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Lord Layard: My Lords, we have all had many letters on the subject, and the most interesting one that I had directly addressed whether a doctor would be playing God if he implemented the Bill. The writer argued that, quite to the contrary, a doctor is playing God by denying a dying person their desire. That is the basic issue that we have to address. It is why the public opinion surveys of what people want are so relevant. They are not opinion surveys like those on capital punishment that ask what you would like done to other people; they are about what you would like for yourself, and 80 per cent of people want the Bill. The figure is more than 80 per cent of disabled people, and a majority of elderly people, and of Catholics and protestants, which is very relevant. The central issue is whether we should try to give people what they want in this matter.

I would never say that one should automatically allow people what they want, especially if it affects other people, as has been said many times. I would not say that, even for some purely private matters. But this matter is very private, where the dying person knows so much more than anyone else.

Regarding autonomy, I cannot imagine that any defender of this Bill thinks, as some right reverend Prelates have seemed to imply, that autonomy is the only good. No one I know thinks that. I certainly do not think that. But autonomy is pretty important when you have little else left of your life. I would have thought that the autonomy argument ought to appeal particularly to liberal-minded noble Lords on the opposite side of the House. After all, what is this Bill? It is a Bill of deregulation. At the moment there is a ban—but which is extremely irregularly applied. Today, I learnt a very relevant fact about what would happen if, for example, my mother was dying in pain at home, she asked me to buy 60 paracetamol tablets, I bought them, took them home, she took them home and she died. If I was prosecuted I would get a reprimand. It is only in hospital that I could not perform that act of love. Surely, that is an anomaly that requires some type of remedy such as that proposed in the Bill. It would be absurd to label that remedy a "therapeutic option". That is not what we are talking about. We are talking about doing in a regular way what can happen only irregularly at present.
 
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I end with the "slippery slope" argument. I have been told that in the first six months of this year, the "slippery slope" was referred to 120 times in this House in topics ranging from the Charities Bill to the Speakership of the House. Even so, we must take the argument seriously. Put most generally, if the Bill was enacted, would the system become inured to assisted dying in a manner that led to it becoming more common, perhaps through further legislation or other channels? We do have to look at other places where such legislation has been introduced to look for evidence. Has there, in the case of either Oregon of Holland, been any increased trend in assisted dying? And what has been the impact on involuntary euthanasia which happens when doctors hasten the process of death? We have statistics from some countries, but in Holland there is no evidence that that has become more common over time. Incidentally, in Holland involuntary euthanasia of that kind is low compared with other countries for which there is evidence—probably due to the scope for voluntary assisted dying. That makes sense, does it not?

Trust of patients in doctors is higher in Holland than in any of the 11 countries surveyed, including our own. Doctors in seven countries were surveyed and were asked whether they thought that voluntary assisted dying would increase involuntary euthanasia as a result of the "slippery slope" argument. The majority said, "No". So we can let the slippery slope argument slip to where it belongs and return to the basic issue—respect for the wishes of the patient and for the relief of their suffering. If patients wish to receive life-preserving treatment we grant their desire. That is contrary, I assume, to the teachings of many religions, but we grant it. By the same logic, we should, surely, grant those patients' desire for assisted dying. In fact, would we not be playing God if we refused to do that?

8.22 pm

Lord Maginnis of Drumglass: My Lords, I join those who have acknowledged the work done by the noble and learned Lord, Lord Mackay of Clashfern, and his Select Committee and thank them. Understandably the committee has considered the issue without coming to a conclusion but assists us by carefully defining the terms in which we might address the matter.

Unlike some, I have no great regard for euphemisms and believe that it is important to acknowledge that both "assisted suicide" and "euthanasia" are "killing". It cannot be otherwise in so far as both bring lives to a premature end. The Voluntary Euthanasia Society has claimed that a vast majority favour a change in the law. I firmly doubt that. It may be the fashionable thing to say when the question is put in terms of "unbearable pain" or "loss of dignity" associated with incontinence, but those can be superficial and misleading criteria. I have never found euthanasia to be a subject that arises in casual conversation. It is not a matter to which the "vast majority" has ever turned its collective mind. So, in terms of the vast majority, we should be exceedingly cautious.
 
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Perhaps I may deal briefly with the so-called loss of dignity. As one who has been in the presence of death—lingering death, sudden death and, I regret, violent death—I can say that there is inevitably and invariably incontinence. I do not know why the Voluntary Euthanasia Society attempts to persuade us that the indignity of incontinence is a likely motivation for a patient to want to be killed off. Incontinence is a condition often associated with comparatively healthy old age. What would the Voluntary Euthanasia Society propose in that circumstance? None of us came into this world or spent our initial years in a particularly dignified fashion, if that is the criterion by which we make a judgment. So why should we now exaggerate the relevance of that matter in the context of how we leave this world?

I have the greatest admiration for nurses and doctors who work at the coalface and particularly for those who provide palliative care—I shall return to that issue later. Where I have grave reservations is in the area where government would, as we have seen recently, deny women suffering from breast cancer access to a drug that might extend their lives and improve their quality of life because of the cost.

And what does one say about a society that over the past few years has allowed our pension system to become massively underfunded to the tune of billions of pounds? Will that not precipitate even greater loss of dignity in old age than anything that may derive from terminal illness?

I raise those examples because I firmly believe that, should we ever legalise so-called "mercy" killing—I do not see it as such—the pressures on the sick, the elderly and the infirm would obviously be to do with pounds, shillings and pence. I shall not rehearse what I have previously said in your Lordships' House about "socially convenient" abortion, but therein lies an obvious parallel. There, we really should think about what we once legislated for and what we have now.

To those who will cite the legal safeguards that will exist, I must say that most people would be happier if life and death issues were left to those who are bound by the Hippocratic principles that have underpinned people's faith in the medical profession for hundreds of years. The law is too much of a movable feast. We saw that when, for example, Commander Paddick decided that in his area of responsibility some drugs offences would no longer be brought before the courts. Could we have similar varied interpretations in cases of so-called mercy killing? Would the huge cost factor of court appeals militate against litigants and limit recourse to the law? In case anyone suggests that I have a religious prejudice that motivates me to speak today, let me reassure him—I have. It is the same motivation that made me vote against capital punishment in another place—because I was not in a position where I could ever "cast the first stone".

Human rights, democracy, equality and equal opportunity can all be enshrined in legislation, but I was brought up to believe that, however sophisticated, intellectually able or educationally competent one may be, it is arrogant to seek to disturb the established
 
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keystones of civilisation. Parliament, particularly over the past 30 years, has substituted legislation for accepted common decency, compassion, respect for what is right and rejection of what is wrong, and I think we are worse off as a result. I therefore advocate—and I respectfully ask noble Lords to travel with me—that until we fully examine and put in place every palliative care resource that is available, we do not further consider this odious alternative.

Hospice provision is of course partly funded by government but it is the so-called vast majority that provides the voluntary funding that really sustains the system. That indicates to me that the vast majority wants to care for and comfort those who are dying—not to have this nation legalise so-called mercy killings.

Resources that would be required to sustain assisted dying—no one has sought to quantify that figure—should be directed exclusively towards palliative care provision. That is the pragmatic way and it is the morally right way.

8.30 pm

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