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Mr. Leigh: If it is true that the Bill errs on the side of life, does the hon. Gentleman agree that there would thus be absolutely no harm in accepting the amendment tabled by the hon. Member for Heywood and Middleton (Jim Dobbin), because that would mean that the Bill would say that an advance directive could not be used to lead to a situation in which a person would not be given life-sustaining treatment in the form of fluid or another substance? Why not put that provision in the Bill? Surely the hon. Member for Sutton and Cheam (Mr. Burstow) accepts that.

Mr. Burstow: I shall listen carefully to what the Minister says in response to that amendment—

Mr. Ronnie Campbell (Blyth Valley) (Lab): How will you vote on it?

Mr. Burstow: Surely listening carefully to an argument and then coming to a conclusion is what we should be doing in this place. That is what free votes are all about, and a free vote is what my party is having on this matter. I shall listen to the Minister's response to the reasoned and reasonable arguments made by the hon. Member for Heywood and Middleton. My concern is that the way in which the amendment is formulated sows the seeds of confusion where there is currently no confusion in law. That is why I am not convinced that the amendment should be supported and currently I do not intend to support it. I shall listen to what the Minister has to say. That is not an unreasonable position to adopt.

Sir Gerald Kaufman (Manchester, Gorton) (Lab): The hon. Gentleman says, and in my view it cannot be disputed, that if, say, a Jehovah's Witness—a sentient person—refuses a blood transfusion, that is a conscious
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act by a sentient person and it is perhaps equivalent to suicide. However, we are not dealing with suicide as such. We are dealing with what happens if a Jehovah's Witness refuses a blood transfusion for his or her child, which is a very different matter from an adult sentient person refusing medical treatment out of conviction.

Mr. Burstow: As I understand the legislation, that would not be possible in those circumstances. I hope that the Minister will confirm that.

The amendments tabled by the right hon. Member for Chingford and Woodford Green are well intentioned and I understand them entirely, but clause 4(5) deals with the matter in a way that enables us not to confuse English law. By using the word "purpose", we would inadvertently put into law a provision that could have the effect of criminalising an act that we all want to happen—that is, the act of giving palliative care and providing assistance and pain relief at the end of life. The amendments might make that unlawful.

The Bill contains so much that is good and important about a person's quality of life and their right to lead their life as they choose that it should make its way on to the statute book today. However, I hope that the Minister can respond to the many concerns that have been aired during this short debate.

Mr. George Howarth : I wish to cover two matters: the issue raised by my hon. Friend the Member for Heywood and Middleton (Jim Dobbin), and the assertion made by my hon. Friend the Member for Crosby (Mrs. Curtis-Thomas). If I misrepresent my hon. Friend's views, I am happy to be corrected by her, but the burden of her argument seemed to be that it is always, in every circumstance, in a patient's best interest to receive food and hydration. I think that that was her point.

Mrs. Curtis-Thomas: No. I do not wish to imply that every person, irrespective of their state, should receive food and fluid, only that people who are living with a condition should do so. When someone begins to die and food and fluid become burdensome, they should be withdrawn. However, if the person is not dying and has no other threatening condition, but needs only food and fluid to survive, that person should receive food and fluid.

Mr. Howarth: I am grateful to my hon. Friend for that clarification, but I think that that formulation would lead to enormous confusion. At some point, someone has to decide when the provision of food and fluid is in a person's best interest and when it is not. My other problem with that argument is that, having listened to medical evidence, like many other hon. Members, I am aware that the pain and suffering of patients with certain conditions can be aggravated by hydration in particular.

The second point that I wanted to make is in response to an issue raised by my hon. Friend the Member for Heywood and Middleton—that clause 61 does not apply in cases where there is an advance directive. That is not my reading of the position now that the Bill has been amended by the House of Lords. I do not know where my hon. Friend is getting his advice from, but I suspect that he is wrong in this instance. I should be
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grateful if the Minister could confirm that my interpretation of the position—that clause 61 would override the circumstances that my hon. Friend describes—is right, or whether my hon. Friend is right.

Secondly, does the Minister accept the burden of the argument of my hon. Friend the Member for Crosby about food and water? Would there be circumstances where people would feel it absolutely necessary to go ahead with feeding or hydrating people through tubes even though it would not necessarily be in their best interests?

Sir Gerald Kaufman : We recognise that these are agonising issues. Recent events in the United States, which we have seen on television, have shown just how agonising these issues are. They are not simple issues, but there is a simple issue behind what some of us seek to achieve, which is to prevent legislation that would allow euthanasia by the back door. That is what has motivated my approach to the Bill from the beginning.

I am baffled by the way in which the Government have handled the Bill from the beginning of its passage through Parliament. If I am fortunate enough to be re-elected in four weeks' time, I shall have sat in the House a few weeks after that for 35 years. Never have I known a Government handle a Bill of this sort in this way. To begin with, no Bill that I have been involved in, dealing with issues of this kind, has been whipped. It has been a tradition of my party—I am not interested in how the other parties conduct themselves—that on issues of conscience such as capital punishment, gay rights or abortion, we are not whipped.

I pleaded with the Government, both at meetings of the parliamentary Labour party and at private meetings with the Chief Whip, not to whip us on this Bill. It is still beyond my understanding why we are being whipped. It is totally beyond me. Yet we are proceeding with the Bill and with the aspects with which the right hon. Member for Chingford and Woodford Green (Mr. Duncan Smith) is dealing in his amendments, on the basis of an extraordinary preoccupation that it is vital, in the dying stages of this Parliament, with only a few days left, that this piece of legislation survives.

This is not a Labour Bill—it did not originate within the Labour party. It is not a manifesto commitment. The Bill originated 16 years ago under the previous Conservative Government as an omission by the Law Commission. For some reason, it has now surfaced as a piece of legislation that a Labour Government, working hard to get themselves re-elected for an historic third term, believe is essential and should receive Royal Assent.

8 pm

Mr. Kevin Barron (Rother Valley) (Lab): Besides the issue of the Whip, is not the answer that people outside the House who have worked with people with mental incapacity for the past decade or more have been waiting for legislation of this breadth to come along, to give those people the rights that society has denied them for far too long?

Sir Gerald Kaufman: I accept every word that my right hon. Friend says when he refers to the breadth of the legislation. Every one of us has received letters this week
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from esteemed charities saying that they want the Bill to become law, and I am not arguing with my right hon. Friend about that. However, he rightly suggests that this is a matter of conscience. This ought not to be a matter of contention between political parties; it should be a matter of honest and respected disagreement between right hon. and hon. Members of the House.

Mr. Barron: If the Bill were about putting euthanasia on to the statute book, is it not the case that we would have a free vote on it?

Sir Gerald Kaufman: That depends on how we interpret it. The fact is that, when the Bill came before the House of Commons last December, and when we were dealing with the very issues on which the right hon. Member for Chingford and Woodford Green has tabled his amendment, the Government were so concerned that it should not be defeated that we got the exhibition of correspondence between the Secretary of State for Constitutional Affairs and the Archbishop of Cardiff being circulated among Labour Back Benchers—something else that I have not seen before in my 35 years in the House. I have never known anything like that to happen on an issue of conscience. What that told us was that the Government had accepted, very belatedly, that this was an issue of conscience. In order to seek to assuage the consciences of a considerable number of Labour Members, they circulated that correspondence. That day, the Prime Minister is said to have been on the telephone to the Cardinal Archbishop in an effort to get an agreement with him that would persuade right hon. and hon. Members on this side of the House.

I do not want the Bill to fall, but I recognise the concerns that are being expressed. Many of us have personal experience of these matters. I had a sister who died after having suffered from Alzheimer's disease for many years. I have an elder brother who does not know me when I go to see him; he, too, is suffering from Alzheimer's. My sister's son and my brother's daughter are loving children. Fine, but we cannot assume that, in a situation relating to the amendment that we are now considering, my nephew and niece would be typical. That is why we have sought the safeguards that we are debating this evening.

I accept that improvements have been made to the Bill in the House of Lords. That cannot be denied. After all, the right hon. Member for Chingford and Woodford Green is tabling an amendment to a Lords amendment. If we compare the Bill with the one that left the House of Commons in December, there is no doubt that it has been improved. However, it still contains this loophole, which causes a twinge of agony to many of us who understand the circumstances in which these decisions might well be made. That is why what my hon. Friends the Members for Heywood and Middleton (Jim Dobbin) and for Knowsley, North and Sefton, East (Mr. Howarth) are saying is important. They are disputing a matter of ethics that impinges on the very nature of human life. What I want to hear from the Minister is either that the contents of the letter from the Archbishop of Cardiff to my right hon. and learned Friend the Lord Chancellor have been effected to the Archbishop's satisfaction, or a clear and specific assurance that will assuage hon. Members' consciences
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because we are considering a clause and an amendment about conscience. We are considering human life and the deepest single issue that relates to human beings.

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