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Tony Wright: I am grateful to the hon. Gentleman for that intervention. I hope that I have not suggested for a second that such matters are not of concern. Indeed, part of my argument is that because they are of such concern, and such difficult concern, we must handle them appropriately. I am suggesting that certain ways of handling them are not appropriate. Happily, we have not seen a great deal of evidence of that today, but we have seen it in the way that people approach us.
As always on such occasions, our old friend the slippery slope has been cited. We are told that if we take one inch in a certain directioneven if it is the inch that codifies the existing positiondangerous doors will open on an abyss. Indeed, we have just heard from the hon. Member for Gainsborough (Mr. Leigh) that the abyssthe slippery slopeis Nazi Germany. That is not a helpful way to approach a matter that requires complex balancing judgments.
In conclusion, the measure is a codifying one. It provides a framework for decision making on those matters. No doubt, there are issues that the Committee will have to explore further in detail but, as I think my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) pointed out, we should not assume that such decisions are not being taken already. Of course, they are. Doctors and judges are already taking them. What Parliament has to do after 15 years is to get in on the act. What Parliament has to do now is to set the framework, growing from the case law and consolidating the case law, because that is what Parliament is expected to do. Indeed, that is Parliament's role.
Mr. Duncan Smith: Does the hon. Gentleman accept that it is not necessarily Parliament's role to enshrine the existing case law if it believes that to be fundamentally wrong? It is our right to challenge that. It is good of him to mention the slippery slope. Let us forget the slippery slope for a second and stand where we are. Does he believe that it is right that the people whom he talks about are making decisions to withdraw fluid and food from someone? Is that a right decision to take? Does he think that Parliament should enshrine that or deal with it and end it?
As I have said, I believe that Parliament now rightly wants to consolidate a position that has developed through some desperately difficult case law. The time has come for Parliament to bring that together and to provide a secure framework. Not to do that would, frankly, be an abdication on the part of
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Parliament. So the idea that there is a default optiona do-nothing optionis a "Parliament leave the picture" option.
Instead of slippery slopes, I would offer the alternative of gradual gradients. Gradual gradients say that we have to try carefully, intelligently and constructively to put a framework around some extremely complex decision-making issues. That is what Parliament has to do. As the hon. Member for Southport (Dr. Pugh) said, in a sense, it will always be a kind of muddle through a minefield, but at least we ought to muddle through as intelligently, rationally and sensitively as we possibly can, and I believe that that is what the Bill tries to do.
Mr. David Amess (Southend, West) (Con): This has been a wonderful and remarkable debate. That is certainly not how I would describe every debate that I have listened to in the House. What a shame that many of those hon. Members who will come in at 10 o'clock tonight to vote Aye in the Division did not have the privilege of listening to the speech by the hon. Member for Crosby (Mrs. Curtis-Thomas). As my hon. Friend the Member for Gainsborough (Mr. Leigh) said, she articulated from her personal experience why many of us are deeply troubled by the Bill and unable to support it.
The Minister who opened the debate, is a splendid person. I had intended to abstain, but I am afraid that, having listened to his arguments, I have become increasingly worried and I shall now vote against the Bill because I am deeply troubled by it. He mentioned that the Department has been working very closely with the Catholic Church on the issue. Those involved might have thought that they had been working closely with the Catholic Church, but they have not produced the sort of Bill that the Catholics bishops would have wanted.
In the view of the Health Committee, mental health is the Cinderella service in the country. None of us knows when we will be struck down with a mental health problem, and none of us knows when one of our loved ones might be struck down with such a problem. When that happens and we become interested and we cry out for help, the help, sadly, simply is not there. It certainly is not there for many of our young people who, for various reasons, are disturbed and need help. We have poor services in the United Kingdom, and we have inadequate services in Southend. We are short of psychiatrists, and we are desperately short of consultant psychiatrists. For that reason, I had the privilege to chair a conference called "On the Edge", and we have set up a voluntary organisation, Trustlinks, which has produced a mental health directory. A number of hon. Members on both sides of the House touched on advocacy, and it is such a shame and a missed opportunity that the Bill does not address that point.
The Bill will totally destroy protection for mentally incapacitated people by enabling euthanasia by omission through the backdoor, with the withdrawal of
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food and fluid from non-dying patients. It certainly does not take an Einstein to recognise that, if people do not eat and take no fluid, they die, but all of a sudden, that totally necessary activity is described as a treatment. So those hon. Members who have raised their concern about that issue are entirely right.
I believe that we, as a legislature, have a responsibility to protect the most vulnerable members of our society, whether they are permanently or temporarily incapable of making decisions for themselves. We have a duty to protect those individuals' rights. The Bill, however, will not protect their rights. Indeed, it will take away some of their rights.
Following the publication of the draft Mental Incapacity Bill, I had hoped that, given the time spent on it, the final Bill would fully protect the welfare and interests of the most vulnerable people in our society. That is not the case. I admit that there are some improvements, but they certainly do not go far enough. In fact, some of the so-called improvements are misleading.
We have already heard about the case of Tony Blanda victim of the Hillsborough disasterin which doctors were allowed to withdraw treatment, including assistance with food and fluid, which he was given through a tube. What is enshrined in the Bill is the principle underlying the Bland judgment. The judgment allowed Tony Bland to be left to die from dehydration and starvation, which is hardly the impression given by the euthanasia lobby's claims about the case. It changed the definition of treatment; until then, providing food and fluid was defined as basic carewhich is, of course, what it is.
The situation was so controversial that the Law Lords decided in their final judgment that those involved with any further persistent vegetative state cases would have to apply to the High Court before treatment could be withdrawn, so bringing about death. Since that time in 1992, there have, in fact, been very few casesI am advised that there have been about 25 in totaland that indicates the feelings of most families in such situations, given that there are about 1,500 such cases in the country at any one time.
Shortly after the Bland case, Lady Thatcher set up the House of Lords Select Committee on Medical Ethics to consider the whole matter of euthanasia. In its report, it not only came down against euthanasia by commission but opposed the Bland judgment being enshrined in statute law. Like most of us, it saw that that could lead to wide-scale euthanasia by omission.
Both Conservative and Labour parties stated repeatedly that they fully supported the recommendations of the Lords Select Committee and would not support the Bland judgment being enshrined in statute law. Since the Bill was published this summer, the Department for Constitutional Affairs has made a great fanfare of assuring us that the Government have honoured their pledgethe Bill does not enshrine the Bland judgment.
Certainly, in any case in which the family or doctors consider it better to withdraw treatment from a post-vegetative-state patient, an application must be made to the High Court. I agree that that is the case, but that does not apply in cases of Alzheimer's, strokes or many other conditions in which patients become mentally
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incapacitated, for there are two somewhat tricky clauses that together mean that a doctor may withdraw assisted food and fluid from a non-dying patient, and there is only one end for any of us who are deprived of food and fluid, and that is death.
"a diagnostic or other procedure"
and follows the Bland judgment by including assisted food and fluid, so they are considered to be treatment rather than basic care, to which we are all entitled, and could be withdrawn from non-dying patients. The Bland judgment is not enshrined in the Bill, but the whole principle underlying that judgment is absolutely basic to those clauses relating to health care.
Here we come to the next loophole, which is that all decisions must be made, as many hon. Members have said, in a patient's "best interests"but what are those best interests? The Bill gives us yet another catch-all, saying that "best interests" refers to a patient's wishes or, even more dangerously, to what someone else considers those wishes might be. It completely omits any reference to health or life, and neither does it contain any defence to allow for those cases where the person declaring that pulling the plug would be in the patient's best interests might be a beneficiary or have some other self-interest.
The equivalent provision in Scotland is far more sensible in a number of ways, one of which is the definition of a patient's best interests. The Adults with Incapacity (Scotland) Act 2000 is simple and straightforward, defining best interests as the patient's benefit. It is vital that the clause including assisted food and fluid as treatment be amended so that nutrition and hydration continue to be regarded as basic care. I also want a clearer definition of best interests, as in Scotland. That is the only way of safeguarding the interests of patients.
I am seriously disturbed about the dangers of making advance directives legally binding, as they can be ambiguous, quite apart from the danger of the elderly and incapacitated being manipulated into signing away their life. I question the motivation of those so determined on this course, especially as the euthanasia lobby has always regarded such legislation as the first step to gaining euthanasia by commission.
I would like to be able to tell the House that I will support the Bill, but I cannot. Unamended, it would simply be another piece of anti-life legislation and another step down the treacherous path of cheapening life. All of us came into politics because we believe that life is everything. I hope that, although hon. Members voting at 10 o'clock may not have heard the speech of the hon. Member for Crosby, there will be enough colleagues to tell them what she said and try to persuade them not to enter the Aye Lobby.
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