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The Archbishop of Canterbury: My Lords, opposition to the principle of this Bill is not confined to people of religious conviction—as we have been reminded by the noble, monotheistic and utilitarian Lord, Lord Carlile—and it would be a lazy counter-argument to suggest that such opposition can be written off because it comes only from those committed to a world view not universally shared. It is worth remembering that the secular or "enlightened" view of human autonomy assumed by many of the Bill's defenders is no less a particular world view rather than a self-evident and universal truth.

It is, of course, the case that the opposition of many of us is rooted in religious conviction—a conviction not about an abstract principle of the sanctity of life but a conviction, rather, about the possibilities of life. All religious believers hold that there is no stage of human life, and no level of human experience, that is intrinsically incapable of being lived through in some kind of trust and hope. They would say that to suggest otherwise is to limit the possibility of faithful and hopeful lives to those who are in charge of their circumstances or who enjoy a measure of control and success. Believers hold that even experiences of pain
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and helplessness can be passed through in a way that is meaningful and that communicates dignity and assurance.

Of course this is not universally held in our society but, if it is true, we should expect that to ignore it would bring disastrous risks. Whether or not your Lordships agree with the fundamental principle from which those of us on these Benches—and, indeed, elsewhere—begin, it is not too difficult to spell out the nature of these risks and perhaps to find agreement there—as, indeed, we have found agreement in the powerful statements from the Royal College of Physicians and, even more, in the extraordinarily detailed submission of the Royal College of Psychiatrists in recent days. Many others will want to elaborate on these risks and, as time is limited, I shall confine myself to what I think are the most evident.

The first is this: whether or not you believe that God enters into consideration, it remains true that to specify, even in the fairly broad terms of the Bill, conditions under which it would be both reasonable and legal to end your life, is to say that certain kinds of human life are not worth living. As soon as this is publicly granted, we put at risk the security of all who experience such conditions. That this is not an abstract matter or a matter concocted for scaremongering purposes by sinister Prelates ought to be evident from what has been said by the Disability Rights Commission and, indeed, by the association of sufferers from motor neurone disease.

Secondly, we jeopardise the security of the vulnerable in another way by radically changing the relationship between patient and physician. The physician is not obliged to raise the possibility of assisted dying with the patient according to the Bill, yet every patient will know that this is a statutory possibility and there are many ways of exerting pressure on people even without intent. Furthermore, if a patient wishing for assistance in dying is confronted with a physician who has conscientious scruples, provision is made that he or she will be entitled to look around for an alternative. But how are we to guarantee that any such alternate could possibly give the advice and informed support that can be provided only by a doctor who has been involved long term with a sufferer? Does not the possibility of an alternate actually deprive even the patient who wishes to end their life of the best in medical care?

Thirdly, we cannot conduct this debate in the abstract. In spite of the assurances helpfully given by the noble Lord, Lord Joffe, and the noble Baroness, Lady Jay, we know all too well that our health service is under severe financial pressure. We know, too, that while the standard of palliative care in the United Kingdom is second to none, it is distributed with great unevenness. What incentive is there to broaden and improve that standard if there is a simpler and, I have to say, more cost-effective solution to these pressures? I recognise fully that this is far from the authentically compassionate intentions of the Bill's proposers, but in our present circumstances, can we say with confidence that this is a climate in which we can secure
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the kind of debate and consideration that is needed? The evidence from Oregon is, at best, ambiguous; that from the Netherlands, as we have been reminded, offers no comfort at all.

Finally, having mentioned palliative care, I shall touch upon one more related matter. It is professionally acknowledged that the number of situations in which physical discomfort or agony is consistently and unavoidably extreme is very small, given our steady advances in pain control. Often what supporters of a change in the law are really arguing about is the mental and spiritual agony of the terminally sick. Those of us who have spent long hours with such people, witnessing and absorbing such agonies, would be the last to dismiss the seriousness of this. Yet to legislate on the basis of states of mind is again to open a door into a general change of attitude about the legitimacy of ending one's life, which has implications for everyone—for the suicidal teenager as well as the dying 80 year-old.

We return to my opening point: what will we be heard to be saying about the worthwhileness of life under certain conditions? Do we, by legally accommodating the mental suffering of some, debase the currency for all? These are not trivial considerations; nor are they parochially religious ones. I believe that they are pertinent for anyone who wishes to see our society remain committed to human dignity and liberty and to the finest possible medical care for all our citizens.

11.02 am

Lord Ashley of Stoke: My Lords, the most reverend Primate the Archbishop of Canterbury mentioned vulnerable people. The effect of the Bill on disabled people has been mentioned in various debates; some opponents claim that the public cannot distinguish between disabled people and those who are terminally ill and that, consequently, disabled people will be at risk. The public often misunderstand disability, largely because they are not basically interested in it, but they surely cannot be so stupid as to believe that Britain's 11 million disabled people are terminally ill. I completely reject that argument.

The Disability Rights Commission says that it cannot support the Bill at this point in history. It suggests that a much higher priority is to legislate for the right to independent living and other matters. But these two things are not mutually exclusive. In fact, I have been working for some months on a major Bill on independent living for disabled people and hope to present it to the House shortly. The organisation that has been of enormous help to me on the Bill has been the Disability Rights Commission. So there is no point in saying that we must choose between one and the other.

The most reverend Primate also mentioned the will of God, slippery slopes and society at large. I believe that these are very convenient arguments which can be transferred to any legislation. The basic question is this: how would those who oppose the Bill respond to a husband, a wife, a son or a daughter who is
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agonisingly and terminally ill and says that he or she has had enough? That person has had all the love, affection and palliative care possible but still finds life unendurable and wants help to die. Would opponents of the Bill say, "Of course I love you and will do what I can to help but you may change your mind so I'm afraid the answer is no"? Would they say, "I would love to help and your personal autonomy is important, but it is only one small element in the complex equation of the broad interests of society. I am sorry that I can't help you, but the answer must be no"? Would they say, "I would do anything to help if I could, but if I help you to die, then I may encourage unscrupulous doctors to kill off disabled people like dogs. I couldn't do that, so the answer is no"? Or would they say, "Of course I want to help but please stick it out until God calls you. He knows what's best and is infallible. I'll pray for you, but I cannot say yes, and the answer is no"?

With their nearest and dearest begging for help, who is to give these excuses and refuse to help? To say yes to a loved one is very hard but to say no is impossible. It is quite wrong to patronise or ignore disabled people; it is even more so to patronise and ignore terminally ill people.

This admirable Bill, presented very ably by the noble Lord, Lord Joffe, offers a way forward which is compassionate, sensible and pragmatic. It can relieve human suffering by people who are begging for release. I hope the House will support it.

11.06 am

Lord Patten: My Lords, I will not repeat the expression of my feelings raised on the issues in the Bill any more than I did when we last debated it on 10 October, save to add that, unlike the noble Lord, Lord Ashley of Stoke, whom I greatly respect, I do not agree that there is no slippery slope. Far from opening up a slippery slope, I think we will be going over the edge of a precipice and into a chasm, should the Bill proceed. That said, I have three points to make.

First, grant the right to die and the right to live is lost. I am particularly concerned for child protection in the future. Today we see children being given abortions without the knowledge of their parents or guardians, despite the assurances to the contrary given when the Abortion Act passed into law. Despite all those assurances and safeguards, presumably some people will inevitably argue, coming from a human rights point of view, should the Bill pass into law, for a similar so-called human right allowing children to seek assisted dying in due course. That will happen, my Lords.

Secondly, I believe in killing the pain, not the patient. I do not believe this is some trite phrase. Whatever my other strong feelings about the Bill are, it has served one good purpose in crystallising the urgent need for a very substantial and geographically just increase in NHS expenditure on palliative care and getting rid of the postcode lottery. I am very grateful to the noble Lord, Lord Joffe, for having brought that so much to the forefront of political debate. There, at least, he and I can agree wholeheartedly.
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Thirdly, as someone who has more than one lawyer and more than one philosopher as a close personal friend, I do not care for many of the arguments advanced for the Bill by some human rights lawyers, aided and abetted by the usual philosophical suspects of a utilitarian or relativist cast of mind. But one does not have to be a human rights lawyer to recognise new human rights. We all have the human right to recognise new human rights, and I feel a new one coming over me: the absolute right to know the intentions in this matter of not just doctors but of nurses and other carers and, should the Bill pass into law, the need to have publicly available registers of those who wish to promote assisted dying. I think the sick, the elderly, the disabled and others concerned have the human right to have that information. Should the Bill proceed into Committee, which I profoundly hope it does not, I shall be arguing very strongly for that right. In registering with a new doctor, I would certainly wish to know his or her views.

Lastly, it is a great pleasure to see the terraces of Bishops in the House. I look forward to seeing the most reverend Primate and his nine colleagues leave those terraces later on during the Division, and to going through the Lobby with them and earlier holders of the Archbishoprics of York and Canterbury on this very important issue.

11.10 am

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