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Dr. Brand: Having listened to the right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell), and various points that have been made, I am persuaded that the Bill needs to go into Committee.
Mr. Singh: I rise to speak primarily because of my beliefs on the subject. However, I also wish to reflect the concerns of my constituents and the Christian, Jewish and Muslim organisations which have made their views known to me. Euthanasia is the intentional killing of a patient by act or by omission as part of their medical treatment when the patient's life is felt to be not worth living. I do not think that anybody should have the right to decide that a patient's life is not worth living.
In this country, thankfully, euthanasia is illegal, and that is the way it should remain, even though, with the Bland judgment, we now have a back-door method of euthanasia by withdrawing food and fluid. The problem in changing a principled stance on euthanasia or the law on euthanasia is that once we draw a new line, it can be redrawn time and time again. It may at first be a case of people in a coma, but it will not finish there. Who will be the next to be added to the list, and the next, and the next? Once we draw a line, it can be redrawn according to the politics and society of the day.
Dr. Tonge:
I should like to turn the hon. Gentleman's argument on its head. With the advance of medical science, we can prolong life almost indefinitely, and in the future it will be indefinitely. Does the hon. Gentleman not think that that, too, is interfering with God's will, and that we should consider those issues?
Mr. Singh:
I am not talking about God's will. I believe that as human beings, our brain produces the technology to master some of the things that have always happened in nature, and to improve our lives by doing so. Letting nature take its course is a dangerous argument. The Spartans, for example, used to put their babies at the bottom of a mountain and let nature take its course so that the weak were killed and the strong survived.
Dr. Brand:
It is clear that hon. Members on both sides of the House go in for hyperbole. We all understand that care should always be there for the individual patient, so I do not think that the Spartan argument quite stands up.
Mr. Singh:
The hon. Gentleman is probably right.
Euthanasia is illegal in this country, but let us have a look at a country where euthanasia is permitted--Holland. My description of what is happening there will show the House that there is a slippery slope.
Mr. Blunt:
On the definition of terms, euthanasia is not allowed in Holland--voluntary euthanasia is legal in
Mr. Singh:
I thank the hon. Gentleman for that clarification, but as I continue, he may hear some facts to make him reconsider whether euthanasia in Holland is voluntary or not.
Mrs. Ann Winterton:
I am sure that the hon. Gentleman recalls that in 1990, of the 3,000 cases of euthanasia in Holland, 1,000 involved patients who had not expressed any wish to be killed in that way. There is a slippery slope. It is well documented in Holland, and counters the point of my hon. Friend the Member for Reigate (Mr. Blunt).
Mr. Singh:
The hon. Lady anticipates some of the points that I was going to make. My figures show that in Holland in 1990, patients had not given their consent in 1,000 cases of euthanasia. There were 2,700 cases of euthanasia or assisted suicide, and in a further 7,000 cases, there was an act of omission by the doctor with the explicit intention of shortening life. In another 15,800 cases, that was the partial intention. According to the magazine "Faith in the Family", the situation in Holland is out of control. In 1990, 20 per cent. of all deaths were the result of euthanasia, in which the doctor's intention was--at least in part--to shorten life.
I am sure that the House will agree that those figures are horrific. They are eye-opening. We do not need a vision of where we might end up with euthanasia; the practical reality is on the other side of the channel. If we reflect on that, we must decide that Great Britain does not want to go down that road.
As has been explained, the Bill was drawn up as a result of the judgment in the Bland case, in which the House of Lords decided that artificial feeding and hydration could legally be withdrawn and that such withdrawal constituted an omission, not a positive act. I respect the eminent Law Lords, but if one withdraws something from someone, that too is an act. However, I accept that the Bill refers to an omission and that we should use that word.
The BMA guidelines, issued in June last year, were also a factor in the introduction of the Bill. They stated that food and fluids constituted medical treatment.
Dr. Harris:
The hon. Gentleman might find that, if he considers those guidelines carefully, they point out that the Law Lords in the Bland case ruled that artificial giving of food and fluids counts as medical treatment, whether it be intravenous or through a gastrostomy tube, surgically placed during an operation under general anaesthetic.
Mr. Singh:
I accept that. My point is that, with those guidelines, the BMA is encouraging a wider group of doctors to view food and fluids as medical treatment. That is a dangerous path to take.
The publishing of those guidelines has led many people to fear--whether their fears are real or not--that in this country there is a creeping euthanasia culture. The Bill would put a stop to that. It is both timely and necessary. If euthanasia were introduced as an answer to difficult and extreme clinical problems, there would be a strong economic temptation to save resources and time by
bringing life to an end sooner rather than later. I am sure that that temptation would arise. If I may revert to new Labour parlance, that would present a huge risk to the many in an attempt to provide an answer for the few.
The Bill will not prevent doctors from ceasing tubal hydration and feeding when its provision has become too burdensome for the patient. However, it will prevent doctors from intentionally bringing about the death of their patients by actions that they take or omit to take. The problem of omission is the loophole that resulted from the Bland judgment; the Bill will close that loophole. The Bill will make it an offence for a doctor to withdraw or withhold from patients treatment or sustenance, if one of his or her purposes is to hasten or cause the death of the patient.
Care for the vulnerable, the elderly and the terminally ill should never be about cost or convenience-- it should be about dignity, proper palliative care and better standards of care. We should be very wary of the argument that euthanasia is a compassionate act or a mercy killing.
I received some information today: in cases where hydration has been withdrawn, it takes 16 days for the person to die. Is that compassionate or merciful? I think not. If it is so compassionate and merciful, why is it that in Holland elderly people carry passports for life, to avoid euthanasia if they happen to end up in hospital? That does not sound very compassionate to me.
Mention was made of Happi, a woman in New Mexico. We read about her in the newspapers, under headlines such as "Coma wife wakes after 16 years". She went into a coma after complications in childbirth. She was in a catatonic state, unable to eat, speak or move, and was kept alive on a life support machine. Sixteen years later, she awoke. Very soon after, she was able to swallow food, move a little on her own and talk.
What would have happened to that woman in the United Kingdom? Would she have been denied the right to life when it eventually came? I think that, given the Bland judgment, she would have been executed by the withdrawal of medical treatment or nutrition and hydration.
Dr. Harris:
The hon. Gentleman should be careful. I am not aware of the details of that case, but "persistent vegetative state" is tightly defined and it does not involve patients who are mechanically ventilated on a life support machine, as the hon. Gentleman suggested that that person was. It is very dangerous to take an anecdotal case from the world's press and say that that has implications. In contrast, judges in cases such as Bland, where there is no statute law, have made their judgments based on the global evidence and specific definitions.
Mr. Singh:
I thank the hon. Gentleman for that intervention. My argument is that doctors do not always get it right; in fact, in very many cases they get it wrong. I do not want them taking decisions about people's lives.
Dr. Tonge:
Will the hon. Gentleman give way?
Mr. Singh:
I am concluding my speech. I have given way numerous times.
Rev. Ian Paisley (North Antrim):
Much has been said in the debate, but I shall be the first to congratulate the hon. Member for Congleton (Mrs. Winterton), who brought the Bill before the House. We are again indebted to her for her eagle eye and defence of principles that some of us believe in and really want maintained for the benefit of all people in this country.
I of course approach this subject as a Christian, but I am glad to say that those of other denominations, of no denomination or of other religions are agreed on the matter. It is good that there is wide agreement on it.
I believe that the vulnerable, the elderly and terminally ill require more, not less care; more, not less respect; more, not less support; and that they do not deserve killing. I want to make that very clear today. Killing is not the answer. The answer is more care, more respect and more support.
The hon. Member for Glasgow, Kelvin (Mr. Galloway) mentioned some of the undertones of what is called "mercy killing." As he said, there is pressure to free hospital resources and pressure from the greed of the beneficiaries who want to inherit.
My colleague, the hon. Member for Belfast, South (Rev. Martin Smyth), spoke about his experience as a minister of the gospel. I have been 52 years in the pastorate and I am alarmed at the rush to get elderly people out of hospitals and out of real care. I salute the work of the hospices. Without the hospices, I do not know what many elderly people would do. The hospices believe that we should call for more care, not for less, and they refuse to accept the pressure that is placed on hospitals. They offer the elderly what they richly deserve. Any country can be judged on how it treats its children and its elderly. This country will certainly be judged according to that principle.
I am alarmed at the attitude of the BMA. It has persistently sought to widen the grounds for the withdrawal of treatment. If people have no confidence in their doctors when they are ill or severely ill, a shadow is left over them that they are not able to bear along with the physical trials that they face. The BMA wants to use the pressures as a loophole to widen the opportunity for what it would call "mercy killing".
The Government's response to the "Who Decides" consultation paper was entitled "Making Decisions", and I regret it. The withdrawal of treatment should not be a matter for a court of protection. The fundamental issue is the right to live and no court should be allowed to make the decision for me or anyone else. That is an important principle.
Far be it from me to praise anything from Europe, but the right to life is a principle of the European convention on human rights. There is some advantage to being in Europe and putting one's view at various times and in various places.
I shall be brief, and I am sure that the House will be glad of that. The Bill will prevent doctors from intentionally being able to kill their patients. I was alarmed by some of the things said from the Liberal Democrats' Front Bench by the hon. Member for Isle of Wight (Dr. Brand), and I think that the county would be alarmed, too.
The Bill follows the Bland case in which a patient was permitted to starve to death. That loophole must be plugged. The Bill is about people, not abstractions. Death
is not the answer to medical problems and need. Medicine should be about life, not about affirming the principles of how people can die and die quickly.
The Bill is about the many, not the few. Only a few people are concerned about pushing the case against the Bill. We should seek cures not cuts and, if the Bill receives a fair wind, it will provide a signal to the whole country that a large section of our community is not prepared to sit idly by and allow mercy killing to continue.
I recently read a study on the issue, which said:
"More than half of all the patients retained consciousness until shortly before death. Basic interventions to maintain patients' comfort were often not provided: oral hygiene was often poor, thirst remained unquenched and little assistance was given to encourage eating. Contact between nurses and the dying patients was minimal; distancing and isolation of patients by most medical and nursing staff was evident; this isolation increased as death approached."
That is not a good way to have patients die, and it is something that we should all be alarmed about.
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