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Noble Lords: Oh!

Baroness Barker: My Lords, we all come to this debate with a predisposition to support or oppose the proposals before us. That predisposition is derived from our knowledge, belief, culture and experience. There is a spectrum of opinion, from one end which holds euthanasia to be an acceptable part of caring treatment, through to that for which any intervention is unacceptable. We have heard the shades of that today.

For myself, the critical point is the involvement of doctors. Doctors should never be the means by which political, social or economic ends are pursued. The
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flaw in the proposals of the noble Lord, Lord Joffe, is one to which he drew attention himself—that it is deficient in its strictures about what doctors and other medical practitioners such as nurses can do.

On vigilance, which has been mentioned, Clause 12, establishing the monitoring commission, must be extensively examined, not least because of the experience in the Netherlands. Furthermore, the appointment, composition, powers and resources of those monitoring commissions need to be explicitly on the face of the Bill and not left to regulation.

Many noble Lords have talked today about the slippery slope, and others have countered with evidence from other jurisdictions. The problem is that the systems about which we have heard today operate in a context where the healthcare system is different, where the culture is different, and where there is no national health service. I suggest that we need evidence from this country of how the Bill, if implemented, would work in our society. Therefore, I believe that one of the omissions in the Bill is provision for a statutory review of the legislation. I want to see in this country a system where people with conditions such as motor neurone disease can make individual decisions about their treatment and do not have to go abroad in order to exercise that choice.

I want to challenge my noble friend Lord Carlile—a perhaps difficult task. I do not believe that his proposal is improper, but I do believe that it is inappropriate. My noble friend has been quite clear. He told the House on 10 November that there is no condition that palliative care cannot address in order to help the individual. Some of us do not have that certainty. Therefore, while he believes that the Bill cannot be made acceptable by amendment, some of us remain unsure.

Furthermore, this is exactly the kind of issue that should be subject to the detailed and expert scrutiny that it would undoubtedly receive in your Lordships' House—a scrutiny which it would be unlikely to receive anywhere else other than in a court. Your Lordships, unelected as we are, can listen, evaluate, and concur with or reject lobby campaigns. We alone are able to act as we see fit. I share the desire of my noble friend to limit the income that lawyers may derive from this legislation and to see that whatever emerges is as clear as possible.

At the end of this debate—the fourth debate since the Select Committee chaired by the noble Lord, Lord Walton, and informed by the report of the Select Committee chaired by the noble and learned Lord, Lord Mackay of Clashfern—it is still possible to change one's mind. Perhaps the most important statement today was that made by the noble Lord, Lord Joffe, when he opened the debate and told the House how he had come to change his mind. Further debate should not necessarily follow public opinion, but it would have a distinct role in informing public opinion. That would be of value.

The aim of all of us who have taken part in this Bill in any way is to secure for ourselves, for those whom we love and for those whom we do not know humane
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treatment and a dignified end to life. I am not sure whether the noble Lord's Bill as it stands would be able to achieve that. But I do not believe that at this stage we should give up trying to see whether it is possible to produce legislation that continues to safeguard individuals and enables them to make the most difficult decision they will ever have to make.

4.29 pm

Lord McColl of Dulwich: My Lords, I want to give a message to the House from my noble friend Lady Park of Monmouth, who is in hospital. We have great respect for her all around the House. The message she wanted me to give was that she is very much opposed to the Bill.

I have another message—from the leader of our party, David Cameron, who says:

As noble Lords know, at 5.20 am on 11 December last year, there was a massive explosion at the Buncefield oil depot in Hertfordshire. Three days later, we received the explanation of what went wrong. My noble friend Lord Newton of Braintree chaired the committee, which found that two safety devices failed, the tank overflowed and so the disaster happened. That disaster illustrates what happens when safeguards do not "fail to safety". Failing to safety would have meant that a malfunction of the safety devices would have stopped the tanks filling up and the disaster would not have occurred.

Noble Lords may be wondering why I refer to those matters and think that I have come to the wrong debate, but I want to illustrate that the law, as it now stands, fails to safety. It errs on the side of life and protecting the vulnerable. For all its intended safeguards, the Bill will not fail to safety. The present law errs on the side of life; the Bill will err on the side of death. That is all the more worrying because when the safeguards in the Bill fail, there will be no explosion. There will not even be a whimper. The failure may never be discovered, because the patient will be dead. It will then be too late to find out whether the request for assistance in dying was truly voluntary. It will be too late to discover whether the patient's decision to seek assistance in dying was truly an informed decision. It will be impossible to discover whether the patient, had he lived, would have looked back and been grateful for the fact that he had not been assisted to die.

I, too, was very moved by the speech of the noble Baroness, Lady Symons of Vernham Dean. It reminded me of Alison Davies, who wrote to me recently and gave evidence to the committee. Several years ago, she was diagnosed with a terminal illness. She was also quite severely disabled. She wanted euthanasia. Of course, that was refused. Difficult although it was, she tried to commit suicide on several occasions, but was always rescued by her friends, who persuaded her that life was worth living.
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Then she took on a new lease of life and started looking to help other people. She says:

How do supporters of the Bill answer Alison Davies?

If anyone is totally confident that the safeguards in the Bill are foolproof and impregnable to error, exactly what is the basis of that confidence? Does it rest on the solicitor who will sign a declaration to say that the patient appears to be of sound mind and that the declaration appears to be made voluntarily? If so, that confidence is misplaced—not because the solicitor will not do his honest best but because the solicitor has no special skill or training that enables him to discern the mental capacity of the patient. Furthermore, he has no way of knowing whether the declaration is truly involuntary. We all know that appearances can be deceptive. A solicitor serves to give the declaration a spurious gravitas, but that is not a true safeguard. Judged objectively, no one can be satisfied that the safeguards in the Bill will always be sufficient and effective. Patients know this, of course. To pass the Bill would therefore not only disadvantage patients but also risk undermining the trust between doctors and patients, as the noble Lord, Lord Nickson, has said so eloquently.

If the Bill becomes law, I could put a lethal tablet in the hand of patient who had made the declaration, and if he swallowed it and died, that would be lawful. If, on the other hand, I took the pill and put it on his tongue and he died, that would be illegal. If he is incapable of moving his hand at all, and I put the tablet on my hand, put it within a few centimetres of his mouth, and his tongue whipped out and took it, would that be lawful? As he is the one taking the medication, I am simply acting as a sort of platform. This is far too fine a distinction for law. Considered from the point of view of the patient, it is also an unprincipled distinction, and one that would not be sustainable in the long term. Proposers of the Bill should know this. They probably hope that the Bill will prove to be a significant and first step on the road to lawful euthanasia, but sometimes first steps are best not taken. This is one such step.

A few years ago, supporters of the Bill were very much in support of euthanasia as practised in Holland. But they now seem to be moving away from that position. The present Bill now involves only assisted suicide, but that is where it all began in Holland. Within a few years, they moved to euthanasia for depressed patients, for disabled patients, and then for newborn babies. There is now a proposal that people over the age of 75 should be considering this. When I look around the Chamber, I see that that might involve quite a few people here. Once the law permits for the first time a particular action such as euthanasia, even though it is only for a few people, the law cannot prevent the boundaries being extended. That is the problem. Some Dutch doctors have actually been disciplined for not agreeing with the principle of euthanasia. One Dutch doctor was no longer allowed to teach medical students because of that.
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It is worth mentioning again that when a Dutch doctor was asked what his first case of euthanasia was like, he said, "It was dreadful. We agonised all day. But the second case was much easier, and the third case was a piece of cake". Many elderly people in Holland are so fearful of euthanasia that they carry cards around with them saying that they do not want it. I was so glad that the noble Lord, Lord Stoddart, mentioned the death penalty. Other noble Lords mentioned polling. It is true that many polls show that British people want the restoration of the death penalty, but presumably we would not countenance that. Why? Because misinformation leads to wrongful conviction. Misinformation to patients leads to wrong decisions, too. Forecasting the outcome of disease is also notoriously difficult. I very much agree with the noble Lord, Lord Turnberg, that the risks of the Bill are too great, and with the noble Lord, Lord Carlile, who described the Bill as a legal minefield and an ethical nightmare, morally indefensible and completely unnecessary.

4.40 pm

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