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Baroness Knight of Collingtree: My Lords, I, too, begin with a tribute to the Select Committee, which did a difficult job extremely well, but there can be no doubt of the validity of the comments of the National Council for Palliative Care in its responses to the report. It says that much more evidence should be sought and lists eight crucial areas that have not been properly examined. Even one of those eight could be enough to stop the Bill in its tracks.
Euthanasia seems quite cosy and humane when it is first suggested: "Let's stop suffering. Let's get doctors to help us out of this vale of tears when things get rough. We put down dogs, cats and horses. Why not humans?". Humans are not dogs, cats or horses. Doctors are not killers. Suffering can be ended without ending life. In Oregon, where euthanasia is legal, palliative care is now regarded as unnecessary. What
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about that for a slippery slope? Apparently, in Oregon, they do not bother to make palliative care available at all—because killing is.
The more evidence that one receives and the more thought that one gives to the actuality of euthanasia, the more one turns against it. Certainly, legalising it puts elderly and helpless people at terrible risk. They know that, which is why so many of them are afraid of what our conclusions may be. Some people say that doctors already kill and have done so for years. Where is the firm evidence? Surely we can all agree that there is no more grave matter than bringing about the death of a human being. Hearsay evidence is not enough when deciding whether, how or in what circumstances killing should be allowed. Not nearly enough is known about palliative care, the extent to which suffering can be contained or how advances in medical techniques and expertise are changing and improving life for sick people all the time. Surely, it is far better to recognise and encourage research into all of that, rather than to forget it and kill people, as is happening in Oregon.
There has been no attempt to answer fears that the Bill could lead to the widespread killing of people who have neither asked nor wanted to be killed. The evidence from Holland shows another slippery slope that has been slipped on well and truly. Surely, no one can say that it has been in a good direction. Doctors in Holland openly admit that legalising euthanasia has led to the killing every year of 1,000 people who never asked to be killed. That may save money, it may empty hospital beds and it may get rid of troublesome people, but, unless Harold Shipman was right, it is wrong. No wonder more than 10,000 people in Holland now carry cards in their wallets saying, "Do not kill me".
Something else is very sinister in the Dutch law, and we have not heard about it yet: it permits children aged between 12 and 17 to ask for euthanasia and to get it. That cannot be either ethical or logical. As many of your Lordships surely know from experience, teenagers are often plunged into moods of black depression by the most trivial things: a football team loses, a love affair goes wrong or an exam is looming. "I just want to die!", they wail. To take them at their word is wicked. To allow such children to be legally killed when they have their whole life ahead and have no experience of how wonderful life can be and no understanding that all disasters end is wrong. They are often immature, emotional and sad little souls who need love, care, help and hope—not death.
We should look more closely at how legalised euthanasia is working elsewhere: at the many examples of the dangerous slippery slope that it opens up; at the denial of human rights that it involves and the terrible fears that it heralds. Nowhere in either the report or the Bill can I find any surety that we could avoid the experience that other countries have faced before us.
Finally, I worry that doctors who fundamentally objected to killing their patients would be forced to do so or would have to leave the profession if the Bill were passed. The Select Committee worried about that too. How could such doctors be protected? In this country, we have huge numbers of Muslim, Hindu, Christian
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and other doctors whose faith directs them only to cure. We could not staff either GP surgeries or the hospital service without them. How can we pass a law that would give patients the right to a procedure that so many doctors object to carrying out, while giving doctors the right not to carry out that procedure? Will we have official lists of doctors who will kill and those who will not? Oh, please not.
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Viscount Craigavon: My Lords, I strongly support this prospective Bill and warmly congratulate the noble and learned Lord the chairman and his committee on producing such a report, one that enables those who want to do so to understand all sides of the present debate. The report and, in particular, its volumes of evidence, make up a valuable and readable account of where this evolving debate has reached. The changes it highlights since the 1994 Lords report on medical ethics are stark.
I shall touch on just a few aspects that seem important to me. Various opinion polls have been quoted and put into context, but I should like to emphasise the very recent Daily Telegraph YouGov poll which showed what was called huge popular backing for legislation for assisted suicide. Some 87 per cent of those questioned agreed with the statement that people who are terminally ill,
"should have the right to decide when they want to die and to ask for medical assistance to help them".
That is a trend and direction in public opinion which should be taken into account even if the exact figure might not be accepted. Reading it in the Telegraph makes it even more persuasive.
We should be grateful that the various royal colleges and societies seem to be moving from a monolithic view to reflect the fact that in practice their members tend to be significantly divided. In my opinion, there is no loss or shame in that. We should welcome this relatively new attitude taken by these various organisations which, in necessarily different ways, have allowed themselves to be much more neutral in this debate. Reading their oral evidence is almost essential in order to understand the rationale and nuances of their position, although I realise that not all the colleges have changed and that they all have slightly different remits.
As has been mentioned, one of the key concepts influencing this is "patient autonomy". The Select Committee report provides throughout a great amount of detail on how in practice this is balanced in making decisions. I hope that anyone trying to relegate the importance placed on patient autonomy in this context will first at least have read the extensive evidence in the report. Indeed, the speech of the right reverend Prelate the Bishop of St Albans sought to set up what was almost a straw man in order to knock him down, while the speech of the right reverend Prelate the Bishop of Oxford was a slightly more sophisticated version of the same. At the very least, patient autonomy should allow for some form of feedback
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from the patient. I was under the impression from both the right reverend Prelates that whatever the patient said would not be taken into account because they had a better and more authoritative idea of what would be good for him.
We have been told that the recent remarkable BMA decision and vote was completely within its rules. As has been said, the BMA's decision is,
"not to oppose legislation which alters the criminal law, but should press for robust safeguards for patients and doctors who do not wish to be involved in such procedures".
Whatever pleadings are made about the figures of the vote, it is a remarkable change of attitude.
I realise that the different organisations collect and report on the views of their members in different ways. I read the oral evidence of the Royal College of Nursing, to which the noble Baroness, Lady Thomas, also referred when making a similar point. Some members of the committee asked the representatives to justify why they were reporting as official policy their "collective" and what were called "themed" views against the thrust of the Bill when it was held to be known that a significant proportion of their members might not agree with that position. I understand that my noble friend Lord Joffe, despite being given assurances of further information and figures from the RCN about the basis of its claimed "themed" position, has still received nothing. One can only guess that this is the way it chooses to show so-called "leadership" to its members.
Another, alternative voice on this subject in the report comes from a nurse. It is set out on page 95 in Volume III. The nurse, the elected chair of the RCN Ethics Forum Steering Committee, submits a most reasoned submission; one made, as she rightly has to say, in her personal capacity. She states that she believes that,
"the submissions received during the RCN's formal consultation process were overwhelmingly in favour of changing the law".
In the first sentence of her conclusion she states her belief that:
Whatever the percentages on either side, I believe that the present RCN approach is counterproductive.
Finally, perhaps I may point out a slight paradox. We are told by opponents of this Bill that the uptake of what might be available is likely to be on a considerable scale. Given that the nearest parallel will probably be the Oregon system, if I may use rather round figures, it is remarkable that out of around 30,000 deaths a year in Oregon, about 60 people are given the prescriptions they request and only 40 actually use them. On such a scale, that is not likely to cause a major change or upset in our attitude to death. The significant proportion of people who ask for the option but then do not use it points to the additional benefit for an even larger number who have the reassurance that a "back-up" system is there and is available to be called upon if they need it. That is a recognised phenomenon and was described very well by the noble Earl, Lord Arran.
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When my noble friend Lord Joffe brings back his revised Bill, I strongly hope that this House will follow the recommendation made in the committee's report that it should have a formal Second Reading before going before a Committee of the Whole House, where I sincerely hope that we can have a rational and considered debate on the details of the Bill.
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