Terminally Ill Adults (End of Life) Bill Debate
Full Debate: Read Full DebateLord Goodman of Wycombe
Main Page: Lord Goodman of Wycombe (Conservative - Life peer)Department Debates - View all Lord Goodman of Wycombe's debates with the Department of Health and Social Care
(2 weeks, 1 day ago)
Lords Chamber
Baroness Cass (CB)
I want to make two very brief points. First, I support the point made about proposed new subsection (6)(g), to be inserted by Amendment 115, by the noble Viscount, Lord Colville, on being clear about whether this is a medical treatment. If it is a medical treatment, it drives physicians continuously to ask people whether they would wish to receive assisted dying.
The issue is not just in Canada. A very close friend of mine recently died in the Netherlands. She was so persistently asked whether she wanted to consider euthanasia there that she chose to die in a Jewish hospice—the one place where they would not persistently ask her that question because they do not carry out euthanasia in that particular hospice.
I would like to make another, more broad point about Amendment 115, which I strongly support. We have frequently had Chris Whitty’s opinion cited on the utility of the Mental Capacity Act because of familiarity. I would say one thing about that. We were incredibly lucky to have Chris Whitty as CMO during the pandemic—cometh the man, cometh the moment—as we had an epidemiologist in post. But he is a specialist in that area. A friend of mine who is a forensic pathologist specialised in freshwater drowning, but once he got into the witness box he was fair game for any pathology question and was asked about the appropriate temperature at which bloodstains might be washed out of clothes. Having very little familiarity with that, he said, “Well, according to my wife”, causing the defence council to jump up and say that he could not say that because it was hearsay. My point is that, if you asked me who I was going to trust on the issue of capacity—an epidemiologist or my noble friend here, who has practised all her life in psychiatry—the choice for me would be very clear.
Lord Goodman of Wycombe (Con)
My Lords, I will speak to my Amendment 113, which concerns a matter that has not previously been raised in the context of mental capacity, or I suspect my amendment would have been grouped earlier; it is about codes of practice. To explain it, I ask any noble Lord interested to turn to Clause 39(2) of the Bill, where they will find what it has to say about codes of practice, which is this:
“The Secretary of State may issue one or more codes of practice in connection with any matters relating to the operation of this Act not required under subsection (1) as the Secretary of State considers appropriate”.
It is a very broad provision concerning any codes of practice that might arise as a consequence of the Bill.
The Delegated Powers Committee, on which I sit, was very critical of this provision, and said the following:
“It may be that clause 39(2) is intended to be a ‘sweep up’ power in case the subject matter covered by the duty in clause 39(1) has missed something. However, such a wide power, with the potential to affect the extent of the legal risk incurred by those carrying out functions in a highly sensitive area of professional practice, should not be conferred as a ‘nice to have’ and requires a compelling justification … The subject matter of codes of practice should be set out on the face of the Bill to the degree necessary for Parliament to understand the subject matter and who might be affected and we therefore recommend that the power in clause 39(2) is removed from the Bill”.
My amendment does not go quite so far as the committee report suggested, but it does say that any code of practice issued under the Mental Capacity Act should not be issued unless
“a draft of the code has been laid by a Minister … before both Houses of Parliament, having engaged in public consultation, and … that the draft has been approved by a resolution of each House of Parliament”.
I therefore ask the sponsor of the Bill, in responding to this amendment, to be as helpful to the Committee today as he indicated he would be when he gave evidence on all matters, except approved substances, to which we will return in due course. I see that he is nodding, and I look forward to his response.
My Lords, I am hoping that I am going to help the noble and learned Lord, Lord Falconer, and I am sure he will be pleased with that help. We have been discussing some fundamental issues of interest to the people who are going to have to carry this Bill through. Therefore, I recommend three very simple things to the noble and learned Lord.
First, the sooner we know what the noble and learned Lord’s amendments are going to be, the very much better it will be. It would allow some of us to help—certainly not me, but the experts—to make sure they are adequate. Secondly, I support the noble and learned Baroness, Lady Butler-Sloss, in her demand that we should know as much as possible in advance. Thirdly—and the gravamen of my points—if you talk to people outside, many of them have no idea about the details of the Bill and have a general view either in favour or against it. However, when you talk to people who have some real understanding of the Bill, the issues which concern them most are those where they feel there is not adequate clarity, especially for the medics and others who are going to be involved.
This debate has been different, if I may say to the noble and learned Lord, from previous debates on this area. It has concentrated on the lack of clarity around what we really mean by competence. We have made the distinction between the competence that is satisfactory to make important but immediate decisions that can be reversed and the competence necessary to make fundamental decisions, where a person needs a longer-term ability.
It therefore seems to me that it would be advantageous to the noble and learned Lord’s whole cause if he could take this very seriously. If he can find a proper answer, which satisfies the sensible things that have been said, it will go very much further—this is a rather delicate sentence, which I hope the noble and learned Lord will not take amiss—to repair the impression that every amendment is shoved off. These are not amendments to treat with anything but the very greatest of care.
Lord Goodman of Wycombe (Con)
I apologise to the noble and learned Lord if he has already answered the question about my amendment. I would be grateful if he would clarify his view of Amendment 113 in relation to the code.
If that is a reference to whether there should be the affirmative rather than the negative procedure, may I take it away? That seems a reasonable request. May I get back to the Committee on that?