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Lord Alton of Liverpool: My Lords, before my noble friend sits down, would he address the point he made about the number of assisted suicides in Oregon? He said that the figure has remained steady over the period of seven years, when in fact the latest report issued on 10 March this year by the Department of Human Services in Oregon includes a graph indicating that there has been an increase of over 200 per cent over the period.
Lord Griffiths of Burry Port: My Lords, the hour is late, and I am number 64 in the batting order. We have heard legal, moral, medical, philosophical and theological views put forward. At this stage perhaps it may be of some consolation that another angle may be opened up, for the line of argument that I want to put to noble Lords is pastoral. I am a Methodist minister; that is my day job. I come to this place to hear the distilled wisdom of your Lordships speaking in such debates. My angle of view allows me to be with people in suffering, from their first reported symptoms right through to after the death and bereavement. That is a long period of contact with those going through the critical stages that we have been discussing today.
It is of course a privilege to be present in homes in very private conditions where people other than immediate family are not normally welcome. In homes
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and in hospitals I have been able to join the loved ones of the dying of all ages, including children. For a number of years I was chaplain at the Middlesex University Hospital after the opening of the new ward to treat adolescents with cancer. So I have seen my fair share of deathbeds, and I have wrestled very hard with some of the questions that have arisen from them.
We were told earlier in the debate that human conditions required human solutions. Nothing about the fact that I believe in God protects me from feeling very human and vulnerable at some of the moments I can think of. I have looked at the sufferer, with pain and agony sometimes, and my only wish for that person has been that they would go now. I think of the carers and the anguish written into their faces. I have wanted for them only that they be released from what, in my view as an observer, is clearly a huge burden. Then there is my plea to God himself that if he had the power he would do something to switch the machine off now and relieve us all from the squalid drama going on in front of our eyes. Oh yes, I have had plenty of moments like that, but they do not prevail, and that is not what it is all about. When it is all over, I have engaged with families in an analysis of what has happened. There is the grief first of all; there is the anger; and, supremely, there is the guilt. How often have I heard the question, "Did we do all we could? Were our thoughts unworthy when we wanted him to die?". You cannot put the clock back then, of course.
I do not want to raise the weasel words of the debate, as I might define them, of "autonomy", "sanctity of life" and "slippery slopes", which have meant different things to different people as the debate has unfolded, but there have been things in the course of the debate that have struck me with great force. The phrase of the noble Lord, Lord Brennan, that the legislation would represent a change of ethos was a strong phrase. The reference to the need for an improvement in and an extension of the provision of palliative care has been a resounding theme repeated again and again. I shall not forget the story told by the noble Baroness, Lady Finlay, at the beginning of the debate about the young man who met all the criteria that would have made an assisted suicide very appropriate in the circumstances but who went on to other outcomes of a radically different nature and who now remains the lone parent, years later, looking after the family.
From the welter of documentation that I and all other noble Lords have received I pick out a paragraph from the midst of the neutrality of the Royal College of Physicians, which has come out with some fairly startling facts for us to consider. It states:
"It will be evident from the foregoing that the management of the dying patient, and, more specifically a clear understanding of the issues surrounding the request for assisted dying, both require a high level of competence in making the complex diagnoses. Anyone involved in the assisted dying process should have received rigorous training in how to discuss these issues with patients and with their supporters; in the legal framework of assisted dying; in the appropriate methods of assisting patients to die; and in the context and settings in which this should take place".
It is the enshrining of difficult cases in the framework of law that worries me greatly. Assisted dying is what it is all about. I want to assist people in dying by adding value to their last moments; by showing solidarity with them in their last days; and by surrounding them with care and love so that in a context of reciprocity and support they can die with the dignity that they deserve. It is not only by framing a law and helping to foreshorten people's lives that you achieve that outcome.
Lord Northbourne: My Lords, I had not intended to speak in the debate, but when I read the excellent report produced by the noble and learned Lord, Lord Mackay, and his team I realised that there seemed to be something lacking.
The report places very strong emphasis, on the one hand, on the sanctity of human life and, on the other hand, on the right to personal autonomy. The lack of emphasis that surprised me in the committee's report arises from the fact that, although there is a lot about the suffering of terminally ill people and about the dilemmas that would face doctors if law along the lines of the Bill were ever enacted, there is next to nothing about the families of those who might end their life through assisted suicide or euthanasia, especially very close relationsthe spouses, the children and, in some cases, alas, the parents. Those issues have been mentioned in the debate in one way or another by the noble Baroness, Lady Flather, the noble Lords, Lord Lucas, Lord Turnberg and Lord Elton, and the noble and right reverend Lord, Lord Carey of Clifton.
The Bill seems to regard people who want medical assistance to end their life as being a world in their own right. There is no requirement in the Bill to consult or even to notify the family of someone planning to take their life in that way. Clause 9 contains a requirement that the attending physician should recommend to the applicant that he or she or his or her next of kin should be notified, but he or she is not obliged to do so. I understand the need for patient confidentiality, and I understand the need for a sense of autonomy, but human beings are, with minor exceptions, social animals. We each rely and depend on our friends, nursing staff or, if we are reasonably lucky, the love and care of our family or those members of our family who are still alive to care for us.
There is an issue of trust in that family and that group. I suggest that, if the Bill is to return to the House, rather more care and thought should be given to the effect on families of taking the decision. That can operate in either wayI am not arguing in favour of the Bill or against it. More consideration should be given to the role that the family playsthe trust, the love and the support that it offers people, especially those suffering from a terminal illness and all the stresses and problems that that involves.
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Lord Hylton: My Lords, the debate has ebbed and flowed. I rise as a layman, who will die one day, to help voice the opposition, in the House and in the country, to the former Bill of the noble Lord, Lord Joffe. I have had letters from all over the country, all of them against the Bill.
Soft words such as "euthanasia" or "assisted dying" tend to destroy the trust between patients and their doctors and nurses. Suicide is not a crime, but why should the medical profession be expected to provide it on request? What is to happen to the old who can no longer make a request and to sick children who cannot yet speak? Physicians no longer, it seems, take the Hippocratic oath, but after the Shipman case and other examples of negligence or malpractice, trust is quite fragile. I do not want to face the spectre of Dr Death.
Doctors themselves are far from happy. My noble friend Lord Alton has already detailed the current state of opinion in the medical profession, so I need not cover that again. This Bill or its successor could have pernicious, unforeseen consequences. Some patients would seek compliant doctors who may know nothing about them beyond the mere facts stated on their case notes; and others would try to find doctors who would let them live out their natural span. We would also hear more about cost-effectiveness and bed-blocking.
The evidence from countries where therapeutic killing is legal is far from reassuring. We have heard something about that tonight. In the Netherlands, Belgium and Oregon, it is clear that safeguards prove ineffective; guidelines are not always observed; and there is under-reporting of actual cases. The Lancet, a reputable journal, has examined illegal infant euthanasia in Flanders. Given that background, let us uphold the sacredness of life for people of all ages. Let us not be beguiled by false notions of utility or, on the other hand, by excessive compassion, but support the best palliative care as given in hospices. Such care should be made available throughout the National Health Service.
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