| Previous Section | Index | Home Page |
Mr. Miller: My hon. Friend speaks in terms of the patient, but in the context of prosecutions under the Bill, the patient would usually be dead. New clause 17 provides that no person should publish any material, but does my hon. Friend agree that the dead person's relatives might, in some circumstances, have the right to overrule that?
Yvette Cooper: The new clause raises complex questions that run both ways. It is not just a case of saying that it is a good thing and should be supported. My greatest concern is patient confidentiality, and although, as my hon. Friend points out, in most such cases the patient will have died, the General Medical Council takes the view that the ethical duty of confidence survives the patient.
We can all imagine a situation in which someone has chosen not to tell relatives or friends about their illness. For example, someone with HIV may choose not to tell relatives about his or her condition. Many patients feel that such information is highly sensitive, and that is their choice. If proceedings were brought under the Bill as it stands, the details of a patient's illness could be broadcast for the world to know, and we should be sensitive to the consequences that that could have for the patient's relatives.
Mr. Miller: My hon. Friend may have missed my point. In the awful case that was publicised last week, the relatives discovered what was written on the records. If the patient had died, surely it would have been legitimate for the family to have published that evidence.
Yvette Cooper: That is a material consideration for the House. I take my hon. Friend's point seriously, but it needs to be weighed against the other issues surrounding patient confidentiality. There is no simple answer, and new clause 17 does not resolve the issues satisfactorily.
Dr. Liam Fox (Woodspring): Will the Minister outline the Government's attitude to new clause 17(1)(b)? That deals with
- any defendant or witness in proceedings under this Act.
Yvette Cooper: The application of new clause 17 to other cases would raise considerable questions, and the Government cannot recommend supporting it. Although it raises important questions that should be considered, and highlights troubling consequences of the Bill, we are worried about some of its broader effects.
New clause 17 is intended to deal with matters of privacy, and appears to be based on a clause in the Law Commission's draft Bill on mental incapacity, which grew out of anxiety about the need to protect the privacy of any person involved in proceedings in which it was alleged that decision-making capacity was lacking. That proposal would have achieved protection by making it an offence to publish identifying information about a person involved in incapacity proceedings. The new clause mentions a range of public media, such as television and radio, but it does not cover publication on the internet.
That is not surprising, given that the Law Commission prepared its draft Bill in 1995, when the internet was in its infancy and relatively few people had access to it in their homes. That has since changed, and the omission of the internet from the new clause is a clear loophole. However, the House will be aware of the extreme difficulty of regulating publications on the internet.
The Government consider that the new clauses raise important issues of clarification. Some are helpful, but others raise more problems than they resolve.
Mr. Trend: Will the Government continue to think about the new clauses? The 96 hon. Members who appeared in the Lobby with the Bill's proponents just now show how great is the groundswell in the country in support of the Bill. The considerable correspondence that Members of Parliament receive from constituents shows how anxious people are about their relationship with doctors and about what doctors, as professionals, do to them.
Will the Government continue to think about whether it is acceptable for doctors to kill patients by starvation? That is at the heart of the Bill.
Yvette Cooper: Certainly the Bill has raised important and weighty matters, and the Government will continue to consider them. The hon. Gentleman raises matters to do with the Bland case. They were subject to widespread public consultation relatively recently in connection with the paper entitled "Who Decides?". As a result of the strongly held views expressed in that consultation, the Government decided not to put the Bland judgment, which is in case law, on the statute book. These matters must be the subject of continued consideration, but I can tell the hon. Gentleman that the Government remain completely opposed to euthanasia.
1 pm
Rev. Martin Smyth (Belfast, South): I appreciate the Minister giving way on that point. She touched on the ambiguity that has developed. One of the Law Lords,
Lord Mustill, said that the decision had left the law morally and intellectually misshapen because it prohibits medical killing by an act but allows it by omission. I appreciate the Minister saying that the Government are still considering this. I hope that they will close the loophole without allowing the medical profession to move towards assisted suicide.
Yvette Cooper: I have tried to make it clear that judgments in such cases must and do depend on the best interests of the patient and that it is unlawful for doctors who have a duty of care to withdraw or withhold available treatment from a patient when it is in their best interests, if that patient has not already refused that treatment.
Dr. Harris: I have been listening to the Minister's comments with great interest and I agree with much of what she says. Does she accept that the Government's reluctance or delay in introducing legislation on these issues runs the risk--perhaps unintentionally--of laying the medical profession open to some pretty dire accusations in the tabloid press and by those campaigning about life issues, when without statute law the medical profession has to work according to its own guidelines, having regard to case law? However, the medical profession is left somewhat exposed and it is really for legislators to take responsibility for the legal position of doctors in respect of difficult end-of-life issues.
Yvette Cooper: The Government have made it clear that they accept existing case law on these issues and that, in respect of questions surrounding the Bland judgment, strong views are held on both sides. As a result, the Government have decided that it is not appropriate to legislate at this time.
Dr. Brand: Does the Minister not agree, however, that it would be far preferable if guidelines--even if we do not go as far as legislating--came from the Department of Health, having been discussed widely, rather than from the BMA or the RCN?
Yvette Cooper: It is important to recognise that, ultimately, we are dealing with clinical decisions. The BMA and the RCN have consulted widely on the guidelines. There is an important principle about clinical decisions, but I accept that we need to keep these issues under consideration as they are extremely important.
Mr. Gerrard: The hon. Member for Isle of Wight (Dr. Brand) has raised an important point. Those of us who are unhappy with the Bill do not necessarily believe that the law is in a satisfactory state, or that it is adequate to have guidelines from a medical association rather than clarity in the law. I hope that the Department of Health will continue to examine these issues as it is in everyone's interests that we achieve clarity in the law. Some of us have difficulty with the Bill because it fails to attain such clarity.
Yvette Cooper: Hon. Members are making important points. I can reassure them that I shall continue to consider the issues that have been raised.
Dr. Iddon: My hon. Friend said that the BMA had consulted widely on the guidelines. If she was referring
to withholding or withdrawing life-prolonging medical treatment, I wonder whether she is aware that a substantial number of doctors do not feel that they have been adequately consulted. Is she also aware that the legality of those guidelines have been questioned during a debate in the Scottish Parliament?
Yvette Cooper: I said that the Government accept current case law. In addition to the guidelines, existing case law refers to omissions as well as acts. So it is not simply a matter of having only guidelines and an absence of legal position in this area.
Mr. Jim Cunningham (Coventry, South): Can my hon. Friend give an indication of the time scale for the Government's consideration of amendments and additions to the law? When exactly might that happen? Can she give us a date?
Yvette Cooper: No, I cannot provide a time scale or any guidance on that question. All I can say is that important issues have been raised, the Government take them seriously, and we shall continue to consider them across Government, as we have done for many years.
Mr. Leigh: Does the Minister realise that the same point is now being made by those on both sides of the argument and both sides of the House? If the Government's view is what I believe it to be--that it is all right for a doctor to end a life by omission rather than commission--it is only fair that the Government stop hiding behind the Law Lords; that legislation is introduced and time allowed for it; and that the House is allowed a free vote. Only by proceeding on that democratic basis can we come to a proper conclusion.
| Next Section
| Index | Home Page |