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Nevertheless, I could not ignore the quantity of letters and the pleas to speak and vote against the Bill that I and many of your Lordships have received. They run into the hundreds, each one representing the concerns and experiences of those who took the time and trouble to write. I tried to read them all, even if it was not possible to reply to them all. I did not receive a single letter in favour of the Bill. If the noble Lord,
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Lord Haskel, is correct in saying that parliamentarians have a duty to represent the views expressed throughout the country, that is exactly what I am now doing.
That said, the debate has been extremely well balanced. There have been many brave speeches and arguments on both sides, underlining the extreme sensitivity and difficulty of the issue. I subscribe to the theologically based opposition to the Bill, but I can explain my position very simply. One reason why I am against capital punishment is that I find it unacceptable to ask and expect any person to carry out the killing of another human being, even after due legal process. One of the consequences of the Bill is that doctors and nurses would be asked to go against all that they believe that their Hippocratic oath represents. I was surprised to hear from the noble Baroness, Lady Tonge, that there are now doctors who do not swear it. From the many representations and all the evidence that I have seen and heard, the vast majority of medical practitioners are against being required to do this. The noble Baroness, Lady Emerton, convincingly described their case, and others have added to that.
Even if there were no alternative, I would vote against the Bill. I believe that there is an alternative, however: palliative care, the case for which was convincingly made at the start of the debate by the noble Baroness, Lady Finlay, and subsequently by many others. Let us now focus our efforts on making palliative care more comprehensive and more of a priority.
In my last minute, I pick up a point made much earlier the debate by my noble friend Lord Gilmour of CraigmillarI am glad to see him returning to the Chamberabout the amount of money spent on a campaign against the Bill. He quoted a newspaper article. I have not had the opportunity to verify the figures that he quoted, but I beg leave to doubt and dismiss them. I am most surprised that the noble Lord, as an experienced politician, should believe everything, or anything, that he reads in the newspapers, whatever the paper.
Lord Moser: My Lords, ever since the noble Lord, Lord Joffe, first raised this crucial subject in your Lordships' House, I have tried to take on board the arguments pro and con. I have taken particular interest in public opinion. The question is how one gauges it. I do not do so simply through what I hear from experts, although I obviously listen to them with great care, nor what I read in the newspapers, norto reassure the noble Lord, Lord Carlilesimple public opinion polls. They deserve the noble Lord's description of "fragile". I am thinking of high quality social research, which has often been shown to be invaluable in throwing light on what the general public, not just the experts, think and feel about complex issues and how opinions are moving.
No one can doubt that this is a subject for society as a whole. Our splendid Select Committee stressed that, as have many others, most recently the British Medical
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Association. There have been a number of surveys. They are not all technically sound by any means, and many of them are from interested organisations and are not unbiased. The best attitude research on this subject comes from the National Survey Centre, and I say that not simply because I was a founder member of itI am still on its board; I declare that interestbut because it is generally regarded as the best survey organisation.
The centre has studied end-of-life issues for some decades, supported by the Nuffield Foundation. General support in these scientific surveys for assisted dying and related matters, only in the most serious circumstances, has steadily risen from 70 per cent in the 1970s to 82 per cent in 1990. A new survey was conducted last year. It will not be published until the autumn, but I have permission to tell your Lordships that it shows consistently strong, unchanging support for the issues raised by this legislation: in the area of 80 per cent I stress that those results are based not on simple opinion surveys, but on serious research, which means a scientific and large random sample of the population. It means a set of neutrally devised questions. Above all, it means that it is the work of a disinterested research body. I do not want to suggest for a moment that public opinion should be the determinant of decisions or of our thinking. Equally, it seems clear to me that, on this subject above all, which affects every one of us, this authoritative and impartial picture of what the public currently feel deserves serious weight.
In listening to the debate, I have been struck on both sides of the argument by the number of detailed issues that deserve further discussion. With that in mind, I hope that the noble Lord, Lord Carlile, might think again about pressing his amendment. We can always vote for or against the Bill on Third Reading, but the House is so splendidly good at Committee stage that I hope we are not deprived of it.
Lord Sheldon: My Lords, whatever happens at the end of the debate, I must admire the achievements of the noble Lord, Lord Joffe, who started the serious consideration of the right to choose the ending of one's life after a period of some agony. I believe that time is on his side. There was a period when suicide was a much more criminal activity that it now is. Attitudes have changed and will continue to change. The noble Lord, Lord Carlile, spoke of the complications with regard to whether the right to die should be allowed, but that is the case for a Committee stage, when the issues can be examined in some detail.
Lord Cavendish of Furness: My Lords, I oppose the Bill because I believe that it puts at additional risk an already vulnerable section of the population; namely,
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the old, the frail and the dying. However, I am chiefly concerned with defending the practice and future development of specialist palliative care as delivered by our hospices, a model which works and which, I believe, is undermined by the provisions of the Bill. I perhaps need to declare an interest in that I was a co-founder of St Mary's Hospice in Ulverston, Cumbria. I have continuous involvement, and I remain its chairman.
The debate has caused distress, and continues to do so, to a significant number of our hospice patients. Such people are fearful as a direct consequence of the Bill and the debate that surrounds it. They are frightened that it is our intention to shorten or terminate their life without their consent. I tell the noble Lord, Lord Joffe, that that is not speculation; that is a fact.
The progress that has been made towards reducing suffering in specialist palliative care is well documented. I estimate that 1 per cent of our patients suffer to the degree that the Bill addresses. I would think that, 10 years ago, the figure might well have been nearer 5 per cent The improvement owes a great deal to clinical advances, but by no means everything. Other factors include the success of the hospice model of care and its acceptance by communities in general and by health professionals in particular. Accordingly, patients come to us earlier than before and self-evidently that hugely enhances our ability to give them the best treatment.
Of course, pain is not only physical; numerous strands of mental and emotional anguish need to be softened or relieved, and we seek to do that, too. Our work is based on the simple principle that every person has unique physical, emotional and spiritual needs and that treatment must be tailored to those needs.
Most of our in-patients admitted for terminal care have, on arrival, an average life expectancy of fewer than 14 days. In normal circumstances, during the first hours and days, pain will be controlled, the fear of pain removed, and, through the ever-growing menu of complementary therapies, quality added to their life. It is deeply wrong, in my view, that, with so few days remaining to these people, the comfort and safety that we seek to provide can be blighted by needless fear and uncertainty.
I know of no member of our staff who has come forward in support of the Bill or of any hospice that wants it. Our care professionals can see no improvement in the care they offer, and there have been no demands to alter the time-honoured definition of "patient autonomy", which I remind your Lordships provides for patients to stop life-prolonging treatment if they so wish.
The other main issue as the Bill affects hospices is what has been described as the "duty to die" factor. I will avoid spending time on that much-rehearsed argument, beyond saying that there is substance to the notion that old and ill people, including our patients, increasingly feel growing pressure that they should stop being a burden to their family, their carers, the
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state and even the institutions charged with their care. I contend that the Bill will lend momentum to that chillingly horrible trend.
The problem before us today has been wrestled with for generations. Those who have gone before us saw the recklessness of going down this road for the reasons so eloquently put today and last October by the noble Lord, Lord Phillips of Sudbury. I believe that a touch or arrogance accompanies the belief among a number of contemporary commentators that ours is an enlightened age that has conferred wisdom and intelligence denied to our forebears. I sometimes think that the opposite is true.
The future lies not with this Bill but with extending and enhancing the scope of palliative care; introducing justice to its uneven provision; and addressing urgently other conditions for which the model is entirely appropriate. Perhaps the greatest unmet need lies with those suffering from certain heart conditions and end-stage respiratory disease. I believe that palliative care is on course to eliminate the suffering that the noble Lord, Lord Joffe, and his supporters seek to address. I ask only that it be allowed to develop rather than be put at risk.
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