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Lord Gilmour of Craigmillar: My Lords, like most of your Lordships I have received many letters about this Bill. Like my noble friend Lord St John, I soon gave up reading them very carefully. Then I learnt from the Catholic Herald that a very expensive campaign had been undertaken by the Catholic bishops, which cost several million pounds, which, of course, they are fully entitled to undertake. However, I could not help thinking that it might have been better to give the money to charities for the poor and that the bishops' lobbying efforts might have been better directed towards Rome to support African efforts to rescind the Vatican's ban on the use of condoms, even among partners with AIDS. The Archbishop of Cardiff has said that this Bill would "kill off" people. However, it will kill off very few people and the people who will be killed will be killed voluntarily, whereas in Africa many people are being killed and there is nothing voluntary about it at all.
In the previous debate the noble Baroness, Lady Hayman, said that she did not think the Bill crossed a Rubicon. I entirely agree that it does not. Up to 1961 there would have been a good deal of logic in the case made by the opponents of the Bill because suicide was illegal. They could have argued that there was no reason why the terminally ill should be allowed to do something that the rest of us were not allowed to do. Today, of course, the case is very different. Suicide is legal and now the Bill's opponents have to explain why those who want to kill themselves because they are terminally ill and in agony, but are unable to do so because of their illness, should not be put in a position to do so, like all the rest of us. No amount of talk about palliative care will alter that position.
The trouble with the Bill's opponents is that they ignore the reality of what happens today. After all, terminally ill patients are allowed to stop taking life preserving drugs and thus probably face many days of pain before they die, and doctors are allowed to give pain killing drugs even though they know that that will speed up the death of the patient. We also know from surveys that doctors commit euthanasia anyway, normally probably in a very good cause. So, the Bill does not constitute the crossing of a Rubicon. Therefore, I cannot help thinking that the Bill's opponents are in the positionI quoted the following words in the previous debatesatirised by Arthur Hugh Clough, who said:
I do not often discuss my condition because it is obvious and I do not want to be defined by it. Today I feel that I must talk about itosteogenesis
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imperfecta. In plain English, this means that my bones were imperfect from the beginning. The consequence is that I have very brittle bones. I believe that the count of my fractures is now well over 600, with residual bone pain as an added bonus.
About four years ago, before I came to your Lordships' House, I had a neck injury that was incredibly painful. For several months I struggled trying various means of pain control. Because I am small and do not weigh very much, this can make pain control even more problematic. It was a difficult time for me. I am fortunate to have a fantastically supportive GP who worked incredibly hard to find the right medication for me. Too little and I could not function because of the pain, too much and I could not function because I was sedated. I live alone so I need to function to live.
After trying several types of medication with no success, my GP phoned the local hospice and asked a palliative care doctor for advice. Within 24 hours my pain was under control and I was physically and mentally able to function. Indeed, I still need to take that medication. Thinking about those months of pain, I dread to think what decisions I might have made if a Bill like this had been passed previously.
I have lost count of the number of times that I have been told by the medical profession, "This could be the beginning of the end". On all of those occasions it is feasible that I would have been classed as terminal under the structure of the Bill. To describe my condition many people would assume unbearable suffering. I would hate to be in a situation where I could be offered physician assisted suicide as a treatment option.
I meet a lot of disabled people. Some are born with conditions, some develop conditions, others are injured in accidents. When a group of disabled people come together the subjects around disability and pain control always include an element of fear about how undervalued the lives of disabled people are and how vulnerable they feel if they need to go into hospital. We fear "Do not resuscitate" instructions being written into files without any discussion or consultation. Often we are not offered the most positive options. We are afraid of the consequences of this Bill.
People who are injured or develop a condition often speak of how they assumed they would not, or could not, enjoy life anymore. This is when they are at their most vulnerable and death can seem the only solution for all concerned. It can take a long time for them to adapt to their new situation but, in my experience, the human spirit usually wins. People begin to value life and eventually enjoy the rest of their life.
Lord Goodhart: My Lords, in the very few minutes available I want to concentrate on the safeguards in the Billsafeguards both for those seeking assistance to die and for those whose assistance is sought.
I recognise that for those who have religious or philosophical objections to the whole concept of assisted dying, safeguards are irrelevant. But I believe
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that I speak for very many people in this country when I say to opponents on grounds of principle, we respect your views. I particularly respect the views of the noble Baroness, Lady Chapman, who has a personal knowledge of the problems of people with disabilities which I believe goes far beyond that of any other Member of your Lordships' House.
We do not wish to use this Bill to force you to do anything that you do not wish to do; but we ask you also to respect our views and not to deny us access to an option that we would like to have at hand, even though we hope that we will never need to use it. Others argue against this Bill not from an absolutely position of principle but on more pragmatic grounds. They fear that we will end up by killing disabled people, or elderly people under pressure from their families, or damaged babies, or people with severe depression. If those are the issues that concern you, then I ask you to consider the safeguards in the Bill.
Let me start by discussing the safeguards for the medical profession. Under Clause 7, no person, whether doctor or other, can be required to take any part in assisting death. No hospital, hospice or other care establishment can be required to permit assisted death on the premises. No doctor can be required to raise the option of assisted death with a patient, or refer the patient to someone who will do so.
Then there is the even more important question of the safeguards for patients. Under Clauses 2 to 6, the decision to assist death must start with a written request from the patient. The decision must be made by two doctors; one the patient's own doctor and the other a consultant diagnostician. Both must be satisfied that the patient has the mental capacity to take the decision. Both must be satisfied that the patient suffers from a terminal illness, defined as progressive, irreversible and likely to lead to death within six months. Both must be satisfied that the patient is suffering unbearably as a result of that illness. The consultant must have informed the patient of the alternatives, including palliative care, and the patient's own doctor must ensure that a specialist in palliative care has seen the patient and explained the benefits of it. Both must be satisfied that the patient's request is made voluntarily and is an informed decision. If either doctor has doubts about capacity, the patient must be referred to a consultant psychiatrist, and assistance cannot be given unless the psychiatrist decides that the patient has capacity. The patient must then sign a witnessed document, one of the witnesses being a solicitor. That document is revocable at any time without formality. No one involved in the process as a medic or a witness can be a person who has any expectation of benefit from the death of the patient.
That seems to me to be a strong list of safeguards. In particular, the requirement for unbearable pain caused by terminal illness and the need for capacity completely rule out assistance to anyone under age, depressed, or just fed up with living, or even suffering unbearable pain from an illness that is chronic but not terminal. If you believe that assisted dying is wrong in any circumstances, the safeguards are meaningless. All
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I can do is ask you not to force your own convictions on others who do not share them. If your opposition is not absolute, but you are not satisfied with the safeguards or with other aspects of the Bill, I ask you to vote for a Second Reading.
We all recognise that this Bill will not become law. There is plainly not enough time to get this Bill through the House of Commons before the end of the Session, even in the unlikely event of the Government being willing to give it time. But giving it a Second Reading would give us a chance to examine and improve the text of the Bill and meet those objections which fall short of absolute objection. Voting to deny this Bill a Second Reading is to imply that it is so wrong and so wicked that we cannot even debate it in a Committee of your Lordships' House. I do not share that view and I believe that most of my fellow citizens of this country do not share that view either.
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