and social worker will stop I would submit that such an assessment should be a core NHS function.
It should identify the patients main concerns and fears and share information about possible options, ideally in a family context. This should happen upfront before discussions about unassisted, rather discussions about unassisted, rather than at the end of when it is far to late to generate a trusting relationship -- about an assisted death. The second is the role of consenting to assisted dying which should be considered separately once other options have been rejected, and I believe this should be through a service external to the NHS.
I have worked in MDGs throughout my career on what is key is respecting the unique skills of colleagues and listening to their views. Icon to my views on this topic not just on the basis of my experience but in large part by listening to organisations representing professionals, GPs, psychiatrists, passive care consultants and physicians. I would strongly encourage noble Lords to take their views very seriously and further deliberations and for that reason I will be supporting Baroness Burgess and her amendment.
As part of the process the bill requires three different doctors, the one undertaking the preliminary discussion, the coordinating doctor and the independent doctor, to discuss the primary diagnosis, prognosis and treatment options as well as palliative care options including symptom management. The latter two doctors must also assess for coercion, domestic abuse and capacity as well as discussing the assisted dying process. I believe I'm the most recently retired medic in this house, having given up my licence to practice last month. Throughout my recent review I have devoted much time and discussions to thinking about meaningful, informed consent.
Back in the day when I was a junior Haussmann we were expected to take consent that knowing much about the relevant procedure or how to adequately answer patients questions we have come along way since then. Options are explained to patients first hand clinicians who are specialists in the topic they are discussing, because it's impossible for other doctors to be up-to-date with the rapidly involving a range of treatments. You may assume that in the case of those seeking assisted dying this has already been done by the treating doctor.
But when someone in part the serious diagnosis you from blank out everything that is said thereafter and may be fearful of asking additional questions. We know nothing about the background and qualifications of the three doctors who are expected to fill this potential gap. The latter two are at least supposed to be able to examine patients medical records and speak to treating professionals. However, written records are rarely adequate as a basis for such discussion and there are major complexities in doctors external to an organisation accessing electronic records.
Furthermore, the treating doctor may not be available in a timely way. And as for advising on palliative care options, the only professionals who can explain the full range of symptom control measures are palliative care consultants. In other words, the coordinating and independent doctors asked to take on two wholly different roles, the first is to substitute for a full multidisciplinary assessment involving the team managing the primary diagnosis, the palliative care specialist and in some circumstances a psychiatrist and social worker will stop I would submit that such an assessment should be a core NHS function.
It should identify the patients main concerns and fears and share information about possible options, ideally in a family context. This should happen upfront before discussions about unassisted, rather discussions about unassisted, rather than at the end of when it is far to late to generate a trusting relationship -- about an assisted death. The second is the role of consenting to assisted dying which should be considered separately once other options have been rejected, and I believe this should be through a service external to the NHS.
I have worked in MDGs throughout my career on what is key is respecting the unique skills of colleagues and listening to their views. Icon to my views on this topic not just on the basis of my experience but in large part by listening to organisations representing professionals, GPs, psychiatrists, passive care consultants and physicians. I would strongly encourage noble Lords to take their views very seriously and further deliberations and for that reason I will be supporting Baroness Burgess and her amendment.
14:30
Lord Goodman of Wycombe (Conservative)
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Lord Goodman of Wycombe (Conservative)
Others have referred to the report of the Delegated Powers Committee into this bill. I am a member of that committee, although I shouldn't size I speaking only for myself personally, not for the committee collectively. I have no idea where that most members of the committee share my view that assisted dying is deeply problematic in principle. But as has been made clear, we concluded that this bill is flawed in practice. Our report made by 13 recommendations covering such vital matters is the investigation of gas, approved substances, probation of advertising and perhaps above all voluntary assisted services stop in other words, the relationship between what this bill proposes and how the NHS will dispose if the bill comes into I quote from the report.
There are several things wrong which we draw to the houses attention. There is insufficient detail or principle for proper parliamentary scrutiny of the underlying policies. In some cases, particularly where statutory regime may be needed, this results in skeletal legislation. There are several instances where delegated powers can be used to do anything. This is a highly appropriate regulation that gives unjustified hours to the government while removing parliamentary scrutiny under the provision that should have been primary legislation and replacing it with the more limited role of scrutinising legislation.
Noble Lords will have received the main question the community was tasked with answering was not what does the bill seek to do about how does it seek to do it. Can I suggest that this is the key question, not just for the committee but for the whole house, which for better or worse, tends to scrutinise legislation more exactly than the other place. If the answer to the question how is an adequate -- inadequately, another question arises. Can it be made adequate at all? I intend to table amendments all? I intend to table amendments that committee.
However, I cannot see how this bill can be made good no matter to what degree it is amended. The Institute of government have noted this Private Members' Bill is profound and complex whatever the degree of government support. A key problem of using this route to legislate is the lack of pre-legislative stages. Legislation on issues like assisted dying would have benefited enormously from a have benefited enormously from a more Doro -- Doro -- thorough pre- legislative stage.
This view was also packed up -- backed up by the Constitution Committee that I had the privilege of sitting in. Perhaps the most crucial criticism of the bill. It surely cannot be right that a matter of survival is the relationship between assisted dying services and the NHS is left to ministers to replace by legislation. I asked noble Lords to consider whether such a proposal can be fit for purpose?
There are several things wrong which we draw to the houses attention. There is insufficient detail or principle for proper parliamentary scrutiny of the underlying policies. In some cases, particularly where statutory regime may be needed, this results in skeletal legislation. There are several instances where delegated powers can be used to do anything. This is a highly appropriate regulation that gives unjustified hours to the government while removing parliamentary scrutiny under the provision that should have been primary legislation and replacing it with the more limited role of scrutinising legislation.
Noble Lords will have received the main question the community was tasked with answering was not what does the bill seek to do about how does it seek to do it. Can I suggest that this is the key question, not just for the committee but for the whole house, which for better or worse, tends to scrutinise legislation more exactly than the other place. If the answer to the question how is an adequate -- inadequately, another question arises. Can it be made adequate at all? I intend to table amendments all? I intend to table amendments that committee.
However, I cannot see how this bill can be made good no matter to what degree it is amended. The Institute of government have noted this Private Members' Bill is profound and complex whatever the degree of government support. A key problem of using this route to legislate is the lack of pre-legislative stages. Legislation on issues like assisted dying would have benefited enormously from a have benefited enormously from a more Doro -- Doro -- thorough pre- legislative stage.
This view was also packed up -- backed up by the Constitution Committee that I had the privilege of sitting in. Perhaps the most crucial criticism of the bill. It surely cannot be right that a matter of survival is the relationship between assisted dying services and the NHS is left to ministers to replace by legislation. I asked noble Lords to consider whether such a proposal can be fit for purpose?
14:34
Baroness Stuart of Edgbaston (Crossbench)
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Baroness Stuart of Edgbaston (Crossbench)
We've had several references in the debate so far to a settled public view, that the public is in favour of this legislation. I might now briefly revert to 2015 private members legislation on assisted dying. My constituency had some interesting aspects like the highest concentration of doctors compared to anywhere in the country. Across the road from the constituency was the Birmingham Auditory -- auditory -- Oratory, a Catholic organisation. I organised three public meetings.
One was organised by the Birmingham medical Society and was largely attended by members of the medical profession. The other one was organised by St John's Church and brought in faith groups. The third one was a public open meeting to all my constituents. The format for all three meetings was the same. I had a lawyer there who would explain what the bill was about and I said, "I'm the bill was about and I said, "I'm going to test my views and hear what you have to say." The outcome was very surprising.
The one group which was always unified in its view where the doctors. They said, "We don't think we should do that." We hear this argument between choices and palliative care. The group which was much -- most divided and apologies to faith leaders in this group, actually, were the churches. The churches were arguing from one end of the argument to the other. The most thoughtful debates were the public who essentially were making the cases for and against.
At the end of the meeting when I said, "What should I do?" $$CAPITALISE's one of them got up and said, "You've got a very tough job so just try to do your best." $$CAPITALISE's I'm explaining this because I think we should be very careful. When you have the kind of public opinion were of course if you ask the question of you want to reduce pain? The simple. But this is a bit palliative care, this is about where the money goes, the consequences of that, and I don't think we have really considered that.
The other thing which I wanted to specifically address was about personal autonomy. Can I just say, to make choices for the few and assume it will not have implications for society as a whole is deeply, deeply misguided. The essence of society is a collective of individuals. If we make something of individuals. If we make something acceptable, to make it an option, I think is problematic. I want to finish with something which the noble Baroness started to address.
I want to quote. "Science is a very human form of knowledge. It stands on the edge of error and is personal. In the end, let me quote the words of Oliver Cromwell. "You may be mistaken."" This is one of those occasions where if we are
**** Possible New Speaker ****
mistaken, we cannot reverse it. It's a privilege to follow the
**** Possible New Speaker ****
It's a privilege to follow the
**** Possible New Speaker ****
It's a privilege to follow the I think the public to broadly support it. They support it only if support it. They support it only if it works. If it doesn't were, if it doesn't deliver what was promised, then the public will be extremely
One was organised by the Birmingham medical Society and was largely attended by members of the medical profession. The other one was organised by St John's Church and brought in faith groups. The third one was a public open meeting to all my constituents. The format for all three meetings was the same. I had a lawyer there who would explain what the bill was about and I said, "I'm the bill was about and I said, "I'm going to test my views and hear what you have to say." The outcome was very surprising.
The one group which was always unified in its view where the doctors. They said, "We don't think we should do that." We hear this argument between choices and palliative care. The group which was much -- most divided and apologies to faith leaders in this group, actually, were the churches. The churches were arguing from one end of the argument to the other. The most thoughtful debates were the public who essentially were making the cases for and against.
At the end of the meeting when I said, "What should I do?" $$CAPITALISE's one of them got up and said, "You've got a very tough job so just try to do your best." $$CAPITALISE's I'm explaining this because I think we should be very careful. When you have the kind of public opinion were of course if you ask the question of you want to reduce pain? The simple. But this is a bit palliative care, this is about where the money goes, the consequences of that, and I don't think we have really considered that.
The other thing which I wanted to specifically address was about personal autonomy. Can I just say, to make choices for the few and assume it will not have implications for society as a whole is deeply, deeply misguided. The essence of society is a collective of individuals. If we make something of individuals. If we make something acceptable, to make it an option, I think is problematic. I want to finish with something which the noble Baroness started to address.
I want to quote. "Science is a very human form of knowledge. It stands on the edge of error and is personal. In the end, let me quote the words of Oliver Cromwell. "You may be mistaken."" This is one of those occasions where if we are
**** Possible New Speaker ****
mistaken, we cannot reverse it. It's a privilege to follow the
**** Possible New Speaker ****
It's a privilege to follow the
**** Possible New Speaker ****
It's a privilege to follow the I think the public to broadly support it. They support it only if support it. They support it only if it works. If it doesn't were, if it doesn't deliver what was promised, then the public will be extremely
14:38
Lord Bethell (Conservative)
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Lord Bethell (Conservative)
then the public will be extremely sceptical that we allowed this to happen. I have some concerns on the fundamental workability of aspects of the bill. I will be invoking my noble friend Lord Goodman and Baroness Cass. This bill creates a vast laundry list of new responsibilities without, I think, the clarity and consensus on execution that such a bill requires. I convened a meeting of frontline clinicians earlier downstairs in the clinicians earlier downstairs in the Attlee room on Tuesday to listen to some of these concerns.
Feedback echoed what we have been hearing from many time and time again. Testing capacity, which a number of noble Lords have alluded to. The criteria remains contested. Signing off on medicines and processes has been extremely unclear. Huge palliative care expectations which are totally unfunded which Lord Stevens referred to. Expert panels consuming vast amounts of very senior professional time, particularly psychiatrist. Don't have that many psychiatrists in this country. If they spend all their time on these panels, the rest of us will get any support at all.
The six month prognosis judgement. Not a very clear methodology. Very importantly, provisions for what I call the non-NHS sector, completely unstructured and left to civil servants and secondary legislation. This leads to what Lord Kakkar referred to. What he meant was bureaucratic complexity without clinical clarity that blows up the intimacy that is needed for the best medical care. Without actually managing down the risks of something going wrong. I know from my time as a minister that confusion in the business of health and in that matter in the business of death very quickly waste vast amounts of resources.
It breeds litigation and cost lives. Who will be defending these court challenges? DHSC is already stretched. Who will be paying compensation if things go wrong? NHS resolution that already has a £60 billion liability bill? Sloppy legislation costs an absolute fortune in the business of health. When we considered IVF which is different but has some of the same can serrations -- same considerations. Instead, we have here what Baroness Murphy called unwieldy and unworkable bill. And sorry to say that I'm concerned that the Commissioner in particular is a role that needs to be clarified.
There is no private sector regulatory capability and there are a large sweeping Henry VIII clauses. In particular, I draw noble Lords attention to the very important clause 40 which is particularly weak. The Constitution Committee demanded that greater detail on the face of the bill regarding intended guidance and direction in this clause is necessary and icily -- and I fully support that. The principle of the bill is very important. It does have the support of our public. Without substantial clarification on reform, this act could devastate the NHS and our healthcare system.
We must address its fundamental flaws or this legislation should be paused before irreparably damaging our before irreparably damaging our
Feedback echoed what we have been hearing from many time and time again. Testing capacity, which a number of noble Lords have alluded to. The criteria remains contested. Signing off on medicines and processes has been extremely unclear. Huge palliative care expectations which are totally unfunded which Lord Stevens referred to. Expert panels consuming vast amounts of very senior professional time, particularly psychiatrist. Don't have that many psychiatrists in this country. If they spend all their time on these panels, the rest of us will get any support at all.
The six month prognosis judgement. Not a very clear methodology. Very importantly, provisions for what I call the non-NHS sector, completely unstructured and left to civil servants and secondary legislation. This leads to what Lord Kakkar referred to. What he meant was bureaucratic complexity without clinical clarity that blows up the intimacy that is needed for the best medical care. Without actually managing down the risks of something going wrong. I know from my time as a minister that confusion in the business of health and in that matter in the business of death very quickly waste vast amounts of resources.
It breeds litigation and cost lives. Who will be defending these court challenges? DHSC is already stretched. Who will be paying compensation if things go wrong? NHS resolution that already has a £60 billion liability bill? Sloppy legislation costs an absolute fortune in the business of health. When we considered IVF which is different but has some of the same can serrations -- same considerations. Instead, we have here what Baroness Murphy called unwieldy and unworkable bill. And sorry to say that I'm concerned that the Commissioner in particular is a role that needs to be clarified.
There is no private sector regulatory capability and there are a large sweeping Henry VIII clauses. In particular, I draw noble Lords attention to the very important clause 40 which is particularly weak. The Constitution Committee demanded that greater detail on the face of the bill regarding intended guidance and direction in this clause is necessary and icily -- and I fully support that. The principle of the bill is very important. It does have the support of our public. Without substantial clarification on reform, this act could devastate the NHS and our healthcare system.
We must address its fundamental flaws or this legislation should be paused before irreparably damaging our before irreparably damaging our
14:42
Lord Biggar (Conservative)
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Lord Biggar (Conservative)
I do think we face a tragic dilemma. On the one hand, advocates for disabled and several Royal colleges voice persistent concerns of risks of abuse that this bill's legalisation of assisted suicide would create. On the other hand, as we've heard, are dreadful cases of individuals suffering grievously or those who helped them -- were those who helped them must endure police investigation. This will be solved, we are told, by the bill before us. Except, my Lords, it would not.
By limiting assisted suicide to the terminally ill, this bill excludes those who are not dying but are still suffering previously. -- Previously. -- greviously. Some people tragically have to suffer and others have to endure police investigation because the social dangers of access are just too great. But if this bill, despite its tragic imperfection and its risks, is supposed to be tolerable, how come the legal status quo with the same tragic imperfection and fewer same tragic imperfection and fewer risks is not? If we were serious about reducing the quantity of human suffering, weight would not focus on assisted suicide at all -- we wouldn't focus on assisted suicide at all.
Instead, we will focus on ensuring the universal provision of adequate palliative care, which as we have been told several times today, more than 100,000 fellow citizens every year need but do not get. And we have known that for decades and done nothing about it. Indeed, if we were to pass the present bill before ensuring that, we would create an unjust inequality of economies -- economies -- autonomies. The privileged which have a choice between assisted suicide and palliative care but otherwise poorer and less white would have to choose between suffering or killing themselves.
That's why two thirds of the 5000 people polled last November wanted end-of-life care sorted out first before any thought is given to assisted suicide. It's also why the assisted suicide. It's also why the 2012 reports suicide, chaired by Lord Faulkner himself, stipulated as an essential condition of legalisation the universal provision of the best end-of-life care available. I for your Lordships available. I for your Lordships Compassion is a virtue. But it needs to look at more than one direction.
And distribute itself equitably. And commercial and that takes in passionate and imprudent risks with the lives of the vulnerable is no virtue at all. So to pass this bill in the current state of palliative care provision, would be a think and just and imprudent, and I can't just and imprudent, and I can't support it. -- Would be, I think, in just and imprudent.
By limiting assisted suicide to the terminally ill, this bill excludes those who are not dying but are still suffering previously. -- Previously. -- greviously. Some people tragically have to suffer and others have to endure police investigation because the social dangers of access are just too great. But if this bill, despite its tragic imperfection and its risks, is supposed to be tolerable, how come the legal status quo with the same tragic imperfection and fewer same tragic imperfection and fewer risks is not? If we were serious about reducing the quantity of human suffering, weight would not focus on assisted suicide at all -- we wouldn't focus on assisted suicide at all.
Instead, we will focus on ensuring the universal provision of adequate palliative care, which as we have been told several times today, more than 100,000 fellow citizens every year need but do not get. And we have known that for decades and done nothing about it. Indeed, if we were to pass the present bill before ensuring that, we would create an unjust inequality of economies -- economies -- autonomies. The privileged which have a choice between assisted suicide and palliative care but otherwise poorer and less white would have to choose between suffering or killing themselves.
That's why two thirds of the 5000 people polled last November wanted end-of-life care sorted out first before any thought is given to assisted suicide. It's also why the assisted suicide. It's also why the 2012 reports suicide, chaired by Lord Faulkner himself, stipulated as an essential condition of legalisation the universal provision of the best end-of-life care available. I for your Lordships available. I for your Lordships Compassion is a virtue. But it needs to look at more than one direction.
And distribute itself equitably. And commercial and that takes in passionate and imprudent risks with the lives of the vulnerable is no virtue at all. So to pass this bill in the current state of palliative care provision, would be a think and just and imprudent, and I can't just and imprudent, and I can't support it. -- Would be, I think, in just and imprudent.
14:46
Lord Rees of Easton (Labour)
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Lord Rees of Easton (Labour)
I, too, would like to begin just by thinking the many people, members of the public and members of this House for the letters that I have received, as many of you have and the power of these personal testimonies that have been brought, have physically been struck by the handwritten letters. I find this a difficult debate, not because I don't have clarity in my position, but because I actually hear the legitimacy of those in favour of the bill, the very real pain that is in people's lives.
But I'm thinking about some of the keywords that have floated around today, when we talked about choice, fear, pain and protection, and the reality is that those things don't land equally in different people's lives. They mean different things. People have different degrees of vulnerability to them and they have different sources. So I speak today when I bring to 2 areas to this discussion, firstly my time as mayor of my city. One of the reflections we had at the end of that good things can have negative consequences for some people.
And that's a very real danger. One of the things we grappled with in Bristol was that there was a 10 year life expectancy different, a 16 year healthy life expectancy different. Those were people with low incomes on poor backgrounds, that means that those people from those backgrounds were more likely to end up in situations in which they feel the pressures towards the end-of-life. The second was I was a manager of recent quality mental health, and we looked at the reality that determines to access to experienced outcomes, people from black and multi-ethnic backgrounds were disproportionately getting the bad end of the stick in terms of our mental health services.
And one of the things that we recognise. Services designed by people in positions of power are designed for people in positions of power. Not for vulnerable people. If you are not one of those people you don't have the sources to navigate the services and even if those services are good, you can fall in the cracks between those services. You don't have to resort to navigate those limos. The social physical qualities with which these bills would be put, if it was to pass, are not inconsequential.
What a service means, what the service means is not what just exists on paper, how it's designed, but the product of its interaction with those inequalities. And I fear that landing on such an unequal society we have, the circumstances and consequences can be quite dire. Communities. It is also true going back to the NHS that we have not tackled inequalities in NHS services from access to experienced outcomes and I fear that putting a terminal service into an organisation, therefore all intents and purposes has not solved health and qualities, but the context with wooden it works -- within it works and the outcomes for the population can be risky.
And the challenge of palliative care. While I absolutely agree with the idea, and the principal of dignity in dying, I do not think that can be detached from an absolute commitment to dignity in life and dignity in sickness. And that means tackling the social, economic and political consequences in which people experience life. I do think also just as a final comment, because the consequences are so big, we cannot afford to go into a situation where we are trying to fix this on the move.
It has to be sorted before the legislation goes through. goes through.
But I'm thinking about some of the keywords that have floated around today, when we talked about choice, fear, pain and protection, and the reality is that those things don't land equally in different people's lives. They mean different things. People have different degrees of vulnerability to them and they have different sources. So I speak today when I bring to 2 areas to this discussion, firstly my time as mayor of my city. One of the reflections we had at the end of that good things can have negative consequences for some people.
And that's a very real danger. One of the things we grappled with in Bristol was that there was a 10 year life expectancy different, a 16 year healthy life expectancy different. Those were people with low incomes on poor backgrounds, that means that those people from those backgrounds were more likely to end up in situations in which they feel the pressures towards the end-of-life. The second was I was a manager of recent quality mental health, and we looked at the reality that determines to access to experienced outcomes, people from black and multi-ethnic backgrounds were disproportionately getting the bad end of the stick in terms of our mental health services.
And one of the things that we recognise. Services designed by people in positions of power are designed for people in positions of power. Not for vulnerable people. If you are not one of those people you don't have the sources to navigate the services and even if those services are good, you can fall in the cracks between those services. You don't have to resort to navigate those limos. The social physical qualities with which these bills would be put, if it was to pass, are not inconsequential.
What a service means, what the service means is not what just exists on paper, how it's designed, but the product of its interaction with those inequalities. And I fear that landing on such an unequal society we have, the circumstances and consequences can be quite dire. Communities. It is also true going back to the NHS that we have not tackled inequalities in NHS services from access to experienced outcomes and I fear that putting a terminal service into an organisation, therefore all intents and purposes has not solved health and qualities, but the context with wooden it works -- within it works and the outcomes for the population can be risky.
And the challenge of palliative care. While I absolutely agree with the idea, and the principal of dignity in dying, I do not think that can be detached from an absolute commitment to dignity in life and dignity in sickness. And that means tackling the social, economic and political consequences in which people experience life. I do think also just as a final comment, because the consequences are so big, we cannot afford to go into a situation where we are trying to fix this on the move.
It has to be sorted before the legislation goes through. goes through.
14:51
Lord Young of Acton (Conservative)
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Lord Young of Acton (Conservative)
My Lords, noble and gallant Lord Lord Faulkner suggested the effect of this bill but noble and learned Lord -- suggested it would improve policy care. That is not the view of my sister, an NHS nurse spent most of her career working in palliative care and it is her reservations about this bill that I want to share with your lordship. Like many noble Lords, she is concerned about the shortage of GPs and other qualified medical practitioners to see patients who want to avail themselves of the assisted dying service, and the shortage of psychiatrists to refer those patients to, if there's any doubt about their capacity.
Baroness Meacher outlining her reasons for introducing the bill said, this law would provide reassurance to those living with a terminal illness that this option will be available to them if the worst should happen. But as my sister points out, not all terminally ill patients will have that option. Because patients have to self life ending drugs and some terminal patients are unable to do this if they are suffering from a neurological illness like motor neurone disease or Parkinson's, as my noble friend Baroness Fraser said.
My 60 off the reasonable question, whether terminal patients will still be eligible for treatments designed to prolong their lives such as oncology treatments, palliative chemo, immunotherapy and hormone treatments, if they have expressed the desire to die and have already embarked on pathway set out in this bill. Would those patients be reluctant to undergo treatments designed to prolong their lives if they know they have to secure a prognosis of having less than six months to live to be eligible for the service? How palliative care doctors and nurses supposed to help those terminal patients who have an incentive to reject the advice? My sister acknowledges that most palliative care patients do, at some point, express a wish to die.
Whether because of pain, no share, extreme fatigue or because they're anxious about dying at home, without adequate care as, or because they feel they have become a burden on their families. In her experience, most of those patients change their minds when helped us calm, solutions are proposed, symptoms alleviated. And they are grateful for the opportunity to spend extra time with their loved ones. It is providing terminally ill patients with these opportunities that makes the work of people in hospices so rewarding.
It is why many of them do it, my Lords. The sense of vocation comes from wanting to improve the health and extend the life of their patients, not from accelerating their deaths. She also makes the point that many terminally ill patients have considerably less that six months to live. Would there be a statutory minimum amount of time patients are expected to live for, alongside the six months statutory maximum? Even if there is no statutory minimum, the timing will take to jump through all the hoops before a patient is prescribed life ending drugs will mean there is a minimum, in effect, if not in law.
What is my sister to say to those patients who want to end their own lives but have no realistic chance of being approved by panel in the time they have left? More generally, my sister is concerned that any attempt to integrate an assisted dying service into one of the most overstretched parts of the NHS with the inevitable bureaucracy and delays, forms incorrectly filled out, and Frank was not answered, will make lives even more miserable. She says her job often feels like working in a war zone and feels this bill will only make things worse.
**** Possible New Speaker ****
I want to focus on the content of existing law relating to end-of-life existing law relating to end-of-life issues. I do so to make the point that the current law recognises the fundamental importance of autonomy stop it rejects the absolute sanctity of life, about which we have heard much from the bishops have heard much from the bishops benches and from noble Lords, and this bill will introduce greater this bill will introduce greater dignity and greater safeguards than currently exists.
There are two
Baroness Meacher outlining her reasons for introducing the bill said, this law would provide reassurance to those living with a terminal illness that this option will be available to them if the worst should happen. But as my sister points out, not all terminally ill patients will have that option. Because patients have to self life ending drugs and some terminal patients are unable to do this if they are suffering from a neurological illness like motor neurone disease or Parkinson's, as my noble friend Baroness Fraser said.
My 60 off the reasonable question, whether terminal patients will still be eligible for treatments designed to prolong their lives such as oncology treatments, palliative chemo, immunotherapy and hormone treatments, if they have expressed the desire to die and have already embarked on pathway set out in this bill. Would those patients be reluctant to undergo treatments designed to prolong their lives if they know they have to secure a prognosis of having less than six months to live to be eligible for the service? How palliative care doctors and nurses supposed to help those terminal patients who have an incentive to reject the advice? My sister acknowledges that most palliative care patients do, at some point, express a wish to die.
Whether because of pain, no share, extreme fatigue or because they're anxious about dying at home, without adequate care as, or because they feel they have become a burden on their families. In her experience, most of those patients change their minds when helped us calm, solutions are proposed, symptoms alleviated. And they are grateful for the opportunity to spend extra time with their loved ones. It is providing terminally ill patients with these opportunities that makes the work of people in hospices so rewarding.
It is why many of them do it, my Lords. The sense of vocation comes from wanting to improve the health and extend the life of their patients, not from accelerating their deaths. She also makes the point that many terminally ill patients have considerably less that six months to live. Would there be a statutory minimum amount of time patients are expected to live for, alongside the six months statutory maximum? Even if there is no statutory minimum, the timing will take to jump through all the hoops before a patient is prescribed life ending drugs will mean there is a minimum, in effect, if not in law.
What is my sister to say to those patients who want to end their own lives but have no realistic chance of being approved by panel in the time they have left? More generally, my sister is concerned that any attempt to integrate an assisted dying service into one of the most overstretched parts of the NHS with the inevitable bureaucracy and delays, forms incorrectly filled out, and Frank was not answered, will make lives even more miserable. She says her job often feels like working in a war zone and feels this bill will only make things worse.
**** Possible New Speaker ****
I want to focus on the content of existing law relating to end-of-life existing law relating to end-of-life issues. I do so to make the point that the current law recognises the fundamental importance of autonomy stop it rejects the absolute sanctity of life, about which we have heard much from the bishops have heard much from the bishops benches and from noble Lords, and this bill will introduce greater this bill will introduce greater dignity and greater safeguards than currently exists.
There are two
14:56
Lord Pannick (Crossbench)
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Lord Pannick (Crossbench)
currently exists. There are two basic legal principles, the first is that you have a legal right to end your life stop since the enactment of the suicide 61, attempted suicide is no longer a crime, you don't need to satisfy a panel of doctors or psychiatrists. There's no special protection against your relatives. If you are a competent adult, the doctors cannot require you to eat, to have a blood transfusion, to have chemotherapy and they can't stop you going to Dignitas.
Why is that? Because the Laura had noises that it is your life. And so it is your decision stop and because more projects the absolute sanctity of life. There's a second legal principle that follows from this. And this that the health system has a legal duty, in some circumstances, to take positive steps to implement your wish to end your life. I give an example, the case in 2002, an adult woman, who was paralysed from the neck down stop she was dependent on an artificial ventilation machine in order to breathe.
She wanted the machine turned off. She wanted to die. Because of the poor quality of her life. And her doctors declined to do so. So she applied to the courts for an order that they do so. And the noble and learned Lady Baroness Butler-Sloss, then president of the family division, granted that order. She said the woman was an adult. She was of sound mind. It was her decision whether to live or whether to die. Parliament has intervened in this area.
We made provision by the Mental Capacity Act 2005, sections 2426, to allow an adult of sound mind to make an advance decision refusing treatment to prolong their life, should the occasion ever arise, and should the person at that time lack the capacity to indicate their wishes. One other example, when Tony Bland, victim of the 1980 Hillsborough for stadium tragedy, was in a persistent vegetative state, with no prospect of recovery, and he could not express a view about whether to live or die, the committee of this House decided in 1993 that because he had no quality of life, there was a legal duty on the health authority to end his life support, to pull the plug and that is what the doctors did.
And there have sadly been many similar tragic cases since. So, icicle for this bill to authorise doctors to assist a person to end their life by providing a drug so they can die with dignity is entirely consistent with well established legal principles which respect autonomy on end-of-life decisions. The bill contains many more safeguards than already exist post-operative enables terminally ill people to end their life in a less painful, and a more humane manner, than starving themselves to death or otherwise committing suicide, I can't take questions, because we are restricted to 4 minutes, and starving themselves to death or otherwise committing suicide or travelling to Switzerland.
I support this bill. I look forward to the debate, including debate that noble and learned Lord Lord Carlile, at committee stage.
**** Possible New Speaker ****
Before the noble Lord sits 60 years ago, Parliament past
**** Possible New Speaker ****
60 years ago, Parliament past what I think would be by common consensus one of the most significant pieces of legislation of the 20th century. Merely the the 20th century. Merely the abolition of capital punishment. The abolition of capital punishment. The rationale for that decision was largely based on three principles, which I think are difficult to argue which I think are difficult to argue against. Firstly, that in a modern,
Why is that? Because the Laura had noises that it is your life. And so it is your decision stop and because more projects the absolute sanctity of life. There's a second legal principle that follows from this. And this that the health system has a legal duty, in some circumstances, to take positive steps to implement your wish to end your life. I give an example, the case in 2002, an adult woman, who was paralysed from the neck down stop she was dependent on an artificial ventilation machine in order to breathe.
She wanted the machine turned off. She wanted to die. Because of the poor quality of her life. And her doctors declined to do so. So she applied to the courts for an order that they do so. And the noble and learned Lady Baroness Butler-Sloss, then president of the family division, granted that order. She said the woman was an adult. She was of sound mind. It was her decision whether to live or whether to die. Parliament has intervened in this area.
We made provision by the Mental Capacity Act 2005, sections 2426, to allow an adult of sound mind to make an advance decision refusing treatment to prolong their life, should the occasion ever arise, and should the person at that time lack the capacity to indicate their wishes. One other example, when Tony Bland, victim of the 1980 Hillsborough for stadium tragedy, was in a persistent vegetative state, with no prospect of recovery, and he could not express a view about whether to live or die, the committee of this House decided in 1993 that because he had no quality of life, there was a legal duty on the health authority to end his life support, to pull the plug and that is what the doctors did.
And there have sadly been many similar tragic cases since. So, icicle for this bill to authorise doctors to assist a person to end their life by providing a drug so they can die with dignity is entirely consistent with well established legal principles which respect autonomy on end-of-life decisions. The bill contains many more safeguards than already exist post-operative enables terminally ill people to end their life in a less painful, and a more humane manner, than starving themselves to death or otherwise committing suicide, I can't take questions, because we are restricted to 4 minutes, and starving themselves to death or otherwise committing suicide or travelling to Switzerland.
I support this bill. I look forward to the debate, including debate that noble and learned Lord Lord Carlile, at committee stage.
**** Possible New Speaker ****
Before the noble Lord sits 60 years ago, Parliament past
**** Possible New Speaker ****
60 years ago, Parliament past what I think would be by common consensus one of the most significant pieces of legislation of the 20th century. Merely the the 20th century. Merely the abolition of capital punishment. The abolition of capital punishment. The rationale for that decision was largely based on three principles, which I think are difficult to argue which I think are difficult to argue against. Firstly, that in a modern,
15:00
Lord Weir of Ballyholme (Democratic Unionist Party)
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Lord Weir of Ballyholme (Democratic Unionist Party)
civilised country, that it was barbaric for the state to decide to kill its own citizens, even after judicial process. Secondly, that whatever projections were put in place, whatever procedures were put in place, that a judge, Judy, or a in place, that a judge, Judy, or a tribunal or panel is made up of human beings who ultimately from time to time will make mistakes. And thirdly, when we are dealing with a situation involving the death of a person, the consequence of a mistake is irreversible.
The clock cannot be turned back six months later when new evidence emerges and that person is that. Those principles have held firm throughout the decades which is why, perhaps, in the 60 years since then, there has never been a realistic prospect of that law ever being revoked. I would contend that the legislation before us today reverses and repudiates all three of those and suppose. And with the added expense of offering and return a false prospectus of a painless, easy death.
If this legislation passes, estate will have control over who is eligible for assisted suicide, it will have control over how that is done, it ultimately will be administering the killing of the individual. Similarly, the panels, whatever procedures we put in place, will make mistakes. We know that in terms of the prognosis, that doctors make, no matter how qualified specialist they are, that cannot be got right all the time. What worries me most is the issue of coercion. This is not simply an academic or hypothetical question.
Sadly, we have seen too many cases over the years, particularly resulting in the tragic deaths of partners or children, where it has then emerged at a later stage that there were years of abuse and coercion, and the reality is that coercion is not easy to spot, because coercion happens behind closed doors. Now, it can be blunt and aggressive, but it can also be sophisticated, subtle. The trip, trip message to the person that they are a burden on their family.
And the reality is that even beyond the coercion that comes from others, there is a risk with this legislation of what I would call self-imposed coercion, where the person decides that they convinced themselves that the burden they are placing in terms of the caring responsibilities, in terms of financial responsibilities, would mean they feel compelled to make the supreme sacrifice for their family. And thirdly, as with capital punishment, if we get it wrong on an issue of coercion, we cannot look back six months down the year and back six months down the year and reverse that is -- a decision.
Finally, to use a classical analogy, today, we not only cross over the river Styx, we cross over the Rubicon if we accept this legislation. Some of the proponents of this legislation already are saying, "Well, it is the first step." We've seen this happen in country after country. While I'm sure we have great faith in this country, we cannot be that uniquely arrogant to believe that we will be the one country which this does not become an expansion of the issue of assisted dying.
I would say in conclusion that this bill rather than being progressive and permissive is cruel and aggressive, and this House should do the mature thing and reject it.
**** Possible New Speaker ****
If I can start again, or if the
The clock cannot be turned back six months later when new evidence emerges and that person is that. Those principles have held firm throughout the decades which is why, perhaps, in the 60 years since then, there has never been a realistic prospect of that law ever being revoked. I would contend that the legislation before us today reverses and repudiates all three of those and suppose. And with the added expense of offering and return a false prospectus of a painless, easy death.
If this legislation passes, estate will have control over who is eligible for assisted suicide, it will have control over how that is done, it ultimately will be administering the killing of the individual. Similarly, the panels, whatever procedures we put in place, will make mistakes. We know that in terms of the prognosis, that doctors make, no matter how qualified specialist they are, that cannot be got right all the time. What worries me most is the issue of coercion. This is not simply an academic or hypothetical question.
Sadly, we have seen too many cases over the years, particularly resulting in the tragic deaths of partners or children, where it has then emerged at a later stage that there were years of abuse and coercion, and the reality is that coercion is not easy to spot, because coercion happens behind closed doors. Now, it can be blunt and aggressive, but it can also be sophisticated, subtle. The trip, trip message to the person that they are a burden on their family.
And the reality is that even beyond the coercion that comes from others, there is a risk with this legislation of what I would call self-imposed coercion, where the person decides that they convinced themselves that the burden they are placing in terms of the caring responsibilities, in terms of financial responsibilities, would mean they feel compelled to make the supreme sacrifice for their family. And thirdly, as with capital punishment, if we get it wrong on an issue of coercion, we cannot look back six months down the year and back six months down the year and reverse that is -- a decision.
Finally, to use a classical analogy, today, we not only cross over the river Styx, we cross over the Rubicon if we accept this legislation. Some of the proponents of this legislation already are saying, "Well, it is the first step." We've seen this happen in country after country. While I'm sure we have great faith in this country, we cannot be that uniquely arrogant to believe that we will be the one country which this does not become an expansion of the issue of assisted dying.
I would say in conclusion that this bill rather than being progressive and permissive is cruel and aggressive, and this House should do the mature thing and reject it.
**** Possible New Speaker ****
If I can start again, or if the
15:05
Lord Hacking (Labour)
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**** Possible New Speaker ****
If I can start again, or if the clock can start again... As with my clock can start again... As with my noble friend Lord Rees and with many peers in this chamber, I have seen lots of emails on this bill, both in the post and by email. Almost everyone stated they were against this bill. I did not count all of them but they added up to 50 in number. Although we are an unelected number.
Although we are an unelected chamber, I believe we should consider these representations we have received. I thought the bill was thoughtful and well drafted. It is a readable and comprehensive. Quite a change from every other bill that has now been descending -- descended upon the house. Proposes safeguards and the assisted dying Commissioner. It carries a number of helpful stipulations and goes into what should be discussed with the patient. Importantly, it defines who is entitled to apply for assisted is entitled to apply for assisted dying.
My noble friend Lord Faulkner spoke of this in his opening remarks. I draw the house's attention to the crucial one which is that the patient has to be indeterminate late -- indeterminate indeterminate late -- indeterminate the ill -- terminally less. I refer to multiple sclerosis, motor neurone disease and advanced Parkinson's - these are all terrible diseases where the patient loses all control of their body movement but they have now direct expectation of death. I would also like to refer to those who have severe spinal injury.
One of my sons received a very serious spinal injury and he went to Stoke Mandeville. I met a sportsman there who had a quadriplegic injury. No who had a quadriplegic injury. No movement below his neck. I was told he wanted to go to Dignitas in Switzerland. I don't know if he ever went there but I can say that he felt he had no future in life. My concern on this bill if passed, inevitably the terms of this bill will be extended.
That is exactly what has happened in Belgium, Netherlands and the state of Oregon, all of whom have assisted dying all of whom have assisted dying legislation for over 20 years. So I expect the lowering of the age of 18 years, inclusion of many more who don't have terminal illness, the prospects are never ending extending this bill. This brings me to the moral position. The moral position is that no doctor should ever be asked to make this decision.
The practical position is that there is palliative care. Palliative care should provide every care for a dying patient. That brings me to oppose this bill.
Lord Hacking (Labour)
**** Possible New Speaker ****
If I can start again, or if the clock can start again... As with my clock can start again... As with my noble friend Lord Rees and with many peers in this chamber, I have seen lots of emails on this bill, both in the post and by email. Almost everyone stated they were against this bill. I did not count all of them but they added up to 50 in number. Although we are an unelected number.
Although we are an unelected chamber, I believe we should consider these representations we have received. I thought the bill was thoughtful and well drafted. It is a readable and comprehensive. Quite a change from every other bill that has now been descending -- descended upon the house. Proposes safeguards and the assisted dying Commissioner. It carries a number of helpful stipulations and goes into what should be discussed with the patient. Importantly, it defines who is entitled to apply for assisted is entitled to apply for assisted dying.
My noble friend Lord Faulkner spoke of this in his opening remarks. I draw the house's attention to the crucial one which is that the patient has to be indeterminate late -- indeterminate indeterminate late -- indeterminate the ill -- terminally less. I refer to multiple sclerosis, motor neurone disease and advanced Parkinson's - these are all terrible diseases where the patient loses all control of their body movement but they have now direct expectation of death. I would also like to refer to those who have severe spinal injury.
One of my sons received a very serious spinal injury and he went to Stoke Mandeville. I met a sportsman there who had a quadriplegic injury. No who had a quadriplegic injury. No movement below his neck. I was told he wanted to go to Dignitas in Switzerland. I don't know if he ever went there but I can say that he felt he had no future in life. My concern on this bill if passed, inevitably the terms of this bill will be extended.
That is exactly what has happened in Belgium, Netherlands and the state of Oregon, all of whom have assisted dying all of whom have assisted dying legislation for over 20 years. So I expect the lowering of the age of 18 years, inclusion of many more who don't have terminal illness, the prospects are never ending extending this bill. This brings me to the moral position. The moral position is that no doctor should ever be asked to make this decision.
The practical position is that there is palliative care. Palliative care should provide every care for a dying patient. That brings me to oppose this bill.
15:09
Baroness Meyer (Conservative)
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Baroness Meyer (Conservative)
Like many noble Lords in this house, I have wrestled with this bill for weeks on end, and I have changed my mind several times. My father died at the age of 97, a father died at the age of 97, a proud and honourable man. A veteran of the French Navy and a devout Catholic. He spent his last days almost blind, incontinent, in pain and confined to a hospital bed. When I visited him with my late husband and sons, he looked at us with love, but he could barely speak.
He only but he could barely speak. He only whispered two words. What torture. That night, after saying goodbye, he tried to end his own life by pulling out his drips. Alarms sounded and the nurses bound his hands so he could not try again. The next day, I was horrified to find my father reduced in this way. That experience left me sympathetic to the right to die. On a personal level, I would want that choice and I do not want my sons to have the last memory of their mother is the one I have of my father.
But personal experiences, however powerful, are not enough to justify enacting a law of such gravity. The risks are stark. Coercion, irreversible Aeros -- errors, erosion of trust between doctors and patients, pressure on the elderly and infirm, financial cost and a burden on an already overstretched GP workforce. And to add to this a long list of concerns so clearly listed by many noble Lords who spoke before me. Some argue we are behind other countries, and so what? Canada gives me pause.
Eight years on, assisted dying has become routine. Now the fifth leading cause of death. Reports show people seeking euthanasia not because they are terminally but because they were poor, isolated or unable to access proper care. A right to die has become a duty to die. Now, in Canada, there is a question of expanding this law to include children. At present, doctors feel compelled to keep people alive at all costs because it is a crime to hasten death.
This has caused some to suffer unnecessarily but if the law changes, we must be equally vigilant that it does not push people in the opposite direction towards feeling that death is expected of them. The advocates of this bill site many cases like my father's -- cite. They are motivated by compassion and yet to enshrine in law the taking of life is a moral hurdle too high to cross. Particularly when he did case -- this could be decided later in in regulation.
Here, my Lords, for me that doubt remains and it is too great to ignore. I wanted to finish by telling you the story of this Swiss 17 zero -- 72-year-old woman who put her name down for Dignitas. The pandemic happened so she didn't make it. She met a neighbour, fell in love, they got married and she was happy.
**** Possible New Speaker ****
I will not try to match that. Some people have proposed remark Some people have proposed remark opposed the bill on principle ground -- opposed the bill on principle -- opposed the bill on principle ground. The Rubicon on that ground. The Rubicon on that principle has already been cross. I want to mention two. First of all, want to mention two. First of all, withdrawal of care essential for the preservation of life is already permissible, including the permissible, including the withdrawal of food and even water in a controlled medical environment.
a controlled medical environment. Secondly, indefinite sedation with drugs is also possible, even when it is understood it may shorten life. These are already practised to some These are already practised to some degree. What we primarily debated -- degree. What we primarily debated -- what were practically debating... Most people want to be able to Most people want to be able to exercise control and especially when they are elderly, fearful or in they are elderly, fearful or in pain. Although the point has been made that those in pain won't get any benefit from this bill because any benefit from this bill because it is silent on the issue.
I remain very nervous about this legislation on many grounds. Many of these have already been mentioned. Can assistance be legally defined and
He only but he could barely speak. He only whispered two words. What torture. That night, after saying goodbye, he tried to end his own life by pulling out his drips. Alarms sounded and the nurses bound his hands so he could not try again. The next day, I was horrified to find my father reduced in this way. That experience left me sympathetic to the right to die. On a personal level, I would want that choice and I do not want my sons to have the last memory of their mother is the one I have of my father.
But personal experiences, however powerful, are not enough to justify enacting a law of such gravity. The risks are stark. Coercion, irreversible Aeros -- errors, erosion of trust between doctors and patients, pressure on the elderly and infirm, financial cost and a burden on an already overstretched GP workforce. And to add to this a long list of concerns so clearly listed by many noble Lords who spoke before me. Some argue we are behind other countries, and so what? Canada gives me pause.
Eight years on, assisted dying has become routine. Now the fifth leading cause of death. Reports show people seeking euthanasia not because they are terminally but because they were poor, isolated or unable to access proper care. A right to die has become a duty to die. Now, in Canada, there is a question of expanding this law to include children. At present, doctors feel compelled to keep people alive at all costs because it is a crime to hasten death.
This has caused some to suffer unnecessarily but if the law changes, we must be equally vigilant that it does not push people in the opposite direction towards feeling that death is expected of them. The advocates of this bill site many cases like my father's -- cite. They are motivated by compassion and yet to enshrine in law the taking of life is a moral hurdle too high to cross. Particularly when he did case -- this could be decided later in in regulation.
Here, my Lords, for me that doubt remains and it is too great to ignore. I wanted to finish by telling you the story of this Swiss 17 zero -- 72-year-old woman who put her name down for Dignitas. The pandemic happened so she didn't make it. She met a neighbour, fell in love, they got married and she was happy.
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I will not try to match that. Some people have proposed remark Some people have proposed remark opposed the bill on principle ground -- opposed the bill on principle -- opposed the bill on principle ground. The Rubicon on that ground. The Rubicon on that principle has already been cross. I want to mention two. First of all, want to mention two. First of all, withdrawal of care essential for the preservation of life is already permissible, including the permissible, including the withdrawal of food and even water in a controlled medical environment.
a controlled medical environment. Secondly, indefinite sedation with drugs is also possible, even when it is understood it may shorten life. These are already practised to some These are already practised to some degree. What we primarily debated -- degree. What we primarily debated -- what were practically debating... Most people want to be able to Most people want to be able to exercise control and especially when they are elderly, fearful or in they are elderly, fearful or in pain. Although the point has been made that those in pain won't get any benefit from this bill because any benefit from this bill because it is silent on the issue.
I remain very nervous about this legislation on many grounds. Many of these have already been mentioned. Can assistance be legally defined and
15:17
Lord Tyrie (Non-affiliated)
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Lord Tyrie (Non-affiliated)
once legalised, will the eligibility criteria be expanded? With the Human Rights Act get engaged here, I think Rights Act get engaged here, I think it will. We've already seen medical science and practice and court science and practice and court scrutiny has taken us will be on the intentions of Parliament in the intentions of Parliament in the Suicide Act of 1961. It will undoubtedly happen again if this undoubtedly happen again if this bill is on the statute book. It's important to bear in mind the discretion I described a moment ago.
discretion I described a moment ago. It was almost certainly not envisaged at the time of that envisaged at the time of that Further concerned, some people may Further concerned, some people may feel pressured into taking decisions at the end of their lives, which at the end of their lives, which don't reflect their true wishes. And we know that some people hold one view of the termination of their lives while they are discussing it while they are well, and quite while they are well, and quite another when they are very ill.
1/3 point I want to make, which has point I want to make, which has already been aired to some degree, the medical profession is deeply split, and many of these issues, split, and many of these issues, just like this House. I personally support people's right to exercise control over their deaths as well as their lives but we have to accept that the regulation needed to support this legislation will be complex and will almost certainly have unintended consequences. So in my view we have to try much harder to get this right.
The sickly to assist the clinicians and the frontline, in ICUs and hospices. To pass this bill in its current form, heavily laden with controversy, and with many arguing as they have today that it has not been properly debated, with the a very profound mistake and it would make for bad law. At the very least, we need a Select Committee. We perhaps need a Royal commission. And we need a bill in government time, as the suicide was brought in, and as was the case with the Mental Capacity Act.
What I have suggested lead to some delay but we were properly get better legislation as a consequence.
discretion I described a moment ago. It was almost certainly not envisaged at the time of that envisaged at the time of that Further concerned, some people may Further concerned, some people may feel pressured into taking decisions at the end of their lives, which at the end of their lives, which don't reflect their true wishes. And we know that some people hold one view of the termination of their lives while they are discussing it while they are well, and quite while they are well, and quite another when they are very ill.
1/3 point I want to make, which has point I want to make, which has already been aired to some degree, the medical profession is deeply split, and many of these issues, split, and many of these issues, just like this House. I personally support people's right to exercise control over their deaths as well as their lives but we have to accept that the regulation needed to support this legislation will be complex and will almost certainly have unintended consequences. So in my view we have to try much harder to get this right.
The sickly to assist the clinicians and the frontline, in ICUs and hospices. To pass this bill in its current form, heavily laden with controversy, and with many arguing as they have today that it has not been properly debated, with the a very profound mistake and it would make for bad law. At the very least, we need a Select Committee. We perhaps need a Royal commission. And we need a bill in government time, as the suicide was brought in, and as was the case with the Mental Capacity Act.
What I have suggested lead to some delay but we were properly get better legislation as a consequence.
15:18
Lord Murray of Blidworth (Conservative)
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Lord Murray of Blidworth (Conservative)
My Lords, irrespective of the underlying moral and policy question, as many noble Lords have already identified, seriously procedurally flawed. I'm against it. IMO is concerned about the impact those floors will have on vulnerable people. Given the time available, two points occur to me which demonstrate this problem. First, at no point in the mechanism under the bill has anybody expressly asked the applicant the reason why they wish to die. Such a question would not be an intrusion on private autonomy.
To the contrary, it would be a reasonable, and I suggest compassionate enquiry. In its own way, it would be a significant card to protect the most vulnerable. Second, more technically, there are very significant failings in the panel stage of the process, as described in the bill and embodied in clause 17. In its current form, the panel stage of the process, as the noble Lord Lord Grabiner identified is lawyer window dressing, I agree. Unlike him, I suggest this stage could and should be used to reinforce the process and to protect the most vulnerable against abuse.
Let me explain. Clause 17 provides that the panels function and application for a certificate of eligibility assisted suicide is simply to determine whether nine boxes set out in clause 17, subclause two. To do so the panel, who are described in schedule two as comprising a lawyer, psychiatrist and social worker, must hear from the coordinating doctor, the applicant, and they may hear from anyone else. Subsection 7 then requires that the panel must grant a certificate if they've satisfied nine boxes in subsection 2 are met.
This is a quasi tribunal process in which the tribunal is bereft of any appropriate powers. Frankly even the parking adjudicator has more evidential power than these panels. In the past few months, this government has given more enforceable rights to employees and tenants to mention two bills which have passed recently, the Renters (Reform) Bill, and to those who seek assistance to die under this bill. How is that so? Because those other piece of legislation, employment insulation, and landlord legislation, go before a court or tribunal with evidential powers to look into the matter before them.
The panel in this bill is toothless. Panel has no power to require evidence, to protect one of the people, no power to summons witnesses, or experts, no power to order the disclosure of documents, no powers of compulsion at all. Indeed, the panel would have no power even to see and applicants will stop to summons evidence to frame relationships. There is no logical reason why applying for a assistance to die should and have their request to a certificate of ability, to be good night by body with fewer powers to compel evidence and make decisions than a person would have had if they had brought unemployment claim for a landlord tenant claim or indeed a road traffic matter.
At the very least, this bill should explicitly provide the part of the statutory role of the panel to investigate motivation and possible coercion. And the panel should have the powers of any other tribunal in that task.
To the contrary, it would be a reasonable, and I suggest compassionate enquiry. In its own way, it would be a significant card to protect the most vulnerable. Second, more technically, there are very significant failings in the panel stage of the process, as described in the bill and embodied in clause 17. In its current form, the panel stage of the process, as the noble Lord Lord Grabiner identified is lawyer window dressing, I agree. Unlike him, I suggest this stage could and should be used to reinforce the process and to protect the most vulnerable against abuse.
Let me explain. Clause 17 provides that the panels function and application for a certificate of eligibility assisted suicide is simply to determine whether nine boxes set out in clause 17, subclause two. To do so the panel, who are described in schedule two as comprising a lawyer, psychiatrist and social worker, must hear from the coordinating doctor, the applicant, and they may hear from anyone else. Subsection 7 then requires that the panel must grant a certificate if they've satisfied nine boxes in subsection 2 are met.
This is a quasi tribunal process in which the tribunal is bereft of any appropriate powers. Frankly even the parking adjudicator has more evidential power than these panels. In the past few months, this government has given more enforceable rights to employees and tenants to mention two bills which have passed recently, the Renters (Reform) Bill, and to those who seek assistance to die under this bill. How is that so? Because those other piece of legislation, employment insulation, and landlord legislation, go before a court or tribunal with evidential powers to look into the matter before them.
The panel in this bill is toothless. Panel has no power to require evidence, to protect one of the people, no power to summons witnesses, or experts, no power to order the disclosure of documents, no powers of compulsion at all. Indeed, the panel would have no power even to see and applicants will stop to summons evidence to frame relationships. There is no logical reason why applying for a assistance to die should and have their request to a certificate of ability, to be good night by body with fewer powers to compel evidence and make decisions than a person would have had if they had brought unemployment claim for a landlord tenant claim or indeed a road traffic matter.
At the very least, this bill should explicitly provide the part of the statutory role of the panel to investigate motivation and possible coercion. And the panel should have the powers of any other tribunal in that task.
15:22
Baroness Goudie (Labour)
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Baroness Goudie (Labour)
I would like to thank all those who kindly wrote to me and send emails both from members of the public, religious organisations, religious leaders and many people in the medical profession. There is no greater responsibility than how we treat those at the end of their life, the vulnerable vulnerable ill, elderly, the dying, and that is slightly why this Bill troubles me so deeply. Let me begin by addressing something fundamental, language, the designed to conceal what is happening.
Why is this what is happening. Why is this called by supporters assisted dying Bill? Assistance sounds good, dying which comes to us all. Pain relief, emotional support, these are vital and uncontroversial. This bill is not about that. It is about assisted suicide and that is an altogether different matter. I understand why some see this as a matter of choice but they cannot ignore the context in which that choice is made. When someone is terminally ill, frightened, exhausted and overwhelmed, they are at their most vulnerable and it is precisely at that moment that this bill proposes to offer them a legal means to end their life.
And that is aided by others, approved by our institutions and normalised by law. An individual who takes their own life alone does not do so out of desperation, does so out of desperation, but a combined operation involving doctors, lawyers, family and the state is something entirely different. Those who support the process may act with the best of intentions but motivations are not always pure. There is rarely, it is really simple and even when they are at risk of and remains real.
I don't believe we can eliminate that risk and this build is certainly not do enough to do so. Once we create a legal route to assisted suicide, how can we enter, ever be sure that the patient's choice is not shaped. By pressure, depression, guilt or simply a sense of being a burden. This is why, this raises another concern, the undermining of palliative care, palliative care is important. Instead of extending choice I feel we are narrowing it, not everyone has access to high quality end-of-life care, not everyone is given full range of pain management.
Hospice support and spiritual care. Or even the time to bear for dignified death. Rather than committing universal excellent palliative services, this bill offers another option, to end life earlier. This is not the service to people but to end their lives. This is an abdication of responsibility, to provide excellent services to those in need stop some will say this is about autonomy but this is not true autonomy, it cannot exist without support to live. We have seen in other countries that what begins as a narrow exception can't widen.
It has or is expanded beyond terminal illness, to chronic illnesses or disabilities. And finally, we must listen to the voices of those most at risk. Many disabled people, organisations oppose this bill. They do not because they fear death. Because they fear a society to often assumes that their lives are not worth living. If we were to compensate society we must invest instead in palliative care, emotional support, hospice services and the time and presence to walk with people to the very end in particular people should able to be looked after at home.
Not the offer of an early death but the assurance their valid supported and most unloved until the last moment. This bill cannot promise that and so with the respect to all those who have spoken on both sides I cannot
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support it. I believe in choice and personal autonomy but as this bill is passed autonomy but as this bill is passed it would change how we treat each it would change how we treat each other as humans and not for the better. Hard cases make bad law. This bill is defective into many respects. I say this despite the imperfect state of the current law. The reports of the delegated powers The reports of the delegated powers and Constitution Committee's cannot be brushed aside.
The bill is long and incomplete. There is insufficient detail or principled evidence for scrutiny of the important powers to be delegated. We important powers to be delegated. We should for example have had draft regulations regarding the coordinating doctors. They are to
Why is this what is happening. Why is this called by supporters assisted dying Bill? Assistance sounds good, dying which comes to us all. Pain relief, emotional support, these are vital and uncontroversial. This bill is not about that. It is about assisted suicide and that is an altogether different matter. I understand why some see this as a matter of choice but they cannot ignore the context in which that choice is made. When someone is terminally ill, frightened, exhausted and overwhelmed, they are at their most vulnerable and it is precisely at that moment that this bill proposes to offer them a legal means to end their life.
And that is aided by others, approved by our institutions and normalised by law. An individual who takes their own life alone does not do so out of desperation, does so out of desperation, but a combined operation involving doctors, lawyers, family and the state is something entirely different. Those who support the process may act with the best of intentions but motivations are not always pure. There is rarely, it is really simple and even when they are at risk of and remains real.
I don't believe we can eliminate that risk and this build is certainly not do enough to do so. Once we create a legal route to assisted suicide, how can we enter, ever be sure that the patient's choice is not shaped. By pressure, depression, guilt or simply a sense of being a burden. This is why, this raises another concern, the undermining of palliative care, palliative care is important. Instead of extending choice I feel we are narrowing it, not everyone has access to high quality end-of-life care, not everyone is given full range of pain management.
Hospice support and spiritual care. Or even the time to bear for dignified death. Rather than committing universal excellent palliative services, this bill offers another option, to end life earlier. This is not the service to people but to end their lives. This is an abdication of responsibility, to provide excellent services to those in need stop some will say this is about autonomy but this is not true autonomy, it cannot exist without support to live. We have seen in other countries that what begins as a narrow exception can't widen.
It has or is expanded beyond terminal illness, to chronic illnesses or disabilities. And finally, we must listen to the voices of those most at risk. Many disabled people, organisations oppose this bill. They do not because they fear death. Because they fear a society to often assumes that their lives are not worth living. If we were to compensate society we must invest instead in palliative care, emotional support, hospice services and the time and presence to walk with people to the very end in particular people should able to be looked after at home.
Not the offer of an early death but the assurance their valid supported and most unloved until the last moment. This bill cannot promise that and so with the respect to all those who have spoken on both sides I cannot
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support it. I believe in choice and personal autonomy but as this bill is passed autonomy but as this bill is passed it would change how we treat each it would change how we treat each other as humans and not for the better. Hard cases make bad law. This bill is defective into many respects. I say this despite the imperfect state of the current law. The reports of the delegated powers The reports of the delegated powers and Constitution Committee's cannot be brushed aside.
The bill is long and incomplete. There is insufficient detail or principled evidence for scrutiny of the important powers to be delegated. We important powers to be delegated. We should for example have had draft regulations regarding the coordinating doctors. They are to
15:27
Lord Sandhurst (Conservative)
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Lord Sandhurst (Conservative)
coordinating doctors. They are to have a central role that would make important assessments. Namely whether the person seeking assistance has sufficient mental capacity, has a clear and settled and informed wish, to end their own life, and seeks assistance voluntarily, without coercion or pleasure from another. How will this be done, from knowledge base? My noble friend Lord Murray explained that. How will the panel then test the process? How long will the panic devote? How will it be resourced? So that it is not and must not be a tick box exercise we all know that subtle family pressures are real.
And until now doctors have been obliged to protect against suicide. This bill goes against that. Death by poison is not treatment. It brings huge ethical challenges and changes for doctors. Next, what sort of people will be the independent advocates with what skills, how will the vulnerable be identified? For qualifying vulnerable persons, are those with a learning disability, mental disorder or autism, which is often not diagnosed. People who may experience substantial difficulty in understanding the processes or information relevant to those processes or communicating their views, which is a feeling.
It's no requirement to involve the independent advocate before a doctor decides to initiate a conversation on assisted dying with people in that cohort, that pushes cohort. The independent advocate will only be appointed once someone is on the path. Who with what resources will consider family coercion, subtle family coercion, or just the old person who thinks, I'm probably a bit of a burden? I'm aware of the head of Safeguarding in a London hospital who has recently said that that person already has issues with families who want to clear the decks.
The noble Lord Lord Grabiner has explained all that. The overloaded NHS is not always safe. Remember the Bristol Children's Hospital, remember the South Staffs hospital scandal is. Mike Chambers was involved in dealing with the aftermath of all those and many other medical disasters. Mistakes happen. Activision is I'm afraid, unknown to change the notes after the events. I've had personal experience of that in matters on which I have been involved. How will we know if the system is working properly? Cover-ups will happen and we are not to have peroneal we are not to have peroneal Giving responsibility to the NHS will create historic financial conflict.
It will damage the delivery of palliative care, most likely. Palliative care should be our focus. This bill cannot be put into acceptable shape. We shall be left with the national debt service, and a poor one at that. We should have had a Royal commission and proper legislation.
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I'd like to acknowledge any emails and letters. What surprises me is the anxieties. I wish to me is the anxieties. I wish to record my appreciation to all who got in touch with me. I wish to help. There have been attempts to help. There have been attempts to ring fence... With the Mental Capacity Act sufficient safeguards? Capacity Act sufficient safeguards? -- a sufficient safeguard? How do we -- a sufficient safeguard? How do we determine whether the individual determine whether the individual lacks the mental capacity to decide lacks the mental capacity to decide on life or death? Gaps exist.
It sidesteps abilities of more successful treatment. Take a soldier, burnt or wounded, poisoned, fighting for his country with no more than a six to -- six month more than a six to -- six month progresses to live. What then of the covenant? Ignored. Ignored, my Lords. The subject were debating is not just about adults seeking death but about the friends, family and others in the individual's life. The views and behaviour of the latter cannot be ignored.
It may not be full proof against this. Presumably, for devolved nations, this bill covers only England and Wales. The bill will be restricted geographically. The idea that there might be a Dignitas equivalent for one part of the UK but not the one part of the UK but not the other... We do not control... Society places special value on the right to live. Should it be approved by law. Whilst not wishing to set by law.
Whilst not wishing to set aside feelings of sympathy, this bill is flawed. bill is flawed.
And until now doctors have been obliged to protect against suicide. This bill goes against that. Death by poison is not treatment. It brings huge ethical challenges and changes for doctors. Next, what sort of people will be the independent advocates with what skills, how will the vulnerable be identified? For qualifying vulnerable persons, are those with a learning disability, mental disorder or autism, which is often not diagnosed. People who may experience substantial difficulty in understanding the processes or information relevant to those processes or communicating their views, which is a feeling.
It's no requirement to involve the independent advocate before a doctor decides to initiate a conversation on assisted dying with people in that cohort, that pushes cohort. The independent advocate will only be appointed once someone is on the path. Who with what resources will consider family coercion, subtle family coercion, or just the old person who thinks, I'm probably a bit of a burden? I'm aware of the head of Safeguarding in a London hospital who has recently said that that person already has issues with families who want to clear the decks.
The noble Lord Lord Grabiner has explained all that. The overloaded NHS is not always safe. Remember the Bristol Children's Hospital, remember the South Staffs hospital scandal is. Mike Chambers was involved in dealing with the aftermath of all those and many other medical disasters. Mistakes happen. Activision is I'm afraid, unknown to change the notes after the events. I've had personal experience of that in matters on which I have been involved. How will we know if the system is working properly? Cover-ups will happen and we are not to have peroneal we are not to have peroneal Giving responsibility to the NHS will create historic financial conflict.
It will damage the delivery of palliative care, most likely. Palliative care should be our focus. This bill cannot be put into acceptable shape. We shall be left with the national debt service, and a poor one at that. We should have had a Royal commission and proper legislation.
**** Possible New Speaker ****
I'd like to acknowledge any emails and letters. What surprises me is the anxieties. I wish to me is the anxieties. I wish to record my appreciation to all who got in touch with me. I wish to help. There have been attempts to help. There have been attempts to ring fence... With the Mental Capacity Act sufficient safeguards? Capacity Act sufficient safeguards? -- a sufficient safeguard? How do we -- a sufficient safeguard? How do we determine whether the individual determine whether the individual lacks the mental capacity to decide lacks the mental capacity to decide on life or death? Gaps exist.
It sidesteps abilities of more successful treatment. Take a soldier, burnt or wounded, poisoned, fighting for his country with no more than a six to -- six month more than a six to -- six month progresses to live. What then of the covenant? Ignored. Ignored, my Lords. The subject were debating is not just about adults seeking death but about the friends, family and others in the individual's life. The views and behaviour of the latter cannot be ignored.
It may not be full proof against this. Presumably, for devolved nations, this bill covers only England and Wales. The bill will be restricted geographically. The idea that there might be a Dignitas equivalent for one part of the UK but not the one part of the UK but not the other... We do not control... Society places special value on the right to live. Should it be approved by law. Whilst not wishing to set by law.
Whilst not wishing to set aside feelings of sympathy, this bill is flawed. bill is flawed.
15:34
15:36
Lord Dodds of Duncairn (Democratic Unionist Party)
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Lord Dodds of Duncairn (Democratic Unionist Party)
already allow for intervention, we would be permitting for the first time a policy and a widespread practice of ending of life by practice of ending of life by medical means. This is a fundamental medical means. This is a fundamental alteration and how we understand the alteration and how we understand the duty of the state and the value we place on life itself. It's not the natural course of dying with support but the deliberate intervention to end life. Of Parliament is to legislate on such a great matter, legislate on such a great matter, the language we should use -- the language we use should be language we use should be transparent.
The public needs to transparent. The public needs to understand what is at stake. It is assisted suicide. We should call it what it is. Human life carries what it is. Human life carries dignity and meaning in every age or circumstance. This is not reduced by age, illness, disability. People age, illness, disability. People fear pain and we must provide support better really. When they fear holiness, we must provide companionship. We should guarantee companionship. We should guarantee care. The solution should not be death.
-- They fear loneliness. People have written on many, many issues, and I thank people for being in contact with me. Essential safeguard is said to be the requirement of the six month prognosis. We've heard about prediction of life expectancy. It's an estimate. Doctors themselves acknowledge that such judgements can be mistaken. If a person is eligible -- eligibility rests on a calculation, that is a fracture and the foundation of the safeguard is insecure. The second thing is, and this is my concern, as has been said by so many people, even where explicit coercion is absent, people will think they should choose an earlier death to relieve others of responsibility or to reduce demands on family or care systems.
Evidence from abroad shows that individuals frequently cite such considerations in their decisions. There will be an expectation on those who already feel vulnerable. Then we are told this legislation is now in scope. Once the principle of assisted suicide is accepted, criteria will broaden. Through later legislation, judicial rulings or medical practice shift. And even if the bill begins with limits, there is no guarantee that those limits will be infirm over time. Regarding safeguards that were outlined by Lord Faulkner in his introduction, some of the most significant checks we were talked about were revised as the bill progress in the other side -- other place.
Administrative structures, clarity has been reduced, there is much vagueness, too much power given to the government through delegated legislation and regulation. Protections appeared if predictions disappear before the bill reaches the statute book -- if predictions disappear before the bill reaches the statute be, this is an issue. There was a conference in Belfast on palliative care which illustrated the many deficiencies in Northern Ireland. Too many families still facing an adequate pain management and insufficient support.
Before contemplating a law that allows doctors the kiss of death in a widespread way, first responsibility is to guarantee that everyone can receive comprehensive palliative care of the highest standard. That is where compassion should directors. No one who has listened to this debate can fail to understand that everyone has compassion that has spoken in this debate. Compassion must be joined with caution. Even those who agree with the principle of assisted dying and assisted suicide must acknowledge that this bill is
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grossly deficient, even for that purpose. I rise to speak against this bill
The public needs to transparent. The public needs to understand what is at stake. It is assisted suicide. We should call it what it is. Human life carries what it is. Human life carries dignity and meaning in every age or circumstance. This is not reduced by age, illness, disability. People age, illness, disability. People fear pain and we must provide support better really. When they fear holiness, we must provide companionship. We should guarantee companionship. We should guarantee care. The solution should not be death.
-- They fear loneliness. People have written on many, many issues, and I thank people for being in contact with me. Essential safeguard is said to be the requirement of the six month prognosis. We've heard about prediction of life expectancy. It's an estimate. Doctors themselves acknowledge that such judgements can be mistaken. If a person is eligible -- eligibility rests on a calculation, that is a fracture and the foundation of the safeguard is insecure. The second thing is, and this is my concern, as has been said by so many people, even where explicit coercion is absent, people will think they should choose an earlier death to relieve others of responsibility or to reduce demands on family or care systems.
Evidence from abroad shows that individuals frequently cite such considerations in their decisions. There will be an expectation on those who already feel vulnerable. Then we are told this legislation is now in scope. Once the principle of assisted suicide is accepted, criteria will broaden. Through later legislation, judicial rulings or medical practice shift. And even if the bill begins with limits, there is no guarantee that those limits will be infirm over time. Regarding safeguards that were outlined by Lord Faulkner in his introduction, some of the most significant checks we were talked about were revised as the bill progress in the other side -- other place.
Administrative structures, clarity has been reduced, there is much vagueness, too much power given to the government through delegated legislation and regulation. Protections appeared if predictions disappear before the bill reaches the statute book -- if predictions disappear before the bill reaches the statute be, this is an issue. There was a conference in Belfast on palliative care which illustrated the many deficiencies in Northern Ireland. Too many families still facing an adequate pain management and insufficient support.
Before contemplating a law that allows doctors the kiss of death in a widespread way, first responsibility is to guarantee that everyone can receive comprehensive palliative care of the highest standard. That is where compassion should directors. No one who has listened to this debate can fail to understand that everyone has compassion that has spoken in this debate. Compassion must be joined with caution. Even those who agree with the principle of assisted dying and assisted suicide must acknowledge that this bill is
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grossly deficient, even for that purpose. I rise to speak against this bill
15:39
Baroness Nicholson of Winterbourne (Conservative)
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I rise to speak against this bill and in support of the amendment, Lord Forsyth's amendment, put Lord Forsyth's amendment, put forward by Lord Carlile. I speak as a former World Health Organization ambassador for Canada and the middle east -- for the middle east. The aim of the World Health Organization is help for all an education for all. help for all an education for all. In that capacity, without -- with outstanding professionals, we have built 90-100 primary health centres and delivered healthcare to 50 million medical consultations committee 50 million people in greatest need.
This has taken over 40 years and all in conflict countries. In Afghanistan, in Iran, right, Romania, Ukraine and in Pakistan and Kashmir. These are all local medical staff. There has been no linguistic misunderstanding of what I'm going to read out. I have to report to the noble Lords, not one single patient during that long time has asked for death. Every patient has asked for life, for understanding, for compassion for their suffering, but also potentially for a future for themselves.
The drive for life is so great that when I was in Damascus last week and so skeleton figures on the street. I've never seen something like it. After skeletons. They were not begging for death, they were begging to be given the they were begging to be given the opportunity to live. Maybe we should lift the restrictions we only put in a few years ago to stop medical professionals easing pain were easily. Because the desire to live is so great that most intolerable circumstances people to be kept alive.
The World Health Organization admits that the National Health Service is not yet perfect. For example, it has never focused on preventative medicine, which is the key to success in the modern world. But this bill destroys even that opportunity because it will take resources away and worse than that, it will divert from the primary purpose of the World Health Organization which is to provide health and life for all. You cannot do both in any organisation. Those of us who have cared companies, businesses and institutions, now you have to have a single mission statement.
You don't have a mission statement that tells you to turn right one minute and left the next. I recall as a child, a wonderful example of this, which some of you example of this, which some of you might remember. It was the push me pull you. Doctor Doolittle. That is what will happen if we bring this dreadful bill before the house any further. Humans are very imperfect creatures who look yesterday... Charlie Kirk was slaughtered. Some people said he deserved it.
Absolutely appalling. We are not perfect people. This bill gives the opportunity for maximum damage for a huge number of individuals.
**** Possible New Speaker ****
What a pleasure and privilege to follow the noble Lady Baroness follow the noble Lady Baroness Nicholson. In light of the impassioned contribution already, I
Baroness Nicholson of Winterbourne (Conservative)
**** Possible New Speaker ****
I rise to speak against this bill and in support of the amendment, Lord Forsyth's amendment, put Lord Forsyth's amendment, put forward by Lord Carlile. I speak as a former World Health Organization ambassador for Canada and the middle east -- for the middle east. The aim of the World Health Organization is help for all an education for all. help for all an education for all. In that capacity, without -- with outstanding professionals, we have built 90-100 primary health centres and delivered healthcare to 50 million medical consultations committee 50 million people in greatest need.
This has taken over 40 years and all in conflict countries. In Afghanistan, in Iran, right, Romania, Ukraine and in Pakistan and Kashmir. These are all local medical staff. There has been no linguistic misunderstanding of what I'm going to read out. I have to report to the noble Lords, not one single patient during that long time has asked for death. Every patient has asked for life, for understanding, for compassion for their suffering, but also potentially for a future for themselves.
The drive for life is so great that when I was in Damascus last week and so skeleton figures on the street. I've never seen something like it. After skeletons. They were not begging for death, they were begging to be given the they were begging to be given the opportunity to live. Maybe we should lift the restrictions we only put in a few years ago to stop medical professionals easing pain were easily. Because the desire to live is so great that most intolerable circumstances people to be kept alive.
The World Health Organization admits that the National Health Service is not yet perfect. For example, it has never focused on preventative medicine, which is the key to success in the modern world. But this bill destroys even that opportunity because it will take resources away and worse than that, it will divert from the primary purpose of the World Health Organization which is to provide health and life for all. You cannot do both in any organisation. Those of us who have cared companies, businesses and institutions, now you have to have a single mission statement.
You don't have a mission statement that tells you to turn right one minute and left the next. I recall as a child, a wonderful example of this, which some of you example of this, which some of you might remember. It was the push me pull you. Doctor Doolittle. That is what will happen if we bring this dreadful bill before the house any further. Humans are very imperfect creatures who look yesterday... Charlie Kirk was slaughtered. Some people said he deserved it.
Absolutely appalling. We are not perfect people. This bill gives the opportunity for maximum damage for a huge number of individuals.
**** Possible New Speaker ****
What a pleasure and privilege to follow the noble Lady Baroness follow the noble Lady Baroness Nicholson. In light of the impassioned contribution already, I
15:43
Baroness Uddin (Non-affiliated)
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Baroness Uddin (Non-affiliated)
impassioned contribution already, I wish to speak as a mother and daughter, and as someone who has worked professionally in suicide prevention. And I speak with a heavy heart and acknowledging the hundreds of letters who have spoken of their pain and suffering in support and in opposition to the bill. My beautiful, intelligent, 46-year-old son and equally magnificent 85- year-old mother lives with various difficulties, disabilities, with my mother encountering numerous times hospital appointments. They have both taught me more about joy, courage and resilience than I could ever have imagined, and to my horror, they have on several occasions been offered no resuscitation during a routine medical treatment.
State action as this for common good may raise fundamental consequences and contended in this bill. It is a lived experience and in fact that during the pandemic, people like my son, disabled, elderly, like my mother, many of minority heritage, died in disproportionate numbers. They died with no resuscitation orders in place on the records without their consent. It is not a surprise if alarm bell rings fear. surprise if alarm bell rings fear. As noble Lord raise -- Rees referred to, this is not fear mongering.
This bill, no matter how well-intentioned sent a powerful message that in the future, if they are seriously ill, they will be offered suicide as a compassionate choice. I do not feel confident that this bill provides safeguarding in wider practices and safeguarding in wider practices and This is not a hypothetical concern, where assisted suicide in other countries, the cliff edge is real, the narrowly designed legislation, and it has expanded to include people with chronic mental illness as a matter of choice.
People choosing death, not because of physical agony but because they are distressed with their base of social condition, healthcare and other provisions. Those may already be vulnerable in our society. Many suggested to me that this is absolute abandonment of every principle our society values, as fundamental basic rights, choice to live in dignity and care. Supporters of this bill say this is about autonomy, choice and exists where there is parity of palliative care. Sadly that is not the case with many elderly and the disabled.
Any already feel abandoned when community care, mental health support and other accessible services remain chronically underfunded and out of their reach. I'm all too aware of the agony and suffering, I do not dismiss grief or human desires to control how they wish to die, but we cannot make laws built on the basis on those who are able to decide to access influence at the highest level, including bringing this matter to our Parliament which is an appearance at least that we may be overlooking the future rights of the most vulnerable in our society.
This proposal is resented as a panacea especially as health and welfare services continue to field the constraint. If this bill passes, how long before mice on all my mother softly and subtly are made to feel that perhaps it is time, as the cost rises of their care, however full of love could and should be ended, dressed as a mercy. Our duty is to protect the fundamentally compromised if this bill with seas of deep consequences, it will send a powerful message that the majority silent opinions no longer count and Parliament can be persuaded to legislate over life and death by influential advocacy, that which many voices, millions of voices in our country have no access
State action as this for common good may raise fundamental consequences and contended in this bill. It is a lived experience and in fact that during the pandemic, people like my son, disabled, elderly, like my mother, many of minority heritage, died in disproportionate numbers. They died with no resuscitation orders in place on the records without their consent. It is not a surprise if alarm bell rings fear. surprise if alarm bell rings fear. As noble Lord raise -- Rees referred to, this is not fear mongering.
This bill, no matter how well-intentioned sent a powerful message that in the future, if they are seriously ill, they will be offered suicide as a compassionate choice. I do not feel confident that this bill provides safeguarding in wider practices and safeguarding in wider practices and This is not a hypothetical concern, where assisted suicide in other countries, the cliff edge is real, the narrowly designed legislation, and it has expanded to include people with chronic mental illness as a matter of choice.
People choosing death, not because of physical agony but because they are distressed with their base of social condition, healthcare and other provisions. Those may already be vulnerable in our society. Many suggested to me that this is absolute abandonment of every principle our society values, as fundamental basic rights, choice to live in dignity and care. Supporters of this bill say this is about autonomy, choice and exists where there is parity of palliative care. Sadly that is not the case with many elderly and the disabled.
Any already feel abandoned when community care, mental health support and other accessible services remain chronically underfunded and out of their reach. I'm all too aware of the agony and suffering, I do not dismiss grief or human desires to control how they wish to die, but we cannot make laws built on the basis on those who are able to decide to access influence at the highest level, including bringing this matter to our Parliament which is an appearance at least that we may be overlooking the future rights of the most vulnerable in our society.
This proposal is resented as a panacea especially as health and welfare services continue to field the constraint. If this bill passes, how long before mice on all my mother softly and subtly are made to feel that perhaps it is time, as the cost rises of their care, however full of love could and should be ended, dressed as a mercy. Our duty is to protect the fundamentally compromised if this bill with seas of deep consequences, it will send a powerful message that the majority silent opinions no longer count and Parliament can be persuaded to legislate over life and death by influential advocacy, that which many voices, millions of voices in our country have no access
15:49
Lord Jackson of Peterborough (Conservative)
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Lord Jackson of Peterborough (Conservative)
Wednesday was world suicide should they. Suicide is always a tragedy and its effects are profoundly felt by whole communities as well as the by whole communities as well as the immediate family. As legislators we have a responsibility to affirm every life as having inherent legal value regardless of age, health, disability or circumstances and I disability or circumstances and I believe we need to seek to prevent suicide, not facilitate it. We have a national strategy for reducing the a national strategy for reducing the a national strategy for reducing the number of lives lost to suicide and sadly the suicide rate in this country is the highest it has been in over two decades.
It's almost in over two decades. It's almost unfathomable that in the very week we should be shining a light on suicide and we are considering amending the 1961 Suicide Act in amending the 1961 Suicide Act in clause 32 of this bill to make it legal for the state to give drugs to people to hasten the end of their own lives. Proponents of this bill have tried to argue that legalising have tried to argue that legalising assisted dying will somehow reduce assisted dying will somehow reduce the number of unassisted suicides but there is robust evidence to suggest it has the opposite effect.
Backers of assisted suicide in the Australian state of Victoria claimed it would prevent 50 suicides each year of terminally ill people. They won the argument since the law was changed on assisted suicide amongst over 65 Scott the largest democratic of terminally ill people, has increased. You can tell why, if you... Some of those who do not qualify will still feel that they should take that same way out. Because you have normalised it. Our commitment to suicide as a society depends on a consistent message that every life has meaning and value, and is deserving of protection.
Suicide can't be both something we should try hard to prevent and something that we should assist in some cases. This is nonsensical. For the state to tell certain suicidal people, you are right, your life isn't worth living, it's an appalling message. It's the ultimate in hopelessness and the opposite of compassion. According to the Royal College of Psychiatrists, suicide ideation in terminal illness typically resolves want a person physical pain or associated fear of it is alleviated. But this bill ignores our duty of care to these people.
It sanctions death by poisoning for those who with the right palliative care and would otherwise often choose to live. This bill will put vulnerable people under greater pressure to end their lives, for fear of being a burden on others, physically, emotionally or financially. We see this in Canada where the medical assisted in dying law has become in the words of an ME sufferer called Madeleine, a " brutal practicality" for people seeking to escape poverty and social isolation lost 137 year old homeless man applied for medical assisted death because in his words, he felt useless.
And thought he was hurting society. Another woman in her 50s asked to die because she could not get adequate housing. He wants to live in a society like that? This utilitarian way of thinking becomes normalised once assisted suicide is legalised, polling shows that over 1/4 of Canadians now think it should be acceptable for people to seek status death as a solution to homeless and poverty -- state assisted death. Exists to protect those who might otherwise feel pressured into and in their lives.
We should be seeking to strengthen people in hope, respect the agency, and give them the care and they need, not firming them in their hopelessness and giving them drugs to kill themselves. We need to ask, is this bill really the best we can do for societies most vulnerable? This bill cannot be improved. It
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must therefore fail. I rise far into a frequently
**** Possible New Speaker ****
I rise far into a frequently heartrending debate, so much about agonising death and so many speeches agonising death and so many speeches that deserve to be noted, physically that of the noble Lord Forsyth, that of the noble Lord Forsyth, about his father's death and his own reflections on it. I speak in a unique position, even a speaker number 85, for the policy the green number 85, for the policy the green part of a grid and Wales is to legally provide with all of the appropriate safeguards, a provision appropriate safeguards, a provision for assisted dying but that does not in anyway tied my hands, for the Green Party does not whip so every vote is a conscience vote.
That policy position was extensively policy position was extensively debated in the party and we heard a great many concerns from disabled people, people from global majority people, people from global majority of amenities, people who fear they are discriminated against and badly treated in our current system and
It's almost in over two decades. It's almost unfathomable that in the very week we should be shining a light on suicide and we are considering amending the 1961 Suicide Act in amending the 1961 Suicide Act in clause 32 of this bill to make it legal for the state to give drugs to people to hasten the end of their own lives. Proponents of this bill have tried to argue that legalising have tried to argue that legalising assisted dying will somehow reduce assisted dying will somehow reduce the number of unassisted suicides but there is robust evidence to suggest it has the opposite effect.
Backers of assisted suicide in the Australian state of Victoria claimed it would prevent 50 suicides each year of terminally ill people. They won the argument since the law was changed on assisted suicide amongst over 65 Scott the largest democratic of terminally ill people, has increased. You can tell why, if you... Some of those who do not qualify will still feel that they should take that same way out. Because you have normalised it. Our commitment to suicide as a society depends on a consistent message that every life has meaning and value, and is deserving of protection.
Suicide can't be both something we should try hard to prevent and something that we should assist in some cases. This is nonsensical. For the state to tell certain suicidal people, you are right, your life isn't worth living, it's an appalling message. It's the ultimate in hopelessness and the opposite of compassion. According to the Royal College of Psychiatrists, suicide ideation in terminal illness typically resolves want a person physical pain or associated fear of it is alleviated. But this bill ignores our duty of care to these people.
It sanctions death by poisoning for those who with the right palliative care and would otherwise often choose to live. This bill will put vulnerable people under greater pressure to end their lives, for fear of being a burden on others, physically, emotionally or financially. We see this in Canada where the medical assisted in dying law has become in the words of an ME sufferer called Madeleine, a " brutal practicality" for people seeking to escape poverty and social isolation lost 137 year old homeless man applied for medical assisted death because in his words, he felt useless.
And thought he was hurting society. Another woman in her 50s asked to die because she could not get adequate housing. He wants to live in a society like that? This utilitarian way of thinking becomes normalised once assisted suicide is legalised, polling shows that over 1/4 of Canadians now think it should be acceptable for people to seek status death as a solution to homeless and poverty -- state assisted death. Exists to protect those who might otherwise feel pressured into and in their lives.
We should be seeking to strengthen people in hope, respect the agency, and give them the care and they need, not firming them in their hopelessness and giving them drugs to kill themselves. We need to ask, is this bill really the best we can do for societies most vulnerable? This bill cannot be improved. It
**** Possible New Speaker ****
must therefore fail. I rise far into a frequently
**** Possible New Speaker ****
I rise far into a frequently heartrending debate, so much about agonising death and so many speeches agonising death and so many speeches that deserve to be noted, physically that of the noble Lord Forsyth, that of the noble Lord Forsyth, about his father's death and his own reflections on it. I speak in a unique position, even a speaker number 85, for the policy the green number 85, for the policy the green part of a grid and Wales is to legally provide with all of the appropriate safeguards, a provision appropriate safeguards, a provision for assisted dying but that does not in anyway tied my hands, for the Green Party does not whip so every vote is a conscience vote.
That policy position was extensively policy position was extensively debated in the party and we heard a great many concerns from disabled people, people from global majority people, people from global majority of amenities, people who fear they are discriminated against and badly treated in our current system and
15:54
Baroness Bennett of Manor Castle (Green Party)
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Baroness Bennett of Manor Castle (Green Party)
treated in our current system and the discrimination hereto. We heard that as I heard fears from learning disabled people at the event earlier this month. As the Lord Lord Faulkner said, safeguards built into this bill means they are more protected in this than they are in other areas of healthcare. Posing those protections right across our health service should certainly be a priority, as should be fully publicly funded quality of quality policy of care. In evidence shows disabled people overall want the same rights as the rest of us when terminally ill.
Too late out plainly, one of the reasons, one of the chief reasons I will support this bill is that we already have assisted dying available to people in Britain. But only some people, those who have the financial wherewithal, the confidence, to navigate foreign systems and travel, and the remaining health and capacity to get to Dignitas in Switzerland. That is a profound inequality that leaves some dying, in the many harrowing conditions which we have heard today. We have heard it also means that P die alone without their loved ones even knowing of their final choice, for fear of the legal repercussions for those they leave behind and dying sooner than they might otherwise because they fear being too ill to travel.
I oppose the amendment from the noble Lady Baroness Burt which I'm afraid can only be regarded as setting an impossible timetable for the bill as the Lord Faulkner explained. I'm not social about the obviously constructively intended amendment from the noble Lord Forsyth, and I will listen to further arguments on that. In addressing both of those I do want to make a point that in progressing to make a new law, particularly a low of conscious such as this, as with the laws on access to abortion and the rights of LGBTQIA plus people, the debate does not only happen in Parliament.
As the noble Lord for cassette out, this bill has received far more Parliamentary attention than many government bills but debate and scrutiny does not only happen in Parliament. It happens in the media, in communities and out of course on the Internet, and social media, and we should not discount the power and importance of that in shaping the law. That I and many other floors have received about this bill, the balance of which reflect the views of the public, and I thank all of those who have taken the time to send, to be in contact with me about it.
That is people's politics and if we look at the opinion polling, the people have a clear view on the need for assisted dying to be available in the UK, not relying on the decisions ready made by the end edges later of Switzerland. The people expect the politics to deliver on their view. Finally, I have been asked to note my noble friend Baroness Jones of Moulsecoomb on medical leave is listening to this debate from home and wishes to have support for this bill.
Too late out plainly, one of the reasons, one of the chief reasons I will support this bill is that we already have assisted dying available to people in Britain. But only some people, those who have the financial wherewithal, the confidence, to navigate foreign systems and travel, and the remaining health and capacity to get to Dignitas in Switzerland. That is a profound inequality that leaves some dying, in the many harrowing conditions which we have heard today. We have heard it also means that P die alone without their loved ones even knowing of their final choice, for fear of the legal repercussions for those they leave behind and dying sooner than they might otherwise because they fear being too ill to travel.
I oppose the amendment from the noble Lady Baroness Burt which I'm afraid can only be regarded as setting an impossible timetable for the bill as the Lord Faulkner explained. I'm not social about the obviously constructively intended amendment from the noble Lord Forsyth, and I will listen to further arguments on that. In addressing both of those I do want to make a point that in progressing to make a new law, particularly a low of conscious such as this, as with the laws on access to abortion and the rights of LGBTQIA plus people, the debate does not only happen in Parliament.
As the noble Lord for cassette out, this bill has received far more Parliamentary attention than many government bills but debate and scrutiny does not only happen in Parliament. It happens in the media, in communities and out of course on the Internet, and social media, and we should not discount the power and importance of that in shaping the law. That I and many other floors have received about this bill, the balance of which reflect the views of the public, and I thank all of those who have taken the time to send, to be in contact with me about it.
That is people's politics and if we look at the opinion polling, the people have a clear view on the need for assisted dying to be available in the UK, not relying on the decisions ready made by the end edges later of Switzerland. The people expect the politics to deliver on their view. Finally, I have been asked to note my noble friend Baroness Jones of Moulsecoomb on medical leave is listening to this debate from home and wishes to have support for this bill.
15:57
Lord Ashcombe (Conservative)
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Lord Ashcombe (Conservative)
This bill raises profound concerns for me and I wish to outline five reasons why I cannot support it in its current form. While many of us face the death in my case have witnessed the extraordinary can offer, this level of care is not universally available as we have heard. I consider myself extremely fortunate. Far too many people due to underfunding and limited access denied this support at the end of life. When individuals are left without proper access to proper palliative care, they may begin to see assisted dying not as a choice but as the only escape from suffering.
My second concern is that as people grow older and lose confidence and become vulnerable. This leads them to being susceptible to subtle pressures, pressures that can rise from well-meaning family & friends. More troubling still is the potential for over coercion. Where someone may be made to feel a burden or believe their life no longer holds value and thus opt for a path they do not truly want. How and by whom is this being evaluated? Third, even with the strictest safeguards, you must learn from the experience of other countries places like Canada and the Netherlands as we have previously heard, have heard a scene extension of the criteria.
What begins as a control process can over time become worryingly permissive. There are reports of individuals shopping around for sympathetic doctors. Even when they are not terminally ill. This risks the potential of normalising suicide as a legitimate solution to human suffering. Fourthly, I'm deeply concerned about the position in which this bill places medical professionals. While I acknowledge that some doctors believe that helping a patient to die peacefully is in certain circumstances an act of compassion, there is a stark difference between that and actively participating in determining who qualifies to die.
I'm particularly concerned that the doctor can't raise the thought of assisted death with a patient without the requirement to also discuss palliative care. This means discussing assisted dying alone could almost be considered coercion. Also goes against the current UK medical law, GMC informed consent, which requires doctors to discuss the various treatments options for patients and give them long enough to consider these options. This is ethically very problematic and challenges the very foundations of the medical profession which is grounded in the preservation of life.
It runs counter to modern GMC guidelines and risks turning doctors into the gatekeepers of death, not lie. Finally I worry about the broader cultural impact. Our society is built on the principle that every life has an inherent value, from the beginning to the natural and. This bill risks undermining that ethos. It sends a dangerous message that lives of the elderly, disabled or the chronically ill may be less worth living. But they are expendable when they are no longer seen as contributing or useful.
My Lords, I do not deny there are tragic cases, and we have heard some today, were medically assisted death may appear preferable to prolong suffering but this bill as it stands is not the right instrument. Potential consequences are to grave. It safeguards to uncertain. And its impact on our societal values to profound, and for those reasons I
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When the question was last before your Lordships I posed any your Lordships I posed any alteration to the present law but I changed my mind -- opposed. I come to believe our present arrangements to believe our present arrangements are discriminatory and hypocritical. are discriminatory and hypocritical. These arrangements benefit one group by conferring upon them effective by conferring upon them effective immunity from prosecution for assisted suicide, and then damages the rest by withholding that same immunity in what looks like an arbitrary basis.
To explain this let arbitrary basis. To explain this let me go back to my five years as DPP when just around 100 cases involving assisted suicide came across my
My second concern is that as people grow older and lose confidence and become vulnerable. This leads them to being susceptible to subtle pressures, pressures that can rise from well-meaning family & friends. More troubling still is the potential for over coercion. Where someone may be made to feel a burden or believe their life no longer holds value and thus opt for a path they do not truly want. How and by whom is this being evaluated? Third, even with the strictest safeguards, you must learn from the experience of other countries places like Canada and the Netherlands as we have previously heard, have heard a scene extension of the criteria.
What begins as a control process can over time become worryingly permissive. There are reports of individuals shopping around for sympathetic doctors. Even when they are not terminally ill. This risks the potential of normalising suicide as a legitimate solution to human suffering. Fourthly, I'm deeply concerned about the position in which this bill places medical professionals. While I acknowledge that some doctors believe that helping a patient to die peacefully is in certain circumstances an act of compassion, there is a stark difference between that and actively participating in determining who qualifies to die.
I'm particularly concerned that the doctor can't raise the thought of assisted death with a patient without the requirement to also discuss palliative care. This means discussing assisted dying alone could almost be considered coercion. Also goes against the current UK medical law, GMC informed consent, which requires doctors to discuss the various treatments options for patients and give them long enough to consider these options. This is ethically very problematic and challenges the very foundations of the medical profession which is grounded in the preservation of life.
It runs counter to modern GMC guidelines and risks turning doctors into the gatekeepers of death, not lie. Finally I worry about the broader cultural impact. Our society is built on the principle that every life has an inherent value, from the beginning to the natural and. This bill risks undermining that ethos. It sends a dangerous message that lives of the elderly, disabled or the chronically ill may be less worth living. But they are expendable when they are no longer seen as contributing or useful.
My Lords, I do not deny there are tragic cases, and we have heard some today, were medically assisted death may appear preferable to prolong suffering but this bill as it stands is not the right instrument. Potential consequences are to grave. It safeguards to uncertain. And its impact on our societal values to profound, and for those reasons I
**** Possible New Speaker ****
When the question was last before your Lordships I posed any your Lordships I posed any alteration to the present law but I changed my mind -- opposed. I come to believe our present arrangements to believe our present arrangements are discriminatory and hypocritical. are discriminatory and hypocritical. These arrangements benefit one group by conferring upon them effective by conferring upon them effective immunity from prosecution for assisted suicide, and then damages the rest by withholding that same immunity in what looks like an arbitrary basis.
To explain this let arbitrary basis. To explain this let me go back to my five years as DPP when just around 100 cases involving assisted suicide came across my
16:02
Lord Macdonald of River Glaven (Crossbench)
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Lord Macdonald of River Glaven (Crossbench)
assisted suicide came across my We didn't prosecute a single one of them. In some cases this was because the bodies had been cremated in Switzerland and there was no firm evidence of cause of death. This meant that our first test for prosecution that had a realistic prospect case for prosecution was not met, in other cases bodies were repatriated the burial and we had a cause of death usually massive barbiturate poisoning. The evidential test was clearly met however even where it is at the second test to consider because prosecutors are given the discretion to determine whether a prosecution would be in the public interest, and in each case we decided it would not.
Why? At a basic level we felt that a mother, father, son and a daughter what asked to accompany father or son to Zurich faced with a commit what to do? Take your terminally ill suffering daughter yourself and be with her as she died or leave had to be taken by somebody else? Even presupposing a rational English jury following proper directions of law for a rational English judge we believe that that jury would never connect mother or a father in the situation.
In all likelihood they would regard the intrusion of the criminals law into such grief as an abomination. Since my time I successes have invariably followed this reasoning except in cases of exploitation or other criminality which were never present in the cases I considered. Indeed my immediate successor Sir Keir Starmer was even required by the then judicial committee of your Lordships house this last judgement before becoming United Kingdom Supreme Court to publish guidance and the factors the prosecutors would consider in determining whether public interest lay in assisted suicide cases.
Like me Sir Keir had resisted the step on the grounds that it would constitute the DPP issuing guidance to the public on how to break the law and get away with it. That's where we are. We all know that if you assisted suicide in Switzerland and avoid anything the DPP has categorised as a feature you may be investigated but you will never be prosecuted. Of course there are cases where improper pressure greed or wickedness are involved but these would remain Serious Crimes Act even with this bill to pass.
These few cases aside this means that reality is the vast majority of assisted dying cases abroad have in effect been decriminalised with notable help from the old Judicial Committee and no involvement at all Committee and no involvement at all from Parliament as a legislative body. That in itself is strange but what is worse is that this dispensation, this de facto right to die only applies to those with the physical ability, the wherewithal, family and friends willing to risk breaking the law to help them and the knowledge to do so.
Those who are too ill to travel, you don't have the wherewithal or can't find anyone to help them or are simply unaware of the extreme unlikelihood of prosecution are left to suffer in the UK. They are abandoned by the state that is unwilling to put the current law into practice, yet equally reluctant to ensure that the benefit of it studied in activity is available to all. In my view this represents an abuse of the cardinal principle of the quality under the law and it can only be addressed by provisions of the sort contained
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within this bill. As I speak towards the end of the
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As I speak towards the end of the day the range of arguments have been thoroughly rehearsed. But I want to focus on and uncomfortable truth, focus on and uncomfortable truth, that most of us do not want to admit even to ourselves. That is the issue even to ourselves. That is the issue of human nature and the evil that is in every human heart. I do pay tribute to noble Lords and Baroness Nicholson who touched on this in their contributions. Every day as we their contributions.
Every day as we gather here we pray the words that gather here we pray the words that rights to tall task and lead us not into temptation but deliver us from evil. It is this that has informed evil. It is this that has informed my strongly held opposition to this bill, no amount of additional scrutiny or legislative tweaks would make it acceptable because I oppose the principle of assisted suicide. the principle of assisted suicide. As a Christian my faith shakes my view but not from a rigid
Why? At a basic level we felt that a mother, father, son and a daughter what asked to accompany father or son to Zurich faced with a commit what to do? Take your terminally ill suffering daughter yourself and be with her as she died or leave had to be taken by somebody else? Even presupposing a rational English jury following proper directions of law for a rational English judge we believe that that jury would never connect mother or a father in the situation.
In all likelihood they would regard the intrusion of the criminals law into such grief as an abomination. Since my time I successes have invariably followed this reasoning except in cases of exploitation or other criminality which were never present in the cases I considered. Indeed my immediate successor Sir Keir Starmer was even required by the then judicial committee of your Lordships house this last judgement before becoming United Kingdom Supreme Court to publish guidance and the factors the prosecutors would consider in determining whether public interest lay in assisted suicide cases.
Like me Sir Keir had resisted the step on the grounds that it would constitute the DPP issuing guidance to the public on how to break the law and get away with it. That's where we are. We all know that if you assisted suicide in Switzerland and avoid anything the DPP has categorised as a feature you may be investigated but you will never be prosecuted. Of course there are cases where improper pressure greed or wickedness are involved but these would remain Serious Crimes Act even with this bill to pass.
These few cases aside this means that reality is the vast majority of assisted dying cases abroad have in effect been decriminalised with notable help from the old Judicial Committee and no involvement at all Committee and no involvement at all from Parliament as a legislative body. That in itself is strange but what is worse is that this dispensation, this de facto right to die only applies to those with the physical ability, the wherewithal, family and friends willing to risk breaking the law to help them and the knowledge to do so.
Those who are too ill to travel, you don't have the wherewithal or can't find anyone to help them or are simply unaware of the extreme unlikelihood of prosecution are left to suffer in the UK. They are abandoned by the state that is unwilling to put the current law into practice, yet equally reluctant to ensure that the benefit of it studied in activity is available to all. In my view this represents an abuse of the cardinal principle of the quality under the law and it can only be addressed by provisions of the sort contained
**** Possible New Speaker ****
within this bill. As I speak towards the end of the
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As I speak towards the end of the day the range of arguments have been thoroughly rehearsed. But I want to focus on and uncomfortable truth, focus on and uncomfortable truth, that most of us do not want to admit even to ourselves. That is the issue even to ourselves. That is the issue of human nature and the evil that is in every human heart. I do pay tribute to noble Lords and Baroness Nicholson who touched on this in their contributions. Every day as we their contributions.
Every day as we gather here we pray the words that gather here we pray the words that rights to tall task and lead us not into temptation but deliver us from evil. It is this that has informed evil. It is this that has informed my strongly held opposition to this bill, no amount of additional scrutiny or legislative tweaks would make it acceptable because I oppose the principle of assisted suicide. the principle of assisted suicide. As a Christian my faith shakes my view but not from a rigid
16:06
Baroness Maclean of Redditch (Conservative)
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Baroness Maclean of Redditch (Conservative)
view but not from a rigid doctrinally perspective, rather on reflecting on the teachings of Jesus who knew humans are capable of great love but also great evil. We pray deliver us from evil because we know that without God's help we are too weak to resist. It's much too easy weak to resist. It's much too easy not to be honest about human nature, we pretend that all families are happy and all children want the best for their dying relatives. We have rightly heard much about elderly people not wanting to be a burden, but we've not talked about putting temptation is a very distressing time in front of otherwise good and moral people and know about safeguarding can take away that temptation to kill off one's relatives under the finesse of assisted dying to get hold of one's inheritance.
These are eye watering the expensive and one can see how easy it would be to say she or he would not have wanted to live that way. No one would ever need to know. We cannot know how we would behave under these conditions of extreme temptation, remember in our human history we have witnessed human beings carrying out unspeakable acts of wickedness and violence against each other. Supporters say the bill is narrow and safe, but the evidence abroad does not persuade me, tells me that no matter how many safeguards are introduced we cannot escape human nature.
How often this place and the other place and those of us who have been members of Parliament have we heard about so many terrible things happen, authorities letting people down, and we gather together and say such and such a terrible thing must not happen again and we must introduce safeguards. But I'm afraid too often it does. But we are not destined to repeat these actions which I am convinced will lead to more suffering and more pain. We talk about vulnerable people and I want to add my words about victims of Domestic Abuse Act, because coercive control in particular is extremely sophisticated.
Abuses are perfectly capable of manipulating their victims to convincingly express a wish to die. By the time the courts with their delays have caught up it is too late. I finished by saying this debate is about what kind of society do we want to be? Do we hold to the truth that every life is made in the image of God and are we able to be clear eyed about the capacity to do evil that lives in all of us even though it is extremely uncomfortable for us to admit that especially in this chamber.
I know my view which is why I do not
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support this bill. The Right Reverend Prelate the Bishop of London this morning said Bishop of London this morning said that to change the law is to change society. The reality is that society society. The reality is that society has already changed. And it wants us to change the law. When the House of to change the law. When the House of Commons passed this bill the daily express newspaper hailed the success
These are eye watering the expensive and one can see how easy it would be to say she or he would not have wanted to live that way. No one would ever need to know. We cannot know how we would behave under these conditions of extreme temptation, remember in our human history we have witnessed human beings carrying out unspeakable acts of wickedness and violence against each other. Supporters say the bill is narrow and safe, but the evidence abroad does not persuade me, tells me that no matter how many safeguards are introduced we cannot escape human nature.
How often this place and the other place and those of us who have been members of Parliament have we heard about so many terrible things happen, authorities letting people down, and we gather together and say such and such a terrible thing must not happen again and we must introduce safeguards. But I'm afraid too often it does. But we are not destined to repeat these actions which I am convinced will lead to more suffering and more pain. We talk about vulnerable people and I want to add my words about victims of Domestic Abuse Act, because coercive control in particular is extremely sophisticated.
Abuses are perfectly capable of manipulating their victims to convincingly express a wish to die. By the time the courts with their delays have caught up it is too late. I finished by saying this debate is about what kind of society do we want to be? Do we hold to the truth that every life is made in the image of God and are we able to be clear eyed about the capacity to do evil that lives in all of us even though it is extremely uncomfortable for us to admit that especially in this chamber.
I know my view which is why I do not
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support this bill. The Right Reverend Prelate the Bishop of London this morning said Bishop of London this morning said that to change the law is to change society. The reality is that society society. The reality is that society has already changed. And it wants us to change the law. When the House of to change the law. When the House of Commons passed this bill the daily express newspaper hailed the success
16:09
Lord Purvis of Tweed (Liberal Democrat)
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Lord Purvis of Tweed (Liberal Democrat)
express newspaper hailed the success of its campaign. 21 years ago when I lodged my bill in the Scottish parliament the Sunday express entire front page, coincidentally on 12 September, shouted I quote, MSP in bid to change the law to kill patients. Death threats I received as a consequence seemed rather ironic to me. So some people have changed their minds over the years. Even in the church. As up to 2017, eight denied someone a Christian barrel if they die by suicide.
But this bill does not concern people who choose to end their life, it concerns those whose life is ending and the choices they are denied to make that ending better. You are given to herding opposition then included that which asserted, palliative care is either the answer or part of the answer but I think we all know that even with comprehensive and and universal palliative care there would be times when someone would prefer not to die through sedated starvation. You can prescribe morphine, but not personal dignity.
A common argument I had then was just to allow doctors to quietly ease the passing of people. Don't interfere. But I don't want an approach to the permanent turning of a blind eye to potential coercion and denial of transparency and protections. 21 years ago police and prosecutors rigorously investigated and prosecuted those loved ones to travel abroad because this enforced law on assistance. I argued then it was unjust, now as we have just heard a few moments ago this is considered unheard-of.
I've not heard any calls today to return to the approach taken before then. Nor have they are the argument today to return to the approach where a patient didn't have the right to an advance directive, to reject in doctors insistence on resuscitation or reducing food and hydration. All these changes in their own right are accepted by opponents of the bill. But they provide for an inconsistent unfair confusing and often, too often, inhumane legal framework. These inconsistencies within England and will be alleviated by the spill, but they also exist where I live in Scotland.
Lynn MacArthur MSP with great care is taking his measure through the Scottish parliament. I hope it passes as I hope this bill does here. Perhaps because I live on the Scottish border we will need to address the cross-border issues of residency for those who live in one country and receive services in country and receive services in another. Adult competences laws, the interaction of resolved and reserved competences in the relationship between health bodies south and north of the border. None of these issues that we need to resolve prohibitive or should be in any way block progress.
Indeed the reverse, as they will assist operability. I don't question the motives of those who have principled objections to this bill. But I note that they favour the current legal right to allow patient either by choice or persuaded that they are a burden without full reporting transparency to decline food and water and die of sedated starvation. I do not want this carrying on for another 21 years. This bill is not about people choosing to die. They are dying. Indeed the point missed by many is that this debate is about people who do not wish to die.
The way someone dies impacts on how their loved ones live the rest of their lives. A better final few days with dignity, love and care means loved ones remember their life lived and lasso
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how it ended. I wish to raise two concerns with this bill. The bill seeks to prevent this bill. The bill seeks to prevent coercion, but that is a high bar. My
But this bill does not concern people who choose to end their life, it concerns those whose life is ending and the choices they are denied to make that ending better. You are given to herding opposition then included that which asserted, palliative care is either the answer or part of the answer but I think we all know that even with comprehensive and and universal palliative care there would be times when someone would prefer not to die through sedated starvation. You can prescribe morphine, but not personal dignity.
A common argument I had then was just to allow doctors to quietly ease the passing of people. Don't interfere. But I don't want an approach to the permanent turning of a blind eye to potential coercion and denial of transparency and protections. 21 years ago police and prosecutors rigorously investigated and prosecuted those loved ones to travel abroad because this enforced law on assistance. I argued then it was unjust, now as we have just heard a few moments ago this is considered unheard-of.
I've not heard any calls today to return to the approach taken before then. Nor have they are the argument today to return to the approach where a patient didn't have the right to an advance directive, to reject in doctors insistence on resuscitation or reducing food and hydration. All these changes in their own right are accepted by opponents of the bill. But they provide for an inconsistent unfair confusing and often, too often, inhumane legal framework. These inconsistencies within England and will be alleviated by the spill, but they also exist where I live in Scotland.
Lynn MacArthur MSP with great care is taking his measure through the Scottish parliament. I hope it passes as I hope this bill does here. Perhaps because I live on the Scottish border we will need to address the cross-border issues of residency for those who live in one country and receive services in country and receive services in another. Adult competences laws, the interaction of resolved and reserved competences in the relationship between health bodies south and north of the border. None of these issues that we need to resolve prohibitive or should be in any way block progress.
Indeed the reverse, as they will assist operability. I don't question the motives of those who have principled objections to this bill. But I note that they favour the current legal right to allow patient either by choice or persuaded that they are a burden without full reporting transparency to decline food and water and die of sedated starvation. I do not want this carrying on for another 21 years. This bill is not about people choosing to die. They are dying. Indeed the point missed by many is that this debate is about people who do not wish to die.
The way someone dies impacts on how their loved ones live the rest of their lives. A better final few days with dignity, love and care means loved ones remember their life lived and lasso
**** Possible New Speaker ****
how it ended. I wish to raise two concerns with this bill. The bill seeks to prevent this bill. The bill seeks to prevent coercion, but that is a high bar. My
16:13
Lord Jamieson (Conservative)
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Lord Jamieson (Conservative)
coercion, but that is a high bar. My concern is with undue influence. As with many others who have been elected I came across many elderly vulnerable and lonely residents. Often they lack support that they should have had an they needed. Yet they voiced concern that they were a burden to their family, to their friends and to society. I combine this with the risk of undue influence being brought to bear. One of my earliest experiences was an elderly lady went to hospital for a major operation.
She had few relatives and gave a relative, one of the few relatives she had left she gave power of attorney. The operation was successful, yet the relative put her into a care home and sought to sell her home. Fortunately she had good friends who managed to nullify the power of eternity and she returned home. This may be an extreme case, but it demonstrates the risks, and I have demonstrates the risks, and I have other less examples of relatives seeking -- letters and examples, of relatives seeking to gain their inheritance sooner full to the second concerns the role of the NHS.
The NHS is a large and complex organisation. It already has a great deal of difficulties in delivering its current roles. From a personal perspective I have had several family members being treated for cancer and despite many good staff, all too often it felt like they were being treated as a unit, and not an individual. In the case of my mother, palliative care was only available eventually. I know that both noble Lords Bethel and Lord Stevenson raised the issue of the capacity of the NHS to do this bill.
The NHS full focus in my opinion should be on health and well-being of the individual. It should not have an additional role to kill people. If this bill were to put progress its delivery should be entirely separate to the NHS and I entirely separate to the NHS and I
She had few relatives and gave a relative, one of the few relatives she had left she gave power of attorney. The operation was successful, yet the relative put her into a care home and sought to sell her home. Fortunately she had good friends who managed to nullify the power of eternity and she returned home. This may be an extreme case, but it demonstrates the risks, and I have demonstrates the risks, and I have other less examples of relatives seeking -- letters and examples, of relatives seeking to gain their inheritance sooner full to the second concerns the role of the NHS.
The NHS is a large and complex organisation. It already has a great deal of difficulties in delivering its current roles. From a personal perspective I have had several family members being treated for cancer and despite many good staff, all too often it felt like they were being treated as a unit, and not an individual. In the case of my mother, palliative care was only available eventually. I know that both noble Lords Bethel and Lord Stevenson raised the issue of the capacity of the NHS to do this bill.
The NHS full focus in my opinion should be on health and well-being of the individual. It should not have an additional role to kill people. If this bill were to put progress its delivery should be entirely separate to the NHS and I entirely separate to the NHS and I
16:15
Baroness Wheatcroft (Crossbench)
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Baroness Wheatcroft (Crossbench)
The strength of feeling on this issue is understandable. Rarely do we get to debate such a momentous issue. But in the end this is a question of personal choice. No one is suggesting that assisted dying should be mandatory, nor even that it should be widely available. In fact, under this bill, few might be eligible to ask for it, let alone choose to take up the option. All this bill would do is make it possible for a dying person to die the death they want.
I don't believe it is my right or the right of any of us in this House to deny another individual that option. Could anyone have been in Millbank House on Tuesday listening to the person battling with pain in order to continue walking one he can still move his cancer ridden body? They deny him what he craves, the certainty that, when he can cope no longer, he can have the debt he chooses. It is, he says, his dying wish that this bill should become law.
Barely 40, until very recently a music teacher and marathon runner, he says he is receiving excellent palliative care. He does not wish to die, yet. But when life becomes intolerable, he wants an assisted death. He is anything but suicidal. The use of that word is an emotive effort to confuse two very different things. Nathaniel does not want to kill himself, he is dying already. Many noble Lords talk of the need for investment in palliative care.
That is not a matter for debate. We all want investment in palliative care. But assisted dying should be viewed as merely part of a palliative care package. Palliative care cannot always deal with all pain. One of the many letters I received on this subject said, " No matter how good we can make palliative care, there are always those for whom the experience of terminal illness and dying involves suffering that cannot be alleviated nor endured.
We need both good palliative care and assisted dying to be available. " The author of that letter was a former hospice director, and consultant in palliative medicine. Sophie Blake has been a vigorous campaigner for better palliative care, and for assisted dying. She does not want to die, despite the pain she suffered from multiple cancers. But she is allergic to a painkiller which makes pain relief difficult. She is terrified of going through excruciating pain when she does die. But worse still, the fear of her daughter watching her.
So while she fights for better palliative care and for her life, she is desperate for the right to have the peaceful and dignified death this bill could deliver for her. I want to be able to reassure Sophie, Nathaniel, and others, that I will help give them the reassurance they crave and that I could not give my own mother when she was dying. During the course of this long and balanced debate, we are only halfway through, many a voice of concern about the lack of safeguards, but there are safeguards and there will be more.
The bill is not perfect. This House will do its job, scrutinise it and improve where possible. But we need this bill to possible. But we need this bill to move ahead quickly. My Lords, I support it. support it.
I don't believe it is my right or the right of any of us in this House to deny another individual that option. Could anyone have been in Millbank House on Tuesday listening to the person battling with pain in order to continue walking one he can still move his cancer ridden body? They deny him what he craves, the certainty that, when he can cope no longer, he can have the debt he chooses. It is, he says, his dying wish that this bill should become law.
Barely 40, until very recently a music teacher and marathon runner, he says he is receiving excellent palliative care. He does not wish to die, yet. But when life becomes intolerable, he wants an assisted death. He is anything but suicidal. The use of that word is an emotive effort to confuse two very different things. Nathaniel does not want to kill himself, he is dying already. Many noble Lords talk of the need for investment in palliative care.
That is not a matter for debate. We all want investment in palliative care. But assisted dying should be viewed as merely part of a palliative care package. Palliative care cannot always deal with all pain. One of the many letters I received on this subject said, " No matter how good we can make palliative care, there are always those for whom the experience of terminal illness and dying involves suffering that cannot be alleviated nor endured.
We need both good palliative care and assisted dying to be available. " The author of that letter was a former hospice director, and consultant in palliative medicine. Sophie Blake has been a vigorous campaigner for better palliative care, and for assisted dying. She does not want to die, despite the pain she suffered from multiple cancers. But she is allergic to a painkiller which makes pain relief difficult. She is terrified of going through excruciating pain when she does die. But worse still, the fear of her daughter watching her.
So while she fights for better palliative care and for her life, she is desperate for the right to have the peaceful and dignified death this bill could deliver for her. I want to be able to reassure Sophie, Nathaniel, and others, that I will help give them the reassurance they crave and that I could not give my own mother when she was dying. During the course of this long and balanced debate, we are only halfway through, many a voice of concern about the lack of safeguards, but there are safeguards and there will be more.
The bill is not perfect. This House will do its job, scrutinise it and improve where possible. But we need this bill to possible. But we need this bill to move ahead quickly. My Lords, I support it. support it.
16:20
Baroness Lawlor (Conservative)
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Baroness Lawlor (Conservative)
My Lords, this is a difficult and controversial bill. Not only because of the substantial amount of delegated legislation, the problem of skeleton legislation, the lack of adequate legislative scrutiny, as committees of this House and pointed out. And as the evidence presented by lawyers and academics, including that of a think tank research director also points out, not only because of the magnitude of the proposed change and potential impact to which the lordships have drawn attention.
Although this has no electoral mandate which would have allowed for pre-legislative consultation and debate nationally, which is not guaranteed by levels. Most important of all, the bill fails to recognise the nature and basis for the law in the fundamental matter of life and death. And that once assisting suicide is allowed, it becomes impossible to detect cases where more than assistance is provided, and someone is, in effect, induced to kill themselves. This is a criminal act.
But under this bill, becomes impossible to police. As the recent Chief Coroner has pointed out, the bill removes any realistic prospect of an effective inquest. The bill also ignores the moral and religious underpinning of a historic tradition based on the principle that the life of each person is sacred. Irrespective of how much or how little value may be put on it by others. Or the state, or whether that life has a cost to others. Without such a premise, we risk a descent into barbarism.
In which human lives may be done away with as fast as battery chickens. By category, by age, disability, on account of their mental and psychiatric conditions. Indeed, the mask proposed by the dramatic change in the law proposed in this bill, the veneer of strict conditionality and the person themselves wanting to commit suicide, and prove consent, this reveals any rinse of the very nature of our society. Society is based on kinship. On based on kinship.
On interdependency. Networks of support both in the public and private sphere. An ultimately on trust. It is underwritten by tradition and conventions which, for centuries, have been given the protections of the law. The basis of this whole structure, though unfashionable to say, the conviction that human life is sacred is there. My Lords, despite the bills conditions, it is alleged limitless this and restrictions, it strikes a hammer blow at a civilisation supported until now by law, custom, kinship, and trust.
Throughout the centuries, whether in peace or war, but now struggling to keep afloat.
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My Lords, on 9 October in 2000, my parents-in-law, Jack and Ruth, my parents-in-law, Jack and Ruth, committed joint suicide. He was dying and she had decided to dying and she had decided to accompany him on this last journey. Jack was born in Bratislava in what Jack was born in Bratislava in what was then Czechoslovakia. The family were Jewish, and following the
Although this has no electoral mandate which would have allowed for pre-legislative consultation and debate nationally, which is not guaranteed by levels. Most important of all, the bill fails to recognise the nature and basis for the law in the fundamental matter of life and death. And that once assisting suicide is allowed, it becomes impossible to detect cases where more than assistance is provided, and someone is, in effect, induced to kill themselves. This is a criminal act.
But under this bill, becomes impossible to police. As the recent Chief Coroner has pointed out, the bill removes any realistic prospect of an effective inquest. The bill also ignores the moral and religious underpinning of a historic tradition based on the principle that the life of each person is sacred. Irrespective of how much or how little value may be put on it by others. Or the state, or whether that life has a cost to others. Without such a premise, we risk a descent into barbarism.
In which human lives may be done away with as fast as battery chickens. By category, by age, disability, on account of their mental and psychiatric conditions. Indeed, the mask proposed by the dramatic change in the law proposed in this bill, the veneer of strict conditionality and the person themselves wanting to commit suicide, and prove consent, this reveals any rinse of the very nature of our society. Society is based on kinship. On based on kinship.
On interdependency. Networks of support both in the public and private sphere. An ultimately on trust. It is underwritten by tradition and conventions which, for centuries, have been given the protections of the law. The basis of this whole structure, though unfashionable to say, the conviction that human life is sacred is there. My Lords, despite the bills conditions, it is alleged limitless this and restrictions, it strikes a hammer blow at a civilisation supported until now by law, custom, kinship, and trust.
Throughout the centuries, whether in peace or war, but now struggling to keep afloat.
**** Possible New Speaker ****
My Lords, on 9 October in 2000, my parents-in-law, Jack and Ruth, my parents-in-law, Jack and Ruth, committed joint suicide. He was dying and she had decided to dying and she had decided to accompany him on this last journey. Jack was born in Bratislava in what Jack was born in Bratislava in what was then Czechoslovakia. The family were Jewish, and following the
16:24
Lord Mitchell (Labour)
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Lord Mitchell (Labour)
were Jewish, and following the events in Munich in 1938, they fled to Philadelphia. When war was declared, Jack went to Canada and joined the Czech division of the RAF. He survived the punishing war, and then worked for British intelligence. He went to Cambridge, and as a demobbed airman and became a brilliant scientist. A professor in biophysics, specialising in the movement of muscles. His work requires him to conduct experiments on animal tissue. He spent much of his time using X-ray refraction in his lab at King's College, and at the synchrotron in Cheshire.
In those days, no one quite understood the long-term dangers of radiation. And protection was rudimentary. For him, it was fatal. In 1998, he was diagnosed with acute myeloid which he knew was terminal. He told me in his usual want-away, "I know how this story ends and it is not pretty. I'm bloody well going out with my boots on. " Not much room for doubt on that one. As he became weak at they both cut themselves off from us, gradually, then completely, so as not to involve us in their deaths.
Letters were returned, emails bounced back, and telephone calls went to the answer machine. We were bereft. We have no one to talk to, and to be honest, when we tried, no one believed us. When we said there was a chance that Ruth would commit suicide along with him, people shook their heads in disbelief. My wife in particular sensed that they would carry out their wishes. After all, they were both intelligent people who had carefully thought this through. There was no one to support Jack and no one on hand to help Ruth, in what must have been hell for her.
The main practical problem for Jack was main practical problem for Jack was curing enough of the medication to ensure one and then another successful suicide. He found a way for top being the scarred Holocaust survivor that Jack was, and the brilliant scientist he had become, there was no way he was going to get the dosage wrong. If there had been assisted dying legislation at that time, I am certain that things would have turned out differently. We could have talked about it openly without the fear of legal consequences.
We could have engaged professional help. I can't be certain about my mother-in-law's motivation to join him, but they both knew that his own suicide at home could well run the risk of her being charged with committing a crime as an accomplice. What I do know is that, had this bill been law then, she probably would have chosen life. My family would have been spared a double bereavement that was unnecessarily brutal, and psychologically damaging for us all. Not surprisingly, I support this bill.
**** Possible New Speaker ****
My Lords, it is a great privilege to sit here all day and listen to noble and learned Earl members of this House. The problem is when you are the penultimate speaker, most of are the penultimate speaker, most of the good ideas and suggestions have already been made. But I would like to pay tribute to my noble friend
In those days, no one quite understood the long-term dangers of radiation. And protection was rudimentary. For him, it was fatal. In 1998, he was diagnosed with acute myeloid which he knew was terminal. He told me in his usual want-away, "I know how this story ends and it is not pretty. I'm bloody well going out with my boots on. " Not much room for doubt on that one. As he became weak at they both cut themselves off from us, gradually, then completely, so as not to involve us in their deaths.
Letters were returned, emails bounced back, and telephone calls went to the answer machine. We were bereft. We have no one to talk to, and to be honest, when we tried, no one believed us. When we said there was a chance that Ruth would commit suicide along with him, people shook their heads in disbelief. My wife in particular sensed that they would carry out their wishes. After all, they were both intelligent people who had carefully thought this through. There was no one to support Jack and no one on hand to help Ruth, in what must have been hell for her.
The main practical problem for Jack was main practical problem for Jack was curing enough of the medication to ensure one and then another successful suicide. He found a way for top being the scarred Holocaust survivor that Jack was, and the brilliant scientist he had become, there was no way he was going to get the dosage wrong. If there had been assisted dying legislation at that time, I am certain that things would have turned out differently. We could have talked about it openly without the fear of legal consequences.
We could have engaged professional help. I can't be certain about my mother-in-law's motivation to join him, but they both knew that his own suicide at home could well run the risk of her being charged with committing a crime as an accomplice. What I do know is that, had this bill been law then, she probably would have chosen life. My family would have been spared a double bereavement that was unnecessarily brutal, and psychologically damaging for us all. Not surprisingly, I support this bill.
**** Possible New Speaker ****
My Lords, it is a great privilege to sit here all day and listen to noble and learned Earl members of this House. The problem is when you are the penultimate speaker, most of are the penultimate speaker, most of the good ideas and suggestions have already been made. But I would like to pay tribute to my noble friend
16:28
Lord Evans of Rainow (Conservative)
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Lord Evans of Rainow (Conservative)
to pay tribute to my noble friend Baroness Meyer May and others. I am concerned about the fundamental shift in this bill and what it will cause with our relationship with the medical professionals. As legislators we go it to the public who will be impacted by this bill to think through all consequences carefully. Whether intended or not, carefully. Whether intended or not, and to think about who we will empower to pass legislation. If this bill passes we will will be moving from an NHS where docs are focused solely on healing and NHS where, with the conditions of this bill being met, any individual doctor with no specific training can raise ending a terminally ill patients life with the endorsement of the state.
No matter how vulnerable patient is full stop we place a lot of trust in our doctors and healthcare professionals to seek what is best for us. This bill risks that implication. If not, the outright declaration that ending your life early is a suitable course of NHS treatment. The honourable member. In the other place is an NHS consultant Dr and reflected on this issue about how patients interact with their doctors during the report stage debate. As a doctor, I am aware that the trust the public places in doctors and the seriousness with which they take what we say.
If a doctor gives information about assisted dying, it is quite reasonable for that person to think that the doctor is suggesting they should take part in that process. Or is hinting that their death will be dreadful and trying to be kind if doctors are allowed to say that this is a good process. More people will take it up than would otherwise want to do. My Lords, I know when I go to the doctors, I assume that the doctor before me will be there to help my health and recovery and nothing else.
That should be our experience. Any threats to this kind of relationship to the medical profession and its patients must be rejected. We cannot afford to fundamentally rewire the NHS to the effect that the public will no longer be sure that their recovery is occupying the totality of doctors thoughts. I worry that, in a cash- strapped NHS trust, someone is calculating and sets out an impact assessment that £13,000 could be saved per patient every four months of unused healthcare for the cost about £14 prescription.
As this bill passes into law and establishes assisted dying as a regulated and approved treatment, something commonplace, we will have to be sure that we are not just systems and processes beyond reproach, but many professionals at all stages of their career have the opportunity and ability to put patients on the route to assisted death. This means you have to have faith in the competence and professionalism of every individual. I have no problem having closely interacted with three NHS Trusts is a member of Parliament, saying that some of the most dedicated people in our country work in the NHS.
But I would be delusional to pretend that this is universally true. I have seen deeply worrying cases where one bad apple was simply shunted from job to job. As with all institutions, doctors are fallible. Mistakes will be made to exhaustion, misunderstanding, and yes, in some cases, malice. And yet advocates for this bill would have us reject common experience. The Member for Vauxhall and raised that report stage that many constituents have grave concerns about the way in which they are treated, because they feel they do not have A-level of equality within our NHS, the Member for Solihull West and Shirley rejected it as rhetoric that engenders a round medical We must not underestimate how much how this will put into the hands of potentially very junior medical professionals and the scope of impact a very small cohort can have.
This is evident in the international jurisdictions with similar regimes, according to an official report in 2021 single doctor in Oregon wrote, 1/8 of all prescriptions Victoria according to the voluntary as review board during 20 during 23/24 during 23/2410 doctors handled 55% of all cases. This bill should not pass in its current form.
No matter how vulnerable patient is full stop we place a lot of trust in our doctors and healthcare professionals to seek what is best for us. This bill risks that implication. If not, the outright declaration that ending your life early is a suitable course of NHS treatment. The honourable member. In the other place is an NHS consultant Dr and reflected on this issue about how patients interact with their doctors during the report stage debate. As a doctor, I am aware that the trust the public places in doctors and the seriousness with which they take what we say.
If a doctor gives information about assisted dying, it is quite reasonable for that person to think that the doctor is suggesting they should take part in that process. Or is hinting that their death will be dreadful and trying to be kind if doctors are allowed to say that this is a good process. More people will take it up than would otherwise want to do. My Lords, I know when I go to the doctors, I assume that the doctor before me will be there to help my health and recovery and nothing else.
That should be our experience. Any threats to this kind of relationship to the medical profession and its patients must be rejected. We cannot afford to fundamentally rewire the NHS to the effect that the public will no longer be sure that their recovery is occupying the totality of doctors thoughts. I worry that, in a cash- strapped NHS trust, someone is calculating and sets out an impact assessment that £13,000 could be saved per patient every four months of unused healthcare for the cost about £14 prescription.
As this bill passes into law and establishes assisted dying as a regulated and approved treatment, something commonplace, we will have to be sure that we are not just systems and processes beyond reproach, but many professionals at all stages of their career have the opportunity and ability to put patients on the route to assisted death. This means you have to have faith in the competence and professionalism of every individual. I have no problem having closely interacted with three NHS Trusts is a member of Parliament, saying that some of the most dedicated people in our country work in the NHS.
But I would be delusional to pretend that this is universally true. I have seen deeply worrying cases where one bad apple was simply shunted from job to job. As with all institutions, doctors are fallible. Mistakes will be made to exhaustion, misunderstanding, and yes, in some cases, malice. And yet advocates for this bill would have us reject common experience. The Member for Vauxhall and raised that report stage that many constituents have grave concerns about the way in which they are treated, because they feel they do not have A-level of equality within our NHS, the Member for Solihull West and Shirley rejected it as rhetoric that engenders a round medical We must not underestimate how much how this will put into the hands of potentially very junior medical professionals and the scope of impact a very small cohort can have.
This is evident in the international jurisdictions with similar regimes, according to an official report in 2021 single doctor in Oregon wrote, 1/8 of all prescriptions Victoria according to the voluntary as review board during 20 during 23/24 during 23/2410 doctors handled 55% of all cases. This bill should not pass in its current form.
16:32
Lord Hogan-Howe (Crossbench)
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Lord Hogan-Howe (Crossbench)
Everything's been said that obviously not yet by me. For me it's a simple matter that shows I support like a choice to support this bill, it's a choice to end your life time of your choosing, the choice to ensure that your passing is peaceful and controlled in the choice so far as possible that as occurs where your prefer with or without the people you choose to be present. At the moment people do have that choice as people have mentioned, to travel to a jurisdiction in which its legal.
This choice is hampered by conditions. If you wish to travel to Switzerland then you will need to build to afford a ticket. If you are imprisoned you will not be able to travel at all. You'll probably need someone to accompany you and help with the arrangements, those people need to risk an investigation and prosecution, is not whether the prosecution takes place, the investigation you are under and the family who are affected for the time that takes to decide that you haven't committed an offence but finally something that hasn't imagine too often is that you will need to be well enough to be travel.
Cause illness progress, not always at the rate at which medical people expect. It can remove that possibility at a time which you most need it. If these three conditions aren't met, your poor, your loan and your already extremely ill then you do not have that choice. So what always the rich the well enough to travel and those with friends and families have the choice? It can't be right even for those fortunate enough to travel they have to end their life in a foreign place which is clinical, cold and anonymous when it could have been at home surrounded by the people they love.
The animal they probably regard as family and the home they've enjoyed. Those who oppose this bill say that a palliative care should remove the need for it assisted dying I don't accept that. I don't accept because we have too many cases where palliative care did not work. I agree with Lord Stevenson particularly said we should have far more palliative care stop there is an irony that while hundred thousand people do not have the opportunity there are probably more in need of this option. The sit in a room and say to them will actually we can can't ease your pain, we might provide more palliative care in the future probably five to 10 years away is hardly a conversation I would like to have with the people affected by it and each one of us might want to imagine we have to have that conversation because that's the power we hold in our hands for me is not for doctors to say was that the five pain-free that is, is for the person who is suffering that trauma.
It's for them to decide when enough is enough. It said that people may be induced or pressurised to go early afraid the risk of outcome is already with us. If anybody imagines that nobody has been pressurised at home to go early then they are naive. I think this possibility is that somebody could intervene should that be happening against so much will, and provide option that provides a better end someone might be anticipating. People could of course take their own life and I've seen people take their own life when all hope is last.
It's not attractive. They are not in control and usually do it in way that affects many other people. Because their families are left with all the uncertainty and pain that can bring to them. When they've not been there or not had the opportunity to make sure it's a far better end. I would just mention very briefly upheld once or twice today people say that suicide is wrong. I think that's the underpinning of why we used to say attempted suicide was a criminal offence.
I don't think it's wrong. It may not be the best and for anybody. But I understand why people come to that conclusion, is a very brave decision to those he made it I don't think the right says the wrong thing. Finally just a thought fall of us in this place. This is the moment when we told 80% of the population support this bill, that matches my own feeling with people I meet. This is a moment of conscience to vote according to own best judgement will stop I don't that means anyone should try and stop the process of this bill by procedural mischief or interminable debates.
If the bill is voted down that's what democracies do. My view very unwise and unfair to prevent the opportunity for this vote. So I support this bill. The time has come to be more humane to the dying this bill achieves a humane solution to the most awful problems at the end of our times on earth.
**** Possible New Speaker ****
I beg to move the debate on the second reading is now adjourned until Friday, 19 September. The question is that the debate
**** Possible New Speaker ****
The question is that the debate now adjourned. As many are of that opinion say, "Content", and of the contrary, "Not content". The "Contents" have it.
**** Possible New Speaker ****
"Contents" have it. It's been a long day at the end of a very long week. As we adjourn of a very long week. As we adjourn our proceedings I'm sure noble Lords our proceedings I'm sure noble Lords will join with me in thanking the catering staff, the attendance, the clerks, Hansard staff, the broadcast clerks, Hansard staff, the broadcast unit at the police, security staff and the doorkeeper is for the excellent support keeping the House operating and keeping assay. With that I beg to move the House do now that I beg to move the House do now adjourned.
-- Keeping us safe.
**** Possible New Speaker ****
That the House do now adjourned.
This choice is hampered by conditions. If you wish to travel to Switzerland then you will need to build to afford a ticket. If you are imprisoned you will not be able to travel at all. You'll probably need someone to accompany you and help with the arrangements, those people need to risk an investigation and prosecution, is not whether the prosecution takes place, the investigation you are under and the family who are affected for the time that takes to decide that you haven't committed an offence but finally something that hasn't imagine too often is that you will need to be well enough to be travel.
Cause illness progress, not always at the rate at which medical people expect. It can remove that possibility at a time which you most need it. If these three conditions aren't met, your poor, your loan and your already extremely ill then you do not have that choice. So what always the rich the well enough to travel and those with friends and families have the choice? It can't be right even for those fortunate enough to travel they have to end their life in a foreign place which is clinical, cold and anonymous when it could have been at home surrounded by the people they love.
The animal they probably regard as family and the home they've enjoyed. Those who oppose this bill say that a palliative care should remove the need for it assisted dying I don't accept that. I don't accept because we have too many cases where palliative care did not work. I agree with Lord Stevenson particularly said we should have far more palliative care stop there is an irony that while hundred thousand people do not have the opportunity there are probably more in need of this option. The sit in a room and say to them will actually we can can't ease your pain, we might provide more palliative care in the future probably five to 10 years away is hardly a conversation I would like to have with the people affected by it and each one of us might want to imagine we have to have that conversation because that's the power we hold in our hands for me is not for doctors to say was that the five pain-free that is, is for the person who is suffering that trauma.
It's for them to decide when enough is enough. It said that people may be induced or pressurised to go early afraid the risk of outcome is already with us. If anybody imagines that nobody has been pressurised at home to go early then they are naive. I think this possibility is that somebody could intervene should that be happening against so much will, and provide option that provides a better end someone might be anticipating. People could of course take their own life and I've seen people take their own life when all hope is last.
It's not attractive. They are not in control and usually do it in way that affects many other people. Because their families are left with all the uncertainty and pain that can bring to them. When they've not been there or not had the opportunity to make sure it's a far better end. I would just mention very briefly upheld once or twice today people say that suicide is wrong. I think that's the underpinning of why we used to say attempted suicide was a criminal offence.
I don't think it's wrong. It may not be the best and for anybody. But I understand why people come to that conclusion, is a very brave decision to those he made it I don't think the right says the wrong thing. Finally just a thought fall of us in this place. This is the moment when we told 80% of the population support this bill, that matches my own feeling with people I meet. This is a moment of conscience to vote according to own best judgement will stop I don't that means anyone should try and stop the process of this bill by procedural mischief or interminable debates.
If the bill is voted down that's what democracies do. My view very unwise and unfair to prevent the opportunity for this vote. So I support this bill. The time has come to be more humane to the dying this bill achieves a humane solution to the most awful problems at the end of our times on earth.
**** Possible New Speaker ****
I beg to move the debate on the second reading is now adjourned until Friday, 19 September. The question is that the debate
**** Possible New Speaker ****
The question is that the debate now adjourned. As many are of that opinion say, "Content", and of the contrary, "Not content". The "Contents" have it.
**** Possible New Speaker ****
"Contents" have it. It's been a long day at the end of a very long week. As we adjourn of a very long week. As we adjourn our proceedings I'm sure noble Lords our proceedings I'm sure noble Lords will join with me in thanking the catering staff, the attendance, the clerks, Hansard staff, the broadcast clerks, Hansard staff, the broadcast unit at the police, security staff and the doorkeeper is for the excellent support keeping the House operating and keeping assay. With that I beg to move the House do now that I beg to move the House do now adjourned.
-- Keeping us safe.
**** Possible New Speaker ****
That the House do now adjourned.