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Mr. Leigh : On a point of order, Mr. Speaker. We are listening to an interesting speech, but we have less than 12 minutes to hear from the Minister. Can we get on to the Minister's speech as quickly as possible?
Sir Gerald Kaufman: I apologise to the hon. Member for Gainsborough (Mr. Leigh); I was not looking at the clock and I did not note when the debate was due to end. However, the hon. Gentleman is right that it is essential to hear from the Minister before reaching a decision. I shall therefore sit down, but I hope that the Government take account of the fact that people feel very uneasy at this stage of the debate.
The Parliamentary Under-Secretary of State for Constitutional Affairs (Mr. David Lammy): When we considered the Bill on Report, concerns were expressed about attorneys and deputies and people who would seek to harm those at the end of their lives. Along with my noble Friend the Lord Chancellor, I undertook to continue dialogue with the Catholic Church and specifically Archbishop Peter Smith. Much has been said in his name tonight and I want to assure hon. Members that amendment No. 4, which proposes a new subsection (5) to clause 4, goes to the heart of the points that he made. He was quoted in Committee in the other place on 25 January 2005 and also said in a letter to my hon. Friend the Member for Heywood and Middleton (Jim Dobbin) that proposed new subsection (5),
"makes it explicit that the Bill does not give authority to doctors, proxies or other third parties considering a patient's best interests to make any decision that is motivated by a desire to kill the person."
Mr. Lammy: In a moment. The concerns that have been expressed in the debate today relate not to the best interests aspect of the Bill but to advance decisions. That is all that is left for the House to determine. We should remember that it is possible to make an advance decision nowthat fact was lost in some parts of the discussion. An advance decision does not mean electing for suicide. The Government stand firm on suicide and have continually made that clear. We did that in relation to clause 58 and best interests and in the context of advance decisions.
Let me finish. One can make an advance decision now. The House has to decide whether to vote for the additional safeguards on advance decisions for which the Bill provides or to retain the current position, with no safeguards. Let me list those safeguards because it is important to set them out. First, importantly, under
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this Bill, if a doctor is not satisfied, he can decide that he will not accept the advance decision as valid and applicable. We therefore either vote to give the doctor that right, or we leave it, and doctors will not have that security.
Helen Jones (Warrington, North) (Lab): I am listening carefully to what my hon. Friend has said, and I accept his view that this Bill has been much improved in the House of Lords. Will he address, however, the issue raised by my hon. Friend the Member for Heywood and Middleton (Jim Dobbin) in relation to ensuring that we prevent advance directives containing suicidal intentions from being carried out? If, as the Minister said, that is the Government's intentionI accept his honest view on thatwhat is wrong with accepting the amendment tabled by my hon. Friend the Member for Heywood and Middleton?
"But this amendment still leaves a major gap. It does not cover advance decisions. The clauses dealing with advance decisions, although tightened up, still leave open the possibility that an expressly suicidal advance decision is binding".
Mr. Lammy: As I was saying, doctors cannot now be forced to accept advance decisions, because, under the Bill, if they are not satisfied, they do not have to do so. On the point raised by my hon. Friend the Member for Warrington, North (Helen Jones), the Bill states specifically that someone must have capacity and be able to weigh information. Someone who is suicidally motivated cannot legally do those things
Mr. Cash: It is indeed. The Minister has just been referring to issues that he claims have been raised by the Archbishop of Cardiff, which is not the case. He is using that as evidence against a professor of law
In addition, there are provisions under clauses 25(5) and (6) of the Bill in relation to the person who elects to have an advance decision. Let us be clear that the Government are not saying that people must have an advance decision; we are accepting that there are those in our community who want to make advance decisions and refuse certain types of treatment. We are accepting that Jehovah's Witnesses, Christian Scientists and all sorts of people want to make that decision. That is why the Bill is supported by the Alzheimer's Society, Age Concern, Mencap and the mental health community, who have written to all Members of the House to argue for the Bill. They have said that it is necessary.
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Mr. Duncan Smith: I realise that we are short of time. Let me make sure that the Minister clearly understands the amendment tabled by the hon. Member for Heywood and Middleton (Jim Dobbin). If the Minister says that the Government's determination and intention is that advance decisions should not represent suicidal intentions, all that he has to do is amend the provision as follows:
Mr. Lammy: I would have thought that that was patently obvious. The reason is that that would force people to stay and die in hospital[Interruption.] It would mean that people cannot elect to die at home. That would be the consequence
Mr. Lammy: There will always be a difficult balance between personal autonomythe person's right to say, "No, thanks, not for me"and having the right safeguards governing that, to allow doctors to say, "I am not satisfied", and to ensure that someone has all their mental faculties and is capable of making their decision.
On all those counts, while the law makes it clear that we do not support assisted suicideMembers will remember the Diane Pretty case, which went to the European Court of Human Rights and was effectively thrown outI urge Members who are concerned about advance decisions and would not choose to make such decisions themselves, but who want to ensure that safeguards exist, to vote for the Bill. They will be ensuring that doctors can make the decision, and that it is in writing that people can make an advance decision only when they are capacitated. On that basis, I commend a Bill for which we have waited 15 years, and for which outside organisations are campaigning.
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