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Mr. Edward Leigh (Gainsborough) (Con): As these debates go into their fourth or fifth hour, one sometimes wonders whether there is anything new worth saying and whether such discussion is achieving anything. However, the defining moment of this debate was when the hon. Member for Crosby (Mrs. Curtis-Thomas) spoke. Hers was an emotional speech, but it was powerful precisely because it was delivered from the heart and dealt with her personal experience. It made the fundamental point that needs to be made in this debate.
The right hon. Member for Coatbridge and Chryston (Mr. Clarke) is right to say that the Minister is acting entirely in good faith, and of course I believe that he is. He doubtless does not want to introduce a Bill that countenances euthanasia, but one only had to listen to the hon. Member for Crosby to realise that if this were a genuine free vote and if every Member of Parliament had been present while she was speaking, the Bill would have died at that very moment, and no amount of artificial respiration could have brought it back to life. She made a very simple point. She talked about her mother, who had suffered a massive stroke and did not want to go through that agony again. She made an advance directive, but when the point came, she blinked the message that she wanted to live. That is what concerns us, and it is why so many of us are determined that there should be a substantial debate on this Bill, so that we can deal with the issues.
What matters is not what is in the mind of the Minister, or the fact that this issue has been debated for 15 years; what matters is that the Bill does not spell out what is in the best interests of the patient. It states that its purpose is indeed to serve the patient's "best interests", but the definition given is woefully deficient. It does not include the relief of pain and, most importantly in terms of practical consequences, it fails to define, or to require, the provision of basic care. As my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith) said, the elephant in this debate is the Bland judgment. We cannot ignore it—it is there. If the Bill is to become a worthwhile Act and to carry out the stated will of Parliament, which is that we are opposed to euthanasia, it has to address the fundamental point of the Bland case. Following that case, basic care—the feeding and
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watering of a patient, albeit by tube—was redefined as medical treatment, thereby enabling the said medical treatment to be withheld or withdrawn, quite legally, without consulting the patient.
In fact, the Bill goes much further than the Bland judgment. Such a definition can now be achieved for any treatment without a court order, but according to a decision laid down in the past, in a document known as a living will, although I would call it a "dying" will. There is no point in denying that if the Bill is passed in its current form, it will be perfectly legal—as the hon. Member for Crosby pointed out in simple and powerful terms—for someone to instruct a doctor to starve or to dehydrate their semi-conscious mother to death, provided that she has previously given written consent to the withdrawal or withholding of medical treatment, or provided that she has appointed them as her attorney. That is undeniable. If that person assaults her, they will be arrested. If they get her doctor to pull out her feeding tubes, that will be lawful, if they have this new lasting power of attorney.
Nobody knows what was going on in the mind of Dr. Shipman. Everybody assumes that he was evil, but perhaps he felt that he was assisting elderly people out of their misery. We do not know. But the point remains that it will be legal to do such things.
We are told that the Bill is about enhancing patient autonomy. Really? Can we be sure of that? The underlying principle is the assumption made so often in the modern world: that the hastening of death is almost always in the best interests of a patient, once their quality of life has deteriorated to a certain level. My basic premise is that I do not accept that. Even the Bill's supporters must accept that the contention that we as a society have a right to take such decisions about a human being is debatable. We have to address that issue.
Mention has been made of the Burke judgment and I need not repeat the arguments, but that judgment is there. The High Court judge, Mr. Justice Munby, challenged the guidance of the General Medical Council, which appeared to permit doctors to withdraw treatment—including food and fluid—from mentally incapacitated patients, regardless of their consent. He reminded us that the withdrawal of food and fluid from patients causes
"pain, discomfort and extreme distress".
We know from the personal experiences related to us today that that is entirely true. He also said that the guidance is unlawful under the European convention on human rights. I do not believe that the Minister has told us the whole story. Civil servants and others who assisted him in the Bill's drafting are seriously concerned about that judgment. Indeed, I am told that they are furiously working on a re-hash of the Bill as we speak. Yet we are told that proceedings in Committee must finish by the end of this month. We have to address these arguments.
Revealingly, for supporters of the Bill such as the Voluntary Euthanasia Society, which claims to have a neutral and impartial view and wishes only to give the "choice" of death or life to certain patients, the Bill in its current form does not appear to recognise the validity of "positive" advance directives, as I would want to do. Such directives require the giving of food and fluid with medical assistance. In the words of Shakespeare's
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"Measure For Measure", this, then, is "absolute for death". I believe sincerely that this Bill is part of a culture of death, and that we are on a slippery slope. People are prepared to play God because they believe that it is no longer in the best interests of a particular patient to survive. I passionately believe that that is a hugely dangerous contention. Once we start down that route, where will it stop?
I shall now say something that will be considered very controversial, and people will doubtless disagree with me. There may well have been people working in Germany before the second world war who believed that there were certain mental patients whose quality of life had deteriorated to such an extent that it was humane to put them out of their misery. Everyone in Europe now utterly deplores that programme. In fact, the German people brought that particular programme—though not, unfortunately, others—to a close. Some people sincerely believed that they were entitled to make such moral judgments, but I believe that once we go down the route of creating people—whether we call them attorneys or deputies, which are legal names, meaning nothing to the general public—who are able to make such judgments, we are creating a class of citizen with the power of life and death over us. That is not a path down which we should tread.
Mr. Leigh: I am about to finish.
It is right to say that a fundamental duty should be placed on doctors. There may come a point where it is right and proper not to go piling on more and more medical treatment, but that should never extend to withholding the basic right to life, which is food and fluid. If we pass the Bill in its present form, I believe—despite the assurances of the Minister—that that will become increasingly common. I sincerely hope that we will vote on the Bill and I will personally vote against it.
7.51 pm
Ms Meg Munn (Sheffield, Heeley) (Lab/Co-op): In following the hon. Member for Gainsborough (Mr. Leigh), I want to say that the Bill is enormously important because it seeks to address the issue of capacity. It deals with how we should deal as a society with circumstances where people lack capacity and it is designed to do so better than we have so far.
I welcome the change in name from the Mental Incapacity to the Mental Capacity Bill, which stresses the positive side. The Bill must ensure that where people have capacity, they can make certain decisions, even though they lack the capacity to make other decisions. It is right to address concerns about issues of capacity. Anyone who has ever worked with or looked after people for whom capacity is a concern—either as a permanent feature of the person's abilities in life or where the person's faculties are deteriorating—knows that current legislation is complex and that there are considerable legal uncertainties. It is difficult to ensure that people are acting in the best interests of a person or indeed in a way that conforms to the person's view of how decisions should be made.
The Bill sets out some very important principles that recognise the need to support people who have difficulties relating to their capacity in order to make
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their own decisions whenever they can. One principle is that there must be an assumption of capacity. So often where we have worked with elderly people and those with learning or speech and communication difficulties, the assumption seems to be that they do not have capacity. We see that in our dealing with children and with adults—and we must stop making such assumptions. The Bill begins to pave the way for what my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) described as a change in attitude and a change in the way we work.
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