Lord Moore of Etchingham
Main Page: Lord Moore of Etchingham (Non-affiliated - Life peer)
Lord Sandhurst (Con)
I agree entirely with the noble Lord. That is why at the start, perhaps briefly and elliptically, I talked about bad agencies and people. That is not the health service’s primary role. It will happen from time to time. I know a medical professional —I mentioned this at Second Reading—who has a relative in charge of safeguarding in a major London trust. One of the concerns they have, and what they have to deal with from day to day, is families who are not all united in their support for an elderly and tiresome relative and would often, in fact, like them helped on their way. I will not say more, but I think the point is clear that this structural point is a major failing in the Bill.
Lord Moore of Etchingham (Non-Afl)
My Lords, the noble Lord, Lord Stevens, who speaks from great experience and professional knowledge, made a very clear case about how the assisted dying navigator is quite outside the normal purposes of the National Health Service. I guess it could be described, in effect, as a form of advocacy. In the ancient world, the dead were carried across the River Styx by Charon. It seems that role would be performed by the navigator, because where is he navigating you to? It is to the River Styx; he is not trying to navigate you to anywhere else.
If that is included in the National Health Service, it would create a quite different purpose from the normal purposes, as the noble Lord, Lord Stevens, described. I wonder, therefore, whether we should consider whether this actually amounts to the National Health Service trying to persuade people to accept assisted dying. If it does, and if you think of the vulnerability of the individual cases that so often will occur, could it be argued that it might become an institutionalised form of coercion?
Baroness Royall of Blaisdon (Lab)
My Lords, I merely point out that this is not a choice between investing in palliative care or changing the law so that we have an assisted dying service. We need to do both. I am mindful of the point made by the noble Lord, Lord Stevens, about the lack of response from the Department of Health and Social Care. It would be very good if some others of us could press for that, because it would be interesting to know how, when and how much the Government are going to invest in palliative care. Whatever we believe about assisted dying, we all fundamentally believe that palliative care needs more investment and should not be a postcode lottery.
Lord Markham (Con)
To build on that, I will put the financial numbers into context. The impact assessment has it down as £28 million; I believe that is 0.000175% of the NHS budget. It is right and proper that we decide how NHS resources are spent and in which direction, as the noble Lord, Lord Winston, said. We make those decisions all the time—for example, whether we put more funding into cancer or other services. It is entirely appropriate.
One of the key phrases was, “It is our NHS”, and what do we know about assisted dying? That 70% of the public support it. Given that, surely it is entirely right that resources are spent in that way.
Lord Moore of Etchingham (Non-Afl)
The point that is being missed was made by the noble Lord, Lord Stevens, and it is the problem with what the noble Lord, Lord Winston, was saying. Can the noble Lord respond to it? We are talking about what the aim of this is, but it is not a health aim. The noble Lord, Lord Winston, spoke of better treatment for cancer and in vitro fertilisation. Are the noble Lords arguing that death is a health aim?
Lord Falconer of Thoroton (Lab)
First of all, there is absolutely no need to apologise for not being a lawyer; some of my best friends are non-lawyers. Secondly, this very thing was very closely considered, hence the provision in the Bill to say that, if there are complications, let us try to agree in advance what we should do. We will not, I am sure, be able to cover every complication, hence the questions from the noble Baroness, Lady Finlay, and the noble Lord, Lord Stevens. The answer is clear and beyond doubt—hence the reference to the need to address the question of complications—that the doctor should do what the doctor is always obliged to do, which is to save life.
Lord Moore of Etchingham (Non-Afl)
Forgive me if I have misunderstood the noble and learned Lord, but what about the situation in which the patient does not die, is conscious and says, “I still want to die”? What is the doctor supposed to do at that point?
Lord Falconer of Thoroton (Lab)
The doctor cannot administer a substance. It has to be done by the patient, because the doctor has no right to kill. If the patient is saying, “No intervention”, then there will be no intervention at that particular point. The key thing about this is that it is assisting somebody to take their own life.
Lord Moore of Etchingham (Non-Afl)
The patient could say, if capable of action after having woken up from taking the poison, “I want more poison, give me some”. If that happened, what would the doctor’s duty be?
Lord Falconer of Thoroton (Lab)
If the person said, “I will take more poison”, then the person can do that. It is perfectly permissible.
Lord Moore of Etchingham (Non-Afl)
My Lords, I 100% support the motive behind the amendment from the noble Baroness, Lady Berger, and what the noble Baroness, Lady Cass, and others have just said, but my question is this: will it make any difference? If you want an assisted death, would you not be able to get it simply by saying that it is related to your terminal illness? You have your terminal illness and you have the prognosis, and you will therefore be advised by anybody who wants to assist you in your death that that is what you must say. How is this therefore a protection for the problem that we are discussing?
Lord Harper (Con)
My Lords, in this group of amendments—the two parts of it, if you like—I support the amendment that the noble Baroness, Lady Berger, has brought forward, which sets out that the primary motivation for seeking assisted death is terminal illness. That is important because, otherwise, the terminal illness is simply a trigger.
One reason why I think this is important is something that I am very nervous about. I am not saying, by the way, that this is the motivation of the sponsor of the Bill, but he will be aware that many people think that this Bill is just a first step—there are campaigners outside this House who absolutely think that. One problem with the way that it is drafted at the moment is that, because the terminal illness is simply a trigger, it would be very simple, if this Bill were on the statute book, to simply remove that qualification, so that the rest of the structure and processes in the Bill would then allow anybody for any reason, without having a terminal illness, to seek an assisted suicide. With the amendment that the noble Baroness, Lady Berger, suggests—that the reason why you are seeking an assisted suicide is your terminal illness—then you could not do that. If you were to remove the terminal illness piece, there would be no motivation, so you would have to do a lot more work. Those of us who are nervous about this Bill as a Trojan horse would be more reassured if that motivation were in place.
The second part to this goes to what my noble friend Lord Deben said about what the public think that this is about. If we look at the opinion polling on what the public think should be reasons why someone should be able to seek assisted suicide, the powerful reasons that many members of the public—not all, but significant numbers—support is to relieve suffering and pain. People are broadly compassionate and think that that is a good idea. What they do not support is people being able to seek assistance to kill themselves because they are poor or for other reasons. They think that that is a terrible reason. The amendment from the noble Baroness, Lady Berger, and other amendments in this group would more closely align the way the Bill is structured and what it would do with what many members of the public think that it should do.
I also support Amendment 320ZA from my noble friend Lord Blencathra, which explicitly says that the purpose of seeking assisted suicide cannot be various societal factors, such as housing or financial circumstances. That is important. The noble and learned Lord, Lord Falconer, and I had an exchange last week where he made it very clear that he thinks that, if those things are the drivers for you wanting to end your life, he is okay with that. I am not, and the polling evidence is that the public are not okay with that either.
Choices should be proper choices. My noble friend Lord Deben set out very well the sort of society that I think people want to see. If people want to end their life because of something not to do with their terminal illness or their pain or their suffering—because they do not have enough money or they have poor housing, or they have other things that they are not happy about—then those things are remediable. They may be expensive, but they are fixable and we can do something about them. I want to live in a society where we do something about them and we make people’s lives better—even if it is only for the last few months of their life, that is still worth doing.
My noble friend Lord Deben is right. He is not saying that the sponsor or those who support this Bill are thinking like this, but he is absolutely right that people make decisions all the time based on weighing up financial consequences. Noble Lords have talked about NICE today. When it assesses approving drugs, NICE looks at quality adjusted life years against the price of the drugs to the health service. It literally weighs up how much valuable quality life you are buying versus how much money we are spending. My worry is that, if you do not exclude people wishing to end their lives for these other reasons, we will get ourselves in a terrible place where we are not prepared to spend the money on improving people’s lives but rushing them towards ending their life in a way that is not necessary.
That is a big choice for Parliament to make and there are different views. The noble and learned Lord, Lord Falconer, set out his view last week. I have set out mine and my noble friend Lord Deben has set out his—we are in agreement. That is a decision for the House. I hope that noble Lords will support the amendment tabled by my noble friend Lord Blencathra and make the decision that you can only seek assisted suicide if it is because of your terminal illness, not because of your other circumstances. I think that that is the right sort of society we would be creating. The package of amendments in this group would improve the Bill. They would also reassure many people who are concerned about the Bill to not be concerned about it, which would be helpful for everybody. I commend them to noble Lords.