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Baroness Cumberlege: My Lords, I should like to begin with a quote from Woody Allen, who said:

I share that view because dying is not for wimps. In the opening lines of her very charming novel, Miss Garnet's Angel, Salley Vickers wrote:

Friends, families, doctors, nurses and bereavement counsellors know that all too well.

Is it surprising, therefore, that doctors in palliative medicine, the very ones who are charged to participate in assisted suicide, are overwhelmingly against this Bill? They know that the way in which we die influences the difficult job of repair. According to the most recent survey, 94 per cent do not want legislation and only 3 per cent are prepared to be involved. Furthermore, young doctors, those training in this specialty, are totally against the Bill. Their representative is on record as saying:

But what about those attending and the consulting physicians, those who are also required to be complicit? Well, not much enthusiasm is to be found there either. The Royal College of Physicians, using the question framed by the noble Lord, Lord Joffe, asked its members and fellows:

That question received a resounding answer: "No". This week the Royal College of General Practitioners issued a statement that the college is also opposed to any change in legislation, as has the Royal College of Psychiatrists. The most recent statement from the Royal College of Nursing is unequivocal:

These are the very people who value and cherish their professionalism, who understand that the most precious element they possess is the trust between their profession, the patient and the public. They recognise how this Bill erodes and corrodes the central tenet on which their very professionalism depends. We should value their commitment and support them in defeating this legislation.

I want to respond briefly to the noble Viscount, Lord Craigavon. I am very disappointed that he should have so misunderstood the fine speech made by
 
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the noble Baroness, Lady Finlay. I would urge him to do as I did and visit her and her inspirational service in Cardiff. I am sure he would then gain insight and a better understanding not only of the noble Baroness but of the hospice movement as a whole.

Finally, I understand that in Switzerland at the Lausanne university teaching hospital, assisted suicide is now freely on offer to patients. I wonder what that does to young doctors, to those who enter the profession to treat and cure and who are now required to learn how to kill. What does that do to the confidence of patients, of whom some in this country are already fearful of being admitted to hospital due to MRSA and hospital-acquired infections? When they are at their most vulnerable and in strange surroundings, is it not possible that they may indeed feel they have a duty to die, not least to save the expense of keeping them alive? I support the amendment.

1.06 pm

Baroness Thomas of Walliswood: My Lords, I speak as one who supports the Bill brought forward by the noble Lord, Lord Joffe. The evidence we read and heard as members of the Select Committee gave me added confidence in that opinion. The things I would have said in defence of the Bill today have been put quite brilliantly by the noble Lords, Lord Ashley of Stoke, Lord Beaumont of Whitley, Lord Gilmour of Craigmillar, the noble Earl, Lord Arran, my noble friend Lord Goodhart, the noble Baronesses, Lady Jay of Paddington, Lady Murphy, Lady Hayman, Lady David, and many others.

Were the Bill to get to a Committee of the whole House, which I devoutly hope it will and which was the unanimous recommendation of the members of the Select Committee, I might want to table amendments to it. In particular, the Bill does not include any reference to the role of nurses in the care of the dying and in that of their friends and families. I understand that reference to this role may be difficult to include in the Bill, bearing in mind that the sole responsibility for responding to a patient's request is laid upon the doctor. But we would need to ensure at the very least that nurses could not be implicated against their will or by mistake.

I want to add only that we live in a secular society within which individuals may express their own belief in the way they live their individual lives. Nothing in the Bill could force anyone who objects to it on religious or philosophical grounds to avail themselves of its provisions, any more than the existence of laws permitting divorce can force a couple to divorce if they feel that their religious beliefs forbid them to do so. I share the dismay expressed by my noble friend Lord Taverne regarding the so-called Christian campaigns against the Bill. But in any case, this issue is surely one for society as a whole to determine, not doctors or divines acting on our behalf.

I turn now to the amendment. I am saddened by my noble friend's decision to move an amendment to kill the Bill. First, it seems to run contrary to the
 
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longstanding traditions of free speech embraced by capital-l Liberals and little-l liberals alike. Secondly, it prevents this House doing what it does best: giving intense and detailed attention to the minutiae of legislation so as to test its real scope and consequences, whether intended or unintended. Thirdly, this Bill and the whole issue of the rights and wrongs of personal control of end-of-life decisions are of intense interest to the public. Indeed, as the noble Lord, Lord Joffe, reminded us, over a number of years there has been a substantial majority in favour of the sort of proposals being put forward in this Bill. This House, more than any other institution I can think of, is ideally suited through its composition and methods of working to render a real service to the people of this country, not by refusing to consider the Bill in detail, but by insisting on so doing.

So I hope that my noble friend will not put his amendment to the vote. But if he does so, I urge noble Lords, and especially those who do not like the Bill, to reject the amendment.

1.10 pm

Baroness Emerton: My Lords, the Bill, like its predecessor, would allow physician-assisted suicide for someone who is,

This is undoubtedly one of the most problematic of the conditions of the Bill. Who is to say what constitutes "unbearable suffering"? As the noble Lord, Lord Joffe, said in his evidence to the Select Committee, it is what the patient says is unbearable. It is defined as,

This is no objective test, no safeguard. By what criteria can a doctor say that the patient is not suffering enough?

The Bill states that the "unbearable suffering" must be as a result of terminal illness, yet so often the greatest suffering derives from unresolved issues and conflicts which resurface during a terminal illness and compound physical symptoms. The Bill does not require any efforts to have been made to relieve the suffering. No wonder the Select Committee firmly recommended that a better safeguard would be "unrelievable" or "intractable" suffering.

But, as has already been mentioned, can we think about the staff—the nurses, doctors and healthcare professionals—who provide care? What are they to do in the face of a patient who is seeking physician-assisted suicide and who is obviously suffering? Do they continue to strive to improve the quality of life with the clock ticking, when all their efforts will be abandoned in favour of death? Indeed, how can they address the emotional, social and spiritual aspects of suffering when all the time knowing that, if they are successful in relieving the suffering, the patient will then become ineligible for the very thing that he or she seeks—namely, assisted suicide? Professionals in Belgium describe that it is harder to give good
 
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palliative care now that their law has changed precisely for this reason. This criterion as a safeguard is unworkable.

I am privileged to have spent my career as a professional nurse, and as a practising Christian I believe in the sanctity of life. I am a member of the Royal College of Nursing, which represents 380,000 nurses. It has recorded its official view that the college members oppose the Bill. I, too, oppose the Bill.

1.13 pm


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