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Baroness Jay of Paddington: My Lords, I congratulate the noble Lord, Lord Joffe, on introducing once again a very important Bill on a fundamentally important issue. As a member of the Select Committee and, indeed, of the Select Committee in your Lordships' House of 10 years ago, I am very pleased that he has now decided to follow the experience of the state of Oregon in its Death with Dignity Act. Those of us who had a chance to visit Oregon and to look at its procedures on the ground were impressed by what we saw.

Until now I think we have followed an exemplary parliamentary procedure on this complex question. The original Private Member's Bill was considered in a very extensive Second Reading. A special committee of the House was then appointed. It took vast amounts of evidence, both in this country and abroad, which led to a unanimous report published just before last year's general election. It is important to note that, because of the timing of that publication, the report recommended that if a new Bill was introduced in this Parliament it should receive the customary Second Reading. I heard what the noble Lord, Lord Carlile, said about procedure and no Bills being taken to a
 
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Division on their Second Reading since 1997. I believe the one that was taken to a Division in the 1997–98 Session was on the welfare of pigs; I suggest that the Bill before us is probably more important. There have been some 105 such Bills since 1997–98 and, again, as is customary, this Bill should be referred to a Committee of the whole House. The noble Lord, Lord Carlile, said that there was a great deal of ignorance and confusion about this issue. I suspect that some of that could well be eliminated in the way suggested by the noble Lord, Lord Joffe, in his opening remarks if we could deal with some of the substantive detailed questions in Committee. I hope very much that that will be the basis on which we can proceed.

I am surprised that the noble Lord, Lord Carlile, who is, as he explained, a member of the committee, has tabled this amendment today. I mean absolutely no disrespect to the noble Lord because I know how busily he is engaged in many matters of enormous importance to this country, but he was unable to attend the great majority of the meetings of the committee and, indeed, did not visit Oregon with those who did and who were so impressed by the system there. I hope therefore that he will respect the collective view of the committee that a Bill of this nature which comes before us should be properly considered and not wrecked at Second Reading, as his amendment would achieve.

I remind noble Lords of the other remarks of the noble Lord, Lord Joffe, on the responsibility of legislators in Parliament. Obviously, we will have a considerable discussion on what society may think about this issue and what it is that is reflected in public opinion polls, but I would emphasise that the democratic accountability of Parliament, whether in this unelected Chamber or in the other place, is a relevant matter which should be considered above the force of special interest groups, however many letters those groups may get together to write. I say that too with great respect and concern for the views of the right reverend Prelates and the most reverend Primate who are to speak in the debate. However much we may respect the opposition in principle to this Bill from those with religious faith and those of us who have a spiritual concern that perhaps may not be a formal religious faith, we live today in a diverse and predominantly secular society where the importance of individual human rights is increasingly valued. The Minister, my noble friend Lord Warner, made the point when winding up our previous debate. He also emphasised on that occasion that patient choice is a central theme in today's healthcare.

The Select Committee heard a consistent message about patient choice. From the evidence we received we simply have to recognise that there are some people who, if they were terminally ill, would prefer to end their lives in a controlled and dignified manner rather than continue to receive care until a so-called natural death. To accept this evidence in no way undermines the importance of palliative care, which plays an enormously important role in modern medicine. This Government have rightly pledged to double their
 
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investment in palliative care. No doubt, as in so many areas, change could move further and faster, but as an advocate for these services in the voluntary sector, in the hospice movement and in the NHS over the past 30 years, I am encouraged by recent progress.

There is no dichotomy between my support for extending palliative care and my support for the Bill before us today. I can only repeat that the vast majority of terminally ill patients can be helped by palliative care; for the minority, they may experience either intractable suffering or simply prefer to end their lives. At no stage in any of the debates we have had—or, indeed, in any of the testimony to the Select Committee—did we hear those who promote palliative care as a universal panacea produce a convincing answer for that minority.

Noble Lords: The time!

Baroness Jay of Paddington: My Lords, I am afraid that I am going to persist for another 30 seconds because this is a Second Reading debate.

The Bill of the noble Lord, Lord Joffe, offers a dignified and humanitarian choice for such people. Throughout his career, the noble Lord has been a very considerable advocate and a very great pioneer of the principle of human rights and, indeed, individual freedom. I very much hope that Parliament—and, indeed, perhaps, the Government—will swiftly follow him.

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Lord St John of Fawsley: My Lords, I congratulate the noble Lord, Lord Joffe, on introducing the Bill. It requires great courage to introduce a Bill of this kind, and he has shown it. If you do not have courage in politics, there is no assurance of achieving anything. I also congratulate him on his record on human rights and the work he has done in that area. If the noble Lord has received some abusive letters, it is a bore but it is a part of the small change of public life. You do not have to read a letter very far before you find that it is abusive—normally it starts before the "dear"—so throw it in the wastepaper basket and forget about it.

The noble Lord, Lord Joffe, has achieved something very important: he has shown the relevance of this House to our social and moral issues. This House is the forum where these great issues can be intelligently and temperately discussed. We have no other institution where this can happen. It is one of the great glories of this House that this should happen here, where there is so much expertise, knowledge, experience and real concern. I am delighted that that is so.

There is tremendous interest in this topic simply because the life of a great society depends on a common possession of moral principles. If those moral principles disappear, the society disappears with them. People are so concerned about this issue because, at a time of great moral change and uncertainty, one of the fundamental pillars of our society is being shaken. And now I leave issues of moral principle to the Bishops. I find it difficult to do so, but we all have to make sacrifices.
 
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The first major practical point I wish to make concerns abuse. The deadly sin of our time is not sexual promiscuity, which the Church goes on about the whole time—too much, in my opinion—and provides a mirror image of the ills of society; the evil of our time is greed, which exists throughout society and at every level. The trouble is that the Bill would open the way to abuse by the greedy and the acquisitive and bring pressure on those who are at their most vulnerable.

My second point is that the end of life, the last period of life, is not a wasteland necessarily. It can be a wonderful period of renewal, reconciliation and acceptance. I have never spoken about this personal experience in public, but I do so now because I feel the issue before us is so important. My dear mother died in a convent here in London. I was summoned from a Shadow Cabinet meeting to her bedside. She said to me, "I do not want to die, but I feel that I am a burden to you". I said, "Dearest, you could never be a burden; you are an inspiration to me". I said, "If you do not want to die, let us say out loud the Lord's Prayer, the Hail Mary and the Prayer of the Trinity"—because vocal prayer is sometimes so powerful. "Our prayer is that, if it is the will of God, you will rise through this crisis". We prayed and she fell into a deep sleep—and from that moment the fear of death lifted. As it lifted from her, I felt what it was like. It was like being up against a brick wall, but you could not get over the wall and you could not move backwards from it. It was one of the most dreadful experiences I have ever had.

A year later she died. The marvellous reverend mother in charge, Mother Serrano, said to her, "Offer up everything you feel with the Lord". She said "Yes", bowed her head and died. Deo gratias for all those who substituted for a snuffing-out tender, loving, practical care and reached such a splendid result.

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