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Baroness Flather: My Lords, in spite of the dismissive way in which my noble friend Lady Knight spoke of dogs, cats and horses, I submit that in this country we adore our pets and give them the best care possible, we tolerate our children and are not that bothered about older people. The culture I come from is not quite the same. Older people are respected and cared for by the younger people, children are ever with
 
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the family and pets take a very low position. In this country, we spend money on pets and take advice from vets. If we want to keep a pet alive against a vet's wishes, we are told that we are being selfish. Yet we do not want to allow a person who can ask for help to have it. We do not want a person who is capable of making his or her wishes known to be allowed to do so. I find that very strange indeed.

We have heard a lot about the Netherlands. Different people have spoken about different things. I worked with a very good friend from the Netherlands who in the very early 1990s told me that her father was very ill. When I said "You will have to go and see him frequently", she said that she had met with her sisters and brothers and that they had decided that their father should have an early termination of life. In the Netherlands, euthanasia was practised before the law legalising it existed. When the law was introduced in 2001, it was not the first time euthanasia was used. I am sure that my noble friend Lord McColl will talk about his experiences in the Netherlands when we served on the committee chaired by the noble Lord, Lord Walton of Detchant.

The situation in the Netherlands is very strange: they were practising general euthanasia, not voluntary euthanasia, long before any law came into being. They are now moving back towards regularising the position. That is a fact. I heard it from my friend and noble Lords will hear more about it in a while.

It is interesting to hear from people of deep faith. It is not possible for anybody who has a deep-seated faith to acknowledge or accept that any patient should be helped to die by a family member or doctor. It is clear that if you believe in God, how and when you go must be God's will.

I was a little surprised by the comments of the most reverend primate the Archbishop of Canterbury in the Telegraph yesterday that we were sleepwalking towards a breaking of trust between doctor and patient. I did not think that we were sleepwalking. Given the number of debates that we have had on the subject and the wonderful report that has been produced, I would not call it sleepwalking. Our eyes are wide open; some of us feel one way and some feel another way, but we are not sleepwalking. Nobody should be in any doubt that we have considered this matter personally and deeply.

I was very much taken with Win and Jan Crew, whom I met at one of the meetings of the noble Lord, Lord Joffe. They took Mr Crew to Switzerland to die. It was absolutely amazing to see those two women, and how when you love someone, you would do that for them—but you cannot do it in this country. Having heard the speech of the noble Lord, Lord Puttnam, I do not think it can be moral to let somebody die by millimetres—I do not want to go into inches—and use the double effect. I find double effect to be hypocrisy, whether others do or not.

This is a very personal issue. Each of us should try and put ourselves in that position and ask how we would feel and what we would want. We cannot speak for anyone other than ourselves, but many people in
 
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this country want some provision. Social legislation does not come out of the ether; it follows public demand. I congratulate the noble Lord, Lord Joffe, on being so persistent. It is very difficult to take on something as controversial as euthanasia.

I do not think that assisted suicide is the way forward. Assisted suicide should be available if one wants it but it should also be possible to have voluntary euthanasia. As the noble Baroness, Lady Finlay, said, it can take 30 hours for a person to die after taking pills. Unless a magic pill is produced, we need voluntary euthanasia in this country.

Lord Cavendish of Furness: My Lords, before my noble friend sits down, and for the purpose of clarity, will she confirm whether, in the example she gave, it was the Dutch family who were going to decide the fate of the father?

Baroness Flather: Yes, my Lords.

Lord Cavendish of Furness: I am much obliged, my Lords.

Baroness Flather: My Lords, I was trying to show that we are not in the same situation as the Netherlands—it is completely different. The Dutch have been practising non-voluntary euthanasia for a long time.

7.29 pm

Baroness Masham of Ilton: My Lords, this mammoth debate shows the interest that there is in this very complex matter. It is obvious that the committee, under the chairmanship of the noble and learned Lord, Lord Mackay of Clashfern, worked very hard to produce this report.

Everyone should have the right to refuse life-prolonging treatment if they so wish, but I cannot support the belief that terminally ill people should have the right to medical assistance to die—pain relief, yes, but not killing. It would be impossible to ensure that any safeguards were not abused, and I agree that the law should not be changed to permit killing, whatever the motive.

As a disabled person with a long-term, permanent condition, and also having a husband who now has multiple, complicated illnesses, I rely on advice from specialist doctors. Above everything, I want to be able to trust them, in the hope that they will preserve life and not give up and kill us.

I am glad that the General Medical Council wrote to the committee to say that a change in the law to allow physician-assisted dying would have profound implications for the role and responsibilities of doctors and their relationship with patients. If the Bill has done anything useful, it has highlighted the need for good palliative care for all who need it.

Many people to whom I have spoken, or who have written to me, have said that it is sad that the BMA's decision appears to leave the medical profession in the position of washing its hands of the clinical
 
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responsibilities for preserving life. Naturally, it is understood that there will be cases where some medical support has been applied to prolong life where easing pain might have been more appropriate. The use of painkillers with the intention of easing suffering would be considered morally acceptable by all, even where this may have the unintentional effect of accelerating death. Is it not the action of giving treatment with the intention of accelerating death that is not acceptable to many people? Such a change in the law to permit euthanasia would be a step over a moral boundary irrevocably with long-term consequences which cannot be foreseen.

I shall quote Jane Campbell, who is a disability rights commissioner. Jane is severely disabled, but works hard. She says:

"The impetus behind calls for assisted dying is fear. People find severely disabled people so difficult they want to pity or tidy them away. They see facilitating death as an ultimate act of pity. No wonder people who fear death see euthanasia as a possible escape. Before considering assisting people to die, should society not assist them to live?"

I hope that all your Lordships have seen and read the open letter from the British faith communities expressing grave concern at continuing and renewed efforts to legislate for euthanasia. I thank all the faith leaders who have signed the letter and I associate myself with their concern that vulnerable people—the elderly, lonely, sick or distressed—would feel pressure, whether real or imagined, to request early death. The so-called right to die would inexorably become the duty to die. Economic pressures and convenience would potentially come to dominate decision-making.

I was reminded the other day that I had once officially opened a GP surgery/health centre in South Yorkshire and that Dr Shipman had worked there. The way in which he killed innocent, trusting patients and got away with it for so long shows the power that doctors have. If we legislate, will we not be opening the door to all sorts of dangerous people instead of protecting the vulnerable?

7.35 pm

Baroness Tonge: My Lords, I became a supporter of assisted dying for the terminally ill after 30 years of medical practice and eight years as international development spokesman for my party. I may not have as much experience of the dying as the noble Baroness, Lady Finlay, who spoke very eloquently earlier, but I have to say to her that I know the various clauses in the Hippocratic Oath and I notice that many of them have now been dropped. Medicine changes; for instance, Hippocrates urged us not to cut for stone. If we were not doing that nowadays, many people would suffer agonies from renal stones and gallstones. Medicine changes and we must change with it and look at things differently as different treatments become available.

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