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12.52 pm

Mr. Tony McWalter (Hemel Hempstead): Many hon. Members have prefaced their speeches by stating their general ethical framework, and I shall do the same. My ethical position on the issue is not overtly a Christian or religious one, but is derived from the ideas of Immanuel Kant. Although that tradition has strong connections to the Christian tradition--what I like to think of as the best elements of the Protestant tradition--and the ideas in the tradition command wide agreement in our society, whether people realise it or not, the tradition does not overtly raise the theological issues that some hon. Members have raised today. The tradition will be germane to some of the conclusions that I draw.

I should like to focus on the Bill's implications for the doctrine of double effect. Before doing so, however, like other hon. Members, I offer a testimonial to the hon. Member for Congleton (Mrs. Winterton): she, like other hon. Members, has raised an issue that has precipitated a very considerable correspondence from my constituents.

Many of my elderly constituents are particularly frightened by a variety of matters. They are certainly frightened that, if the Medical Treatment (Prevention of Euthanasia) Bill were thrown out, euthanasia might not be long in coming. To the extent that there is an issue that needs to be addressed, we as politicians are failing to provide many of our citizens with the type of reassurances that they need about their lives and how they are valued. Equally, the hon. Member for Congleton has identified some aspects of the law that are deeply troubling.

Much of the debate has been around whether people should be denied access to sustenance, and we heard a graphic portrayal of the terrible death that can often ensue. The hon. Lady is right to have raised that issue, so there is some sense in the Bill being considered in Committee. Having said that, however, clause 1--its defining clause--includes the word "or" four times. I am grateful to my hon. Friend the Member for North-East Derbyshire (Mr. Barnes) for pointing out that that means that the Bill contains not one proposition, but 16.

The debate has focused on the withdrawal of sustenance by any person responsible for the care of a patient if his purpose is to hasten the death of the patient. That is one of the 16 propositions in the Bill. What about the other 15? Another proposition in this incredibly complex clause is as follows:

That is a very different proposal.

My hon. Friend the Member for Hull, North (Mr. McNamara), who is no longer in his place, said that the purpose of medical treatment was to cater for the best interests of the patients. That principle should be etched into medical practice. Other hon. Members have said that the primary purpose of medical treatment is often to alleviate pain. However, if the primary purpose of treatment is to alleviate pain, but in doing so it hastens the death of the patient, it could be demonstrated that one

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of its purposes was to hasten the death of the patient. So there are major discrepancies between the intention of the Bill and its wording.

We are all drawing on our own case histories--often on the suffering of our own families. I had an uncle--a philosophical farmer--who influenced me a great deal. He was a gentle, kind man who got cancer of the spine. He was taken to a hospital in Dublin where the doctrine of double effect was not particularly well regarded. In Dublin in the 1960s many people took the view that a person suffering mortal torture would get some time off from purgatory and that the only reason God could let anyone suffer was that it was part of his plan. Their attitude to death has been described several times today: "God will take you when it is your time, although he offers human beings the opportunity to alleviate pain." In my uncle's case, the hospital did not countenance any dose of morphine that might shorten his life, even by the smallest amount.

I heard the terrible description of what it is like to die of hunger and thirst. The hon. Member for Congleton rightly addressed that issue, and I have paid tribute to her. However, my uncle weighed under four stone when that medical neglect finally reached its tortured and terrible conclusion.

The doctrine of double effect, which my hon. Friend the Member for Bolton, South-East (Dr. Iddon) was drawing into question, is in part a doctrine which embodies compassion and respect--a key theme in the Kantian ethic--and enjoins each and every one of us to show not merely respect for one another, but reverence. To treat somebody as if they must be denied, on some technical grounds, the kind of care and support that we all owe one another and which we owe our elderly constituents is wrong; it is morally wrong.

Among other aspects of the debate, we have heard from the hon. Member for Congleton that it is up to patients to decline treatment. I can say that I do not want that striving "officiously to keep alive"--I can say no. We have heard cases of someone having cancer and needing kidney dialysis. I can say no to the dialysis until I am unconscious. However, the doctor then has a slight problem. He is not allowed to withhold medical treatment from me if that would hasten or cause my death. If he decides that withholding dialysis would hasten or cause my death, he is guilty, under the Bill, of murder. As a result, having finally got to the stage where I am no longer able to decline treatment, the Bill now enjoins the doctor to take over. It obliges him legally to do so.

Mrs. Ann Winterton: No.

Mr. McWalter: The hon. Lady says no, but much of the debate is about whether people's views should be treated with respect or not. I completely agree with my hon. Friend the Member for Bradford, West (Mr. Singh) about the absolute necessity of avoiding involuntary or non-voluntary euthanasia. However, if my view about my life is that I do not want to be on a life-support machine for 16 years even if a miracle is going to happen--no thank you, I do not want to do that to my family and those I love--others may have a right to say that also.

We have all seen the horror films in which people are conscious and their eyes are open, but people think that they are dead. We have all lived in that horror film and,

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from my correspondence, I can see that some of my elderly constituents are living in it. Those late-night films reach their summit when the coffin is opened and the person has been scratching at the lid because they were alive when buried.

We have to make judgments about probabilities. In practice, if I am asked to weigh up the probability of wanting to avoid being a tremendous encumbrance on those I love for many years, or escaping from the coma after 15 years, it is up to me to take the former option. In practice, if people decline treatment, very often that is overridden because of Bills such as this.

My card from the Voluntary Euthanasia Society declines treatment. Now I do not want to die, and I certainly do not want to be put down if I have good prospects, but I want people to accept that the enormous medical effort involved in treating brain-dead people would be inappropriate for me. That does not mean that it would be inappropriate for anyone else: other people can do what they like, but I believe that I have freedom of choice in the matter, and I want other people to respect what I consider to be best when it comes to my life.

However, if my elderly constituents feel uneasy at that, we must acknowledge that unease. We cannot allow people to believe that what I want today will be forced on them tomorrow. That would be the creeping euthanasia that was mentioned earlier. If people are worried about that, we must change the legal framework. People must not be left utterly disconcerted by a patchwork of case law that does not embody clear ethical principles or respect for people's views.

Equally, I do not want doctors, such as those who were too frightened to treat my uncle properly, to risk being arraigned for murder. It is reasonable for the BMA to be worried about the sloppy, 16-fold complexity that is clause 1.

In the end, the debate comes down to the most sombre subject of all--death. We all face our own personal death, and we are discussing the conditions in which other people will decide--or not--that we are near our time, at our time or, possibly, beyond our time. We must address the problem from the perspective that death is part of life, that there is such a thing as a good death, and that one can die loved, cherished, respected and revered. Everyone has a right to such a death, and no one has a right to countermand anyone else's view on a matter that is so near to us all, and so delicate.

In Committee, we must try and ensure that the genuine compassion evident in the Bill is gilded with sufficient logic that the law that eventuates from the process retains a reverence for people, and expresses that reverence more clearly than hitherto.

Mr. Ashton: On a point of order, Mr. Deputy Speaker. I seek your advice about the composition of the Standing Committee. So far, some nine hon. Members have spoken in favour of the Bill, and two have spoken against it. However, I think that at least four or five other hon. Members want to speak against the Bill.

Will the Standing Committee scrutinising the Bill reflect the total number of speakers today, or will it take into account those hon. Members who oppose the Bill but who did not get the opportunity to speak?

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