Terminally Ill Adults (End of Life) Bill Debate

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Department: Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Lord Brooke of Alverthorpe Excerpts
Lord Brooke of Alverthorpe Portrait Lord Brooke of Alverthorpe (Lab)
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My Lords, I have no interest to declare other than that I book the Lords Residence Room 2 for Christian Peers of all denominations to meet weekly for interesting conversations and study. The meeting starts at 1 pm and runs for 45 minutes. All are welcome. So, at least I have found something new to say that has not already been said.

I am a believer that there is some higher power, some spirit or energy of creation. It was there before humans and their religions came along, and it is here now with us. If the human race disappears—as it might, faced with AI and climate change—that power, which gives purpose, goodness, beauty and love, will continue indefinitely. For me, it is my source of hope.

That power, however, also gives me the freedom of choice. I have been here since 1997, so, like the noble Baroness, Lady Hayman, I have been involved in numerous attempts to change this law. Unlike her, I voted against Lord Joffe’s Bill in 2004, and I voted against other similar initiatives. In 2014, I spoke and voted against the Bill of the noble and learned Lord, Lord Falconer of Thoroton. But much has changed since then, and God moves in a mysterious way, in my experience. I have come now to take a decision to change my mind.

Experience has shown over recent years that change does happen: it happens to churches and it happens to me. When I first came here, there were no women Bishops. The Lords Spiritual (Women) Act 2015 changed that. That is a minor change compared with this century’s growth in the world population from 6.1 billion to 8.2 billion—a 25% increase in 25 years. Just think what the 2025 numbers would be if abortion had not been legalised or there had not been wide-scale usage and advocacy of contraception. Indeed, the growth of homosexuality throughout society has reduced the number of children that we would have had. Had the churches had their way, we would have had a very much bigger population than we presently have, facing the difficulties we have with climate change. We all have change taking place around us, including the churches.

For some, dying is welcomed and is peaceful and serene; for others, it is full of great difficulties, pain, anxiety and misery, notwithstanding all the admirable efforts of palliative care. In my experience in recent years, I have seen people with terminal illnesses dying in fear, acute pain and misery. Of course, this can be avoided, as has been said by others, if one has the money. Anyone can go to Switzerland to Dignitas for assisted dying at a price. Further, you can go virtually safe in the knowledge that it is highly unlikely that any punitive action will be taken against you. Why is not such action taken? Is it not because most people see assistance with dying for the terminally ill as an act of caring, compassion and love? For those without the funds for that, this Bill, amended as the House sees fit, provides just that: for them to do it at their home. Who am I to deny that those less able to afford it should not have that choice?

Terminally Ill Adults (End of Life) Bill Debate

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Department: Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Lord Brooke of Alverthorpe Excerpts
Baroness Lawlor Portrait Baroness Lawlor (Con)
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My Lords, I would like to follow my noble friend Lord Gove’s able introduction of the series of amendments in the name of the noble Lord, Lord Frost, and add a few words about why they are particularly important, giving a little more detail on some of the individual amendments to supplement that given by my noble friend. The amendments from the noble Lord, Lord Frost, hang on there being a neutral adviser to whom a person is directed if the general practitioner, the medical practitioner in the Bill, does not feel willing or able to discuss assisted dying with them.

The amendments would ensure that the information was provided by someone neutral. Under Amendment 195, they must keep and report a record of the advice or information given, and the date, to the commissioner within five days; and under Amendment 196, they must be an organisation designated as such by the Secretary of State, by regulation, in consultation with the commissioner. They must also be required to make a declaration, as we have heard, that they have no potential conflict of interest as an organisation by virtue of either employing people or having volunteers on the books who have in some way or another been associated with promoting assisted dying—I am glad to see the noble Lord, Lord Frost, here; I stand ready to be corrected by the teacher—for instance, if the organisation supports assisted dying in principle, if it does so politically or ideologically, or if it does so by means of advocacy or employment, or in any way makes money from it. We can think of lobbyists and PR firms who are acting for such organisations.

Neutrality matters and it must be established, particularly since we are dealing with a publicly funded service in the name of, and provided by, the state. As it is, the Bill stands open to an ever-expanding bureaucracy. Bureaucracy itself is likely to be self-perpetuating. There is a danger that those involved may be fervent advocates of assisted suicide. They may be, or may have been, associated with those organisations advocating it, or they may be lobbyists. The Bill as it stands allows the GP to initiate the prospect of an assisted death with a patient suffering from a terminal illness, and perhaps to plant the idea. However, if the GP does not want to enter into discussion of an assisted suicide, the Bill opens the prospect of the patient being referred to someone who will.

The amendments of the noble Lord, Lord Frost, would ensure that, if the Bill becomes law, assisted suicide in the UK does not become a state dying service, as has happened, as some feared, in Canada, including many physicians over there. In some cases, medically assisted dying becomes the default option, with nearly one in 20 deaths now resulting from assisted dying, and 5% opting for this step because of direct pressure from medical professionals—as is well documented, and we have spoken about some of these cases in Committee—or because of indirect pressure such as a lack of housing, of the support needed at home, of financial support or of palliative care. These amendments would ensure that in this country, the person to whom a patient was directed, when a doctor does not want to discuss the issue with them, was neutral and did not have an interest in promoting assisted dying.

Lord Brooke of Alverthorpe Portrait Lord Brooke of Alverthorpe (Lab)
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My intervention will be brief and is addressed to the noble and learned Lord. Does he believe that his amendments will ever be adopted and incorporated into a piece of legislation that will be passed in this Session? If in fact, as we read in many newspapers and in other media, it is unlikely to be adopted, I therefore address a question to my noble friend the Minister: why are we permitting more time to be given to a pointless exercise, when the country can ill afford to be spending money on pursuing legislation that will never be implemented?

Lord Goodman of Wycombe Portrait Lord Goodman of Wycombe (Con)
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My Lords, I have four amendments in this group. Two of them cover ground already explored by other noble Lords, so I will not go over that ground again. We will simply address two of them, Amendments 540A and 862C. I will deal with the latter amendment first. Amendment 862C relates in subject matter to Amendment 459A, which the noble and learned Lord, Lord Falconer, described to noble Lords a few moments ago, and which he tabled in response to the concerns of the Delegated Powers Committee. As others have said, that is very welcome. My amendment seeks to ensure that the regulation-making power in Clause 22 is subject to the affirmative resolution procedure. After all, that is a more exacting procedure, and I would have thought it was appropriate. If the noble and learned Lord thinks it is not, perhaps he would like to explain why when he responds to this debate.

Amendment 540A concerns a matter raised earlier in the debate by the noble Baroness, Lady Cass: training. The impact assessment refers to training for healthcare professionals and sets out three levels: tiers 1, 2 and 3. Tier 1 is

“a 90-minute e-learning module and a 60-minute online interactive session with a facilitator”.

That is the lowest level, and then there is tier 2. Tier 3 is

“an advanced two-day in-person training package, aimed at staff who are likely to lead the VAD service and act as the coordinating doctor”.

I would be grateful if the noble and learned Lord could answer this when he responds: given the importance of the role of the independent advocate, is it not necessary for training to be at the highest level? Would not, say, the tier 3 training set out in the impact assessment be appropriate? If it is not, what other training does he think might be appropriate?