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Baroness O'Cathain: My Lords, I oppose the Bill and will be voting for the amendment. I shall not do it from the point of sanctity of life; I am not going to speak about that because we have already heard wonderful speeches. I should like to say that terminal illness gives us all an opportunity to give love, care and concern to those who are nearest to us. We are getting better at confronting the inevitable—death—and the palliative care people have told us that the memories from the last days of life are often the best. The best memory of my young brother is when he was drinking a seriously good glass of Burgundy while pumping away at his pain control machine, roaring with laughter, joking, and taking the mickey out of me. Three days later he was dead. Maybe it hastened his death, but he had a happy end of life. This Bill could choke off that experience and leave survivors with most unhappy memories and a huge, long-lasting feeling of guilt and remorse that they did not give enough encouragement to their loved ones not to ask for suicide.

The responsibility on each of us taking part in this debate is enormous. I feel that it is overwhelming. Even if the Bill goes nowhere, it will now have an impact on our country. So many are concerned; we are being watched and we are being prayed for. We are being heard here but others really want to be heard. That was epitomised for me this week by Dr John Wiles, the chairman of the Association of Palliative Care Medicine, who said twice:

That same day—Wednesday—the Royal College of General Practitioners, the largest of the medical colleges, stated:

Not too much has been said about the people who are most likely to be affected by the Bill—not those asking for their life to be terminated but those who have to carry out the act. Such people will be affected daily if the Bill is enacted. Trust between patient and doctor, as has already been said, has been damaged. The objective of medical practitioners would have to change from single-minded determination to heal to the objective of healing while at times confronting a huge ethical dilemma of assisted suicide.

The noble Lord, Lord Joffe, has withdrawn his wish for this to be a first stage. But, like the rest of us, he is not immortal. He will pass on, and who knows what the attitude of those who follow us will be? If the Bill were enacted it would be much easier to add on bits rather than to start all over again. I took deep offence when the director of Dignitas in Switzerland said in several press releases and in the newspapers about two weeks ago that we should progress this Bill in this country even going as far as applying it to youth, whether terminally ill or not.

The noble Baroness, Lady Murphy, in a wonderful speech, said that the Bill would help only a very small group of people. Are we putting at risk all our principles of life and maintaining the sanctity of life for
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very few people? It would be much better to become involved in developing and producing much better palliative care so that those very few people would not feel that they were required to take their own lives.

We know that the wish to die is more often an expression of depression, pain or poor symptom control rather than a genuine wish to die. Psychiatric help, anti-depressants and excellent palliative care can and would counter all of those. The development of those options even in the past 10 years has been phenomenal, and they will continue to develop. As we heard yesterday, medical research in this country is among the best in the world.

Let us not forget that the Netherlands Government legalised assisted suicide in 2002. Now they are considering an extension to the legislation to include newborn babies who are not perfect. Let us not listen to the Oregon experience. It is voluntary reporting, as the noble Lord, Lord Clement-Jones, said. It is not exactly a reliable basis for policy making. This is a dangerous Bill and I shall certainly be voting against it.

2.29 pm

Lord Neill of Bladen: My Lords, at this hour I can be brief and summarise my points. This has been an absolutely excellent debate. It has been particularly moving to hear from those who have first-hand experience of the issue, with their hand on the fingers of those who are about to die.

I have looked at the effects of the Bill, of which I shall speak about four or five. The first is the effect on the doctor/patient relationship. I see nothing but harm from this Bill in that respect. The trust that we have and should have in the medical advisers who look after us will be damaged as soon as they are involved as instrumentalities in death. There is an extraordinary provision—I have not heard anyone mention it, but I was out of the Chamber for a moment or two—about deeming an assisting doctor not to be guilty of a breach of his Hippocratic oath. By what power does this House say that somebody has not broken an oath that they took in their youth? I do not understand that.

The effect on the nurse/patient relationship would be nothing but adverse. The nurses are there to care and to preserve life. As for palliative care, there should be an endless search for improvement in standards. I think that at the moment we are probably at the top in the world in that respect, but there is no reason to stop; we should be moving always upwards. We should not listen to the insidious voice that says, "Well, resources could be better spent in this way and that, because you know now that there's this new method".

As I stressed on the two previous occasions when I spoke on the issue, there will be a particular effect on the vulnerable and the disabled, as well as on their families. As many people have written to me in letters, the Bill would put pressure on those very well intentioned, kindly people who know that they are in a decrepit condition and that they are using resources on a weekly or monthly basis that the family unit can scarcely bear if there are to be any resources left when
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they die. The mere fact of passing this legislation would put pressure on those people, without a word being said, to remove themselves from the scene. That pressure would always be there. It is not difficult to imagine divided voices within families: "We think she's getting on alright"; or, "We think he's really going downhill; he was in terrible pain last time we were there". There will be a division: some family members will want the awkward, remaining relative dead, while others will think that that is the most terrible thing even to contemplate.

I see nothing but harm and hardship in every direction I look as being the immediate consequence of this Bill.

2.32 pm

Lord Hughes of Woodside: My Lords, I rise to support the Bill and to emphasise what needs to be emphasised: the Bill is voluntary, it represents choice and it imposes nothing on anyone who does not want to take part in the procedures that it lays down. I say that because it is clear to me that much of the opposition to the Bill of the noble Lord, Lord Joffe, in this House, and certainly outside this House, is aimed not at the Bill at all. Indeed, the noble Lord, Lord Roberts, said that he did not mind the Bill of the noble Lord, Lord Joffe, so much as the ones that had not appeared yet. This is opposition to a mythical set of circumstances.

A common theme has run through many of the letters that I have had. Some of those were standard letters and others were close to standard letters. As someone who was chair of the Anti-Apartheid Movement for more than 20 years, I have no principled objection to standard letters; I used to put them out every day, with model resolutions to trade unions and the Labour Party. There is nothing wrong with campaigning, but I object to the use of the tactics of scaremongering. Most of the letters that I have had from the religious communities—from the Christian Churches, from those who follow Judaism and from those who follow Islam—say that the old, the disabled and people from ethnic minorities are at risk from the Bill. Some of the correspondents have even said that the Bill is designed to affect them.

Why should people be afraid? They are afraid because they have been told to be afraid. That has been the tactic. If there is any doubt about how far the fear goes, I shall quote from only two letters. One said:

the Bill. The second was in a sense more chilling. It said:

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What fear to instil in old people! The people who have indulged in those tactics should be thoroughly ashamed of themselves.

I apologise if I am not following the even-tempered nature of this debate, but I have been led to say things that will not be entirely to the liking of your Lordships' House. Those of us who are involved in these debates need to be careful about how we present our arguments. I do not doubt that some of these things are done in good faith and out of great principle. The noble Lord, Lord Elton, said that, at the Home Office, policy was driven by money. As may indeed be the case, palliative care is more expensive, whereas the pill is cheap. However, that leaves an impression that these things are likely to happen. My noble friend Lord Brennan, for whom I have the greatest respect, uses language moderately and sincerely, but when he says in this House that the passing of this Bill would lead tomorrow to doctor-shopping and death clinics, he is going far too far. No wonder people outside are frightened of what is in fact a very modest Bill.

We have to have a care. We have to appreciate that people hold views as a result of very strong principles, and I respect them. But I do not think that people's fears and susceptibilities should be used to promote a religious view that some seek to impose on others. People should think about where religious extremism takes them. It takes them to the Taliban, and we do not want that in this country.

2.37 pm

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