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Lord Patten: My Lords, I have four main points to make. First, if a Bill such as the one proposed by the noble Lord, Lord Joffe, were to pass into law, in future years it would come to be viewed as an event rather like the discovery of nuclear power when used for weapons of mass destruction, or the passage of legislation that made abortion possible. In other words, we are in the foothills of one of history's possible "no turning back" moments, if we proceed down the route that the noble Lord wishes to take.
Your Lordships will well remember the arguments when the Abortion Bill 1967, known as the Steel Bill, was first debated in another placethat it would affect very few people, that there would be very strict conditions, and so on. The exact opposite has turned out to be the case, with more than 5 million deaths of pre-born children since 1967. So, too, the arguments in Holland and Oregon over euthanasia and assisted dying have run. Once the laws have been passed, contrary to the stated aims of those legislators when the legislation was debated, the recognised duration of terminal illness has been unofficially extended, according to evidence of which I have been made aware. New reasons, such as dependency or isolation, have been introduced and then accepted as reasons for legitimately offering people the opportunity to hasten their own death.
The problem with the Bill proposed by the noble Lord, Lord Joffe, as the noble Baroness, Lady Finlay, reminded me on a previous occasion, is that it assumes that if strict conditions are prescribed, they will be followed in practice. Good law-making cannot assume that people will behave according to the prescription of the rubric of the law so that the vulnerable will be protected. As the organisation RADAR put it succinctly in its briefing for this debate:
That brings me to my second point. The proposals in this Bill are not only concerned with private morality or utilitarian matters but are matters for the wider community. A positive choice sometimes has to be made in favour of protecting the interests of our most vulnerable members, even if that means limiting the freedom of others to determine our end. As your Lordships know, I am one of the simpler sorts of Peer; I make no claim to be a philosopher, although I am broadminded enough to have had philosophers among my circle of friends in the past and at present. We all know that, beat the thickets of philosophy well and hard, and it can be guaranteed that out will pop some hedgerow philosopher, willing to grease any slippery slope that your Lordships care to name. However, I have yet to find one philosopherif they are present, perhaps they will stand up; I would be happy to give
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waywho does not recognise that the exercise of personal autonomy always has to be limited, if only to some extent, to enable us to live together in reasonable harmony.
Lord Patten: My Lords, I think that His Holiness Pope Benedict rather makes the right point when he warns against the dictatorship of relativism. I warn the noble Lord, Lord Joffe, that he may be mistaken if he tries to corral those who do not care for his Bill as being just a few religious persons and the leadership of the Churches. I have one very close friendI wish that I had asked his permission to quote him todaywho I can describe only as a High Church atheist, so passionate is his disbelief in God, who feels exactly the same as many people who do not care for the Bill of the noble Lord, Lord Joffe.
That brings me to my third point, which is the need not to destroy our trust in the medical profession, for patient autonomy can oh so quickly give way to medical and to state power. I trust my medical advisers, at least at present. I think that they will never harm me and that they will do their best, although, of course, everyone is fallible and mistakes can be made. However, that trust comes about not because of my belief that doctors have some superior moral quality but because of their tradition of doing no harm, held by those of faith and of no faith. In the face of that, and with great respect to the Select Committee, I would have wished that the committee, which quite properly considered the conscientious objections of doctors and nurses, had addressed the conscientious objections of patients and the rights of patients to know about the attitudes of their doctors. That is an oversight. Should the Bill of the noble Lord, Lord Joffe, reach the statute book in some form, we would de facto have to make provision for patients who wished to know what kind of doctor was going to treat them: a doctor who cared to preserve life and a doctor who, in shorthandor in "headline terms", to borrow the excellent phrase of the noble Baroness, Lady Jaywas really a "vet" doctor prepared to take part in the end of life. There would need to be separate training, and separate registers of the two classes of doctors would have to be made public. The Select Committee might have usefully considered a little more the pragmatic and conscientious feelings of patients themselves as well as those of doctors.
Fourthly, should a Bill like that of the noble Lord, Lord Joffe, ever see the light of the statute book, it surely cries out for a sunset clause after five years, or whenever. If there was ever such a case, it is this Bill.
Finally, I admire no one more than the long-running Minister who will reply to the debate at about midnight. I have a couple of questions for him, as I have sensed a certain amount of news management in
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the air from sources quite close to sources that are close to government saying that, should a Bill like that of the noble Lord, Lord Joffe, come forward, the Government are minded to give it government time. I should like the Minister to say specifically what the Government's intentions are in this matter. I am hopeful that he will answer that question. If his answer is that the Government intend to give the Bill time, I ask him and his colleagues to pause, first, because I think that it would cause amazement among the public that a government led by this particular Prime Minister should go down that route and, secondlyI hasten to add that I myself make no accusations in this regardthat it will raise fears among many that extending government time for this Bill means that the Government wish to save money on the National Health Service in future months and years if it becomes law. I do not know that that is the case and I am not suggesting that it is, but those arguments will run. The Minister can set those arguments to lie now or later in his winding-up speech, if he wishes.
Lord Russell-Johnston: My Lords, my views are not the same as those of the noble Lord, Lord Patten. The substance of the argument was made in the debate on 6 June 2003, to which I made a brief contribution. I do not believe that that substance has been diluted by the Select Committee report, which was so well and so fairly chaired by the noble and learned Lord, Lord Mackay of Clashfern. In the short time that I have, I shall inform the House about a debate on a report on this subject held in the Parliamentary Assembly of the Council of Europe on 27 April. I shall use the words of others to express my opinion.
The Council of Europe report was presented by a Swiss called Dick Marty. It did not recommend euthanasia, but recommended that in all member states a debate should be opened to consider how best to approach a very real, deep problem, which at the moment in most countries is unregulated or covered up. The rapporteur said that he was especially pleased that his report was supported by the international committee of nursing staff in the European Union.
"There are many arguments to support Mr Marty's report and recommendations. Evidence-based scientific studies prove that euthanasia and other end-of-life decisions are practised in many, if not all, countries. In The Lancet, a study of the position in six European countries confirms that doctors' assistance to patients at the end of life is practised in all of them, including those where it is currently illegal. One of the study's most important conclusions is that a natural dying process occurs in only one third of all death cases. The proportion of deaths that were preceded by medical end-of-life decisions ranged between 23 per cent in Italy to 51 per cent in Switzerland. A scientific study in Australia shows the same picture as Europe".
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