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Friday 19th September 2025
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10:06
Legislation: Terminally Ill Adults (End of Life) Bill – second reading (day two) For a full list of speakers please check day one of second reading on 12 Sept. For a list of which members will speak on day two, please refer to Today's List on the Government Whip's website, available on the morning of the debate: https://www.lordswhips.org.uk/
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Resumed Resumed debate Resumed debate on Resumed debate on second Resumed debate on second reading
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of the terminally ill adults and of life bill. Before the debate is resumed, I
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Before the debate is resumed, I want to remind the house of a few important points. Firstly, I think important points. Firstly, I think the whole house will join with me in recognising as the senior Deputy Speakers did yesterday, that the Speakers did yesterday, that the first day of the second reading last week was the Lord Oates it best. Noble Lords observed the advisory Noble Lords observed the advisory time limits, the courteous and respect of every contribution regardless of the wide-ranging views regardless of the wide-ranging views on the topic.
The advisory timings for Backbench contributions remains for Backbench contributions remains at four minutes as it was last week. I would ask all noble Lords to I would ask all noble Lords to respect that and each other by sticking to it closely. That means, sticking to it closely. That means, when you get three minutes, you start making your concluding remarks and four minutes, your time is up. and four minutes, your time is up. Of course, as the openers did, some speakers will have longer as for the usual conventions.
Those colleagues will also make sure the remarks are considerate at the overall debate. I considerate at the overall debate. I estimate that noble Lords followed this guidance and after all motions this guidance and after all motions are decided upon, we should be able to rise at around 4 PM today. I would also like to highlight the letter to the whole house for my noble friend Lord Faulkner which set out their agreement of Baroness Berridge's revised motion to set up a time-limited Select Committee.
If that motion is indeed carried today, and I will arrange for a revised forthcoming business to be issued at the end of next week, advertising updated dates for the bill. The Senior Deputy Speaker will also be able to make provision for the committee to be setup as soon as possible to commence its important
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work urgently. But that, I beg to move the debate. The question is that the debate
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The question is that the debate on men to the second reading of the terminally ill adults end-of-life bill be now resumed. As many of that bill be now resumed. As many of that opinion will say content. The
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contents have it. It is indeed an honour to open
Legislation: Terminally Ill Adults (End of Life) Bill – second reading (day two) For a full list of speakers please check day one of second reading on 12 Sept. For a list of which members will speak on day two, please refer to Today's List on the Government Whip's website, available on the morning of the debate: https://www.lordswhips.org.uk/
**** Possible New Speaker ****
Resumed Resumed debate Resumed debate on Resumed debate on second Resumed debate on second reading
**** Possible New Speaker ****
of the terminally ill adults and of life bill. Before the debate is resumed, I
**** Possible New Speaker ****
Before the debate is resumed, I want to remind the house of a few important points. Firstly, I think important points. Firstly, I think the whole house will join with me in recognising as the senior Deputy Speakers did yesterday, that the Speakers did yesterday, that the first day of the second reading last week was the Lord Oates it best. Noble Lords observed the advisory Noble Lords observed the advisory time limits, the courteous and respect of every contribution regardless of the wide-ranging views regardless of the wide-ranging views on the topic.
The advisory timings for Backbench contributions remains for Backbench contributions remains at four minutes as it was last week. I would ask all noble Lords to I would ask all noble Lords to respect that and each other by sticking to it closely. That means, sticking to it closely. That means, when you get three minutes, you start making your concluding remarks and four minutes, your time is up. and four minutes, your time is up. Of course, as the openers did, some speakers will have longer as for the usual conventions.
Those colleagues will also make sure the remarks are considerate at the overall debate. I considerate at the overall debate. I estimate that noble Lords followed this guidance and after all motions this guidance and after all motions are decided upon, we should be able to rise at around 4 PM today. I would also like to highlight the letter to the whole house for my noble friend Lord Faulkner which set out their agreement of Baroness Berridge's revised motion to set up a time-limited Select Committee.
If that motion is indeed carried today, and I will arrange for a revised forthcoming business to be issued at the end of next week, advertising updated dates for the bill. The Senior Deputy Speaker will also be able to make provision for the committee to be setup as soon as possible to commence its important
**** Possible New Speaker ****
work urgently. But that, I beg to move the debate. The question is that the debate
**** Possible New Speaker ****
The question is that the debate on men to the second reading of the terminally ill adults end-of-life bill be now resumed. As many of that bill be now resumed. As many of that opinion will say content. The
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contents have it. It is indeed an honour to open
10:09
Baroness Thornton (Labour)
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It is indeed an honour to open the second day of our debate on the terminally ill end-of-life bill. Can I pay tribute to my honourable I pay tribute to my honourable friend who was also represented the seat in which I was born for bringing this to us in the Commons and thank Lord Faulkner for the clarity and excellence of his introduction and his leadership of this bill. Last Friday's debate was, as my noble friend has said, outstanding and the House of Lords at its best.
There were many questions to be addressed as we do our job in scrutinising the bill and the questions posed came from both those of us who support this bill and those who do not. So I am greatly relieved that my noble friend's Baroness Berridge and Lord Faulkner in their email to all peers said their amendment would allow the bill to go through all stages of the Lordships house. Because for those who disagree in principle with assisted dying, I think it is important that we remember that this bill came to us from the Commons, has undergone scrutiny, and our job is to scrutinise it further and improve it if we need to do so.
It is not our job to kill this bill. Indeed, I was saddened last week by the noble Lady speaking about this being a suicide bill. People have written to me in the last week very distressed and they say things like we are not suicidal, we want to live. But we are dying and we do not have the choice or ability to change that. Assisted dying is not suicide. I hope today that the house will conduct this debate with compassion and I'm going to read an extract for one of the many letters I received which explains the importance of compassion and I cannot better it.
It concerns a woman who is a lay priest and has terminal cancer, and with her permission, Pamela says I live in terror at the prospect of how my final weeks of life may be. I have seen other members of my family at the end of their cancer journey and I know what may lie ahead. Even the best palliative care has its limits. This is the fear that I carry around with me all the time. I am not asking anyone to help me shorten my life.
In supporting this bill, I seek to have control over my death and my final weeks should my pain and suffering prove unbearable. As a Christian, I believe in loving my neighbour as myself and on this basis, I seek the same choice relating to others. As a lay preacher, I cannot reconcile Christian compassion with the status quo that obliges people to suffer drawnout process of dying in pain when it is against their will. And they have the capacity to choose. Church leaders often apply the concept of sanctity of life to resist assisted dying for top sanctity of life is rightly central to Christian faith.
For me, this active life is about honouring the life of every individual, and this necessarily includes providing the care and treatment they need, including excellent palliative care. I reject the assumption that the sanctity of life acquires terminally ill people to undergo a distressing and painful death against their will. I am asking you to support this bill. It will be tragic if the bill were to fail now having passed through the Commons with a clear majority. It would be personally devastating for me and countless others.
The majority of the UK population supports this bill and there is a majority along congregations despite the churches leadership's energetic lobby against the bill. Please remember that this is not about shortening life. It is about shortening painful and distressing ways of dying. Despite the best palliative care around 20 people die in agony. This is a plea for compassion. This is her plea for compassion and mine as well.
Baroness Thornton (Labour)
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It is indeed an honour to open the second day of our debate on the terminally ill end-of-life bill. Can I pay tribute to my honourable I pay tribute to my honourable friend who was also represented the seat in which I was born for bringing this to us in the Commons and thank Lord Faulkner for the clarity and excellence of his introduction and his leadership of this bill. Last Friday's debate was, as my noble friend has said, outstanding and the House of Lords at its best.
There were many questions to be addressed as we do our job in scrutinising the bill and the questions posed came from both those of us who support this bill and those who do not. So I am greatly relieved that my noble friend's Baroness Berridge and Lord Faulkner in their email to all peers said their amendment would allow the bill to go through all stages of the Lordships house. Because for those who disagree in principle with assisted dying, I think it is important that we remember that this bill came to us from the Commons, has undergone scrutiny, and our job is to scrutinise it further and improve it if we need to do so.
It is not our job to kill this bill. Indeed, I was saddened last week by the noble Lady speaking about this being a suicide bill. People have written to me in the last week very distressed and they say things like we are not suicidal, we want to live. But we are dying and we do not have the choice or ability to change that. Assisted dying is not suicide. I hope today that the house will conduct this debate with compassion and I'm going to read an extract for one of the many letters I received which explains the importance of compassion and I cannot better it.
It concerns a woman who is a lay priest and has terminal cancer, and with her permission, Pamela says I live in terror at the prospect of how my final weeks of life may be. I have seen other members of my family at the end of their cancer journey and I know what may lie ahead. Even the best palliative care has its limits. This is the fear that I carry around with me all the time. I am not asking anyone to help me shorten my life.
In supporting this bill, I seek to have control over my death and my final weeks should my pain and suffering prove unbearable. As a Christian, I believe in loving my neighbour as myself and on this basis, I seek the same choice relating to others. As a lay preacher, I cannot reconcile Christian compassion with the status quo that obliges people to suffer drawnout process of dying in pain when it is against their will. And they have the capacity to choose. Church leaders often apply the concept of sanctity of life to resist assisted dying for top sanctity of life is rightly central to Christian faith.
For me, this active life is about honouring the life of every individual, and this necessarily includes providing the care and treatment they need, including excellent palliative care. I reject the assumption that the sanctity of life acquires terminally ill people to undergo a distressing and painful death against their will. I am asking you to support this bill. It will be tragic if the bill were to fail now having passed through the Commons with a clear majority. It would be personally devastating for me and countless others.
The majority of the UK population supports this bill and there is a majority along congregations despite the churches leadership's energetic lobby against the bill. Please remember that this is not about shortening life. It is about shortening painful and distressing ways of dying. Despite the best palliative care around 20 people die in agony. This is a plea for compassion. This is her plea for compassion and mine as well.
10:13
Lord Deben (Conservative)
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Lord Deben (Conservative)
The house will know that I have a moral position on this but I'm not going to talk about that. What I'm going to try to say is that this has been a most remarkable debate and all of us have learned from both sides from what has been said and what has come out of it seems to me that this is a very difficult issue. The second thing is that although other countries have tried to do this, no one has produced an example of saying that's where it works.
What they have done is to say that needs to be changed, there is a problem, and yet we are trying to debate this very serious matter. On a Private Member's Bill, which was inadequately dealt with in the Commons, and which has been criticised seriously by two of our expert committees. And what we're trying to do is something which is momentous because we are seeking to depart from what has always been an attitude, apart from the issue of capital punishment which I fought against for many years, we are empowering the state to kill.
Now, you can argue it, but let's realise just how serious it is. I was an MP for 40 years and I met wonderful people in both my urban constituency and my rural constituency. But I also met people who felt that their old relations were a terrible burden and were spending money which would be much better left to them. I don't think we can ignore that fact, and I disagree with my noble friend when he suggested that somehow or other, this was an inconceivable concept.
And what I want to put the house as this, that not only is it conceivable, but it is increasingly dangerous because families who have never seen any real money now see an aged relative who has house which is aged relative who has house which is The temptation for those people that I know and have met, to say to that person, you really have a duty to save this money for your family. You know that Roger has got a real problem, you can help him.
This is what you should do. And no doctor is going to be able to analyse what has happened over maybe some long time. Because the incident which we are discussing is very often the end of a long period. And people come to that decision with that kind of pressure. I am sorry that that is the case. And it is the case in a society which has far too many people who have been suggested they are not worth anything.
Recreating the worth of all of us. The place that we all have towards society. I am a Tory I have to say, but I do see individuals as living in a society. And that means that we have responsibilities. And it may be, and I say this with due humility, it may be that the contribution to society that someone in great pain may have is to protect vulnerable people by bearing that in order that they will not be destroyed.
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My Lords, I support the intent of this bill to increase personal autonomy to those with life limiting autonomy to those with life limiting illnesses. Good legislation must provide adequate protection for the provide adequate protection for the vulnerable, including those with eating disorders. The malnutrition eating disorders. The malnutrition that accompanies anorexia means, as noble Lady said, that if treatment noble Lady said, that if treatment is delayed or refused, then the is delayed or refused, then the physical condition of someone with a mental illness can deteriorate to a life threatening degree.
A life threatening degree. A starvation of the brain causes starvation of the brain causes distorted thinking. And it severely impairs how a person weighs up information. I remember vividly when information. I remember vividly when our daughter is in the grips of our daughter is in the grips of severe anorexia. She could debate proportional representation with me but she was adamant she would rather but she was adamant she would rather die than put on weight. And yet in countries where assisted dying is legal, lethal drugs are being given legal, lethal drugs are being given to people with this condition which has a well-established link to has a well-established link to depression and suicidality.
Despite the fact that, with the right treatment and support, recovery is possible, even after many years of having the disease. According to systematic review of the available evidence of assisted dying, published in Frontiers in Psychiatry, eating disorders are being classed as terminal. And at least 60 people with them have been helped to die. To be clear, that is in countries where, like this legislation proposes, assisted dying is only legal for those with a terminal illness.
In the Commons, in the debates, Kim Leadbitter MP said she did not want people with anorexia to be included within the scope of the bill. I agree with you. But as it stands, they are. The Royal College of Psychiatrists has called for the Bill to be amended. So that it explicitly states that the physical effects of a mental illness, such as an eating disorder, would not make a person eligible. I urge noble Lords to heed that call.
Vulnerable lives must be protected if we are to take this momentous step.
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My Lords, it is a great honour to follow the noble Baroness. We are at
What they have done is to say that needs to be changed, there is a problem, and yet we are trying to debate this very serious matter. On a Private Member's Bill, which was inadequately dealt with in the Commons, and which has been criticised seriously by two of our expert committees. And what we're trying to do is something which is momentous because we are seeking to depart from what has always been an attitude, apart from the issue of capital punishment which I fought against for many years, we are empowering the state to kill.
Now, you can argue it, but let's realise just how serious it is. I was an MP for 40 years and I met wonderful people in both my urban constituency and my rural constituency. But I also met people who felt that their old relations were a terrible burden and were spending money which would be much better left to them. I don't think we can ignore that fact, and I disagree with my noble friend when he suggested that somehow or other, this was an inconceivable concept.
And what I want to put the house as this, that not only is it conceivable, but it is increasingly dangerous because families who have never seen any real money now see an aged relative who has house which is aged relative who has house which is The temptation for those people that I know and have met, to say to that person, you really have a duty to save this money for your family. You know that Roger has got a real problem, you can help him.
This is what you should do. And no doctor is going to be able to analyse what has happened over maybe some long time. Because the incident which we are discussing is very often the end of a long period. And people come to that decision with that kind of pressure. I am sorry that that is the case. And it is the case in a society which has far too many people who have been suggested they are not worth anything.
Recreating the worth of all of us. The place that we all have towards society. I am a Tory I have to say, but I do see individuals as living in a society. And that means that we have responsibilities. And it may be, and I say this with due humility, it may be that the contribution to society that someone in great pain may have is to protect vulnerable people by bearing that in order that they will not be destroyed.
**** Possible New Speaker ****
My Lords, I support the intent of this bill to increase personal autonomy to those with life limiting autonomy to those with life limiting illnesses. Good legislation must provide adequate protection for the provide adequate protection for the vulnerable, including those with eating disorders. The malnutrition eating disorders. The malnutrition that accompanies anorexia means, as noble Lady said, that if treatment noble Lady said, that if treatment is delayed or refused, then the is delayed or refused, then the physical condition of someone with a mental illness can deteriorate to a life threatening degree.
A life threatening degree. A starvation of the brain causes starvation of the brain causes distorted thinking. And it severely impairs how a person weighs up information. I remember vividly when information. I remember vividly when our daughter is in the grips of our daughter is in the grips of severe anorexia. She could debate proportional representation with me but she was adamant she would rather but she was adamant she would rather die than put on weight. And yet in countries where assisted dying is legal, lethal drugs are being given legal, lethal drugs are being given to people with this condition which has a well-established link to has a well-established link to depression and suicidality.
Despite the fact that, with the right treatment and support, recovery is possible, even after many years of having the disease. According to systematic review of the available evidence of assisted dying, published in Frontiers in Psychiatry, eating disorders are being classed as terminal. And at least 60 people with them have been helped to die. To be clear, that is in countries where, like this legislation proposes, assisted dying is only legal for those with a terminal illness.
In the Commons, in the debates, Kim Leadbitter MP said she did not want people with anorexia to be included within the scope of the bill. I agree with you. But as it stands, they are. The Royal College of Psychiatrists has called for the Bill to be amended. So that it explicitly states that the physical effects of a mental illness, such as an eating disorder, would not make a person eligible. I urge noble Lords to heed that call.
Vulnerable lives must be protected if we are to take this momentous step.
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My Lords, it is a great honour to follow the noble Baroness. We are at
10:20
Lord Curry of Kirkharle (Crossbench)
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Lord Curry of Kirkharle (Crossbench)
follow the noble Baroness. We are at a crossroads and must decide what kind of a nation we want to be. We have long believed that human life is sacred. Worthy of dignity and respect. This has been enshrined within biblical foundations by laws. Some would say this belief in the sanctity of human life is outmoded, only if you have old-fashioned Christian views. I strongly adhere to those beliefs. What happens if we reject this fundamental principle is to set up the nation so well for so long, in terms of this old-fashioned view of life? To do so in my view would undermine the very foundation of our societal values.
Matthew Parris in 'The Times' recently argued that the elderly and infirm are a drain on resources and it would be a good thing if they felt the pressure that their time is up. This kind of attitude will lead to an economic evaluation of human life against the backdrop of the crushing weight of the pressure on the NHS and the nation's finances. There is no question that this bill, if passed, would devalue the importance of human life, and economics would become part of the decision-making process.
The NHS will save money, and people will protect inheritance. This has been estimated that the Canadian government and its provinces are now saving at least $150 million a year as a result of assisted suicide. As we know, the scope for eligibility there continues to be expanded, and the same will happen here. I'm not at all reassured by the bill's sponsors about the restricted eligibility. The slippery slope will become a reality. We must not dismiss the concerns of many in the medical profession about this bill.
Some individuals and organisations have flagged that they are either opposed to the bill, or extremely worried about aspects of the bill including most of the Royal Society's, as have been mentioned in number of times in this debate. This is deeply concerning. It became apparent last Friday that some supporters of the Friday that some supporters of the bill believe that the bill might prove to be unwieldy if not unworkable. That there is too much bureaucracy and oversight ready in the bill.
Others, who I agree with, thinks the bill needs lots of additional safeguards including to protect those with mental illness, eating disorders, disabilities, communication difficulties and so on. Not only is the bill currently not fit for purpose, but it would become completely unworkable if amended even further. Not only will we devalue the precious gift of God given life, we will see people who can live for years dying early because of this, and depriving society of their contribution.
Information from DWP shows that one in five people who qualify for end- of-life benefits are still alive three years later. My Lords, the noble Lord Forsyth referred to his father in his contribution. He did so last time we debated this topic as I recall. I referred them to our daughter who died aged 42 in 2013. I will get emotional if I explore that further. I mention this because we all have personal stories and family experiences that have shaped our views for or against the bill.
But we have to stick with principles. If we support it, we risk diluting our sympathy and concern for the elderly and frail, the disabled and oppressed, seeing them as a drain on resources when we opt to live at society's expense rather than conform to the new norm and die. This bill is dangerous and retrograde step.
Matthew Parris in 'The Times' recently argued that the elderly and infirm are a drain on resources and it would be a good thing if they felt the pressure that their time is up. This kind of attitude will lead to an economic evaluation of human life against the backdrop of the crushing weight of the pressure on the NHS and the nation's finances. There is no question that this bill, if passed, would devalue the importance of human life, and economics would become part of the decision-making process.
The NHS will save money, and people will protect inheritance. This has been estimated that the Canadian government and its provinces are now saving at least $150 million a year as a result of assisted suicide. As we know, the scope for eligibility there continues to be expanded, and the same will happen here. I'm not at all reassured by the bill's sponsors about the restricted eligibility. The slippery slope will become a reality. We must not dismiss the concerns of many in the medical profession about this bill.
Some individuals and organisations have flagged that they are either opposed to the bill, or extremely worried about aspects of the bill including most of the Royal Society's, as have been mentioned in number of times in this debate. This is deeply concerning. It became apparent last Friday that some supporters of the Friday that some supporters of the bill believe that the bill might prove to be unwieldy if not unworkable. That there is too much bureaucracy and oversight ready in the bill.
Others, who I agree with, thinks the bill needs lots of additional safeguards including to protect those with mental illness, eating disorders, disabilities, communication difficulties and so on. Not only is the bill currently not fit for purpose, but it would become completely unworkable if amended even further. Not only will we devalue the precious gift of God given life, we will see people who can live for years dying early because of this, and depriving society of their contribution.
Information from DWP shows that one in five people who qualify for end- of-life benefits are still alive three years later. My Lords, the noble Lord Forsyth referred to his father in his contribution. He did so last time we debated this topic as I recall. I referred them to our daughter who died aged 42 in 2013. I will get emotional if I explore that further. I mention this because we all have personal stories and family experiences that have shaped our views for or against the bill.
But we have to stick with principles. If we support it, we risk diluting our sympathy and concern for the elderly and frail, the disabled and oppressed, seeing them as a drain on resources when we opt to live at society's expense rather than conform to the new norm and die. This bill is dangerous and retrograde step.
10:24
The Lord Bishop of Chichester (Bishops)
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The Lord Bishop of Chichester (Bishops)
It is a privilege to follow Lord Currie. I wish to begin by acknowledging reference for all contributors to this debate which touches on our deepest emotions, and the things of which tiers are made. Lord Carlisle are very reminded us that since the end of capital punishment, causing the death of another citizen is not allowed in- law other than in law. An Lord Herbert of South Downs was not alone in describing the introduction of a provision in law to cause death as a crossing the Rubicon moment.
Although the right to life enshrined in law is a moral principle consistent with the Christian faith, it should not be regarded as the imposition of Christianity upon the pluralistic democracy we are proud to be. However, many Christians, including myself, see this bill as crossing the Rubicon. This is why. Christians derive commitment to the sanctity of life from our understanding of the very nature of God as Trinity, not begotten made of material substance, in nature or omnipotent, but distinct persons in the relationship of father, son, and Holy Spirit.
Distinctness and relation Allah see in God also become characteristic of how and what, in love, God makes us to be as human beings. Endowing us with free will. And the capacity to use or misuse God's gift of life in all its dimensions. Unique likeness to God, which encompasses an immaterial spiritual dimension subsists equally we believe in the flesh and blood of every human being. This is a foundational contribution to the common law prohibition of homicide.
And it consequently inhibits us as Christians from supporting legislation to take the life of another person, as is envisaged in the bill. Furthermore, the Bible beautifully identifies compassion as essential to the nature of God. And so human suffering, around the end of life especially, compels us to press ever more urgently for significant increased and sustained investment in palliative care. And to learn lessons from hospice movement attention to the qualities of distinctive, individual needs, and relationships.
In sharp contrast to the complex bureaucratic processes that outlined in this bill. Our scrutiny of this bill must also assess its disproportionate effect on many people, as has been referred to, who already doubt whether they are valued and understood. People for example in the outer estates of coastal towns, and that shadow lands of rural villages, where I minister in Sussex. This bill takes from them Sussex. This bill takes from them the laws from the Lord's protection to their dignity.
When Pope Benedict addressed Parliament in 2010, he asked where the ethical foundation for political choices was to be found. And whether social consensus is a sufficient basis for addressing the moral dilemmas, considerable as they are, for the present age. My Lords, beyond a limited degree of social consensus, I do not see a solid ethical foundation for what is presented in this bill. Human dignity demands of us better
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treatment. I have spoken in favour of
Although the right to life enshrined in law is a moral principle consistent with the Christian faith, it should not be regarded as the imposition of Christianity upon the pluralistic democracy we are proud to be. However, many Christians, including myself, see this bill as crossing the Rubicon. This is why. Christians derive commitment to the sanctity of life from our understanding of the very nature of God as Trinity, not begotten made of material substance, in nature or omnipotent, but distinct persons in the relationship of father, son, and Holy Spirit.
Distinctness and relation Allah see in God also become characteristic of how and what, in love, God makes us to be as human beings. Endowing us with free will. And the capacity to use or misuse God's gift of life in all its dimensions. Unique likeness to God, which encompasses an immaterial spiritual dimension subsists equally we believe in the flesh and blood of every human being. This is a foundational contribution to the common law prohibition of homicide.
And it consequently inhibits us as Christians from supporting legislation to take the life of another person, as is envisaged in the bill. Furthermore, the Bible beautifully identifies compassion as essential to the nature of God. And so human suffering, around the end of life especially, compels us to press ever more urgently for significant increased and sustained investment in palliative care. And to learn lessons from hospice movement attention to the qualities of distinctive, individual needs, and relationships.
In sharp contrast to the complex bureaucratic processes that outlined in this bill. Our scrutiny of this bill must also assess its disproportionate effect on many people, as has been referred to, who already doubt whether they are valued and understood. People for example in the outer estates of coastal towns, and that shadow lands of rural villages, where I minister in Sussex. This bill takes from them Sussex. This bill takes from them the laws from the Lord's protection to their dignity.
When Pope Benedict addressed Parliament in 2010, he asked where the ethical foundation for political choices was to be found. And whether social consensus is a sufficient basis for addressing the moral dilemmas, considerable as they are, for the present age. My Lords, beyond a limited degree of social consensus, I do not see a solid ethical foundation for what is presented in this bill. Human dignity demands of us better
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treatment. I have spoken in favour of
10:28
Baroness Blackstone (Labour)
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I have spoken in favour of assisted dying in previous debate in this House. That is still my position. If I'm grateful to Kim Leadbitter MP full steering this Leadbitter MP full steering this bill through the Commons. We must not forget that the elected House has supported it, our task is to scrutinise not to reject. Like Baroness Thornton, I was concerned at proposals last week of the Select Committee might undermine the agreed timetable. Scrutiny committee. After so many years considering assisted dying, whether in a Select Committee or Private Members' Bills, it is now important that we complete the process.
Therefore I'm grateful that my noble friend Baroness Berridge has agreed to allow the bill to go through all stages before the session ends. With a view to improving the bill. I welcome the opportunity to look into procedures and safeguards, calling evidence from experts. I am impressed by many of the contributions we have heard so far including some speeches from those not in support of the bill was top I do however regret the language used to sometimes, such as references to the killing bill or the assisted suicide bill.
Because of my personal experience, I am affronted by this. My former husband, in hospice care, was dying of stomach cancer at the age of 44, in agonising pain with terrible nausea, he desperately wanted it to come to an end, as he put it. He asked for my help. I tried to persuade his carers to speed up his persuade his carers to speed up his death but failed. Was his wish to die suicide? Surely not. He did not want to die but he was dying.
And when life became truly unbearable, he longed for death. Because of the law, I could not help him end his We have a duty to consider public opinion. Surveys report high support for the bill ranging from 73 to 80%. The council and Essex set up a jury in assisted dying earlier this year. Support for all change grew over the eight week long deliberation and participants had views from all sides. There are also large majorities in favour of assisted dying among Christians and those of other faiths as well as disabled people.
Some speeches have referred rightly to the inadequacies of the status quo. Prosecutions of people who admit to helping a close relative die usually end injuries refusing to conflict. All should not remain on the statute books where this is the case. Currently, there is no safeguarding either where people and their lives at dignity asked. Unregulated ways of ending lives such as starvation take place. Those who oppose this bill do need to address the problems of the status quo. More palliative care, yes, but it cannot always and the horrors of agonising deaths.
I end with to please. Allow fellow human beings greater autonomy over how they die. It is for them to decide and not for others to impose their views. Second, be truly compassionate. Inspiring terrible suffering as death approaches. Allowing those to choose to die sooner to do so.
Baroness Blackstone (Labour)
**** Possible New Speaker ****
I have spoken in favour of assisted dying in previous debate in this House. That is still my position. If I'm grateful to Kim Leadbitter MP full steering this Leadbitter MP full steering this bill through the Commons. We must not forget that the elected House has supported it, our task is to scrutinise not to reject. Like Baroness Thornton, I was concerned at proposals last week of the Select Committee might undermine the agreed timetable. Scrutiny committee. After so many years considering assisted dying, whether in a Select Committee or Private Members' Bills, it is now important that we complete the process.
Therefore I'm grateful that my noble friend Baroness Berridge has agreed to allow the bill to go through all stages before the session ends. With a view to improving the bill. I welcome the opportunity to look into procedures and safeguards, calling evidence from experts. I am impressed by many of the contributions we have heard so far including some speeches from those not in support of the bill was top I do however regret the language used to sometimes, such as references to the killing bill or the assisted suicide bill.
Because of my personal experience, I am affronted by this. My former husband, in hospice care, was dying of stomach cancer at the age of 44, in agonising pain with terrible nausea, he desperately wanted it to come to an end, as he put it. He asked for my help. I tried to persuade his carers to speed up his persuade his carers to speed up his death but failed. Was his wish to die suicide? Surely not. He did not want to die but he was dying.
And when life became truly unbearable, he longed for death. Because of the law, I could not help him end his We have a duty to consider public opinion. Surveys report high support for the bill ranging from 73 to 80%. The council and Essex set up a jury in assisted dying earlier this year. Support for all change grew over the eight week long deliberation and participants had views from all sides. There are also large majorities in favour of assisted dying among Christians and those of other faiths as well as disabled people.
Some speeches have referred rightly to the inadequacies of the status quo. Prosecutions of people who admit to helping a close relative die usually end injuries refusing to conflict. All should not remain on the statute books where this is the case. Currently, there is no safeguarding either where people and their lives at dignity asked. Unregulated ways of ending lives such as starvation take place. Those who oppose this bill do need to address the problems of the status quo. More palliative care, yes, but it cannot always and the horrors of agonising deaths.
I end with to please. Allow fellow human beings greater autonomy over how they die. It is for them to decide and not for others to impose their views. Second, be truly compassionate. Inspiring terrible suffering as death approaches. Allowing those to choose to die sooner to do so.
10:32
Lord Patten (Conservative)
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Lord Patten (Conservative)
I have two points that I wish to make. The first is that I do not support this bill in its stated aims. Neither do I support the increasing strange and weird way it has proceeded before Parliament, mutating into some sort of ever- changing hybrid Private Member's Bill. We have giving some covert and now more overt help to these beleaguered measures rather than taking its own responsibilities which they should have done from the start. It was truly prescient of Cardinal Nicholls when he wrote back in February on the fifth this year, and I quote exactly, that there was something deeply lacking in a government that isn't prepared to guide and a sponsor.
If it wants to, this process, of change. I think his eminence has been proved spot on in what he said then. So, this unholy legislative mass can only be helped if it by the excellent and consummated proposals are Baroness Prashar and all that she has suggested for the Select Committee and stuff. It must be helped to improve. My second point after procedure of palliative care. I am not in favour of suicide provided by the state in the face of possible terminal illness.
Illness is often not always diagnosed in the right place. I do not believe that there is some automatic choices dying badly if you don't want to do that, to go along and have some assisted suicide. Rather, we must look at the very seriously ill with great compassion, better than we do now. We need much greater protection and legal penalties against coercion to buy. I'm afraid to say that families aren't always very nice places in the way in which they behave.
Alas. And the domestic setting can sometimes be one for domestic, elder abuse, abuse of a mentally disabled, which I'm very worried about indeed, and the physically disabled. We do much more precautionary effort in order to protect and safeguard those at risk. Maximising the opportunities to safeguard the vulnerable which I think this bill just fails to do in what has been said so far. Lastly, I do not pretend that we can make death lose its sting. Of course, we can't. It is Mother Teresa who has prayed here in our chapels at St Mary undercroft once said, the real freedom is to value all people exactly the same and to value them all, not to be thought of as trouble or a nuisance.
So we need more palliative care which is woefully underfunded in this country, and it has long been so, and it is a shame on us all. The provision remains Apache postcode lottery with current estimates of around the hundred thousand a year who should be getting it not getting it. And for my own personal point of view, whilst full, if from now on death becomes the default solution to perceive suffering, to become the new normal, I believe this will have implications which will be more than just significant the way in which we live now.
live now.
If it wants to, this process, of change. I think his eminence has been proved spot on in what he said then. So, this unholy legislative mass can only be helped if it by the excellent and consummated proposals are Baroness Prashar and all that she has suggested for the Select Committee and stuff. It must be helped to improve. My second point after procedure of palliative care. I am not in favour of suicide provided by the state in the face of possible terminal illness.
Illness is often not always diagnosed in the right place. I do not believe that there is some automatic choices dying badly if you don't want to do that, to go along and have some assisted suicide. Rather, we must look at the very seriously ill with great compassion, better than we do now. We need much greater protection and legal penalties against coercion to buy. I'm afraid to say that families aren't always very nice places in the way in which they behave.
Alas. And the domestic setting can sometimes be one for domestic, elder abuse, abuse of a mentally disabled, which I'm very worried about indeed, and the physically disabled. We do much more precautionary effort in order to protect and safeguard those at risk. Maximising the opportunities to safeguard the vulnerable which I think this bill just fails to do in what has been said so far. Lastly, I do not pretend that we can make death lose its sting. Of course, we can't. It is Mother Teresa who has prayed here in our chapels at St Mary undercroft once said, the real freedom is to value all people exactly the same and to value them all, not to be thought of as trouble or a nuisance.
So we need more palliative care which is woefully underfunded in this country, and it has long been so, and it is a shame on us all. The provision remains Apache postcode lottery with current estimates of around the hundred thousand a year who should be getting it not getting it. And for my own personal point of view, whilst full, if from now on death becomes the default solution to perceive suffering, to become the new normal, I believe this will have implications which will be more than just significant the way in which we live now.
live now.
10:36
Baroness Royall of Blaisdon (Labour)
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Baroness Royall of Blaisdon (Labour)
I support this bill. I'm grateful to Kim Leadbeater for her work, and to advocates. I'm grateful to my noble friend Baroness Berridge for showing us a way forward in terms of a committee and for setting out a clear timetable. Also only welcome the compassionate and moderate tone of last week's debate from which we learned a lot, like my noble friend, I was dismayed at the conflation made by some of suicide and assisted dying. This isn't just about careless language.
It is actively damaging to people who are already suffering. Let's be clear. People who choose assisted dying are not suicidal. They are dying and want to regain some choice, control, and dignity where it has otherwise been stripped away. We should hear the views of terminally ill people, some of him had a letter published in the Independent this week. We are not suicidal, we want to live and to make the most of the time we have left with the people we love.
But we are dying and we have no choice or ability to change that. We are not seeking to make a choice between living and dying but between two kinds of death to create choice and control over the time and manner of inevitable and imminent death with suicide is deeply insensitive to those of us facing this position. Australia's leading suicide prevention organisation warned confusing these terms can delay access to suicide prevention services people in distress, and complicate or delay care for those who are seeking an additional choice at the end-of-life.
When in 2021 I asked the government to provide data on the number of people who take their own lives every year, I did so because this debate needs to be guided by evidence and the lived experience of dying people and their families. The best available evidence estimates that around 300 terminally ill people and their own lives at home every year in England. These deaths are recorded as suicides but it is clear from talking to and listening to family members, that these are not people who wish to end their own lives but people who are taking drastic and often violent steps to control an inevitable and imminent death.
There is absolutely no evidence that assisted dying undermines or runs counter to effective suicide prevention strategies, nor is there evidence to suggest that legalised assisted dying leads to a shift in attitudes towards suicide. Figures from Victoria in Australia show a slight decrease in suicide rates since it introduced assisted dying. In 2021 in the second reading of the bill, I said that the current blanket ban on assisted dying does not eradicate demand for choice at the end-of-life. With simple forces people to take matters into their people to take matters into their own hands.
Those words remain true today. We continue to hear of dying people taking their own lives and we continue to hear about the devastating impact this has on families. It is time to change the law. I am a humanist. I respect those who believe in the sanctity of life and I subscribe to many of their values but this bill will not compare anyone to act against their conscience. It provides agency and choice for people who are near death the ability to decide how they spend their final days, whether they have faith or no faith.
I'm confident that the scrutiny of this bill will be as robust in your Lordships house as it was in the Commons. We will do our work with due diligence, improving the bill, including by making anorexia part of the bill, but we will always be mindful of our duty to respect the privacy of the Commons.
It is actively damaging to people who are already suffering. Let's be clear. People who choose assisted dying are not suicidal. They are dying and want to regain some choice, control, and dignity where it has otherwise been stripped away. We should hear the views of terminally ill people, some of him had a letter published in the Independent this week. We are not suicidal, we want to live and to make the most of the time we have left with the people we love.
But we are dying and we have no choice or ability to change that. We are not seeking to make a choice between living and dying but between two kinds of death to create choice and control over the time and manner of inevitable and imminent death with suicide is deeply insensitive to those of us facing this position. Australia's leading suicide prevention organisation warned confusing these terms can delay access to suicide prevention services people in distress, and complicate or delay care for those who are seeking an additional choice at the end-of-life.
When in 2021 I asked the government to provide data on the number of people who take their own lives every year, I did so because this debate needs to be guided by evidence and the lived experience of dying people and their families. The best available evidence estimates that around 300 terminally ill people and their own lives at home every year in England. These deaths are recorded as suicides but it is clear from talking to and listening to family members, that these are not people who wish to end their own lives but people who are taking drastic and often violent steps to control an inevitable and imminent death.
There is absolutely no evidence that assisted dying undermines or runs counter to effective suicide prevention strategies, nor is there evidence to suggest that legalised assisted dying leads to a shift in attitudes towards suicide. Figures from Victoria in Australia show a slight decrease in suicide rates since it introduced assisted dying. In 2021 in the second reading of the bill, I said that the current blanket ban on assisted dying does not eradicate demand for choice at the end-of-life. With simple forces people to take matters into their people to take matters into their own hands.
Those words remain true today. We continue to hear of dying people taking their own lives and we continue to hear about the devastating impact this has on families. It is time to change the law. I am a humanist. I respect those who believe in the sanctity of life and I subscribe to many of their values but this bill will not compare anyone to act against their conscience. It provides agency and choice for people who are near death the ability to decide how they spend their final days, whether they have faith or no faith.
I'm confident that the scrutiny of this bill will be as robust in your Lordships house as it was in the Commons. We will do our work with due diligence, improving the bill, including by making anorexia part of the bill, but we will always be mindful of our duty to respect the privacy of the Commons.
10:40
Lord Jopling (Conservative)
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Lord Jopling (Conservative)
I have not changed my opposition to the concept of assisted dying. Since the previous debates in 2015 Since the previous debates in 2015 and 2021. My views which are not influenced by religious teaching are based on my opposition to the passing of laws which permit the taking of life. That is why years ago, in 1964, I supported the Private Member's Bill to abolish capital punishment, much to the irritation of some of my then constituents.
But in particular, I am concerned in this bill onto dangers to these proposals. We heard already on the effects of the bill and encouraging greedy families and I quote as an example of that my own mother who was widowed at 58 and, during temporary doubts of illness and depression, on many occasions, told us that she wished she could die, but of course, we join her along and in the event she lived until she was 96, having led an interesting life and having seen a good deal of the world during those years.
And I know that during those depressed moments, we could perfectly well have agreed with her and told her that we will try to arrange assisted dying if it had been done available. And the second concern I have is concern at the issue of doctors for higher. These are people who strongly support assisted dying and build a reputation for sanctioning it to become what I can only describe as a soft touch. An example of this, I noticed in the advice we have all had over this bill that, with regard to the Canadian situation, I saw one small sentence which said that, in Canada, 4% of medical aid in dying practitioners provide these services more than 30 times a year.
And that is the sort of danger I am concerned about when I talk about doctors for hire. And so, on two previous occasions, when we have discussed this bill, I have put down amendments in order to restrict the number of times a doctor can consign the particular certificate. And provided this bill is given a second reading which I'm sure will happen, I intend to put down again and amendment, this time to suggest that no doctor should sign a certificate more than twice in four years.
That is a limitation which is open to discussion as to the frequency of one doctor might be restricted to signing the certificates. We can discuss this between committee and report, and finally, I just remind the noble Lord Lord Faulkner that when I have made this proposal on previous occasions, back in 2015, he told me that I am very happy to discuss with noble Lords the idea of there being some limit, and he went on to say, and again I quote, however, I am completely engaged on how one seeks to deal with the issue of doctors for hire.
I hope this is what I think would be a helpful amendment to this bill in preventing doctors setting up this reputation doctors setting up this reputation
But in particular, I am concerned in this bill onto dangers to these proposals. We heard already on the effects of the bill and encouraging greedy families and I quote as an example of that my own mother who was widowed at 58 and, during temporary doubts of illness and depression, on many occasions, told us that she wished she could die, but of course, we join her along and in the event she lived until she was 96, having led an interesting life and having seen a good deal of the world during those years.
And I know that during those depressed moments, we could perfectly well have agreed with her and told her that we will try to arrange assisted dying if it had been done available. And the second concern I have is concern at the issue of doctors for higher. These are people who strongly support assisted dying and build a reputation for sanctioning it to become what I can only describe as a soft touch. An example of this, I noticed in the advice we have all had over this bill that, with regard to the Canadian situation, I saw one small sentence which said that, in Canada, 4% of medical aid in dying practitioners provide these services more than 30 times a year.
And that is the sort of danger I am concerned about when I talk about doctors for hire. And so, on two previous occasions, when we have discussed this bill, I have put down amendments in order to restrict the number of times a doctor can consign the particular certificate. And provided this bill is given a second reading which I'm sure will happen, I intend to put down again and amendment, this time to suggest that no doctor should sign a certificate more than twice in four years.
That is a limitation which is open to discussion as to the frequency of one doctor might be restricted to signing the certificates. We can discuss this between committee and report, and finally, I just remind the noble Lord Lord Faulkner that when I have made this proposal on previous occasions, back in 2015, he told me that I am very happy to discuss with noble Lords the idea of there being some limit, and he went on to say, and again I quote, however, I am completely engaged on how one seeks to deal with the issue of doctors for hire.
I hope this is what I think would be a helpful amendment to this bill in preventing doctors setting up this reputation doctors setting up this reputation
10:45
Baroness Butler-Sloss (Crossbench)
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Baroness Butler-Sloss (Crossbench)
I oppose this bill but I do recognise there are arguments which we have heard which many people support. I'm particularly relieved at the motion from Baroness Berger to get some proper scrutiny of this bill. My main concern is that it is a badly flawed bill. It needs radical improvement. And, as many have already said, it is probably one of the most important bills that this House will ever have to consider. But this bill is not the right way to go into law.
We start with 42 delegated power. This will be dealt with by the Secretary of State, but obviously more likely by the civil servants. In the Department of Health. We are not asked to consider nearly all the crucial details of this enormously important bill. We have already heard of the very real concerns of the Delegated Powers and Regulatory Reform Committee, and the Constitution Committee. I don't remember ever before reading in such a report words like " The power is inappropriate and should be removed.
" The highly inappropriate nature of clause 37, the panel, is it intended to meet in public and hear evidence? Will they meet at all? Or will it be a tick box ceremony? Why no coroner check? Surely that is an obvious safeguard? Assisted dying will be paid for by the NHS, as so many have pointed out already. Only 30% of the palliative care is paid for so this is an obvious inequality. I declare an interest as a former vice president of the Exeter and Devon hospice care.
It is a wonderful institution helping a dying friend of mine to stay at home. The process will require assessment of coordinating doctor, the independent doctor, the panel psychiatrist, and the doctor to carry out the death. The NHS ready to cope with this? We should not ignore many real concerns of colleges including psychiatrists who are very concerned about the bill. They of course are expected to provide panel members. I declare an interest as an honorary fellow of the College of psychiatrists.
It is I understand not easy to assess when a patient will die within six months. The Lockerbie bomber lived three years, as has already been said. Six months may also be very unfair to those with motor neurone disease or other similar diseases may not have the physical ability to take the final step they need to take. Is this bill intended to be the start? Will it be amended shortly to increase the ability to expanding assisted dying to one year, two years, three years? This is a slippery slope as others have said.
The possibility of coercion will be even more likely, and the feeling of being a burden on others, especially a financial burden, is, as so many others have said, obvious. This is a serious flawed bill. It is a Private Members' Bill and it is time the government took it over and put it properly into order.
**** Possible New Speaker ****
My Lords I could not possibly attempt to compete with the forensic
We start with 42 delegated power. This will be dealt with by the Secretary of State, but obviously more likely by the civil servants. In the Department of Health. We are not asked to consider nearly all the crucial details of this enormously important bill. We have already heard of the very real concerns of the Delegated Powers and Regulatory Reform Committee, and the Constitution Committee. I don't remember ever before reading in such a report words like " The power is inappropriate and should be removed.
" The highly inappropriate nature of clause 37, the panel, is it intended to meet in public and hear evidence? Will they meet at all? Or will it be a tick box ceremony? Why no coroner check? Surely that is an obvious safeguard? Assisted dying will be paid for by the NHS, as so many have pointed out already. Only 30% of the palliative care is paid for so this is an obvious inequality. I declare an interest as a former vice president of the Exeter and Devon hospice care.
It is a wonderful institution helping a dying friend of mine to stay at home. The process will require assessment of coordinating doctor, the independent doctor, the panel psychiatrist, and the doctor to carry out the death. The NHS ready to cope with this? We should not ignore many real concerns of colleges including psychiatrists who are very concerned about the bill. They of course are expected to provide panel members. I declare an interest as an honorary fellow of the College of psychiatrists.
It is I understand not easy to assess when a patient will die within six months. The Lockerbie bomber lived three years, as has already been said. Six months may also be very unfair to those with motor neurone disease or other similar diseases may not have the physical ability to take the final step they need to take. Is this bill intended to be the start? Will it be amended shortly to increase the ability to expanding assisted dying to one year, two years, three years? This is a slippery slope as others have said.
The possibility of coercion will be even more likely, and the feeling of being a burden on others, especially a financial burden, is, as so many others have said, obvious. This is a serious flawed bill. It is a Private Members' Bill and it is time the government took it over and put it properly into order.
**** Possible New Speaker ****
My Lords I could not possibly attempt to compete with the forensic
10:49
Lord Moore of Etchingham (Non-affiliated)
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Lord Moore of Etchingham (Non-affiliated)
attempt to compete with the forensic skill of the noble and learned Earl Baroness Butler-Sloss which is so impressive. I want to add one striking comparison which I hope will be illuminated. Near my home in Sussex, stands a beautiful cliff of Beachley head. It is the most popular National trust property with two and a half million visitors every year. It is also the number one suicide slot in the world. Online suicide forums instruct people exactly how to get there and jump to their death.
At least one such candidate arrives every single day. Also every day, a remarkable charity is there, based five minutes walk from the fatal cliff edge. Purpose is the opposite of assisted suicide they try to persuade those who have come to die to live. They are astonishingly successful. I have the latest figure from the team CEO. So far this year, they have engaged with 271 people who have come to kill themselves. Of those only four have jumped. The chaplaincy team also worked tirelessly with Sussex police, council, clinical mental health professionals, the local pub, local taxi service and the National trust, at all practical method of dissuasion.
Such preventative actions work. The total of those who arrived intending to jump has fallen by 32% since 2023. As these potential suicides make that nine minute walk, chaplains who are well trained in spotting symptoms and often carrying intelligence about individual arrivals try to engage in a conversation. There carefully honed technique starts by showing empathy and moves to establishing rapport to suggested behavioural change and walking them down to the teams building for a cup of tea.
Studies show that suicidal ideation, the overriding presence of thoughts of death and suicide is never continuous for more than four hours. Often for much less. Offer the right mixture of professionalism and human kindness, people do change their minds. Of those 271, only 57 even reached the cliff. And as I say, only four actually jumped. I'm sure your Lordships House will admire this moving example of cooperation between private charity and public services. And the triumphal life itself. Indeed the police intervene against suicide attempts and article two of the European Charter of human rights, the right to life.
Some may object the sort of suicide being assisted by this bill before us is very different from that being prevented on bleakly head. But I would quite like to end by asking your Lordships to think that this bill does not stop the freedom to kill yourself, it confers a right to kill yourself at public expense. It also reverses the operation of the power of human persuasion which works such wonders. Under this legislation, professionals will, by definition, people wishing to fulfil a person's wish to die.
No one will be present to advocates choice of life. I do not believe that our country, and particularly our national health, can successfully contain such a contradiction in public policy morality. If this bill is enacted, the same hospitals where professionals help rescue potential suicides will contain other professionals who give gravely sick people the substances to kill themselves. The chaplains say, "Please don't jump. " And in regards to this bill I say the same to you.
At least one such candidate arrives every single day. Also every day, a remarkable charity is there, based five minutes walk from the fatal cliff edge. Purpose is the opposite of assisted suicide they try to persuade those who have come to die to live. They are astonishingly successful. I have the latest figure from the team CEO. So far this year, they have engaged with 271 people who have come to kill themselves. Of those only four have jumped. The chaplaincy team also worked tirelessly with Sussex police, council, clinical mental health professionals, the local pub, local taxi service and the National trust, at all practical method of dissuasion.
Such preventative actions work. The total of those who arrived intending to jump has fallen by 32% since 2023. As these potential suicides make that nine minute walk, chaplains who are well trained in spotting symptoms and often carrying intelligence about individual arrivals try to engage in a conversation. There carefully honed technique starts by showing empathy and moves to establishing rapport to suggested behavioural change and walking them down to the teams building for a cup of tea.
Studies show that suicidal ideation, the overriding presence of thoughts of death and suicide is never continuous for more than four hours. Often for much less. Offer the right mixture of professionalism and human kindness, people do change their minds. Of those 271, only 57 even reached the cliff. And as I say, only four actually jumped. I'm sure your Lordships House will admire this moving example of cooperation between private charity and public services. And the triumphal life itself. Indeed the police intervene against suicide attempts and article two of the European Charter of human rights, the right to life.
Some may object the sort of suicide being assisted by this bill before us is very different from that being prevented on bleakly head. But I would quite like to end by asking your Lordships to think that this bill does not stop the freedom to kill yourself, it confers a right to kill yourself at public expense. It also reverses the operation of the power of human persuasion which works such wonders. Under this legislation, professionals will, by definition, people wishing to fulfil a person's wish to die.
No one will be present to advocates choice of life. I do not believe that our country, and particularly our national health, can successfully contain such a contradiction in public policy morality. If this bill is enacted, the same hospitals where professionals help rescue potential suicides will contain other professionals who give gravely sick people the substances to kill themselves. The chaplains say, "Please don't jump. " And in regards to this bill I say the same to you.
10:53
Baroness Coffey (Conservative)
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Baroness Coffey (Conservative)
1,500 people will die in the UK today, nearly 500 from cancer. Death does come to us all and we want to make sure people have as comfortable a death as possible. In the legislation before us do we want people to be enabled to take their own life. We are asking to provide services that happen. I reckon as we have had a lot of distressing stories where people have suffered pain, intolerable pain at the end of their life.
The suggestion is that introducing this assisted dying control suicide, and the pain can be avoided. There is no reference to pain or suffering in this bill. We have heard the debate about polling and how this is effectively control suicide. The BMA survey shows that support for GPs has fallen, Royal colleges have expressed concerns. I do not want to extend life unduly. In the week the government has introduced the Hillsborough Law, the legal case of Tony Bland, the 96th victim, the decision to artificially keep alive I think was the right one.
I support the concept of DNR. I have seen firsthand how the patient relationship can be frighteningly coercive even with something as simple as sedation for a broken hip. I think back with a shudder to the Liverpool pathway. What an awful way to die. It had become commonplace, and I raised this when I first entered Parliament and gathered enough support from other MPs to get the government to review and end the practice. I do have serious doubts about how or whether we can get this legislation right, to cover in particular indirect coercion.
This indirect coercion is real. The feeling of being a burden. Knowing you can save money for the NHS if you went that bit earlier. Knowing you might want to leave more money to your children rather than pay care fees. As such, I'm generally concerned about how this may become commonplace here, as it is already in Canada. There will be other concerns I raised in Committee stage including the provision in Wales, given that the Welsh Senate has given that the Welsh Senate has voted against this.
I follow proceedings of the bill since it was introduced in the Commons and the bill has changed considerably since it was first introduced. I welcome the proposal for a short Select Committee ahead of our consideration of the Committee stage. One change the Commons did make report stage was I welcome was not to allow doctors to raise this option with a child. Which the promoters of this bill opposed. It got through against their desire. Dressing Lord Forsyth's amendment, which I'm pleased he has indicated he will withdraw later, I don't need to dwell on the differences in processes between the Commons and Lords in its consideration.
But I do not agree that this Private Members' Bill should get particularly special treatment in your Lordships House. This bill has already received substantial support from civil servants. I'm not questioning that because I appreciate you have to get this in the wake can be delivered. But as has been exposed by the two select committees already that consider this bill, that has led to an extreme number of regulations and unlimited powers. Indeed both the MoJ and the Department for Health and Social Care have asked for specific areas.
I take you back sometime but on a much shorter bill five clauses with a majority of children certifying the Commons, not just the 23 this bill enjoys, which fell from Second Reading to third reading Lordships did stop consideration of Committee stage will stop government then put the bill the Manifesto at the election and it passed eventually through both houses. This private member's bill should not be turned into a government bill now. Will take all the fixes. I hope people will doing their best to scrutinise it and get something that work but I fear it may not.
The suggestion is that introducing this assisted dying control suicide, and the pain can be avoided. There is no reference to pain or suffering in this bill. We have heard the debate about polling and how this is effectively control suicide. The BMA survey shows that support for GPs has fallen, Royal colleges have expressed concerns. I do not want to extend life unduly. In the week the government has introduced the Hillsborough Law, the legal case of Tony Bland, the 96th victim, the decision to artificially keep alive I think was the right one.
I support the concept of DNR. I have seen firsthand how the patient relationship can be frighteningly coercive even with something as simple as sedation for a broken hip. I think back with a shudder to the Liverpool pathway. What an awful way to die. It had become commonplace, and I raised this when I first entered Parliament and gathered enough support from other MPs to get the government to review and end the practice. I do have serious doubts about how or whether we can get this legislation right, to cover in particular indirect coercion.
This indirect coercion is real. The feeling of being a burden. Knowing you can save money for the NHS if you went that bit earlier. Knowing you might want to leave more money to your children rather than pay care fees. As such, I'm generally concerned about how this may become commonplace here, as it is already in Canada. There will be other concerns I raised in Committee stage including the provision in Wales, given that the Welsh Senate has given that the Welsh Senate has voted against this.
I follow proceedings of the bill since it was introduced in the Commons and the bill has changed considerably since it was first introduced. I welcome the proposal for a short Select Committee ahead of our consideration of the Committee stage. One change the Commons did make report stage was I welcome was not to allow doctors to raise this option with a child. Which the promoters of this bill opposed. It got through against their desire. Dressing Lord Forsyth's amendment, which I'm pleased he has indicated he will withdraw later, I don't need to dwell on the differences in processes between the Commons and Lords in its consideration.
But I do not agree that this Private Members' Bill should get particularly special treatment in your Lordships House. This bill has already received substantial support from civil servants. I'm not questioning that because I appreciate you have to get this in the wake can be delivered. But as has been exposed by the two select committees already that consider this bill, that has led to an extreme number of regulations and unlimited powers. Indeed both the MoJ and the Department for Health and Social Care have asked for specific areas.
I take you back sometime but on a much shorter bill five clauses with a majority of children certifying the Commons, not just the 23 this bill enjoys, which fell from Second Reading to third reading Lordships did stop consideration of Committee stage will stop government then put the bill the Manifesto at the election and it passed eventually through both houses. This private member's bill should not be turned into a government bill now. Will take all the fixes. I hope people will doing their best to scrutinise it and get something that work but I fear it may not.
10:58
Baroness Alexander of Cleveden (Labour)
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Baroness Alexander of Cleveden (Labour)
My Lords, it is not easy to be speak at number 108. And presumably even harder to be speaker 168. As a relatively new member of your Lordships House, last week's debate was a privilege. Arguments about choice, autonomy, and the sanctity of life, led throughout by extraordinarily moving personal experiences. And for this Lord's novice, it seemed a classic second reading. Yet today's debate seems to call for something slightly different. And to focus on what has been asked of us as legislators.
For its supporters, this bill provides choice aligned with public opinion, respect for the other place, and no compunction on anyone to do anything that they don't wish to do. For the 40+ opposing speeches, it was more nuanced. The opposing speeches falling to TEA main categories. Firstly those who oppose the bill in principle. Because they believe in the sanctity of life is that universal value in all circumstances. And it is an honourable position. Yet more opposing speeches focused on the bill's details.
These noble Lords professed no philosophical objection to the right to end one's life under agreed conditions. But they nevertheless expressed profound concerns about the bill's provisions. And for those whose concerns lie with the details, a week has indeed been a long time in politics. We now do have a new and exceptional Select Committee. A space to probe. Other protections for the vulnerable the right ones? Other safeguards appropriate? Are any of the processes over complex? And time to interrogate those delegated power.
As a Scottish resident, I won't be subject to this bill. The sister bill making its way through the Scottish Parliament has different safeguards. For example it involves two doctors but no panel on different levels. As a supporter of the bill, I recognise all these aspects and more will be up for scrutiny at the Select Committee, and Committee stage, and report Our scrutiny matters because our postbag's are heaving with misplaced anxieties. It is proper to be odd by the responsibility of scrutiny interrogating the detail.
Making the bill as good as it can be in our less than perfect world. So, I say to noble Lords with practical reservations please don't kill off this bill because the details are demanding. Has the time not come to bring together all those who recognise, as Lord McDonald did last week, our current laws are not being enforced. We no longer prosecute family members for offering support. We permit indefinite sedation. People take their own lives, as we've heard, and those who can afford to do so go overseas.
It is time to bring the law up-to-date. To conclude, I recognise that, for some, this bill is a personal moral Red Line, but I believe for most noble Lords, for the Commons and certainly for the country, it is time to make the choices currently available equitably. In the service of a quiet and loving end, it's time to do what this place does best, to interrogate, to scrutinise, and to improve. It is time to move forwards with compassion, with care, and kindness.
Thank you.
**** Possible New Speaker ****
Like the noble Baroness, I welcome the important development
For its supporters, this bill provides choice aligned with public opinion, respect for the other place, and no compunction on anyone to do anything that they don't wish to do. For the 40+ opposing speeches, it was more nuanced. The opposing speeches falling to TEA main categories. Firstly those who oppose the bill in principle. Because they believe in the sanctity of life is that universal value in all circumstances. And it is an honourable position. Yet more opposing speeches focused on the bill's details.
These noble Lords professed no philosophical objection to the right to end one's life under agreed conditions. But they nevertheless expressed profound concerns about the bill's provisions. And for those whose concerns lie with the details, a week has indeed been a long time in politics. We now do have a new and exceptional Select Committee. A space to probe. Other protections for the vulnerable the right ones? Other safeguards appropriate? Are any of the processes over complex? And time to interrogate those delegated power.
As a Scottish resident, I won't be subject to this bill. The sister bill making its way through the Scottish Parliament has different safeguards. For example it involves two doctors but no panel on different levels. As a supporter of the bill, I recognise all these aspects and more will be up for scrutiny at the Select Committee, and Committee stage, and report Our scrutiny matters because our postbag's are heaving with misplaced anxieties. It is proper to be odd by the responsibility of scrutiny interrogating the detail.
Making the bill as good as it can be in our less than perfect world. So, I say to noble Lords with practical reservations please don't kill off this bill because the details are demanding. Has the time not come to bring together all those who recognise, as Lord McDonald did last week, our current laws are not being enforced. We no longer prosecute family members for offering support. We permit indefinite sedation. People take their own lives, as we've heard, and those who can afford to do so go overseas.
It is time to bring the law up-to-date. To conclude, I recognise that, for some, this bill is a personal moral Red Line, but I believe for most noble Lords, for the Commons and certainly for the country, it is time to make the choices currently available equitably. In the service of a quiet and loving end, it's time to do what this place does best, to interrogate, to scrutinise, and to improve. It is time to move forwards with compassion, with care, and kindness.
Thank you.
**** Possible New Speaker ****
Like the noble Baroness, I welcome the important development
11:02
Lord Willetts (Conservative)
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Lord Willetts (Conservative)
welcome the important development since our debate last Friday with the new motion from Baroness Barker. It is very important that we take every opportunity to scrutinise this bill and consider the issues without jeopardising the overall timetable of parliamentary scrutiny. In this mornings debate, as last week, we have had many concerns expressed about coercion. Coercion in various forms to get people to an assisted death. And the bill has many provisions to address these concerns about coercion, and of course, more options need to be considered.
But we have heard less about the coercion which is already in force under the law today. Using the power of the state to forbid some of the most compassionate forms of assisted dying. That is coercion as well, and it is causing deep human distress as we have heard throughout this debate. Sometimes, we can and do use the power of law to enforce a moral consensus in our society. But that is not the case here. Many humanists and others do not see any objection in principle to assisted dying, especially when, as with this legislation, it is restricted to people who are terminally ill.
Like the noble Baroness Blackstone, I have been very influenced by the most careful study of public attitudes by the Nuffield Council of bioethics, including assisting citizens jury. This showed very clear support, majority support for assisted dying, provided it is limited to people who are terminally ill and they have a capacity to take a decision for themselves. That is the settled moral view of our society reflected in the vote in the other house recently. There are people with strong objections of principle.
There should be no coercion for them to go for assisted dying. They should live and die according to their beliefs. But equally, there is no basis for them to forbid others who are terminally L and to have a different and legitimate moral view from taking the opportunity of assisted death. An Lord Roberts of Belgravia, in his powerful speech last week, showed that view on the right to assisted dying for the terminally L is deeply rooted in our Western tradition.
And Lord Mohammed of Tinsley made a very powerful point last week. He said he and his family, with their religious beliefs, with absolutely not wish to have anything to do with assisted dying. But he did not wish to forbid others who had a different moral view from taking the opportunity provided through this bill. This debate and this legislation is about how a society with a range of different moral and religious views can live together, and I think this bill, with its protections and provisions paradoxically shows how our treatment of assisted dying can also enable us to live together as a society.
But we have heard less about the coercion which is already in force under the law today. Using the power of the state to forbid some of the most compassionate forms of assisted dying. That is coercion as well, and it is causing deep human distress as we have heard throughout this debate. Sometimes, we can and do use the power of law to enforce a moral consensus in our society. But that is not the case here. Many humanists and others do not see any objection in principle to assisted dying, especially when, as with this legislation, it is restricted to people who are terminally ill.
Like the noble Baroness Blackstone, I have been very influenced by the most careful study of public attitudes by the Nuffield Council of bioethics, including assisting citizens jury. This showed very clear support, majority support for assisted dying, provided it is limited to people who are terminally ill and they have a capacity to take a decision for themselves. That is the settled moral view of our society reflected in the vote in the other house recently. There are people with strong objections of principle.
There should be no coercion for them to go for assisted dying. They should live and die according to their beliefs. But equally, there is no basis for them to forbid others who are terminally L and to have a different and legitimate moral view from taking the opportunity of assisted death. An Lord Roberts of Belgravia, in his powerful speech last week, showed that view on the right to assisted dying for the terminally L is deeply rooted in our Western tradition.
And Lord Mohammed of Tinsley made a very powerful point last week. He said he and his family, with their religious beliefs, with absolutely not wish to have anything to do with assisted dying. But he did not wish to forbid others who had a different moral view from taking the opportunity provided through this bill. This debate and this legislation is about how a society with a range of different moral and religious views can live together, and I think this bill, with its protections and provisions paradoxically shows how our treatment of assisted dying can also enable us to live together as a society.
11:06
Lord Empey (Ulster Unionist Party)
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Lord Empey (Ulster Unionist Party)
I have been shocked at the Parliamentary process applied to this bill. It is like the detailed scrutiny that such a major piece of legislation requires as confirmed in recent devastating reports committees of this house. Despite all the hype in the Commons, it failed to gain the support of the majority of MPs. Let us be clear on what this does. It authorises medical professionals in employment of the state to introduce and ultimately provide the means through which an individual in the care of the NHS can be assisted to commit suicide and to observe and supervise that process.
The bill also gives unprecedented powers to the Secretary of State. This bill is not fit for purpose and I am not convinced that it can be adequately reformed. As a member of the Presbyterian Church, I accept my churches teaching on the principle of this bill, but I'm also a legislator which confers its own responsibilities. In my family's case, we were faced with the illness of my late wife Stella. She suffered from complicated medical conditions. In January 2023, she was very unwell to the extent that the consultant called the family together and said that she was not going to pull out of it this time.
He would have said yes, she would die in six months. Would he have signed off expecting the death in six days? I believe so, as that is what we were told. Nine months later, I was still taking her out most days and she was able to enjoy the time with our children and grandchildren. I am also aware that she felt she was impacted on the ability of our children to get on with their careers. I could sense the anxiety she felt impacting on our lives.
This is the pressure point that is glossed over in this bill and the discourse around it. Doctors don't get it right all the time and this arbitrary six month timescale in my view is a dangerous nonsense. The bill would fundamentally change the relationship between the medical profession and patients at all levels. Gone would be the days that do no harm. Doctors could be seen not only as healers but as instruments to end the life of a patient in hospital, may be spend on by financial reasons.
Families aren't always welcoming environments. They can be toxic with competing pressures, especially over money. It is in these circumstances where subtle pressures to end a life can be generated. Some of the basic practicalities have not yet been investigated because of this mad dash to get this bill through. I know all of us in this chamber want the same thing, to reduce and minimise suffering. None of us know how our days will end, but I believe we are adding to suffering by introducing massive anxiety to patients at the most vulnerable time of the lives.
We may be characterised by messages from disabled people, the elderly and others who feel a sense that they are no longer valued by society, surplus to requirements, may cost centres. I know this is not the intention of responses, but that is the inevitable outcome. To involve the entire NHS and turn its ethos upside down is a serious mistake. People also may be afraid to present themselves to doctors for fear of getting a one-way ticket. But those of us with the financial means to get the best advice can do so, but for those without resources, it is the NHS or nothing.
It is time to think again. We have underinvested in palliative care for years, reducing not enhancing choice. Surely it makes sense to follow that route as emphasised by former prime minister Gordon Brown, rather than risky nearly 80 years of the embedding of a life-saving NHS in our nations DNA.
**** Possible New Speaker ****
I am aware that many of your
The bill also gives unprecedented powers to the Secretary of State. This bill is not fit for purpose and I am not convinced that it can be adequately reformed. As a member of the Presbyterian Church, I accept my churches teaching on the principle of this bill, but I'm also a legislator which confers its own responsibilities. In my family's case, we were faced with the illness of my late wife Stella. She suffered from complicated medical conditions. In January 2023, she was very unwell to the extent that the consultant called the family together and said that she was not going to pull out of it this time.
He would have said yes, she would die in six months. Would he have signed off expecting the death in six days? I believe so, as that is what we were told. Nine months later, I was still taking her out most days and she was able to enjoy the time with our children and grandchildren. I am also aware that she felt she was impacted on the ability of our children to get on with their careers. I could sense the anxiety she felt impacting on our lives.
This is the pressure point that is glossed over in this bill and the discourse around it. Doctors don't get it right all the time and this arbitrary six month timescale in my view is a dangerous nonsense. The bill would fundamentally change the relationship between the medical profession and patients at all levels. Gone would be the days that do no harm. Doctors could be seen not only as healers but as instruments to end the life of a patient in hospital, may be spend on by financial reasons.
Families aren't always welcoming environments. They can be toxic with competing pressures, especially over money. It is in these circumstances where subtle pressures to end a life can be generated. Some of the basic practicalities have not yet been investigated because of this mad dash to get this bill through. I know all of us in this chamber want the same thing, to reduce and minimise suffering. None of us know how our days will end, but I believe we are adding to suffering by introducing massive anxiety to patients at the most vulnerable time of the lives.
We may be characterised by messages from disabled people, the elderly and others who feel a sense that they are no longer valued by society, surplus to requirements, may cost centres. I know this is not the intention of responses, but that is the inevitable outcome. To involve the entire NHS and turn its ethos upside down is a serious mistake. People also may be afraid to present themselves to doctors for fear of getting a one-way ticket. But those of us with the financial means to get the best advice can do so, but for those without resources, it is the NHS or nothing.
It is time to think again. We have underinvested in palliative care for years, reducing not enhancing choice. Surely it makes sense to follow that route as emphasised by former prime minister Gordon Brown, rather than risky nearly 80 years of the embedding of a life-saving NHS in our nations DNA.
**** Possible New Speaker ****
I am aware that many of your
11:11
Lord Griffiths of Burry Port (Labour)
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**** Possible New Speaker ****
I am aware that many of your Lordships will know that my life has been spent as a Methodist minister been spent as a Methodist minister in pastoral work who will have reached an assumption that they know what I'm going to say. It is not necessarily the case. I have tried knowing that that awareness would exist to give my best attention to the material that has flooded our way over the last month. And I have tried to make sense of it in as rational a way as I possibly can.
If I have a qualification for speaking in a debate of this kind, it is simply the fact that my experience of the phenomena we are describing has always or often begun when symptoms presented themselves, moved through to diagnosis, went in to treatment, saw the last days and end of a particular person's life, and dealt with all the emotions that were released after the death amongst the nearest and dearest of the people who have died. It is a long curve of being with people directly affected by the phenomena we are talking about.
And I have to say that families are not good places necessarily. But within families, you have views that put pressure on people. But also, others who take a much more humane view of things blame after the death, you could have done better, we shouldn't have done this and so on and so forth. Choice is not an individual making a decision, forensically separated from all of the circumstances and context within which that happens. But surrounded by complexity.
Predisposed attitudes, and I therefore wish that we could look again at what we think we mean when we say choice. The choice for the person who needs or wants to die is not a choice exercised for the most part in isolation from other factors. I am delighted that my noble friends have come to an agreement about a Committee stage to look further at the sorts of issue and phenomena that we are describing in a debate of this kind.
For that reason, her letter with her associates was the lodestone for my making sense of all the material I've been wrestling with, and I'm glad that we received the subsequent letter that suggests there may be a proper place where we can look into the proper worries that have been expressed here in this chamber. I myself doubt whether November 7 is to near as a starting point, but we can look at that in due course. All I know is that a person who dies may want to or may not want to, may be led to want to, or averted from wanting to.
There are near and dear people who turn out to be quite problematic in the total pastoral situation. This is not an easy matter. But I have to say, at the end of the day, I would vote with all of us in this situation emerging for the amendment, but I can't dismiss from my head what a senior doctor said, that this will change the practice and culture of medicine in ways that no amendment of this bill can prevent.
**** Possible New Speaker ****
I am against this bill. I'm against it because it is legally and
Lord Griffiths of Burry Port (Labour)
**** Possible New Speaker ****
I am aware that many of your Lordships will know that my life has been spent as a Methodist minister been spent as a Methodist minister in pastoral work who will have reached an assumption that they know what I'm going to say. It is not necessarily the case. I have tried knowing that that awareness would exist to give my best attention to the material that has flooded our way over the last month. And I have tried to make sense of it in as rational a way as I possibly can.
If I have a qualification for speaking in a debate of this kind, it is simply the fact that my experience of the phenomena we are describing has always or often begun when symptoms presented themselves, moved through to diagnosis, went in to treatment, saw the last days and end of a particular person's life, and dealt with all the emotions that were released after the death amongst the nearest and dearest of the people who have died. It is a long curve of being with people directly affected by the phenomena we are talking about.
And I have to say that families are not good places necessarily. But within families, you have views that put pressure on people. But also, others who take a much more humane view of things blame after the death, you could have done better, we shouldn't have done this and so on and so forth. Choice is not an individual making a decision, forensically separated from all of the circumstances and context within which that happens. But surrounded by complexity.
Predisposed attitudes, and I therefore wish that we could look again at what we think we mean when we say choice. The choice for the person who needs or wants to die is not a choice exercised for the most part in isolation from other factors. I am delighted that my noble friends have come to an agreement about a Committee stage to look further at the sorts of issue and phenomena that we are describing in a debate of this kind.
For that reason, her letter with her associates was the lodestone for my making sense of all the material I've been wrestling with, and I'm glad that we received the subsequent letter that suggests there may be a proper place where we can look into the proper worries that have been expressed here in this chamber. I myself doubt whether November 7 is to near as a starting point, but we can look at that in due course. All I know is that a person who dies may want to or may not want to, may be led to want to, or averted from wanting to.
There are near and dear people who turn out to be quite problematic in the total pastoral situation. This is not an easy matter. But I have to say, at the end of the day, I would vote with all of us in this situation emerging for the amendment, but I can't dismiss from my head what a senior doctor said, that this will change the practice and culture of medicine in ways that no amendment of this bill can prevent.
**** Possible New Speaker ****
I am against this bill. I'm against it because it is legally and
11:15
Lord Frost (Conservative)
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Lord Frost (Conservative)
against it because it is legally and practically defective in many ways, as many other noble Lords have already said. But I am against it for philosophical and religious reasons as well. For the first time ever, this bill seeks to give a person of sound will in mind the right to act contrary to a fundamental element of the ethical tradition that has been fundamental to this country. That is, Judaeo- Christian morality. The view that our life is not our own possession to dispose of as we see fit, nor to be taken from us by others at our While many noble Lords may ask, why does this matter to me? I am not religious, they say, and I do not share that ethical system.
Such noble Lords, and we have heard some say they have the right to free choice, to autonomy over their own life. The right to protect the dignity, as they see it, of those close to them. I want to briefly explain why I don't think this argument is sufficient. And why even those of no religious belief should still be concerned by the prospect of going down the road set out in this bill. The problem, as I see it, is that the values used to justify this bill, values of ensuring dignity, preserving autonomy, personal freedom, are themselves also derived from that Judaeo- Christian ethical system.
As my noble friend reminded us last week, they have been in the past, and there still are today, many societies that don't fully share those values. They are not self- evident. However much many of us would wish they were. What we are proposing to do in this bill is to dismantle part of that inherited ethical system by allowing the state to engage in killing innocent people at their request. But once we have dismantled one part of that system because we think we know best, what then is the status of the rest of that moral and ethical system? Once you have introduced utilitarianism into our societies decisions, do you stop? The ultimate destination of this journey is utilitarian society with utilitarian government.
One where there is no freestanding inherited moral principles of any kind but only the principles that we think we are clever enough to create. The problem is that, in such a society, none of us are really safe. The only protection for any of us then is that collective wishes of society, whatever they are at any given moment. In such a society, the rights of those who are inconvenienced, the disabled, the ill, the elderly, or maybe those were just unpopular have no robust defence, and are potentially vulnerable.
Any of us might one day fall into any of those categories. At that point, your only protection against the general will of society comes from an appeal to the same ethical system that you have just decided is merely contingent. Capable of being disposed of if it is inconvenient. You may think, as I do, human dignity or autonomy or freedom are important, but what if the general will of society does not? What grounds do you have to stand on them? My Lords, that is why it is so dangerous to continue dismantling this ethical code, as this bill does.
I urge us to ask ourselves and think hard, are we really confident that we are the generation that is so sure of its judgement, so wise, so knowledgeable, so confident we can create a good society on foundations not that we have inherited but that we should we ourselves have design? Are we so sure of all of those things that we can casually cast aside 2,000 years of our moral tradition and tell ourselves that it does not matter. Look around our country and ask yourself that question.
I do not think so. And fall.
Such noble Lords, and we have heard some say they have the right to free choice, to autonomy over their own life. The right to protect the dignity, as they see it, of those close to them. I want to briefly explain why I don't think this argument is sufficient. And why even those of no religious belief should still be concerned by the prospect of going down the road set out in this bill. The problem, as I see it, is that the values used to justify this bill, values of ensuring dignity, preserving autonomy, personal freedom, are themselves also derived from that Judaeo- Christian ethical system.
As my noble friend reminded us last week, they have been in the past, and there still are today, many societies that don't fully share those values. They are not self- evident. However much many of us would wish they were. What we are proposing to do in this bill is to dismantle part of that inherited ethical system by allowing the state to engage in killing innocent people at their request. But once we have dismantled one part of that system because we think we know best, what then is the status of the rest of that moral and ethical system? Once you have introduced utilitarianism into our societies decisions, do you stop? The ultimate destination of this journey is utilitarian society with utilitarian government.
One where there is no freestanding inherited moral principles of any kind but only the principles that we think we are clever enough to create. The problem is that, in such a society, none of us are really safe. The only protection for any of us then is that collective wishes of society, whatever they are at any given moment. In such a society, the rights of those who are inconvenienced, the disabled, the ill, the elderly, or maybe those were just unpopular have no robust defence, and are potentially vulnerable.
Any of us might one day fall into any of those categories. At that point, your only protection against the general will of society comes from an appeal to the same ethical system that you have just decided is merely contingent. Capable of being disposed of if it is inconvenient. You may think, as I do, human dignity or autonomy or freedom are important, but what if the general will of society does not? What grounds do you have to stand on them? My Lords, that is why it is so dangerous to continue dismantling this ethical code, as this bill does.
I urge us to ask ourselves and think hard, are we really confident that we are the generation that is so sure of its judgement, so wise, so knowledgeable, so confident we can create a good society on foundations not that we have inherited but that we should we ourselves have design? Are we so sure of all of those things that we can casually cast aside 2,000 years of our moral tradition and tell ourselves that it does not matter. Look around our country and ask yourself that question.
I do not think so. And fall.
11:19
Lord Beith (Liberal Democrat)
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Lord Beith (Liberal Democrat)
I don't bring to this debate any medical knowledge or expertise. My relevant experience is having headed home for both my first and second wife as they faced the terminal stages of cancer. Noble Lords will have memories of my second wife and her work in this House which she continued with determination as she coped with the cancer treatment. Whatever ethical or religious who I might take about assisted dying assisted suicide, I respect the sincerity and strength of feeling of those who want this change in the law.
Whatever view I individually take, as a liberal I cannot simply deny that feeling to others unless granting the freedom causes or could cause so many problems that it justifies intervention of the law. I think the debate has demonstrated there are potentially significant harms to others that could result in problems. We are duty-bound to assess the harm, and see if it can be successfully mitigated or is so great that the bill should not proceed. I won't list all the stages identified, but my concerns are the fears that many people have that day and others will feel pressure to end their lives.
They may feel they should take this course rather than be seen as a burden to their families, the health service, or society, and I'm concerned that this will severely damage the way medical staff interact with patients. I think it would be quite wrong to offer an unequal choice to patient through assisted suicide and palliative care. The suicide help is available, but the requisite level of care may not be. I've met wonderful people working in palliative care but there are not enough of them.
The service varies greatly, in terms of quality in different areas. I'm concerned that existing palliative care practice could be adversely affected by the bill. If medical practitioners administer drugs to relieve pain symptoms and the patient dies within six months, will they be accused of failing to go through the procedures this bill provides for intended death when there was no such intent and the drug use was entirely to bring comfort to the patient? The hospice movement, it is massively dependent on charitable giving has many concerned about how the bill would operate, both as regards clinical practice and in terms of its impact on giving from people who do not want their gifts to support assisted suicide.
As the bill stands, hospices whether residential or home-based are not allowed to opt completely out of the system. That cannot be right. I serve on the Constitution Committee of this House and endorse the objections raised to an amendable secondary legislation, and to defy many of the central features of the system being created and its relationship to the NHS. I'm worried by the exclusion of the coroner's jurisdiction. There will be cases which would, without this provision, justify investigation. And in some cases an inquest.
It is unwise to forget there are doctors and families who almost was be acting in good faith in very distressing circumstances. Medical carelessness, malpractice, and undue influence can occur. I was struck by Baroness May's reference that the bill would impact on the level of suicide for young people. It might say that ending life is the answer is your problem is we have to do something about that. I would still want it to have the most careful scrutiny and detailed evidence not just a few Fridays in House of Lords sittings.
We may get that although under a very tight timetable. I say this not in criticism of the bill's promoters. They are working on the straitjacket of private members proceedings. But we have to set about filling the gap to make sure the bill goes ahead and our concerns met to a much greater extent than achieved in the Commons. If this cannot be achieved, we should give up on the bill and start again. I have this fear this is one of those big decisions society may one day regret.
There will be no way back.
**** Possible New Speaker ****
My Lords, I want to speak briefly to the concern of feeling a burden
Whatever view I individually take, as a liberal I cannot simply deny that feeling to others unless granting the freedom causes or could cause so many problems that it justifies intervention of the law. I think the debate has demonstrated there are potentially significant harms to others that could result in problems. We are duty-bound to assess the harm, and see if it can be successfully mitigated or is so great that the bill should not proceed. I won't list all the stages identified, but my concerns are the fears that many people have that day and others will feel pressure to end their lives.
They may feel they should take this course rather than be seen as a burden to their families, the health service, or society, and I'm concerned that this will severely damage the way medical staff interact with patients. I think it would be quite wrong to offer an unequal choice to patient through assisted suicide and palliative care. The suicide help is available, but the requisite level of care may not be. I've met wonderful people working in palliative care but there are not enough of them.
The service varies greatly, in terms of quality in different areas. I'm concerned that existing palliative care practice could be adversely affected by the bill. If medical practitioners administer drugs to relieve pain symptoms and the patient dies within six months, will they be accused of failing to go through the procedures this bill provides for intended death when there was no such intent and the drug use was entirely to bring comfort to the patient? The hospice movement, it is massively dependent on charitable giving has many concerned about how the bill would operate, both as regards clinical practice and in terms of its impact on giving from people who do not want their gifts to support assisted suicide.
As the bill stands, hospices whether residential or home-based are not allowed to opt completely out of the system. That cannot be right. I serve on the Constitution Committee of this House and endorse the objections raised to an amendable secondary legislation, and to defy many of the central features of the system being created and its relationship to the NHS. I'm worried by the exclusion of the coroner's jurisdiction. There will be cases which would, without this provision, justify investigation. And in some cases an inquest.
It is unwise to forget there are doctors and families who almost was be acting in good faith in very distressing circumstances. Medical carelessness, malpractice, and undue influence can occur. I was struck by Baroness May's reference that the bill would impact on the level of suicide for young people. It might say that ending life is the answer is your problem is we have to do something about that. I would still want it to have the most careful scrutiny and detailed evidence not just a few Fridays in House of Lords sittings.
We may get that although under a very tight timetable. I say this not in criticism of the bill's promoters. They are working on the straitjacket of private members proceedings. But we have to set about filling the gap to make sure the bill goes ahead and our concerns met to a much greater extent than achieved in the Commons. If this cannot be achieved, we should give up on the bill and start again. I have this fear this is one of those big decisions society may one day regret.
There will be no way back.
**** Possible New Speaker ****
My Lords, I want to speak briefly to the concern of feeling a burden
11:23
Baroness Foster of Aghadrumsee (Non-affiliated)
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Baroness Foster of Aghadrumsee (Non-affiliated)
to ones carers and the impact that that would have if this bill were to pass. This has been mentioned by many speakers this morning. As many of you know, across this House, caregivers are the best of us and we can all attest to stories of people we know who have given everything to support their loved ones. Imagine an elderly parent aware of the sacrifices of their child being made to care for them. And thinking to themselves they will be better off to be dead.
This thought may be fleeting or it may take root. And the very existence of this piece of legislation gives legitimacy to those thoughts. By legalising assisted suicide, you de-facto make the statement that some desires to end your life are justified. The Guild someone feels will never be isolated or separate from their desire for an assisted death. Since the Oregon Death with Dignity act came in in 1998, to the end of 2024, 46.6% of those who have chosen to end their life, when asked for the reason why, sites being a burden on family, friends, and caregivers.
Of course if this bill is made law we won't know why people chose to end their life as it is not in the bill. This guilt people feel stands in stark contrast to the ideals of choice and autonomy opponents of the bill have attempted to set out in this House boat last Friday and today. Caring for a terminally or chronically ill loved one is undeniably hard. Carers make sacrifices every day, emotionally, physically, and financially. My Lords, the recent impact assessment is explicit about what this bill might mean for carers.
It says, in a chilling paragraph " One of the reported benefits of services to unpaid is the reduction in time spent providing care for the terminally ill adult who chooses to end their own life. Evidence suggests that providing unpaid, particularly at higher intensities, is associated with negative physical and mental health outcomes and employment impacts. " The impact assessment also set out that a person privately funding their residential nursing care is paid on average £1567 a week.
And someone paying for Carers Week could be paying £30 an hour. This financial impact compounds the already present emotional burden of terminal illness both the individual and for the unpaid. But they should never under our law feel pressurised towards a premature death. Today it should be a cause for great sadness that we are discussing how to help people die sooner rather than how to support them to live more comfortably, and to support those who care for their family members.
My own loved and precious mother died in June of this year. Rather than feeling a burden however, she than feeling a burden however, she was surrounded by the most excellent care in a residential home and in an acute hospital. The palliative care she received at the end of her life was passionate, pain relieving, and such a comfort to her and to us her family. I want that care and compassion for all who are dying not just some. And I certainly don't want someone like my mother feeling as if they have to end their life prematurely because they are a burden to the taxpayer, their carers, all the family.
No one should feel pressurised towards death because of financial strain or emotional guilt. There is no safeguard against asylum pressures with care. No clause can protect against the belief that life is too costly, and too much. Today we debate how to help people to die sooner. But we should be asking how to help them live better and how to support those who care for them. Creating a burden to die because we have not addressed the burden of care is not a legacy I want for this House.
This thought may be fleeting or it may take root. And the very existence of this piece of legislation gives legitimacy to those thoughts. By legalising assisted suicide, you de-facto make the statement that some desires to end your life are justified. The Guild someone feels will never be isolated or separate from their desire for an assisted death. Since the Oregon Death with Dignity act came in in 1998, to the end of 2024, 46.6% of those who have chosen to end their life, when asked for the reason why, sites being a burden on family, friends, and caregivers.
Of course if this bill is made law we won't know why people chose to end their life as it is not in the bill. This guilt people feel stands in stark contrast to the ideals of choice and autonomy opponents of the bill have attempted to set out in this House boat last Friday and today. Caring for a terminally or chronically ill loved one is undeniably hard. Carers make sacrifices every day, emotionally, physically, and financially. My Lords, the recent impact assessment is explicit about what this bill might mean for carers.
It says, in a chilling paragraph " One of the reported benefits of services to unpaid is the reduction in time spent providing care for the terminally ill adult who chooses to end their own life. Evidence suggests that providing unpaid, particularly at higher intensities, is associated with negative physical and mental health outcomes and employment impacts. " The impact assessment also set out that a person privately funding their residential nursing care is paid on average £1567 a week.
And someone paying for Carers Week could be paying £30 an hour. This financial impact compounds the already present emotional burden of terminal illness both the individual and for the unpaid. But they should never under our law feel pressurised towards a premature death. Today it should be a cause for great sadness that we are discussing how to help people die sooner rather than how to support them to live more comfortably, and to support those who care for their family members.
My own loved and precious mother died in June of this year. Rather than feeling a burden however, she than feeling a burden however, she was surrounded by the most excellent care in a residential home and in an acute hospital. The palliative care she received at the end of her life was passionate, pain relieving, and such a comfort to her and to us her family. I want that care and compassion for all who are dying not just some. And I certainly don't want someone like my mother feeling as if they have to end their life prematurely because they are a burden to the taxpayer, their carers, all the family.
No one should feel pressurised towards death because of financial strain or emotional guilt. There is no safeguard against asylum pressures with care. No clause can protect against the belief that life is too costly, and too much. Today we debate how to help people to die sooner. But we should be asking how to help them live better and how to support those who care for them. Creating a burden to die because we have not addressed the burden of care is not a legacy I want for this House.
11:28
Lord Young of Norwood Green (Labour)
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Lord Young of Norwood Green (Labour)
My Lords, as somebody once said at this stage in the debate, everything that can be said has already been said. And then added "But but not by everyone. " I am the everyone and I hope I will add something of interest. The noble Lord said this has never been tried before. It actually has, in Oregon and a number of others. It is a matter of opinion. The overwhelming weight of correspondence that I received is in favour of this bill.
Overwhelming. I'm sure they did not single me out because they knew what I thought on the issue. The other problem that has been drawn to our attention is if we go down the road of this bill, it will have an enormous strain on the NHS. I must admit, I don't understand that argument. Whether anybody opts for this or not, palliative care will have to be provided and that is already being provided stop so I don't really understand that.
Then we are told that this bill is not the right one. I've looked through it, and it seems to me that this is a very carefully worded and structured bill. It provides all the safeguards that we should want. Preliminary discussion, first declarations, subsequent assessments. And it goes on and on with safeguards. The bill contains a number of safeguards to establish at the various stages of the process including at the time approved substances were provided to the person for self administration.
The person has the capacity to make the decision to end their life. They have a clear settled and formed wish to end their life. They have made the decision that they wish to end their own life and have requested provision and assistance. I won't go on to read all of it. There are more than enough safeguards in my view. I listened carefully as one would to some of the best legal brains that we have in this House. I listened carefully to Lady Butler-Sloss who said it is badly drawn.
Once again, with due respect to her, it is a matter of opinion. I don't think it is. This is a carefully thought out well drawn bill that has been developed over a significant period developed over a significant period I would say this to the house, that what are the alternatives that present themselves to somebody in this situation? Are we really saying that that is what you want people to do? You want them to take a choice and go to Switzerland to dignity us with the rest of their family feeling anxious, concerned and worried? I don't think that is the sort of choice that we should be inflicting upon people.
I'm in favour of scrutiny and this house will do it. There is a Select Committee that is going to look at it but not in a way that will prevent the progress of this bill, so my view is, and I hope the house will recognise, that this is a good and fair bill that gives people the right to choose at a very difficult time in their life without coercion, support and help.
**** Possible New Speaker ****
The powerful speeches in this debate have shown compassion and seriousness and reflect the depth of
Overwhelming. I'm sure they did not single me out because they knew what I thought on the issue. The other problem that has been drawn to our attention is if we go down the road of this bill, it will have an enormous strain on the NHS. I must admit, I don't understand that argument. Whether anybody opts for this or not, palliative care will have to be provided and that is already being provided stop so I don't really understand that.
Then we are told that this bill is not the right one. I've looked through it, and it seems to me that this is a very carefully worded and structured bill. It provides all the safeguards that we should want. Preliminary discussion, first declarations, subsequent assessments. And it goes on and on with safeguards. The bill contains a number of safeguards to establish at the various stages of the process including at the time approved substances were provided to the person for self administration.
The person has the capacity to make the decision to end their life. They have a clear settled and formed wish to end their life. They have made the decision that they wish to end their own life and have requested provision and assistance. I won't go on to read all of it. There are more than enough safeguards in my view. I listened carefully as one would to some of the best legal brains that we have in this House. I listened carefully to Lady Butler-Sloss who said it is badly drawn.
Once again, with due respect to her, it is a matter of opinion. I don't think it is. This is a carefully thought out well drawn bill that has been developed over a significant period developed over a significant period I would say this to the house, that what are the alternatives that present themselves to somebody in this situation? Are we really saying that that is what you want people to do? You want them to take a choice and go to Switzerland to dignity us with the rest of their family feeling anxious, concerned and worried? I don't think that is the sort of choice that we should be inflicting upon people.
I'm in favour of scrutiny and this house will do it. There is a Select Committee that is going to look at it but not in a way that will prevent the progress of this bill, so my view is, and I hope the house will recognise, that this is a good and fair bill that gives people the right to choose at a very difficult time in their life without coercion, support and help.
**** Possible New Speaker ****
The powerful speeches in this debate have shown compassion and seriousness and reflect the depth of
11:32
Baroness Finn (Conservative)
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Baroness Finn (Conservative)
seriousness and reflect the depth of feeling on all sides. It is a privilege to take part. Like other noble Lords, I thank all who have written to me on the subject. Let me begin with the law as it stands. The suicide act 1961 is shot through with contradiction. It makes suicide lawful yet criminalises assistance with a penalty of up to 14 years in prison. That contradiction does not just fall upon private individuals. It is the daily terrain for doctors, nurses, police officers, coroners and prosecutors who must operate with rules whose boundaries are blurred.
Patients, families and professionals are all left to navigate an area of law where the line between compassion and crime can be perilously unclear. In practice, we have combined a lawful right to end one's life with a criminal prohibition on the assistance that may be needed to exercise that right safely and humanely. That is the very tension our clinicians and prosecutors are asked to manage without pay a Parliamentary settlement. The human cost is all too real. Families live in fear and uncertainty. If a person, because they are suffering, wishes to exercise their lawful right to end the life, the law pushes them towards doing so alone.
Too often, in traumatic ways. Others are driven overseas. Hundreds of our fellow citizens have travelled to citizens to die and those who booked tickets or a company them risk investigation on their return, and it is entirely plausible that if they are a beneficiary under the deceased's well, they can also be denied any inheritance. This is not humane or dignified settlement. Since the CPS began collating information, well over 190 suspected assisted suicide cases have been referred. Enforcement is arbitrary because the framework is incoherent.
No family can know in advance whether an act of love will be treated as a serious. The courts have done what they properly can. In the cases of Diane pretty and Paul Lamb, judges recognise the failings of the law but concluded rightly that only Parliament can resolve them. And we have also heard about the morality of assisted dying. I honour and respect those who differ from me, especially when their views are branded impersonal religious faith. But we should respect the decision of the elected House on the principal, a decision which reflects the settled view of a great many fellow citizens.
In our democratic system, the role of the house is to improve the bill so that it gives affected that decision with the greatest possible care. The bill before us is not perfect. No Private Member's Bill ever could be. Noble Lords have raised serious concerns about process, safeguards, palliative care, and ideally, this should have been a government bill drafted with the resources of Whitehall and the time deserved. To strengthen it and to improve it. I pay tribute to Lord Faulkner for his agreement to set up a Select Committee to hear further evidence and that it will report back in time to allow the whole house to consider the bill through all its stages.
In the same spirit, we should match the same quality of this debate in our approach to the bill not by defending an indefensible status quo, not by closing the door on the elected House but by doing what we do best, rigorous scrutiny and constructive amendment.
**** Possible New Speaker ****
I have no interest to declare
Patients, families and professionals are all left to navigate an area of law where the line between compassion and crime can be perilously unclear. In practice, we have combined a lawful right to end one's life with a criminal prohibition on the assistance that may be needed to exercise that right safely and humanely. That is the very tension our clinicians and prosecutors are asked to manage without pay a Parliamentary settlement. The human cost is all too real. Families live in fear and uncertainty. If a person, because they are suffering, wishes to exercise their lawful right to end the life, the law pushes them towards doing so alone.
Too often, in traumatic ways. Others are driven overseas. Hundreds of our fellow citizens have travelled to citizens to die and those who booked tickets or a company them risk investigation on their return, and it is entirely plausible that if they are a beneficiary under the deceased's well, they can also be denied any inheritance. This is not humane or dignified settlement. Since the CPS began collating information, well over 190 suspected assisted suicide cases have been referred. Enforcement is arbitrary because the framework is incoherent.
No family can know in advance whether an act of love will be treated as a serious. The courts have done what they properly can. In the cases of Diane pretty and Paul Lamb, judges recognise the failings of the law but concluded rightly that only Parliament can resolve them. And we have also heard about the morality of assisted dying. I honour and respect those who differ from me, especially when their views are branded impersonal religious faith. But we should respect the decision of the elected House on the principal, a decision which reflects the settled view of a great many fellow citizens.
In our democratic system, the role of the house is to improve the bill so that it gives affected that decision with the greatest possible care. The bill before us is not perfect. No Private Member's Bill ever could be. Noble Lords have raised serious concerns about process, safeguards, palliative care, and ideally, this should have been a government bill drafted with the resources of Whitehall and the time deserved. To strengthen it and to improve it. I pay tribute to Lord Faulkner for his agreement to set up a Select Committee to hear further evidence and that it will report back in time to allow the whole house to consider the bill through all its stages.
In the same spirit, we should match the same quality of this debate in our approach to the bill not by defending an indefensible status quo, not by closing the door on the elected House but by doing what we do best, rigorous scrutiny and constructive amendment.
**** Possible New Speaker ****
I have no interest to declare
11:36
Lord Brooke of Alverthorpe (Labour)
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**** Possible New Speaker ****
I have no interest to declare other then I booked the Lord's residence room two for Christian peers alter nominations to meet weekly for interesting conversations weekly for interesting conversations and study. The meeting starts at 1 PM and runs for 45 minutes. All are welcome. So, I have found something new to say that is not already been said. I am a believer that there is some higher power, some spirit or energy of creation. It was there before humans came along, their religions came along, and it is here now with us and if the human race disappears as it might faced with AI and climate change, that plough which gives purpose, beauty and love will continue indefinitely.
And for me, it is my source of hope. That power also gives me the freedom of choice. I have been here since 1997, so I have been involved in numerous attempts to change its law. But unlike her, I voted against the bill in 2004 and I voted against other similar initiatives, and in 2014, I spoke against Lord Faulkner. Much has changed since then. And God moves in a mysterious way in my experience. I have come now to take a decision to change my mind.
Experience has shown over recent years that change does happen, to churches, and it happened to me. When I first came here, there were no women bishops. The Lord spirit women act of 2015 change that. That's a minor change compared with the centuries growth the world population from 6.1 billion to 8.2 billion. 25% increase in 25 years, but just think what the numbers will be if abortion had not been legalised. Or, if there had not been skilled usage and advocacy of contraception.
And indeed, a growth of homosexuality throughout society has reduced the number of children we would have had had the churches had their way. We would have had a very much bigger population than we presently have facing the difficulties we have with climate change. So we all have change taking place around us, including the churches. For some, dying is welcome and is peaceful and serene. For others, it is full of difficulties, of great difficulties of pain, anxiety, and misery, notwithstanding all the admirable efforts of palliative care.
People with terminal illnesses in my experience in recent years have seen dying in fear, acute pain, and misery. Of course, this can be avoided if one has the money. Anyone can go to Switzerland for assisted dying at a price. Further, you can go virtually safe in the knowledge that any punitive action will be taken against you. Why isn't such action taken? Isn't it because most people see assistance with dying for the terminally ill as an act of caring, compassion and love? For those without the funds for that, this bill avoids just that.
Who am I to deny that those less able to afford it should not have a choice?
**** Possible New Speaker ****
As legislators, all sorts of laws
Lord Brooke of Alverthorpe (Labour)
**** Possible New Speaker ****
I have no interest to declare other then I booked the Lord's residence room two for Christian peers alter nominations to meet weekly for interesting conversations weekly for interesting conversations and study. The meeting starts at 1 PM and runs for 45 minutes. All are welcome. So, I have found something new to say that is not already been said. I am a believer that there is some higher power, some spirit or energy of creation. It was there before humans came along, their religions came along, and it is here now with us and if the human race disappears as it might faced with AI and climate change, that plough which gives purpose, beauty and love will continue indefinitely.
And for me, it is my source of hope. That power also gives me the freedom of choice. I have been here since 1997, so I have been involved in numerous attempts to change its law. But unlike her, I voted against the bill in 2004 and I voted against other similar initiatives, and in 2014, I spoke against Lord Faulkner. Much has changed since then. And God moves in a mysterious way in my experience. I have come now to take a decision to change my mind.
Experience has shown over recent years that change does happen, to churches, and it happened to me. When I first came here, there were no women bishops. The Lord spirit women act of 2015 change that. That's a minor change compared with the centuries growth the world population from 6.1 billion to 8.2 billion. 25% increase in 25 years, but just think what the numbers will be if abortion had not been legalised. Or, if there had not been skilled usage and advocacy of contraception.
And indeed, a growth of homosexuality throughout society has reduced the number of children we would have had had the churches had their way. We would have had a very much bigger population than we presently have facing the difficulties we have with climate change. So we all have change taking place around us, including the churches. For some, dying is welcome and is peaceful and serene. For others, it is full of difficulties, of great difficulties of pain, anxiety, and misery, notwithstanding all the admirable efforts of palliative care.
People with terminal illnesses in my experience in recent years have seen dying in fear, acute pain, and misery. Of course, this can be avoided if one has the money. Anyone can go to Switzerland for assisted dying at a price. Further, you can go virtually safe in the knowledge that any punitive action will be taken against you. Why isn't such action taken? Isn't it because most people see assistance with dying for the terminally ill as an act of caring, compassion and love? For those without the funds for that, this bill avoids just that.
Who am I to deny that those less able to afford it should not have a choice?
**** Possible New Speaker ****
As legislators, all sorts of laws
11:40
Baroness Fox of Buckley (Non-affiliated)
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**** Possible New Speaker ****
As legislators, all sorts of laws passed through our hands, the good, the bad, and the ugly. All are consequential fellow citizens but consequential fellow citizens but rarely does a bill way as heavily as this one. Wherever we stand, this law change could have a seismic impact on social attitudes to life, illness, and death. Our task is formidable because of how many norms the bill will overturn, just mention a few. The bill unsettles century- old medical ethics. It re-brands assisting someone to die as medical treatment or pending its understood meaning.
The bill rewrites the role of doctors. They will no longer be guided by the do no harm ethos of preserving and protecting life instead, the bill mandates that they actively engage in taking a patient's life by supplying lethal drugs that will kill them. The bill especially shakes the foundations of society's attitudes to suicide and yes, that is the accurate word, and we know that because, at present, assisting someone to end their life is a criminal offence, so this bill is forced to amend the 1961 suicide act to allow medical professionals to intentionally plan, prepare, and assist in ending the lives of a particular group of citizens.
My greatest read is that this state licensing of suicide could unleash a progressive culture change. For decades, we have made concerted efforts to deferred people last week by the noble Lady Baroness May and the noble Lord Jackson, but now just a pause. For any of us who have known family or friends who have committed suicide, it is gutwrenching the tragic and brings an especially visible and broad grief. This is compounded by a guilt as loved ones endlessly soul- searching totally unfairly blaming themselves.
What more could we have done? If we see someone about jump from the bridge, even if they give us 100 objective reasons why their life is not worth living, even if they've only got a few months to live, we don't just shrug and walk on. We cling onto them and plead don't do it, don't jump. All this reflects our deep humanistic intuition that when a person plans to end their life, should be resisted with all the energy society can muster. But what happens culturally when the state shouts jump, or rather, agrees with those metaphorically slapped down, acted, the one indisputable reason for that law was to close down suicide sites, something echoed by the prime minister only yesterday, and we had to protect the young from online influences.
But I worry this bill that we are debating today is a legislative embodiment of a suicide influencer. What we think will happen when we tell newly franchised teens that in some instances, taking your own life equates to dying in your own life equates to dying in dignity? Saying it is restricted to those with terminal illnesses just won't wash with a generation immersed in the language of rights and entitlements? Why not assist me when I'm suffering so much? Why am I being discriminated against? Which brings me to my final point.
We have had some very fine speeches from supporters of the bill stressing the importance of autonomy and giving people control of their lives. Sentiments I'm usually a champion of in a political term. But when used to justify the state having a role in ending human life. For those stating my life, my choice, why back a bill limiting that choice to the terminally L? Surely that right should apply to anyone who wants to kill themselves and no doubt this logic will lead to demands to expand the law and God help us once human rights lawyers get involved.
As I've said, we have responsibility to ensure such nightmarish consequences
**** Possible New Speaker ****
don't become a reality. The last time your Lordships house debated assisted dying was October was October 2021. More than
Baroness Fox of Buckley (Non-affiliated)
**** Possible New Speaker ****
As legislators, all sorts of laws passed through our hands, the good, the bad, and the ugly. All are consequential fellow citizens but consequential fellow citizens but rarely does a bill way as heavily as this one. Wherever we stand, this law change could have a seismic impact on social attitudes to life, illness, and death. Our task is formidable because of how many norms the bill will overturn, just mention a few. The bill unsettles century- old medical ethics. It re-brands assisting someone to die as medical treatment or pending its understood meaning.
The bill rewrites the role of doctors. They will no longer be guided by the do no harm ethos of preserving and protecting life instead, the bill mandates that they actively engage in taking a patient's life by supplying lethal drugs that will kill them. The bill especially shakes the foundations of society's attitudes to suicide and yes, that is the accurate word, and we know that because, at present, assisting someone to end their life is a criminal offence, so this bill is forced to amend the 1961 suicide act to allow medical professionals to intentionally plan, prepare, and assist in ending the lives of a particular group of citizens.
My greatest read is that this state licensing of suicide could unleash a progressive culture change. For decades, we have made concerted efforts to deferred people last week by the noble Lady Baroness May and the noble Lord Jackson, but now just a pause. For any of us who have known family or friends who have committed suicide, it is gutwrenching the tragic and brings an especially visible and broad grief. This is compounded by a guilt as loved ones endlessly soul- searching totally unfairly blaming themselves.
What more could we have done? If we see someone about jump from the bridge, even if they give us 100 objective reasons why their life is not worth living, even if they've only got a few months to live, we don't just shrug and walk on. We cling onto them and plead don't do it, don't jump. All this reflects our deep humanistic intuition that when a person plans to end their life, should be resisted with all the energy society can muster. But what happens culturally when the state shouts jump, or rather, agrees with those metaphorically slapped down, acted, the one indisputable reason for that law was to close down suicide sites, something echoed by the prime minister only yesterday, and we had to protect the young from online influences.
But I worry this bill that we are debating today is a legislative embodiment of a suicide influencer. What we think will happen when we tell newly franchised teens that in some instances, taking your own life equates to dying in your own life equates to dying in dignity? Saying it is restricted to those with terminal illnesses just won't wash with a generation immersed in the language of rights and entitlements? Why not assist me when I'm suffering so much? Why am I being discriminated against? Which brings me to my final point.
We have had some very fine speeches from supporters of the bill stressing the importance of autonomy and giving people control of their lives. Sentiments I'm usually a champion of in a political term. But when used to justify the state having a role in ending human life. For those stating my life, my choice, why back a bill limiting that choice to the terminally L? Surely that right should apply to anyone who wants to kill themselves and no doubt this logic will lead to demands to expand the law and God help us once human rights lawyers get involved.
As I've said, we have responsibility to ensure such nightmarish consequences
**** Possible New Speaker ****
don't become a reality. The last time your Lordships house debated assisted dying was October was October 2021. More than
11:45
Lord McDonald of Salford (Crossbench)
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Lord McDonald of Salford (Crossbench)
October was October 2021. More than 130 noble Lords signed up for the debate. I did not. I was a relatively new member of the house and either with so many speakers, someone was bound to say what I thought, but that was not the case. Everyone I heard spoke eloquently, passionately, persuasively but everyone had made up their mind for against, and I felt I was torn in two directions. But in the last four years, I settled and I am in favour of this bill because this bill addresses one of my chief addresses one of my chief The bill felt as if it was a foot in the door and would inevitably get wider.
This bill is framed more specifically, it is for the terminally ill for the last six months of their life capacity. It excludes a large number of people. I know that distress is my noble friend Baroness Murphy but mentally ill, depressed, people with dementia not be part of this bill. I think that is right and I think it is a reminder to us and people in the country that we should have an advanced care plan that helps our relatives and our doctors to know what to do when we do lose capacity.
My second point is about the safeguards. The safeguards in this bill are elaborate. I fear they might be to elaborate. Last week Lord Meston reminded us that the first attempt for such a bill floundered because it was felt the safeguards were too cumbersome. I wonder what the panel would do? It seems to me the key is that the patient is in control and they need to be two doctors, two expert senior and independent from each other and independent from each other doctors.
One of them probably a consultant in the disease of the terminally ill patient suffers, on the other, a consultant in palliative care. With that amount of assurance, I think people at the end of their lives should be able to proceed rather quicker than all this Chrissie would suggest. I was a bureaucrat, and the idea that bureaucracy makes things safer I think is sadly wrong. But one bit of safeguarding that I asked to be included is what happens to the unused doses.
Last week Baroness Hames reminded us that up to 40% of doses in Oregon are not used. Could there be a line about whether they are destroyed, whether they are kept by the doctor for future use? It seems to me that that needs to be addressed. My last point is about that this bill is so important that we need to get cracking. A lot of people hesitate because it is a Private Members' Bill. But I would remind your Lordships House that usually the societal issue starts as a Private Members' Bill.
Sidney Silverman has already been mentioned and his efforts were Private Members' Bill. This is the same but this clearly needs greater government help and attention if this is to become law. I hope it does become law. I hope we can prove it, but even if it is not changed, I would vote in favour.
**** Possible New Speaker ****
In a House packed to the gunwales
This bill is framed more specifically, it is for the terminally ill for the last six months of their life capacity. It excludes a large number of people. I know that distress is my noble friend Baroness Murphy but mentally ill, depressed, people with dementia not be part of this bill. I think that is right and I think it is a reminder to us and people in the country that we should have an advanced care plan that helps our relatives and our doctors to know what to do when we do lose capacity.
My second point is about the safeguards. The safeguards in this bill are elaborate. I fear they might be to elaborate. Last week Lord Meston reminded us that the first attempt for such a bill floundered because it was felt the safeguards were too cumbersome. I wonder what the panel would do? It seems to me the key is that the patient is in control and they need to be two doctors, two expert senior and independent from each other and independent from each other doctors.
One of them probably a consultant in the disease of the terminally ill patient suffers, on the other, a consultant in palliative care. With that amount of assurance, I think people at the end of their lives should be able to proceed rather quicker than all this Chrissie would suggest. I was a bureaucrat, and the idea that bureaucracy makes things safer I think is sadly wrong. But one bit of safeguarding that I asked to be included is what happens to the unused doses.
Last week Baroness Hames reminded us that up to 40% of doses in Oregon are not used. Could there be a line about whether they are destroyed, whether they are kept by the doctor for future use? It seems to me that that needs to be addressed. My last point is about that this bill is so important that we need to get cracking. A lot of people hesitate because it is a Private Members' Bill. But I would remind your Lordships House that usually the societal issue starts as a Private Members' Bill.
Sidney Silverman has already been mentioned and his efforts were Private Members' Bill. This is the same but this clearly needs greater government help and attention if this is to become law. I hope it does become law. I hope we can prove it, but even if it is not changed, I would vote in favour.
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In a House packed to the gunwales
11:49
Baroness Crawley (Labour)
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In a House packed to the gunwales with legal, medical, and moral experts, it is almost impertinent. But along with many noble Lords, I have had unprecedented lobbying on this bill. And it is only respectful to those who have contacted me to say a few words. In one of the most significant second readings in my 27 years in this House, we have watched loved ones die. Sometimes peacefully, sometimes in drawnout struggle. And like many noble Lords, I am conflicted on this end-of-life bill.
I voted against the last bill to come before us some years ago. However, in the intervening years, I have tried to see the argument for self-determination at the end of one's life. And acknowledge the current totally inadequate position of the law in this area. After all, in nearly every other aspect of our lives, we are able to practice autonomy in our decision-making. For those of us with agency what we are. So why not self-determination in death? If that is our wish and if life has become unbearable? Yet still my Lords I can't dismiss the misgivings I have.
When it comes to the bill. Not religious misgivings, I'm afraid I'm a collapsed catholic, but those of the bill underestimating the coercive factors in society that could affect people at their most vulnerable time. Be they personal or financial. And the bill over estimating people's ability not to feel a burden on their families and caregivers. I know that in clause 11 of the bill, regulations are to be set out to avoid this happening.
But the whole issue of the bill relying so much on regulations yet to be seen has been rehearsed in the report of the Delegated Powers and Regulatory Reform Committee. And they have a point. I worry we have not yet had time to listen to those professional bodies that are hesitant about the bill. And ask them about the reliability of the six-month diagnosis. I worry about the lack of learning from other countries where assisted dying is already the law.
And where we have been given examples of assisted dying being offered too quickly to those who simply need greater support. I worry about the economics of healthcare under this bill. That assisted dying will be fully funded in our overstretched NHS, while palliative care is only partly funded, as Lord Stevenson of Birmingham highlighted last week. Choices squeezed out in such a scenario. I do not wish to see a future where palliative care withers on the vine, while assisted dying becomes the default and cheaper option.
Having said all that, the Commons has spoken. And sent us this bill. And it is our responsibility now to take this bill and to make it as workable as possible for our most vulnerable citizens. As seen in the compromised reach between Lord Faulkner authority and Baroness Berger. We have a job to do in the coming months, and the whole country is watching. Not something you often hear about your Lordships House.
**** Possible New Speaker ****
It is a great pleasure to follow
**** Possible New Speaker ****
It is a great pleasure to follow the noble Lady, and at the end of her speech it is very clear she should have had no concerns about the contribution that she would make
Baroness Crawley (Labour)
**** Possible New Speaker ****
In a House packed to the gunwales with legal, medical, and moral experts, it is almost impertinent. But along with many noble Lords, I have had unprecedented lobbying on this bill. And it is only respectful to those who have contacted me to say a few words. In one of the most significant second readings in my 27 years in this House, we have watched loved ones die. Sometimes peacefully, sometimes in drawnout struggle. And like many noble Lords, I am conflicted on this end-of-life bill.
I voted against the last bill to come before us some years ago. However, in the intervening years, I have tried to see the argument for self-determination at the end of one's life. And acknowledge the current totally inadequate position of the law in this area. After all, in nearly every other aspect of our lives, we are able to practice autonomy in our decision-making. For those of us with agency what we are. So why not self-determination in death? If that is our wish and if life has become unbearable? Yet still my Lords I can't dismiss the misgivings I have.
When it comes to the bill. Not religious misgivings, I'm afraid I'm a collapsed catholic, but those of the bill underestimating the coercive factors in society that could affect people at their most vulnerable time. Be they personal or financial. And the bill over estimating people's ability not to feel a burden on their families and caregivers. I know that in clause 11 of the bill, regulations are to be set out to avoid this happening.
But the whole issue of the bill relying so much on regulations yet to be seen has been rehearsed in the report of the Delegated Powers and Regulatory Reform Committee. And they have a point. I worry we have not yet had time to listen to those professional bodies that are hesitant about the bill. And ask them about the reliability of the six-month diagnosis. I worry about the lack of learning from other countries where assisted dying is already the law.
And where we have been given examples of assisted dying being offered too quickly to those who simply need greater support. I worry about the economics of healthcare under this bill. That assisted dying will be fully funded in our overstretched NHS, while palliative care is only partly funded, as Lord Stevenson of Birmingham highlighted last week. Choices squeezed out in such a scenario. I do not wish to see a future where palliative care withers on the vine, while assisted dying becomes the default and cheaper option.
Having said all that, the Commons has spoken. And sent us this bill. And it is our responsibility now to take this bill and to make it as workable as possible for our most vulnerable citizens. As seen in the compromised reach between Lord Faulkner authority and Baroness Berger. We have a job to do in the coming months, and the whole country is watching. Not something you often hear about your Lordships House.
**** Possible New Speaker ****
It is a great pleasure to follow
**** Possible New Speaker ****
It is a great pleasure to follow the noble Lady, and at the end of her speech it is very clear she should have had no concerns about the contribution that she would make
11:53
Lord Harper (Conservative)
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Lord Harper (Conservative)
the contribution that she would make to the debate. It was a very powerful speech. My Lords, we are all products of our experiences. And one of the most profound and shaping I had in public life was both being the Shadow Minister and the Minister for disabled people. And the reason for that was the opportunity that I had over the four years or so in those two roles. In the people that I met. The people of all ages who had thrown in front of them, sometimes over the whole of their life, and sometimes as a result of circumstances challenges and difficulties that they faced doing the things that we all take for granted living and independent life, working, bringing up a family, and contributing to society, and making the best of what they had in front of them.
Many of those people are profoundly concerned about what this bill will do to society's view of people who have challenges thrown in front of them. I know that is not the intention of the promoters of the bill does something fundamental about society's view of life particularly life lived by people who have profound challenges. That is why this bill is not supported by a single organisation in this country that represents disabled people. Not a single one of them. And I think we should listen to their views and take them very seriously.
The second very powerful argument that we have heard in this debate that was referred to by Baroness Fox is the one about choice and autonomy. The reason why I think that argument fails in this case is because that is an argument we were taking a decision that only impacts upon yourself and has no consequences for others. The problem is that, in delivering rights and choices for those that would be the beneficiaries, if that is the right word of this bill, you are effectively taking away choices and opportunities from others.
There are competing rights. And it is with the case that when we have beating rights, we have the most difficult decisions to make. They are always the most charged political conversations that we have. The second reason why the argument fails is, for choice to mean anything it has to be a meaningful choice. And we do not have in this country. We have some excellent palliative care but it is not universally available to everyone. And in the government's 10 year plan for the NHS, there is no plan and no ambition to make it so.
Not even at the end of that 10 year period. And I'm afraid a choice, where you have a choice for an assisted suicide, you do not have access to good quality palliative care, that is no choice at all. And the final thing that I would like to say it's about being clear about what we are doing here. As the noble what we are doing here. As the noble Baroness said and my noble friend Baroness May said last week, this is about suicide.
If the promoters of this bill and those who support it find plain and clear language uncomfortable, rather than attacking those that use the plain and clear language as they have done with my noble friend, they should reflect perhaps upon what it is they wish to do.
Many of those people are profoundly concerned about what this bill will do to society's view of people who have challenges thrown in front of them. I know that is not the intention of the promoters of the bill does something fundamental about society's view of life particularly life lived by people who have profound challenges. That is why this bill is not supported by a single organisation in this country that represents disabled people. Not a single one of them. And I think we should listen to their views and take them very seriously.
The second very powerful argument that we have heard in this debate that was referred to by Baroness Fox is the one about choice and autonomy. The reason why I think that argument fails in this case is because that is an argument we were taking a decision that only impacts upon yourself and has no consequences for others. The problem is that, in delivering rights and choices for those that would be the beneficiaries, if that is the right word of this bill, you are effectively taking away choices and opportunities from others.
There are competing rights. And it is with the case that when we have beating rights, we have the most difficult decisions to make. They are always the most charged political conversations that we have. The second reason why the argument fails is, for choice to mean anything it has to be a meaningful choice. And we do not have in this country. We have some excellent palliative care but it is not universally available to everyone. And in the government's 10 year plan for the NHS, there is no plan and no ambition to make it so.
Not even at the end of that 10 year period. And I'm afraid a choice, where you have a choice for an assisted suicide, you do not have access to good quality palliative care, that is no choice at all. And the final thing that I would like to say it's about being clear about what we are doing here. As the noble what we are doing here. As the noble Baroness said and my noble friend Baroness May said last week, this is about suicide.
If the promoters of this bill and those who support it find plain and clear language uncomfortable, rather than attacking those that use the plain and clear language as they have done with my noble friend, they should reflect perhaps upon what it is they wish to do.
11:57
Baroness Smith of Llanfaes (Plaid Cymru)
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Baroness Smith of Llanfaes (Plaid Cymru)
I begin by thanking the hundreds of people who have written to many of us about this bill. The letters often deeply personal, deserve our attention and respect. Thank you. I have also listened carefully, both last Friday and again today, to the many thoughtful contributions from noble Lords, each informed by personal and professional experiences. As this is a matter of conscience, I will share my own perspective. My view on the principle of this bill has been shaped in part by my own experiences, as a carer for my late father, and by the experiences of my friend, Claire, who recently passed away at the age of 42.
Claire was initially misdiagnosed with IBS and was later diagnosed with terminal ontological cancer. In the face of a devastating diagnosis she founded Claire's Campaign, telling her own difficult experience into a campaign for change in Wales, and building a platform to amplify the voices of women who had long gone unheard. Claire said last November, " This bill legislates for people with a terminal illness diagnosis and six months to live. Thankfully there are not many of us who are facing those circumstances imminently.
So for those of us who will face this reality sooner rather than later, this bill offers something really important. I have excellent palliative care it does not address all of my needs, and how I imagine a good death. It is not just about pain management. " And for many people facing the end of life, simply having the choice, even if they never act on that choice, can bring immense comfort. And for those reasons I support the principle of this bill.
Clear communication in health care is vital, especially when facing complex decisions. That is why I want to highlight the clause in this bill secured by my colleague in the other place, Liz Saville Roberts, which requires that all reasonable steps to be taken to ensure access to assisted dying services in the Welsh medium. Imagine discussing such sensitive matters with your GP and being unable to use your first language. Welsh speakers must be able to receive care, in their mother tongue. And however I must raise a serious concern, the constitutional implications of this bill for Wales.
While the criminal law remains reserved, health is not. And this bill, if passed, would have serious consequences on a completely devolved matter in Wales. Just less than a year ago the Senedd debated assisted dying and the result, 19 in favour, 26 against. Those voting against included the First Minister and the Health Minister. To ask the House, if this bill proceed here at Westminster, are we comfortable asking a Welsh Government minister who has voted against the principle of assisted dying to make the decision on whether to deliver this service within the NHS in Wales? Shouldn't the Senedd have the first say on whether such a service should be introduced in Wales at all? It is their role to scrutinise the delivery of health services in Wales, and it is the Welsh Government budget that would fund any new service.
In committee and the other place, a provision was inserted to reflect the need for devolved consent. Regrettably, this was removed at reports. This is deeply problematic. There is a strong argument that this Bill, in its entirety, engages devolved responsibilities. Storing a requirement for the Senedd's consent to to make sense, regardless of what your view might be on the bill's principle. My Lords, as this bill continues its passage through this House, I urge all noble Lords to reflect carefully, not only on the moral weight of the matter before us, but also on the constitutional responsibilities we bear.
We must respect the role of devolved parliaments. Matters that are
Claire was initially misdiagnosed with IBS and was later diagnosed with terminal ontological cancer. In the face of a devastating diagnosis she founded Claire's Campaign, telling her own difficult experience into a campaign for change in Wales, and building a platform to amplify the voices of women who had long gone unheard. Claire said last November, " This bill legislates for people with a terminal illness diagnosis and six months to live. Thankfully there are not many of us who are facing those circumstances imminently.
So for those of us who will face this reality sooner rather than later, this bill offers something really important. I have excellent palliative care it does not address all of my needs, and how I imagine a good death. It is not just about pain management. " And for many people facing the end of life, simply having the choice, even if they never act on that choice, can bring immense comfort. And for those reasons I support the principle of this bill.
Clear communication in health care is vital, especially when facing complex decisions. That is why I want to highlight the clause in this bill secured by my colleague in the other place, Liz Saville Roberts, which requires that all reasonable steps to be taken to ensure access to assisted dying services in the Welsh medium. Imagine discussing such sensitive matters with your GP and being unable to use your first language. Welsh speakers must be able to receive care, in their mother tongue. And however I must raise a serious concern, the constitutional implications of this bill for Wales.
While the criminal law remains reserved, health is not. And this bill, if passed, would have serious consequences on a completely devolved matter in Wales. Just less than a year ago the Senedd debated assisted dying and the result, 19 in favour, 26 against. Those voting against included the First Minister and the Health Minister. To ask the House, if this bill proceed here at Westminster, are we comfortable asking a Welsh Government minister who has voted against the principle of assisted dying to make the decision on whether to deliver this service within the NHS in Wales? Shouldn't the Senedd have the first say on whether such a service should be introduced in Wales at all? It is their role to scrutinise the delivery of health services in Wales, and it is the Welsh Government budget that would fund any new service.
In committee and the other place, a provision was inserted to reflect the need for devolved consent. Regrettably, this was removed at reports. This is deeply problematic. There is a strong argument that this Bill, in its entirety, engages devolved responsibilities. Storing a requirement for the Senedd's consent to to make sense, regardless of what your view might be on the bill's principle. My Lords, as this bill continues its passage through this House, I urge all noble Lords to reflect carefully, not only on the moral weight of the matter before us, but also on the constitutional responsibilities we bear.
We must respect the role of devolved parliaments. Matters that are
12:02
Baroness Stroud (Conservative)
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Baroness Stroud (Conservative)
It is a privilege to speak today and contribute to a debate that has been characterised by such thoughtful, considered and respect all speeches from all points of view. However, I rise to speak to the dangers of this Bill and add my voice to those who believe this Bill should not proceed. This nation was founded on the principle that every human being is not just a value but of infinite value. It is what has led this nation to be a world leader in our care for the poor, the refugees are children, for the elderly and those for disabilities.
It is all too easy to make laws that are well motivated but that have unintended consequences. All of us are moved when we hear stories of people who are experiencing significant suffering and who feel they cannot go on. But this Bill does not address that issue. And there is a danger that this Bill will put vulnerable, the elderly, the poor, the lonely and people with disabilities particularly at risk. I know that many in this House are sympathetic to this Bill.
We are people who are used to being in control. We are used to being listened to and to being heard. It is why many here do not fear this legislation, in fact, quite like this legislation. The idea of being in control right the way to the end of our days is an appealing one. But life is not like that for most people. And this ought to be a particular concern to us as we face a future with increasing pressure on social care and the NHS, as more people live for longer and the cost of care increases.
It is not hard to see how assisted suicide could overtime be portrayed to the elderly or people with disabilities as a way not to be a burden to loved ones. We need to listen to the voices not just of celebrity endorses of the Bill, but of the vulnerable two. There is a reason why over 350 There is a reason why over 350 disability groups oppose this bill. I am also concerned about people feeling a burden to the state, Canadian report, as we have heard this morning, has projected savings of up to $150 million each year as a result of the countries medical assistance and dying program.
In a context where there often are not enough hospital beds and there is a shortage of hospital and care staff, it is not impossible to imagine vulnerable people feeling a duty to choose assisted suicide or being subtly coerced by misguided or even sinister word from a frustrated family member or a medical national -- recessional. A medical professional recently said me in Canada the common recommendation has become that if you are over 60, do not go to hospital on your own. That is a pretty drastic state of affairs.
Where good palliative and social care are lacking, demand for assisted suicide will grow and the danger is it will fill a gap in places where palliative care services are inadequate. Last week, as we have heard, there was an oral question on the suicide prevention strategy. I listened to the concerns from all corners of the House and the determination from the Government Front Benches to ensure that everyone had the appropriate support, so that no one would ever be tempted to choose a suicide pathway.
And yet here we have a bill being debated in the same chamber wanting to legalise this pathway. This Bill passed in the Commons with a small and decreasing majority before the summer. Over the summer, we were given a moment to pause and to stop and examine ourselves as a nation. Is this the sort of nation we want to be where protection is removed all the vulnerable, the poorest, the elderly and those with disabilities? Where budgets are health provision can be cut because the vulnerable are being encouraged to choose death? I can just hear the Department of Health working through the budgetary reductions with the OBR, based on the percentage increase of those expected to choose assisted dying.
I believe this country can be better than this, that we should be having a different conversation and that the palliative care we provide for those who are terminally ill could developed to become a world leader. Now that would be an ambitious vision that would be worth voting for.
It is all too easy to make laws that are well motivated but that have unintended consequences. All of us are moved when we hear stories of people who are experiencing significant suffering and who feel they cannot go on. But this Bill does not address that issue. And there is a danger that this Bill will put vulnerable, the elderly, the poor, the lonely and people with disabilities particularly at risk. I know that many in this House are sympathetic to this Bill.
We are people who are used to being in control. We are used to being listened to and to being heard. It is why many here do not fear this legislation, in fact, quite like this legislation. The idea of being in control right the way to the end of our days is an appealing one. But life is not like that for most people. And this ought to be a particular concern to us as we face a future with increasing pressure on social care and the NHS, as more people live for longer and the cost of care increases.
It is not hard to see how assisted suicide could overtime be portrayed to the elderly or people with disabilities as a way not to be a burden to loved ones. We need to listen to the voices not just of celebrity endorses of the Bill, but of the vulnerable two. There is a reason why over 350 There is a reason why over 350 disability groups oppose this bill. I am also concerned about people feeling a burden to the state, Canadian report, as we have heard this morning, has projected savings of up to $150 million each year as a result of the countries medical assistance and dying program.
In a context where there often are not enough hospital beds and there is a shortage of hospital and care staff, it is not impossible to imagine vulnerable people feeling a duty to choose assisted suicide or being subtly coerced by misguided or even sinister word from a frustrated family member or a medical national -- recessional. A medical professional recently said me in Canada the common recommendation has become that if you are over 60, do not go to hospital on your own. That is a pretty drastic state of affairs.
Where good palliative and social care are lacking, demand for assisted suicide will grow and the danger is it will fill a gap in places where palliative care services are inadequate. Last week, as we have heard, there was an oral question on the suicide prevention strategy. I listened to the concerns from all corners of the House and the determination from the Government Front Benches to ensure that everyone had the appropriate support, so that no one would ever be tempted to choose a suicide pathway.
And yet here we have a bill being debated in the same chamber wanting to legalise this pathway. This Bill passed in the Commons with a small and decreasing majority before the summer. Over the summer, we were given a moment to pause and to stop and examine ourselves as a nation. Is this the sort of nation we want to be where protection is removed all the vulnerable, the poorest, the elderly and those with disabilities? Where budgets are health provision can be cut because the vulnerable are being encouraged to choose death? I can just hear the Department of Health working through the budgetary reductions with the OBR, based on the percentage increase of those expected to choose assisted dying.
I believe this country can be better than this, that we should be having a different conversation and that the palliative care we provide for those who are terminally ill could developed to become a world leader. Now that would be an ambitious vision that would be worth voting for.
12:06
Lord Sassoon (Conservative)
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Lord Sassoon (Conservative)
My reason for rising to speak in this debate is that I also feel the very many people who have written to us all deserve to know where each of us stands. I support the introduction of a carefully circumscribed assisted dying regime along the lines of this bill. I have seen two very severely ill immediate family members have the times of their deaths determined by a combination of medical practitioners and other close family members. And if such decisions can be made on behalf of individuals who are very ill but who are not capable of making the decisions themselves, I ask myself why should we deny a similar right to people who can make such decisions? I firmly believe that any moral or religious become over the determination of the time of a person's death in this country was crossed long ago.
If I have significant doubts over the bill, it is very much those of the noble Lord McDonald of Salford, over whether the safeguards within it risk imposing excessive Chrissie to the detriment of effective protection of the individual. -- Excessive bureaucracy. Many have criticised the Bill for the extent of its delegated powers and if this was a government Bill, of course I would also be appalled. But in this case, of Private Members' Bill, where it is clearly not a question of the promoters taking powers for themselves without proper scrutiny, I am not unduly concerned.
The committee raises important questions and quite properly and importantly, those delegated power issues will be carefully considered, I know, in committee. On the passage of this Bill through the House, I feel strongly with others that we must return it to the other place. It is a bill that has already been through the other place and it is a bill which has wide public support. It will be extensively scrutinised and no doubt improved by this House and it should then be returned to the other place in the normal course.
And in that connection, I add my thanks to the noble Baroness, lady Bircza, and the promoters of this bill, for agreeing on an improved scrutiny process. -- Lady Berger. I believe this is an important bill. It is a bill that needs much more scrutiny but it is a bill that would further improve the dignity of dying in this country. And I hope the House gives it a second reading.
If I have significant doubts over the bill, it is very much those of the noble Lord McDonald of Salford, over whether the safeguards within it risk imposing excessive Chrissie to the detriment of effective protection of the individual. -- Excessive bureaucracy. Many have criticised the Bill for the extent of its delegated powers and if this was a government Bill, of course I would also be appalled. But in this case, of Private Members' Bill, where it is clearly not a question of the promoters taking powers for themselves without proper scrutiny, I am not unduly concerned.
The committee raises important questions and quite properly and importantly, those delegated power issues will be carefully considered, I know, in committee. On the passage of this Bill through the House, I feel strongly with others that we must return it to the other place. It is a bill that has already been through the other place and it is a bill which has wide public support. It will be extensively scrutinised and no doubt improved by this House and it should then be returned to the other place in the normal course.
And in that connection, I add my thanks to the noble Baroness, lady Bircza, and the promoters of this bill, for agreeing on an improved scrutiny process. -- Lady Berger. I believe this is an important bill. It is a bill that needs much more scrutiny but it is a bill that would further improve the dignity of dying in this country. And I hope the House gives it a second reading.
12:10
Lord Truscott (Non-affiliated)
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Lord Truscott (Non-affiliated)
I am not a medical expert or a lawyer but I am a trained historian. And I can say that the international precedents for assisted dying or assisted suicide are more good. When William Beveridge set out his report on the future welfare state, the idea was to sport -- support live from the cradle to the greatest when Nye Bevan established the NHS, it was established to improve life and outcomes for all. Assisted dying Sibley had no place in the founding principles of the NHS.
The 2,500 years, the Hippocratic oath has been a foundational code of medical ethics and the principal do no harm has been a central tenant all those years. Many doctors and medical professionals are uneasy about crossing that line and so they should be, as the trust between doctor and patient is at the core of the patient doctor relationship. The societal impact of changing the relationship between doctor and patient will be profound and may well lead to fear and mistrust, as noble Lords have heard.
The person before you may not simply be there to care for you but to actively end your life. Dying a painful death, which does affect about 5% of people but is not a ground for assisted death under the bill, underlined the key point that more resources should be put into our Cinderella palliative care and research services. And while one in 20 may die a painful death, terrible as that is, in the Netherlands, where assisted dying is well established, one in four deaths are now assisted suicides.
Showing that the painful end is not the main reason for people to seek a state enabled suicide. Noble Lords with legal training will be aware that despite the Government statement that the Bill is compatible with the European Convention on Human Rights, article 2 of the ECHR protects the right to life. It does so by placing two obligations of the state. The positive obligation to protect the right to life by law and negative obligation not to intentionally deprived the individual of life.
My second major concern about this Bill is the issue of coercion. Despite its mentioned throughout the Bill and being made a criminal offence under clause 34, it is almost impossible to prove and police, as noble Lords had indicated. According to the Home Office's own figures, 50% of coercive cases are dropped through lack of evidence and only 5% result in conviction. Internationally, as research and the excellent House of Lords lively has shown, known and proven cases of coercion in jurisdictions which allow assisted dying are few and far between.
-- House of Lords library. Subtle version is well-nigh impossible to prove. In any event, the most common reason for people choosing assisted dying elsewhere is the fear of becoming a burden to others, a form of self coercion, not the fear of a painful death. At a time when the UK is about to see the biggest transfer of wealth in its history, with £7 trillion moving between generations by 2050, primarily from the baby boomers, this is not the time to pass this assisted suicide bill.
Nor should we as a society normalised suicide, as has been mentioned. Studies show assisted suicide laws have led to a substantial increase in total suicide rates, including unassisted suicides. And the most affected group by this legislative changes women. The Bill as drafted has simply too many flaws, in my view, and unintended consequences. As your Lordships referred at length. It should be rejected.
The 2,500 years, the Hippocratic oath has been a foundational code of medical ethics and the principal do no harm has been a central tenant all those years. Many doctors and medical professionals are uneasy about crossing that line and so they should be, as the trust between doctor and patient is at the core of the patient doctor relationship. The societal impact of changing the relationship between doctor and patient will be profound and may well lead to fear and mistrust, as noble Lords have heard.
The person before you may not simply be there to care for you but to actively end your life. Dying a painful death, which does affect about 5% of people but is not a ground for assisted death under the bill, underlined the key point that more resources should be put into our Cinderella palliative care and research services. And while one in 20 may die a painful death, terrible as that is, in the Netherlands, where assisted dying is well established, one in four deaths are now assisted suicides.
Showing that the painful end is not the main reason for people to seek a state enabled suicide. Noble Lords with legal training will be aware that despite the Government statement that the Bill is compatible with the European Convention on Human Rights, article 2 of the ECHR protects the right to life. It does so by placing two obligations of the state. The positive obligation to protect the right to life by law and negative obligation not to intentionally deprived the individual of life.
My second major concern about this Bill is the issue of coercion. Despite its mentioned throughout the Bill and being made a criminal offence under clause 34, it is almost impossible to prove and police, as noble Lords had indicated. According to the Home Office's own figures, 50% of coercive cases are dropped through lack of evidence and only 5% result in conviction. Internationally, as research and the excellent House of Lords lively has shown, known and proven cases of coercion in jurisdictions which allow assisted dying are few and far between.
-- House of Lords library. Subtle version is well-nigh impossible to prove. In any event, the most common reason for people choosing assisted dying elsewhere is the fear of becoming a burden to others, a form of self coercion, not the fear of a painful death. At a time when the UK is about to see the biggest transfer of wealth in its history, with £7 trillion moving between generations by 2050, primarily from the baby boomers, this is not the time to pass this assisted suicide bill.
Nor should we as a society normalised suicide, as has been mentioned. Studies show assisted suicide laws have led to a substantial increase in total suicide rates, including unassisted suicides. And the most affected group by this legislative changes women. The Bill as drafted has simply too many flaws, in my view, and unintended consequences. As your Lordships referred at length. It should be rejected.
12:13
Baroness Berger (Labour)
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Baroness Berger (Labour)
My noble Lords, there are passionately held views on the subject before us and the informed and respectful deliberation so far shows your Lordships' House at its best. We are being asked to legislate for autonomy, but we also have a duty to set out that principle within the reality of our unequal society. I'm deeply concerned that this Bill as it stands would not only ignore but deepen those inequalities. My views are shaped in part from learning about my mother's work as a counsellor in a palliative care unit and the hours I spent at the bedside of three of my grandparents as they need the end, including as they took their last breaths.
And while in one of the younger members of this place and I hope I've got at least another 50 years ahead of me, I have thought about the end of my life and ideally, I would like to die naturally at home and if needed, with access to the high quality palliative care that everyone deserves. While I would not want an assisted death, I recognise that some noble Lords do, as expressed during this debate. We are fortunate, as noble Lords we have a fortunate, as noble Lords we have a voice, above average resources and agency.
The ability to make Aaron choices, free from interference, prejudice, coercion or undue influence. But assisted dying, if introduced, would not only exist as a choice for us and other comparatively fortunate people, it would also enter the lives of those most at risk. People already overlooked, unprotected and vulnerable at the end of life. It was a privilege to be a member of Parliament for almost a decade and I have so many fond memories of my former constituents. But some of the most searing moment I experienced as a member of the other place came at my weekly surgeries.
The first time I heard someone speak openly in the most unsavoury terms about wanting a family member dead and shook. I was appalled. And I could not believe what I was hearing. I was naive to think this would be an isolated case. I have also not forgotten the words and realities of too many former constituents, people isolated and abused in their own homes, sometimes for decades, in fear for their own lives. People who felt like a burden because of long-term illness or serious mental health conditions, especially the elderly.
And people treated as though their lives were worth less because they had a disability. Many were from low income backgrounds, facing not only poor health, but the crushing stress of unaffordable care costs. These voices still ring in my ears and motivate me profoundly as I consider this Bill, alongside the many powerful representations we have heard in recent weeks, including as we have heard from other members. There is no organisation of or for disabled people in this country who support this bill.
In considering who this Bill might benefit by giving them autonomy, we must equally consider who it may harm by taking their autonomy away. We have a duty in this House to test the bills safeguards when they meet reality and I think we must also consider the role of family members and carers. This Bill does not require their involvement. It does not even guarantee they will be informed. Yet these are exactly the people who know a patient Best, who may spot signs of corrosion, confusion or fear that professionals might miss and their exclusion is not just a procedural oversight, it is a moral failing.
In conclusion, if this Bill passes, the relationship between vulnerable people and their doctors and the state would change forever. There would be no going back. This Bill touches the deepest and most exposed moments of human life, it demands our upmost scrutiny, not just in principle but in practice. And in practice, it currently falls short. We cannot legislate for irreversible decisions on the basis of incomplete protections. We have important work
And while in one of the younger members of this place and I hope I've got at least another 50 years ahead of me, I have thought about the end of my life and ideally, I would like to die naturally at home and if needed, with access to the high quality palliative care that everyone deserves. While I would not want an assisted death, I recognise that some noble Lords do, as expressed during this debate. We are fortunate, as noble Lords we have a fortunate, as noble Lords we have a voice, above average resources and agency.
The ability to make Aaron choices, free from interference, prejudice, coercion or undue influence. But assisted dying, if introduced, would not only exist as a choice for us and other comparatively fortunate people, it would also enter the lives of those most at risk. People already overlooked, unprotected and vulnerable at the end of life. It was a privilege to be a member of Parliament for almost a decade and I have so many fond memories of my former constituents. But some of the most searing moment I experienced as a member of the other place came at my weekly surgeries.
The first time I heard someone speak openly in the most unsavoury terms about wanting a family member dead and shook. I was appalled. And I could not believe what I was hearing. I was naive to think this would be an isolated case. I have also not forgotten the words and realities of too many former constituents, people isolated and abused in their own homes, sometimes for decades, in fear for their own lives. People who felt like a burden because of long-term illness or serious mental health conditions, especially the elderly.
And people treated as though their lives were worth less because they had a disability. Many were from low income backgrounds, facing not only poor health, but the crushing stress of unaffordable care costs. These voices still ring in my ears and motivate me profoundly as I consider this Bill, alongside the many powerful representations we have heard in recent weeks, including as we have heard from other members. There is no organisation of or for disabled people in this country who support this bill.
In considering who this Bill might benefit by giving them autonomy, we must equally consider who it may harm by taking their autonomy away. We have a duty in this House to test the bills safeguards when they meet reality and I think we must also consider the role of family members and carers. This Bill does not require their involvement. It does not even guarantee they will be informed. Yet these are exactly the people who know a patient Best, who may spot signs of corrosion, confusion or fear that professionals might miss and their exclusion is not just a procedural oversight, it is a moral failing.
In conclusion, if this Bill passes, the relationship between vulnerable people and their doctors and the state would change forever. There would be no going back. This Bill touches the deepest and most exposed moments of human life, it demands our upmost scrutiny, not just in principle but in practice. And in practice, it currently falls short. We cannot legislate for irreversible decisions on the basis of incomplete protections. We have important work
12:18
Lord Markham (Conservative)
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Lord Markham (Conservative)
Like many noble Lords, I comment from a personal -- from personal experience. My mother was diagnosed with terminal cancer and given weeks to live. She was taken to a hospice three weeks later, barely conscious and very quickly the clinicians gathered around her next-of-kin and suggested she was in a lot of pain. We all agreed and we all thank that hospice to this day. That kind and peaceful death that they gave her.
This happened not in some faraway land, but right here in the UK. And we are probably aware of many such instances in the UK were informally and quietly, terminally ill people are helped to have a kinder, compassionate, pain-free death. It is that experience which is why I'm in favour of finding a way to allow other people to experience that other people to experience that kinder, safer death in a way of their choosing. I know from talking to many terminally ill people, it gives them great comfort knowing that they can have that ability to take that earlier train.
I do understand the concerns that many noble Lords have. I understand that for some it is a point of principle, for religious or moral reasons. And I understand from many others the concerns they have, the risks presented, which is why I support the approach of the amendment to have committees scrutinise the bill to make it as best as it possibly can be, which is what we do best in the Lords. I do believe that arguments in terms of burden on the NHS...
I don't believe that arguments about undue burden are ones that should be reasons to oppose this bill. I would also like to make point that after speaking to many terminally ill people, I think it is wrong to deny -- equate their wish to die without pain with suicide. These people very much want to live but they know that they will shortly die so would be able to have that choice, to do that in a way of their choosing - with comfort and in pain-freeway.
To conclude, I believe this choice -- this bill is about choices. Whether terminally ill are being given the choice voluntarily to face a kinder, pain-free death, whether they should be able to take that earlier train home. Or whether we should choose that that choice should be denied to them because somehow they are not fit to make that choice or they might be coerced into it. I believe that giving people the choice is a fundamental right and that's why I want to work on this bill to make sure that we do it in the kindest and safest way.
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It's an honour to participate in
This happened not in some faraway land, but right here in the UK. And we are probably aware of many such instances in the UK were informally and quietly, terminally ill people are helped to have a kinder, compassionate, pain-free death. It is that experience which is why I'm in favour of finding a way to allow other people to experience that other people to experience that kinder, safer death in a way of their choosing. I know from talking to many terminally ill people, it gives them great comfort knowing that they can have that ability to take that earlier train.
I do understand the concerns that many noble Lords have. I understand that for some it is a point of principle, for religious or moral reasons. And I understand from many others the concerns they have, the risks presented, which is why I support the approach of the amendment to have committees scrutinise the bill to make it as best as it possibly can be, which is what we do best in the Lords. I do believe that arguments in terms of burden on the NHS...
I don't believe that arguments about undue burden are ones that should be reasons to oppose this bill. I would also like to make point that after speaking to many terminally ill people, I think it is wrong to deny -- equate their wish to die without pain with suicide. These people very much want to live but they know that they will shortly die so would be able to have that choice, to do that in a way of their choosing - with comfort and in pain-freeway.
To conclude, I believe this choice -- this bill is about choices. Whether terminally ill are being given the choice voluntarily to face a kinder, pain-free death, whether they should be able to take that earlier train home. Or whether we should choose that that choice should be denied to them because somehow they are not fit to make that choice or they might be coerced into it. I believe that giving people the choice is a fundamental right and that's why I want to work on this bill to make sure that we do it in the kindest and safest way.
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It's an honour to participate in
12:21
Lord Carey of Clifton (Crossbench)
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It's an honour to participate in the debate this afternoon. I want to thank particularly Baroness Thornton for an excellent speech. I support for an excellent speech. I support this bill. Many now that I've been on both sides of this debate during the years. I remember the bill in 2005 and I voted against it. As I went deeper into the subject, I began to realise Christian faith had very little to say directly about this modern issue. This shocked me very deeply and I then explored the experience of people going through shocking experiences of pain and indignity.
You and I have heard many of the stories, and survey after survey shows that some 75% of our population, our fellow citizens, want a change in the law. It is right that the bishops have spoken so powerfully and well in this debate, but the irony is that they're not representing their own church in this matter. I am doing that this afternoon with others. In addition, there are many, many Jews, Muslims, Hindus and Sikha who are also in favour of the legislation -- Sikhs.
The bishops will know this. I'm not haranguing them. They will know that in Christian spirituality, there is a called the Jesus Prior. It stems from a blind man calling to Jesus from the wayside. "Lord have mercy. Have mercy upon me. Those goods --". Compassion, the active kindness with the act of healing. It is alleviate suffering at the point of death -- alleviating. There has been some questioning of legislation in this debate. The right Honourable Baroness May Hugh used the graphic phrase "Licence to kill" To describe the legislation.
As much as I respect the right honourable lady, I resist this description and I believe that this bill gives safeguards and protections that without question will resist abuse and we may want to add to those safeguards. May I add, with temerity, a rhetorical question addressed to the bishops benches, but I think to us all? Do we really want to stand in the way of this want to stand in the way of this bill? It will pass, whether now or later.
It has commanding support from the British public and pass the elected house after an unprecedented period of scrutiny. There is renewed public debate as to our role in society as churches and I pray that both of these institutions, which I hold so dearly for the importance of our role in public life, do not risk our legitimacy by claiming that we know better from both the public and
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the other place. It's an honour to follow the
Lord Carey of Clifton (Crossbench)
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It's an honour to participate in the debate this afternoon. I want to thank particularly Baroness Thornton for an excellent speech. I support for an excellent speech. I support this bill. Many now that I've been on both sides of this debate during the years. I remember the bill in 2005 and I voted against it. As I went deeper into the subject, I began to realise Christian faith had very little to say directly about this modern issue. This shocked me very deeply and I then explored the experience of people going through shocking experiences of pain and indignity.
You and I have heard many of the stories, and survey after survey shows that some 75% of our population, our fellow citizens, want a change in the law. It is right that the bishops have spoken so powerfully and well in this debate, but the irony is that they're not representing their own church in this matter. I am doing that this afternoon with others. In addition, there are many, many Jews, Muslims, Hindus and Sikha who are also in favour of the legislation -- Sikhs.
The bishops will know this. I'm not haranguing them. They will know that in Christian spirituality, there is a called the Jesus Prior. It stems from a blind man calling to Jesus from the wayside. "Lord have mercy. Have mercy upon me. Those goods --". Compassion, the active kindness with the act of healing. It is alleviate suffering at the point of death -- alleviating. There has been some questioning of legislation in this debate. The right Honourable Baroness May Hugh used the graphic phrase "Licence to kill" To describe the legislation.
As much as I respect the right honourable lady, I resist this description and I believe that this bill gives safeguards and protections that without question will resist abuse and we may want to add to those safeguards. May I add, with temerity, a rhetorical question addressed to the bishops benches, but I think to us all? Do we really want to stand in the way of this want to stand in the way of this bill? It will pass, whether now or later.
It has commanding support from the British public and pass the elected house after an unprecedented period of scrutiny. There is renewed public debate as to our role in society as churches and I pray that both of these institutions, which I hold so dearly for the importance of our role in public life, do not risk our legitimacy by claiming that we know better from both the public and
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the other place. It's an honour to follow the
12:26
Lord Bellamy (Conservative)
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It's an honour to follow the noble Lord Lord Carey. Declaring my membership of the Constitution membership of the Constitution Committee, I say first that the delegated powers in this bill are excessive. Clause 41.4 permits the Secretary of State to amend the National Health Service Act by delegating legislation to enable that fundamental legislation dedicated to prolonging life, to enable the Minister to do the opposite, namely assist death, but no details as to how that function should be discharged is not a proper exercise of delegated powers.
Turning to fundamentals, this bill is not in fact based on a suffering, as others have pointed out. According to the impact statement, other regimes have based either on intolerable suffering, that is Canada, Belgium, Netherlands. Under this bill, those with terminal illness were not suffering may assist -- request assisted death but those were suffering intolerably and are not terminally ill may not do so. Given that so much support for this bill depends on the avoidance of suffering, and so that we are all clear, may I respectfully ask the noble and learned Lord to put fully on the record why this bill is not based on suffering? Next, we are told in the impact statement, that by your 10 -- year 10, this bill will gives rise to some 7000 assisted deaths in England and Wales per year.
That is only around 1% of deaths. That to my mind raises two quite opposite questions. The first question is : if so few people are to benefit from assisted dying, is sufficient to justify the profound change to society and to the role of the state which this bill tends to bring about? But the second and opposite question is whether we can trust this 1%? Apparently and somewhat bizarrely based on the experience of the largely you will experience of the largely you will macro -- rural state of Oregon.
Is this bill the thin end of the wedge? Once the principle is considered, will pressure to go further inevitably increase? May I ask the supporters of the bill to give the house reassurance on that important point? Finally, as many have already said, individual autonomy, which is the other main argument in this debate, cannot be exercised in isolation from the rest of society. Once the principle is conceded, everyone's doctor-patient is affected. It affects all of our relationships with their doctors. Similarly, the vulnerable, the inarticulate, those for whom autonomy is largely illusory are all affected.
Given these very difficult questions, including those of mental capacity, the bill's complex Chrissie and the role of the coroner to give only a few examples, my Lords, in my view we need much more substance in this bill before we can
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proceed any further. My Lords, like all in this house
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My Lords, like all in this house I have been inundated by a flood of mail by post and online on this
Lord Bellamy (Conservative)
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It's an honour to follow the noble Lord Lord Carey. Declaring my membership of the Constitution membership of the Constitution Committee, I say first that the delegated powers in this bill are excessive. Clause 41.4 permits the Secretary of State to amend the National Health Service Act by delegating legislation to enable that fundamental legislation dedicated to prolonging life, to enable the Minister to do the opposite, namely assist death, but no details as to how that function should be discharged is not a proper exercise of delegated powers.
Turning to fundamentals, this bill is not in fact based on a suffering, as others have pointed out. According to the impact statement, other regimes have based either on intolerable suffering, that is Canada, Belgium, Netherlands. Under this bill, those with terminal illness were not suffering may assist -- request assisted death but those were suffering intolerably and are not terminally ill may not do so. Given that so much support for this bill depends on the avoidance of suffering, and so that we are all clear, may I respectfully ask the noble and learned Lord to put fully on the record why this bill is not based on suffering? Next, we are told in the impact statement, that by your 10 -- year 10, this bill will gives rise to some 7000 assisted deaths in England and Wales per year.
That is only around 1% of deaths. That to my mind raises two quite opposite questions. The first question is : if so few people are to benefit from assisted dying, is sufficient to justify the profound change to society and to the role of the state which this bill tends to bring about? But the second and opposite question is whether we can trust this 1%? Apparently and somewhat bizarrely based on the experience of the largely you will experience of the largely you will macro -- rural state of Oregon.
Is this bill the thin end of the wedge? Once the principle is considered, will pressure to go further inevitably increase? May I ask the supporters of the bill to give the house reassurance on that important point? Finally, as many have already said, individual autonomy, which is the other main argument in this debate, cannot be exercised in isolation from the rest of society. Once the principle is conceded, everyone's doctor-patient is affected. It affects all of our relationships with their doctors. Similarly, the vulnerable, the inarticulate, those for whom autonomy is largely illusory are all affected.
Given these very difficult questions, including those of mental capacity, the bill's complex Chrissie and the role of the coroner to give only a few examples, my Lords, in my view we need much more substance in this bill before we can
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proceed any further. My Lords, like all in this house
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My Lords, like all in this house I have been inundated by a flood of mail by post and online on this
12:30
Baroness Ramsay of Cartvale (Labour)
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Baroness Ramsay of Cartvale (Labour)
mail by post and online on this bill. More than I have ever experienced in almost 30 years in Your Lordships' House. Unfortunately, it's not possible to answer all individually but I'd like to put on record here my appreciation to all who sent their opinions and shared personal details, which were often emotional to read and most certainly it must have been a very emotional to write. I lived for three years in the Netherlands and recently, my closest friend of many years, and intelligent, attractive, the end linguist and a professional interpreter, became ill with terminal cancer.
They were undergoing treatment. For some time, when she decided to end her suffering and her life. Her wishes were granted after she fulfilled the necessary required procedures. I spoke with her brother, a retired doctor, by telephone on the afternoon of the day she had died. He told me that that morning, he brought his sister home from the hospital. He said all the decisions were completely hers. She was in her own bed and in her own house and he added movingly, overcoat and she was still a beautiful woman" still a beautiful woman" $$CAPITALISE's.
I was very sad to lose my friend but I felt contentment for her having the and that she wanted. The point I would like to make clear is that my support for this bill does not in any way affect my admiration and respect for our excellent hospices, for those who wish and need hospice care. A shining example of which I'm familiar with is Saint Christopher's in south London, founded in 1967 as the first UK hospice whose purpose was and is to link pain control with compassionate care.
Finally, we all know that legislation on the choice of ending life, of dignity in dying, as we debated in Parliament over a number of years. The details are clearly set out in the available rating papers briefing papers. -- Briefing papers. Changes will no doubt be made here but the fundamental decision is we are trying to make here is whether to give individuals the choice of ending their own lives with whatever safeguarding requirements Parliament No one can disagree with the statement that in the interest of good legislation, the House should have opportunity to scrutinise and make decisions.
If this can indeed done in the timescale of Baroness Berger's amendment, to report by 7 November, and the dates for the Parliamentary session allow time to take the Bill through all its phases, then it warrants support. But please let us not forget that fundamental question that we are looking for the answer to, that the time has come.
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So much has been said about the principal and the technicalities of
They were undergoing treatment. For some time, when she decided to end her suffering and her life. Her wishes were granted after she fulfilled the necessary required procedures. I spoke with her brother, a retired doctor, by telephone on the afternoon of the day she had died. He told me that that morning, he brought his sister home from the hospital. He said all the decisions were completely hers. She was in her own bed and in her own house and he added movingly, overcoat and she was still a beautiful woman" still a beautiful woman" $$CAPITALISE's.
I was very sad to lose my friend but I felt contentment for her having the and that she wanted. The point I would like to make clear is that my support for this bill does not in any way affect my admiration and respect for our excellent hospices, for those who wish and need hospice care. A shining example of which I'm familiar with is Saint Christopher's in south London, founded in 1967 as the first UK hospice whose purpose was and is to link pain control with compassionate care.
Finally, we all know that legislation on the choice of ending life, of dignity in dying, as we debated in Parliament over a number of years. The details are clearly set out in the available rating papers briefing papers. -- Briefing papers. Changes will no doubt be made here but the fundamental decision is we are trying to make here is whether to give individuals the choice of ending their own lives with whatever safeguarding requirements Parliament No one can disagree with the statement that in the interest of good legislation, the House should have opportunity to scrutinise and make decisions.
If this can indeed done in the timescale of Baroness Berger's amendment, to report by 7 November, and the dates for the Parliamentary session allow time to take the Bill through all its phases, then it warrants support. But please let us not forget that fundamental question that we are looking for the answer to, that the time has come.
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So much has been said about the principal and the technicalities of
12:34
Lord Moylan (Conservative)
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Lord Moylan (Conservative)
principal and the technicalities of the Bill but I thought I would use my few moments to return to the language used in the Bill. I realise that is a controversial thing to do because I have seen the reaction to the speech of my noble friend, Lady May. But I wish to express some solidarity with her. Because the argument against her has been that people wishing to access an assisted death do not actually want to die. But suicides presumably do.
And I think that is a mistake. I think if one looks at the case of suicides, most of them don't want to die. Most of them want their girlfriends or their families back or they want their fortunes restored, they want their pain taken away. The distinction is not collapses when you look at it closely, they are very much in the same position as people who are trying to avoid paying at the end of their life. So I do want to express my solidarity with the noble Baroness.
But there are other points about the language. It is notable that the words death and dying hardly appear. The poison to be used is described as an approved substance. The still mysterious contraption by which it is to be administered is called an approved device. And the business itself, when you get to clause 25, you will find it is headed Administration of assistance. Provision of assistance. Assistance, in fact, is the term used throughout the whole of the bill. Is this something that is going to become part of our daily language? Have you considered assistance, Mrs Smith? We know what this is.
It is euphemism. An old, ancient Greek device for hiding from the gods through the use of flowery language something of which you are ashamed. And that is what the language of this Bill is constantly expressing at every turn. I think we are right to be ashamed of what is in this Bill. I think we should take the opportunity not only to scrutinise it but if we see fit, to give the Commons an opportunity to consider it in a second parliamentary session.
And see if their view remains as firm as it is now, which is not very firm after all, purely on the numbers. I will only say finally one point in response to an argument that I have heard several times in the course of this debate, that it is somehow discriminatory that some people, some well off people, can afford to go abroad to evade the law. And that this is a discrimination which needs to be addressed by giving everybody the opportunity to evade the current law.
But we never use that argument on anything else, do we? Have I ever use that argument when it comes to tax evasion, for example? It is a very strange argument indeed and one that I do not think does credit to those who promote it. So with that, my lords, I would say I think this Bill is one which yes, indeed Bill is one which yes, indeed deserve scrutiny, but we are not in whiny -- in anyway committed or obliged to pass it.
It is a Private Members' Bill and if it is the view of the House that it should not pass, then that is the view that the House should take.
And I think that is a mistake. I think if one looks at the case of suicides, most of them don't want to die. Most of them want their girlfriends or their families back or they want their fortunes restored, they want their pain taken away. The distinction is not collapses when you look at it closely, they are very much in the same position as people who are trying to avoid paying at the end of their life. So I do want to express my solidarity with the noble Baroness.
But there are other points about the language. It is notable that the words death and dying hardly appear. The poison to be used is described as an approved substance. The still mysterious contraption by which it is to be administered is called an approved device. And the business itself, when you get to clause 25, you will find it is headed Administration of assistance. Provision of assistance. Assistance, in fact, is the term used throughout the whole of the bill. Is this something that is going to become part of our daily language? Have you considered assistance, Mrs Smith? We know what this is.
It is euphemism. An old, ancient Greek device for hiding from the gods through the use of flowery language something of which you are ashamed. And that is what the language of this Bill is constantly expressing at every turn. I think we are right to be ashamed of what is in this Bill. I think we should take the opportunity not only to scrutinise it but if we see fit, to give the Commons an opportunity to consider it in a second parliamentary session.
And see if their view remains as firm as it is now, which is not very firm after all, purely on the numbers. I will only say finally one point in response to an argument that I have heard several times in the course of this debate, that it is somehow discriminatory that some people, some well off people, can afford to go abroad to evade the law. And that this is a discrimination which needs to be addressed by giving everybody the opportunity to evade the current law.
But we never use that argument on anything else, do we? Have I ever use that argument when it comes to tax evasion, for example? It is a very strange argument indeed and one that I do not think does credit to those who promote it. So with that, my lords, I would say I think this Bill is one which yes, indeed Bill is one which yes, indeed deserve scrutiny, but we are not in whiny -- in anyway committed or obliged to pass it.
It is a Private Members' Bill and if it is the view of the House that it should not pass, then that is the view that the House should take.
12:38
Baroness Berridge (Conservative)
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Baroness Berridge (Conservative)
Sadness and sympathy are palpable in our inboxes and in this chamber, your Lordships' House is a sobering scene. But I begin with what is missing from the Bill, the S, the plural. As the noble Lady verger has outlined, there is no mention of family or relative, it is premise, the Western Enlightenment view of the self and individual autonomy which is alien to parts of the UK, let alone some of our ethnic minority communities. On the latter I can put in a better than an article by Jenny McDonnell, director of Diaz to the Times on 26 November last year stop "Many people will be familiar with the South African term...
Which means I am but his you are. ) Her community there is the concept of the fraternity of the community. There is a strong sense of existing not as an individual knitted into a family. The idea that someone who is facing death might not want to be a burden is an anathema to the West African tradition. You cannot be a burden because you are not a separate entity, you are part of a whole. And anyone who has visited the north- east of England might attest to a similar thick community.
But I did hear also the compelling story of someone with PTSD, after watching the huge syringes of drugs go into their father. There's no duty here under the Bill to one them. And what about the effects on you of Wister's -- are witnessing the failed process the Bill outlines? Or are they just not allowed to be there? Another S, subtle. Many noble Lords have spoken of subtle pressure and pressure and coercion are used in the Bill relatives that can be hard to detect.
But there is another wrong premise in the Bill that pressure comes from a person. If you join a Facebook networking group, say a fellow sufferers of the same disease, the algorithm can alter the content offered to you or comments by others can cause you to idealise the thought of assisted dying, create a reward pathway in your brain and even, according to studies, change the network and structure of your brain. Thus in fact the coercion can come from an unquantifiable force, even an algorithm, not a person.
How can medical practitioners ever know if you have been pressurised like this? And though this research field is still in its infancy, could we in 10 years be reporting that deaths were actually through coercion on social networking? Even today, a family are suing OpenAI as they say the ChatGPT encourage their son to take his life. Other studies are now reporting that people are more likely to return to social media reports for medical health and qualified physicians. This is the world in which we are legislating.
We know this can influence elections, how can it not influence these decisions? The clause to prohibit advertising is insufficient. This Bill is for an analogue age, not one on the cusp of AI. So although I support the suggestion of the noble Lady burgers Select Committee, I hope I'm not throwing a spanner into a timetable because I do not think we can ignore these issues. -- Lady Berger is. I'm an optimist and I hope the six-month timeline in the bill, again because we are on the cusp of medical breakthroughs, will in the future become impossible.
Anyone who knows parents of children with cystic fibrosis no that drugs are transforming, how will clinicians advise when they do not know the breakthroughs were on the cusp? The final S I want to talk to is as noble Truscott said, women and single women in particular. A meta- analysis, the best quality analysis from Oregon between 1998 and 2018 says they have witnessed an increase in voluntary suicide in older women over the age of 65 over the age of 65 x 50%.
We know that suicide can be contagious, we opening up that Pandora's box again? I agree with the speech of the right reverend Prelate, the Bishop of London, to vote on the principle stop this is leadership from the Church of England that the feedback to me is very welcome. I do not view this as taking your own life, I view it as giving your life back to God. This
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is a sacred act and not one the state should provide. I oppose this Bill, largely for
Which means I am but his you are. ) Her community there is the concept of the fraternity of the community. There is a strong sense of existing not as an individual knitted into a family. The idea that someone who is facing death might not want to be a burden is an anathema to the West African tradition. You cannot be a burden because you are not a separate entity, you are part of a whole. And anyone who has visited the north- east of England might attest to a similar thick community.
But I did hear also the compelling story of someone with PTSD, after watching the huge syringes of drugs go into their father. There's no duty here under the Bill to one them. And what about the effects on you of Wister's -- are witnessing the failed process the Bill outlines? Or are they just not allowed to be there? Another S, subtle. Many noble Lords have spoken of subtle pressure and pressure and coercion are used in the Bill relatives that can be hard to detect.
But there is another wrong premise in the Bill that pressure comes from a person. If you join a Facebook networking group, say a fellow sufferers of the same disease, the algorithm can alter the content offered to you or comments by others can cause you to idealise the thought of assisted dying, create a reward pathway in your brain and even, according to studies, change the network and structure of your brain. Thus in fact the coercion can come from an unquantifiable force, even an algorithm, not a person.
How can medical practitioners ever know if you have been pressurised like this? And though this research field is still in its infancy, could we in 10 years be reporting that deaths were actually through coercion on social networking? Even today, a family are suing OpenAI as they say the ChatGPT encourage their son to take his life. Other studies are now reporting that people are more likely to return to social media reports for medical health and qualified physicians. This is the world in which we are legislating.
We know this can influence elections, how can it not influence these decisions? The clause to prohibit advertising is insufficient. This Bill is for an analogue age, not one on the cusp of AI. So although I support the suggestion of the noble Lady burgers Select Committee, I hope I'm not throwing a spanner into a timetable because I do not think we can ignore these issues. -- Lady Berger is. I'm an optimist and I hope the six-month timeline in the bill, again because we are on the cusp of medical breakthroughs, will in the future become impossible.
Anyone who knows parents of children with cystic fibrosis no that drugs are transforming, how will clinicians advise when they do not know the breakthroughs were on the cusp? The final S I want to talk to is as noble Truscott said, women and single women in particular. A meta- analysis, the best quality analysis from Oregon between 1998 and 2018 says they have witnessed an increase in voluntary suicide in older women over the age of 65 over the age of 65 x 50%.
We know that suicide can be contagious, we opening up that Pandora's box again? I agree with the speech of the right reverend Prelate, the Bishop of London, to vote on the principle stop this is leadership from the Church of England that the feedback to me is very welcome. I do not view this as taking your own life, I view it as giving your life back to God. This
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is a sacred act and not one the state should provide. I oppose this Bill, largely for
12:42
Lord Banner (Conservative)
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I oppose this Bill, largely for the reason so eloquently articulated the reason so eloquently articulated by nine noble friend, Baroness May of Maidenhead, the right Telecom the Bishop of London and my noble friend the Baroness Prentis. His own personal harrowing express following her own diagnosis of cancer, feeling a burden on her family, despite all the advantages in life she is lucky to have, speaks volume. The pressures those less fortunate will come under if this Bill becomes law.
I would like to add two points to those already made. First, this is not a debate about the principle of assisted dying. We are not being asked to answer and essay question. We are being asked whether this Many speakers on the opposition side of this debate who have drawn of this debate who have drawn Avoid it. My Avoid it. My noble Avoid it. My noble friend Avoid it. My noble friend Lord Sandhurst said last week, hard cases make bad law.
Secondly I would like to address the contention that any expansion of the bill's criteria to the extent they would not face the belittle would need to come back before Parliament. May I remind noble Lords of the section 3 of the Human Rights Act 1998, that stays in subsection 1, so far as it is possible to do so, primary legislation must be read and given effect in a way which is compatible with Convention rights. The judicial authority at the highest level that this can enable and require a court to twist the words, an example, in 2022 case, Lord Stone held that in accordance with the will of Parliament as reflected in section 3, it will sometimes be necessary to adopt an interpretation which linguistically may appear strained.
The techniques to be used will not only involve the reading done of express language in statute but also the implication of provisions. I would therefore caution noble Lords against assuming that the words in this Bill will be interpreted in a literal way. On the contrary. Section 3 of the Human Rights Act is a goldmine for judicial expansionism without Parliament being re- consulted. Those concerned about considering whether this is the right bill as opposed to being swayed by jury speeches about the principle of assisted dying, would therefore do well to treat its wording with considerable pinch of salt.
Unless it is amended to exclude section 3 of the Human Rights Act, as section 15 of the Illegal Migration Act 2003 does. I expect to invite the noble Lord and wind up the debate if he would accept such exclusion and if he cannot and does not give unequivocal commitment to do so clearly indicates the scope of mission creep
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Like many in this house, I have
Lord Banner (Conservative)
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I oppose this Bill, largely for the reason so eloquently articulated the reason so eloquently articulated by nine noble friend, Baroness May of Maidenhead, the right Telecom the Bishop of London and my noble friend the Baroness Prentis. His own personal harrowing express following her own diagnosis of cancer, feeling a burden on her family, despite all the advantages in life she is lucky to have, speaks volume. The pressures those less fortunate will come under if this Bill becomes law.
I would like to add two points to those already made. First, this is not a debate about the principle of assisted dying. We are not being asked to answer and essay question. We are being asked whether this Many speakers on the opposition side of this debate who have drawn of this debate who have drawn Avoid it. My Avoid it. My noble Avoid it. My noble friend Avoid it. My noble friend Lord Sandhurst said last week, hard cases make bad law.
Secondly I would like to address the contention that any expansion of the bill's criteria to the extent they would not face the belittle would need to come back before Parliament. May I remind noble Lords of the section 3 of the Human Rights Act 1998, that stays in subsection 1, so far as it is possible to do so, primary legislation must be read and given effect in a way which is compatible with Convention rights. The judicial authority at the highest level that this can enable and require a court to twist the words, an example, in 2022 case, Lord Stone held that in accordance with the will of Parliament as reflected in section 3, it will sometimes be necessary to adopt an interpretation which linguistically may appear strained.
The techniques to be used will not only involve the reading done of express language in statute but also the implication of provisions. I would therefore caution noble Lords against assuming that the words in this Bill will be interpreted in a literal way. On the contrary. Section 3 of the Human Rights Act is a goldmine for judicial expansionism without Parliament being re- consulted. Those concerned about considering whether this is the right bill as opposed to being swayed by jury speeches about the principle of assisted dying, would therefore do well to treat its wording with considerable pinch of salt.
Unless it is amended to exclude section 3 of the Human Rights Act, as section 15 of the Illegal Migration Act 2003 does. I expect to invite the noble Lord and wind up the debate if he would accept such exclusion and if he cannot and does not give unequivocal commitment to do so clearly indicates the scope of mission creep
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Like many in this house, I have
12:46
Lord Browne of Belmont (Democratic Unionist Party)
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Like many in this house, I have always opposed the change to always opposed the change to assisted dying law. I have listened to the many eloquent speeches given by peers from across the house in favour of the change. However, I have never been convinced by the idea that such a law would be the right way forward. I continue to believe that this is not the path we should go down. In addition, I strongly agree with the concerns expressed by many noble Lords that such a serious issue has been introduced using a private members process and thus has received such scant scrutiny.
We are making life- and-death decisions today on this bill. As we do so, it behoves us to listen to the authoritative medical voices who have been publishing their views on this issue as the conversation on assisted dying has proceeded and as the bill itself has been developed. Several professional organisations made statements on this legislation. It is not just one medical Association that has given us warnings, which we might be tempted to discount as outliers, but it is at least five organisations.
First, the Royal College of Physicians Said, it would need adequate protection of patients. There are neutral on the principle of this bill but have warned that it is essential that decisions patients may make are considered in the current context of the NHS and held current context of the NHS and held power in England and Wales. The Royal College of Psychiatrists was even more explicit when they said they could not support the bill in its current form, highlighting that the Mental Capacity Act does not provide a framework for assessing decisions about ending one's own life.
That it's not clear what a psychiatrist but macro -- psychiatrist's role and that it is a risk factor for suicide. We need to take note of these important points. Second, the two colleges joined forces on 12 June to warn this house again about the impact of this bill, expressing concerns about safeguarding and fears that the NHS workforce does not currently have the resource required to meet these additional demands. Third, the Royal College of Pathologists have said they could not support the bill saying that's following assisted dying should be notified to the coroner, just as other deaths following the administration of drugs prescribed or not must be.
drugs prescribed or not must be. Close 38 -- clause 38 does not line up. Number four, the British Geriatric Society highlighted in adequate safeguards to protect older people from harm. Number five, finally, the national Down's syndrome policy group added their name to those concerned about the impact this bill on individuals with Down syndrome and learning disability. We are repeatedly told this bill is the safest in the world. Our medical professionals, organisations caring for those affected by the bill, are warning us it falls short.
This is not the right bill to protect patients. I hope noble Lords across this house will take those warnings to heart today and we should not be coerced into believing that we must pass such flawed legislation. such flawed legislation.
Lord Browne of Belmont (Democratic Unionist Party)
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Like many in this house, I have always opposed the change to always opposed the change to assisted dying law. I have listened to the many eloquent speeches given by peers from across the house in favour of the change. However, I have never been convinced by the idea that such a law would be the right way forward. I continue to believe that this is not the path we should go down. In addition, I strongly agree with the concerns expressed by many noble Lords that such a serious issue has been introduced using a private members process and thus has received such scant scrutiny.
We are making life- and-death decisions today on this bill. As we do so, it behoves us to listen to the authoritative medical voices who have been publishing their views on this issue as the conversation on assisted dying has proceeded and as the bill itself has been developed. Several professional organisations made statements on this legislation. It is not just one medical Association that has given us warnings, which we might be tempted to discount as outliers, but it is at least five organisations.
First, the Royal College of Physicians Said, it would need adequate protection of patients. There are neutral on the principle of this bill but have warned that it is essential that decisions patients may make are considered in the current context of the NHS and held current context of the NHS and held power in England and Wales. The Royal College of Psychiatrists was even more explicit when they said they could not support the bill in its current form, highlighting that the Mental Capacity Act does not provide a framework for assessing decisions about ending one's own life.
That it's not clear what a psychiatrist but macro -- psychiatrist's role and that it is a risk factor for suicide. We need to take note of these important points. Second, the two colleges joined forces on 12 June to warn this house again about the impact of this bill, expressing concerns about safeguarding and fears that the NHS workforce does not currently have the resource required to meet these additional demands. Third, the Royal College of Pathologists have said they could not support the bill saying that's following assisted dying should be notified to the coroner, just as other deaths following the administration of drugs prescribed or not must be.
drugs prescribed or not must be. Close 38 -- clause 38 does not line up. Number four, the British Geriatric Society highlighted in adequate safeguards to protect older people from harm. Number five, finally, the national Down's syndrome policy group added their name to those concerned about the impact this bill on individuals with Down syndrome and learning disability. We are repeatedly told this bill is the safest in the world. Our medical professionals, organisations caring for those affected by the bill, are warning us it falls short.
This is not the right bill to protect patients. I hope noble Lords across this house will take those warnings to heart today and we should not be coerced into believing that we must pass such flawed legislation. such flawed legislation.
12:50
Lord Johnson of Marylebone (Conservative)
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Lord Johnson of Marylebone (Conservative)
I was one of 118 members of the other Place who voted unsuccessfully in favour of the assisted dying bill a decade ago when it was thrown out by that house in September, 2015. Notwithstanding many powerful Notwithstanding many powerful Last Friday and again today, my position on this subject hasn't changed. I do support this latest effort to legalise it. As we've all heard, assisted dying does have strong public support. It's also got a mandate of the elected house in our Parliament, and I think we should give it a fair hearing today and speed it on its way.
People who suffering from people who suffer from incurable conditions should not be forced to endure suffering. The case for change remains strong. It will provide Terminally Ill Adults Bill with choice of compassionate dates -- it will provide terminally ill adults with agency and control over their lives. There is also in this House strong agreement that this bill is not yet perfect, and also a desire to use this House's best efforts to improve it. I think that is what we should all focus on incoming weeks.
There is one area where I think it might benefit from further debate and that is with respect to the, in my view rather arbitrary, six-month threshold for eligibility. I think it is worth us debating carefully whether there is not a case instead to have a test based on clinical progression so that assisted dying is available to adults with a progressive disease, illness or condition from which they are unlikely to recover and which can be reasonably expected to cause their death.
Either way, I'm confident that this house will do its job and scrutinise this bill carefully and improve it where possible and where necessary.
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This has been a most impressive debate, with the house operating at
People who suffering from people who suffer from incurable conditions should not be forced to endure suffering. The case for change remains strong. It will provide Terminally Ill Adults Bill with choice of compassionate dates -- it will provide terminally ill adults with agency and control over their lives. There is also in this House strong agreement that this bill is not yet perfect, and also a desire to use this House's best efforts to improve it. I think that is what we should all focus on incoming weeks.
There is one area where I think it might benefit from further debate and that is with respect to the, in my view rather arbitrary, six-month threshold for eligibility. I think it is worth us debating carefully whether there is not a case instead to have a test based on clinical progression so that assisted dying is available to adults with a progressive disease, illness or condition from which they are unlikely to recover and which can be reasonably expected to cause their death.
Either way, I'm confident that this house will do its job and scrutinise this bill carefully and improve it where possible and where necessary.
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This has been a most impressive debate, with the house operating at
12:52
Lord Green of Deddington (Crossbench)
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Lord Green of Deddington (Crossbench)
debate, with the house operating at its best. We now, however, face a challenge. The bill, as drafted, frankly, is a bit of a shambles. This is both in the detail that has been raised and on central issues. It also contains the risk that some people will feel that they must end their lives because they feel they have become a burden on others. The have become a burden on others. The noble Lord Lord Kakkar described this as a complex and serious issue that will ultimately change the relationship between the citizen and the state, and indeed between patients and doctors.
That point has also been made by others. Lord Kakkar pointed out also that this bill makes provision for the state to pay entirely for the dying service. But not fully funding palliative care. This will have wider implications which is wider implications which is tactfully put. Indeed, this may be partly the reason why palliative care doctors are opposed to this bill in its present form. One cause of concern, which I share, is the disappearance of the High Court judges from the oversight system for reasons that are entirely understandable, but as a result, those panels are likely to be staffed mainly by those who favour the new arrangements and we have seen in Canada how rapidly the number of assisted deaths could grow.
In seven years, they have increased from 1000 a year to 15,000 increased from 1000 a year to 15,000 a year. A further major difficulty with the present bill is that while doctors can decline to be involved in the new system, hospices in care homes cannot opt out. And did, some care homes my well -- might well have to close. This bill even includes a requirement for medical professionals to signpost patients towards information about how to access and assisted suicide if they so wish.
That's an extraordinary requirement. Not so different from the ordinary suicide websites which we rightly seek to prohibit. This bill would also permit doctor shopping where a patient refused by one Doctor could simply find another who is willing to sign the documents and could indeed -- and there could indeed be money to be made by some of these doctors. Some cases may be excluded from coroner investigations. I trust this house will now address itself. Lord Currie spoke powerfully.
This leaves me into minds and I'll see where we get to before I decide to vote.
That point has also been made by others. Lord Kakkar pointed out also that this bill makes provision for the state to pay entirely for the dying service. But not fully funding palliative care. This will have wider implications which is wider implications which is tactfully put. Indeed, this may be partly the reason why palliative care doctors are opposed to this bill in its present form. One cause of concern, which I share, is the disappearance of the High Court judges from the oversight system for reasons that are entirely understandable, but as a result, those panels are likely to be staffed mainly by those who favour the new arrangements and we have seen in Canada how rapidly the number of assisted deaths could grow.
In seven years, they have increased from 1000 a year to 15,000 increased from 1000 a year to 15,000 a year. A further major difficulty with the present bill is that while doctors can decline to be involved in the new system, hospices in care homes cannot opt out. And did, some care homes my well -- might well have to close. This bill even includes a requirement for medical professionals to signpost patients towards information about how to access and assisted suicide if they so wish.
That's an extraordinary requirement. Not so different from the ordinary suicide websites which we rightly seek to prohibit. This bill would also permit doctor shopping where a patient refused by one Doctor could simply find another who is willing to sign the documents and could indeed -- and there could indeed be money to be made by some of these doctors. Some cases may be excluded from coroner investigations. I trust this house will now address itself. Lord Currie spoke powerfully.
This leaves me into minds and I'll see where we get to before I decide to vote.
12:56
Lord Shinkwin (Conservative)
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Lord Shinkwin (Conservative)
Lord Shinkwin is taking part remotely.
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It was a day much like any other when I was diagnosed. A day at the office was followed by hospital office was followed by hospital appointment to find out why within months my face has -- had months my face has -- had effectively shut down on the left side. Nothing prepared me for what side. Nothing prepared me for what I I made I made a I made a recovery. I made a recovery.
My I made a recovery. My doctor I made a recovery. My doctor said I made a recovery. My doctor said I I made a recovery. My doctor said I beat the odds. What she did not say was "I can help you to die." This bill will fundamentally enter the conversation a patient has with the doctor they trust to do no harm. Noble Lords have highlighted this. Notwithstanding an excruciating and painful long recovery, the surgery was a success, although I have to speak slowly to be understood and I'm grateful to noble Lords patience and understanding.
Ironically, 20 years later I became a member of Your Lordships' House. This brings me to some wide words -- wise words from 12 March, 2007. I quote, "Our role in scrutiny is vital. We are a legislative chamber. There will no doubt be unforeseen consequences but they need to be considered." I thank they need to be considered." I thank noble Lords. It is indeed a duty to scrutinise this bill and consider scrutinise this bill and consider all its unforeseen consequences.
I wonder if we have any idea of the Pandora's box this bill will pry open. Many noble Lords have referred to jurisdictions where assisted dying has already been introduced. The precedence that those jurisdictions provide clearly show the chain of events that this bill would set off, not just for disabled people but also young people with mental health issues and young women with eating disorders. It is the stuff of nightmares. My noble friend baroness May told us how her friend referred to the bill as the licence to kill bill.
She's right. It offers the licence to kill the wrong type of people. My Lords, I am the wrong type. As Lord Faulkner pointed out in his speech, there are savings to be made should assisted dying be introduced, and this bill effectively puts a price on my head. Indeed, should it become law and precedent set elsewhere apply in the UK over time, then I face the realistic possibility as a severely disabled person of being killed as a result of legislation passed by this As my noble friend Lord Harper reminded us, no organisation of or for disabled people support the bill.
I close with a plea, that we do not allow anything to deter us from doing our duty. And subjecting this Bill, with all its unforeseen and irreversible consequences, to the scrutiny it not only deserves but so desperately needs. I support Baroness Berger's motion. Baroness Berger's motion.
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It was a day much like any other when I was diagnosed. A day at the office was followed by hospital office was followed by hospital appointment to find out why within months my face has -- had months my face has -- had effectively shut down on the left side. Nothing prepared me for what side. Nothing prepared me for what I I made I made a I made a recovery. I made a recovery.
My I made a recovery. My doctor I made a recovery. My doctor said I made a recovery. My doctor said I I made a recovery. My doctor said I beat the odds. What she did not say was "I can help you to die." This bill will fundamentally enter the conversation a patient has with the doctor they trust to do no harm. Noble Lords have highlighted this. Notwithstanding an excruciating and painful long recovery, the surgery was a success, although I have to speak slowly to be understood and I'm grateful to noble Lords patience and understanding.
Ironically, 20 years later I became a member of Your Lordships' House. This brings me to some wide words -- wise words from 12 March, 2007. I quote, "Our role in scrutiny is vital. We are a legislative chamber. There will no doubt be unforeseen consequences but they need to be considered." I thank they need to be considered." I thank noble Lords. It is indeed a duty to scrutinise this bill and consider scrutinise this bill and consider all its unforeseen consequences.
I wonder if we have any idea of the Pandora's box this bill will pry open. Many noble Lords have referred to jurisdictions where assisted dying has already been introduced. The precedence that those jurisdictions provide clearly show the chain of events that this bill would set off, not just for disabled people but also young people with mental health issues and young women with eating disorders. It is the stuff of nightmares. My noble friend baroness May told us how her friend referred to the bill as the licence to kill bill.
She's right. It offers the licence to kill the wrong type of people. My Lords, I am the wrong type. As Lord Faulkner pointed out in his speech, there are savings to be made should assisted dying be introduced, and this bill effectively puts a price on my head. Indeed, should it become law and precedent set elsewhere apply in the UK over time, then I face the realistic possibility as a severely disabled person of being killed as a result of legislation passed by this As my noble friend Lord Harper reminded us, no organisation of or for disabled people support the bill.
I close with a plea, that we do not allow anything to deter us from doing our duty. And subjecting this Bill, with all its unforeseen and irreversible consequences, to the scrutiny it not only deserves but so desperately needs. I support Baroness Berger's motion. Baroness Berger's motion.
13:01
Lord Taylor of Warwick (Non-affiliated)
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Lord Taylor of Warwick (Non-affiliated)
I found the dignified words of my noble friend, Lord Shinkwin, most powerful and persuasive and he used the phrase Pandora's box and I to oppose this bill. It is said that one of the lessons of history is that we do not learn lessons from history. So we must learn lessons from history of this important matter. One can only have compassion for those who are in so much pain and suffering that they wish to end their lives.
But supporters of this Bill say this is a matter of choice and I question that. Because assisted dying would not be a real choice if the alternative option, of high quality end-of-life palliative care is not available. This Bill is based on assessing someone as being within six months of natural death. Such a prognosis is often unreliable. I still recall that awful time when a hospital doctor asked for my permission to turn off the machine that was basically keeping my mother alive.
But I was aware of the fact that her church was praying for her and her family were praying for her, so I said no. And he said, well, that's your choice. She went on to live for several years longer. Enjoying her family in particular, her grandchildren. And as that doctor said to me some years later, "Well, it was a miracle stop there must be power in prayer." I said, "Yet, that's right." Those are except a time limit of six months now to get the Bill passed me come back again in a few years time to shorten or even remove a time limit.
And I believe in this Bill there is a lack of genuine safeguards for vulnerable people. There is no longer judicial oversight, namely that a High Court judge should approve assisted suicide. And I use that word suicide not to cause offence but I think this is really what it is. So the original key safeguard has been replaced. So -- psychiatrists and social work at who are to be included in the panel system have warned that there are not enough of them to fill this role.
And unfortunately there are very well- meaning and experienced social workers who miss the abuse of children and babies. And yet this Bill seeks to put even more pressure on that profession. And evidence from countries where assisted suicide is legal and available, for example, in Canada, New Zealand, the Netherlands, indicates that it is likely there will be a move from assisted suicide for the terminally ill only, to those with other health conditions. The National Health Service is already under huge pressure, struggling to meet targets.
This Bill would put even more pressure on the NHS at precisely the wrong time. As the Health Secretary Wes Streeting said, if Parliament chooses to go ahead with assisted dying, it is making a choice that this is an area to make for investment and these choices would come at the expense of other choices. Surely the investment should be in better palliative care for the terminally ill in hospices or care homes, ensuring a better quality of life in the last years, months or days.
In the Bible, there were five characters in particular who contemplated suicide. Hannah, who contemplated suicide. Hannah, Elisha, Joe, David and Jonah. -- Elisha. In each case, even during the anguish of their suffering, they eventually found that God had created them gave them a reason to continue living until the natural time of their death. I oppose this bill, the first duty of government is to protect its people, not to give a state licensed to kill its people.
But supporters of this Bill say this is a matter of choice and I question that. Because assisted dying would not be a real choice if the alternative option, of high quality end-of-life palliative care is not available. This Bill is based on assessing someone as being within six months of natural death. Such a prognosis is often unreliable. I still recall that awful time when a hospital doctor asked for my permission to turn off the machine that was basically keeping my mother alive.
But I was aware of the fact that her church was praying for her and her family were praying for her, so I said no. And he said, well, that's your choice. She went on to live for several years longer. Enjoying her family in particular, her grandchildren. And as that doctor said to me some years later, "Well, it was a miracle stop there must be power in prayer." I said, "Yet, that's right." Those are except a time limit of six months now to get the Bill passed me come back again in a few years time to shorten or even remove a time limit.
And I believe in this Bill there is a lack of genuine safeguards for vulnerable people. There is no longer judicial oversight, namely that a High Court judge should approve assisted suicide. And I use that word suicide not to cause offence but I think this is really what it is. So the original key safeguard has been replaced. So -- psychiatrists and social work at who are to be included in the panel system have warned that there are not enough of them to fill this role.
And unfortunately there are very well- meaning and experienced social workers who miss the abuse of children and babies. And yet this Bill seeks to put even more pressure on that profession. And evidence from countries where assisted suicide is legal and available, for example, in Canada, New Zealand, the Netherlands, indicates that it is likely there will be a move from assisted suicide for the terminally ill only, to those with other health conditions. The National Health Service is already under huge pressure, struggling to meet targets.
This Bill would put even more pressure on the NHS at precisely the wrong time. As the Health Secretary Wes Streeting said, if Parliament chooses to go ahead with assisted dying, it is making a choice that this is an area to make for investment and these choices would come at the expense of other choices. Surely the investment should be in better palliative care for the terminally ill in hospices or care homes, ensuring a better quality of life in the last years, months or days.
In the Bible, there were five characters in particular who contemplated suicide. Hannah, who contemplated suicide. Hannah, Elisha, Joe, David and Jonah. -- Elisha. In each case, even during the anguish of their suffering, they eventually found that God had created them gave them a reason to continue living until the natural time of their death. I oppose this bill, the first duty of government is to protect its people, not to give a state licensed to kill its people.
13:06
Lord Moynihan (Conservative)
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Lord Moynihan (Conservative)
The passage of this Bill, as much of its existence to my grandfather in your Lordships' House. -- Owes much of its existence. First voluntary euthanasia legislation built in 1936, and reduced -- introduced under the society... $$CAPITALISE, was written by my grandfather. A leading surgeon of his generation. A Surgeon General in the First World War, he had the unenviable job of overseeing the medical treatment along the Western front. Where he spent many months organising treatment for the 2.5 million military personnel who were wounded.
He introduced the Bill at first reading. Days later, his wife of over 40 years died peacefully, he was grief stricken in his Leeds home, sat in his office, wrote a letter to his son and died a few days later from a broken heart, never to speak at second reading. Later the noble Lord Ponsonby's great-grandfather to move his second reading opening speech. His commitment was born of a lifetime dedication for caring for patients, to surgery and medicine from which he became the first man to be elected president of the Royal College of surgeons from outside London and the only one to be elected twice.
Like him, I believe the right to die within the law as a matter of the ultimate importance and the ultimate compassion and human dignity. For those approaching the end of their lives, with any decision to exercise that right, -- wrote that right to dive to be taken only the most robust legal safeguards possible and to take the vulnerable. If I may quote him, our desire is to have legal... For cases of advance and inevitably fatal disease, attended by agony which reaches or oversteps the boundaries of human endurance, the suffer of the legal inquiry and after due observance of all safeguards, shall have the right to demand and be entitled to receive release." Of course, medicine has moved on and we are blessed with ways to address many instances of the agonies which were suffered by those fighting in the great War.
In no case is it a question of a trade-off of palliative care or whether palliative care should be made available or not, all cases should be available for palliative care. And I believe it is for those facing imminent death to choose to do so at a time and place of their choosing, rather than in ways which they fear may cause intense suffering. This is not a bill compelling and anyone taxed -- compelling anyone to act against their conscience. I was deeply moved by the speech of the noble Lord outer dice -- Lord Elder Daesh, a man of deeply religious beliefs, comes from a Christian perspective and can reach a different view to that of the right reverend Prelate, the Bishop of London.
I welcome the decision of the noble Baroness Lady Berger, working with Lord Faulkner, that the Select Committee should be set up to hear evidence. Her proposal respect the right timetable to allow, should both Houses wish, to make sure that the Bill goes through all its parliamentary stages. I believe my grandfather was right about providing a patient who is terminally ill, while all the legal safeguards are met, that they, like us all, should have the choice about how we die. And that is why I support this Bill and the opportunities we have to improve it.
He introduced the Bill at first reading. Days later, his wife of over 40 years died peacefully, he was grief stricken in his Leeds home, sat in his office, wrote a letter to his son and died a few days later from a broken heart, never to speak at second reading. Later the noble Lord Ponsonby's great-grandfather to move his second reading opening speech. His commitment was born of a lifetime dedication for caring for patients, to surgery and medicine from which he became the first man to be elected president of the Royal College of surgeons from outside London and the only one to be elected twice.
Like him, I believe the right to die within the law as a matter of the ultimate importance and the ultimate compassion and human dignity. For those approaching the end of their lives, with any decision to exercise that right, -- wrote that right to dive to be taken only the most robust legal safeguards possible and to take the vulnerable. If I may quote him, our desire is to have legal... For cases of advance and inevitably fatal disease, attended by agony which reaches or oversteps the boundaries of human endurance, the suffer of the legal inquiry and after due observance of all safeguards, shall have the right to demand and be entitled to receive release." Of course, medicine has moved on and we are blessed with ways to address many instances of the agonies which were suffered by those fighting in the great War.
In no case is it a question of a trade-off of palliative care or whether palliative care should be made available or not, all cases should be available for palliative care. And I believe it is for those facing imminent death to choose to do so at a time and place of their choosing, rather than in ways which they fear may cause intense suffering. This is not a bill compelling and anyone taxed -- compelling anyone to act against their conscience. I was deeply moved by the speech of the noble Lord outer dice -- Lord Elder Daesh, a man of deeply religious beliefs, comes from a Christian perspective and can reach a different view to that of the right reverend Prelate, the Bishop of London.
I welcome the decision of the noble Baroness Lady Berger, working with Lord Faulkner, that the Select Committee should be set up to hear evidence. Her proposal respect the right timetable to allow, should both Houses wish, to make sure that the Bill goes through all its parliamentary stages. I believe my grandfather was right about providing a patient who is terminally ill, while all the legal safeguards are met, that they, like us all, should have the choice about how we die. And that is why I support this Bill and the opportunities we have to improve it.
13:10
Lord Rook (Labour)
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Lord Rook (Labour)
I'm grateful to all noble Lords for the sincerity and the seriousness of this debate over these last few days, it has been illuminating and moving to hear so many family stories and personal testimonies. I know my interest as a carer for my father, Roy, who suffers with dementia. This time tomorrow my dad will knock on the door of the care office in his supported living complex, to address an issue of single importance. Namely whether his choice has been registered for the 4 o'clock fish supper.
Dad will have already made this trip four or five times, and all, his ever kind and patient care, will smile and affirm once again that he has chose haddock and chips and paid a 7 pound bill. My dad will lean back and say thank you, I will see you soon. This will indeed be true also in the hours that followed, he will return many times to ask the same question. I do not make light of my father's condition all -- all carers know we see many dark moments and some of the lighter moments are the ones that give us a degree of hope and happiness.
But the truth is that my dad's life is immeasurably improved by the fact that he lives in a loving environment with tailored medical support, endless activity and entertainment and an astonishing team with almost infinite capacity for kindness and compassion. Despite his diminishing and terminal condition, he has a good standard of living. And why? Because he can afford it. We have heard a great deal in your Lordships' House over the last days about choice and I believe choice is a good thing.
Hence my concern in assessing this legislation is for those who have less choice than us, those who unlike my father, cannot subsidise their own care in the final season of life. The most disadvantaged members of our communities already suffer increased mortality rates. The pronounced effect health inequalities, they find it hard to see a GP, they wait longer for treatment and struggle to navigate conflict health systems. We have heard it said over and over, the NHS is currently only able to support 30% of the palliative care costs of our country.
I simply cannot sing how the introduction of this legislation will not pressurise those without access to first-rate care and who cannot afford to supplement what the NHS struggles to provide, like my father, how they won't turn to assisted dying not as their first choice, but as their last and final option. For noble Lords sceptical at this point, we should pay attention to states who have gone this way before. In Canada, increasing numbers of patients, many of them disabled, are being driven in the direction of assisted dying due to poverty and a lack of ability to fund their own care.
In Victoria, Australia, Robert Clark, the former Attorney-General has said that disadvantaged patients are likely seeking assisted dying precisely because of the problems in accessing adequate care. The same is true in the United States. In Washington, those choosing assisted dying because of concerns about their finances has risen fivefold, from 2% to 10% of cases. And in Oregon, the percentage of patients choosing this route because they fear becoming a burden to the family has climbed from 13% to 52%. In scrutinising this Bill, I hope we will learn from these countries and take a different course.
Where my concern, where my own choice is concerned, I have chosen to support my noble friend, Aaron S Berger, for her intervention and support the agreement to convene a select committee. -- Baroness Berger. I hope this will give us an opportunity to listen carefully to voices that have not been heard, as much as they should, in the procedures and the processes and the legislation before us. I look forward to working with noble Lords in this house, in committee, for as long as it takes to ensure that we can give a good end for all.
Dad will have already made this trip four or five times, and all, his ever kind and patient care, will smile and affirm once again that he has chose haddock and chips and paid a 7 pound bill. My dad will lean back and say thank you, I will see you soon. This will indeed be true also in the hours that followed, he will return many times to ask the same question. I do not make light of my father's condition all -- all carers know we see many dark moments and some of the lighter moments are the ones that give us a degree of hope and happiness.
But the truth is that my dad's life is immeasurably improved by the fact that he lives in a loving environment with tailored medical support, endless activity and entertainment and an astonishing team with almost infinite capacity for kindness and compassion. Despite his diminishing and terminal condition, he has a good standard of living. And why? Because he can afford it. We have heard a great deal in your Lordships' House over the last days about choice and I believe choice is a good thing.
Hence my concern in assessing this legislation is for those who have less choice than us, those who unlike my father, cannot subsidise their own care in the final season of life. The most disadvantaged members of our communities already suffer increased mortality rates. The pronounced effect health inequalities, they find it hard to see a GP, they wait longer for treatment and struggle to navigate conflict health systems. We have heard it said over and over, the NHS is currently only able to support 30% of the palliative care costs of our country.
I simply cannot sing how the introduction of this legislation will not pressurise those without access to first-rate care and who cannot afford to supplement what the NHS struggles to provide, like my father, how they won't turn to assisted dying not as their first choice, but as their last and final option. For noble Lords sceptical at this point, we should pay attention to states who have gone this way before. In Canada, increasing numbers of patients, many of them disabled, are being driven in the direction of assisted dying due to poverty and a lack of ability to fund their own care.
In Victoria, Australia, Robert Clark, the former Attorney-General has said that disadvantaged patients are likely seeking assisted dying precisely because of the problems in accessing adequate care. The same is true in the United States. In Washington, those choosing assisted dying because of concerns about their finances has risen fivefold, from 2% to 10% of cases. And in Oregon, the percentage of patients choosing this route because they fear becoming a burden to the family has climbed from 13% to 52%. In scrutinising this Bill, I hope we will learn from these countries and take a different course.
Where my concern, where my own choice is concerned, I have chosen to support my noble friend, Aaron S Berger, for her intervention and support the agreement to convene a select committee. -- Baroness Berger. I hope this will give us an opportunity to listen carefully to voices that have not been heard, as much as they should, in the procedures and the processes and the legislation before us. I look forward to working with noble Lords in this house, in committee, for as long as it takes to ensure that we can give a good end for all.
13:14
Lord Green of Hurstpierpoint (Crossbench)
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Lord Green of Hurstpierpoint (Crossbench)
I have agonised, as we all have, about this bill. I rise to make three points briefly. First of all, that I support the principle of the bill. I say that as a religious person. I seek to live by Christian narrative and I share with many Jewish and Muslim friends, amongst many others, I believe in the given this and the sanctity of life. But there is no simple deduction to be drawn from this as to what the state can properly permit or prohibit.
And if a terminally ill person of sound mind and settle disposition wishes to end their suffering and dying dignity, I do not think that in principle that should be a criminal offence to assist them. Secondly though, I share the worries of many of your noble Lords about encouraging a climate of suggestibility, which subtly or not so subtly influences the vulnerable. But I want just to tell a story, which in effect raises the opposite issue. This occurred in a jurisdiction notorious for its relatively loose framework of legislation about assisted dying.
I disguise the details somewhat because this is still raw for those intimately concerned. But a person with terminal cancer decided to die in dignity. A family meal was held to celebrate the life, all drank a glass of champagne, but then the person went to the next room and the doctors were ready to administer the dose. In the aftermath, the spouse was grief stricken and depressed, the grandchildren were in floods of tears and demanding to know why the grandparent had done this.
The parents, struggling with their own bereavement, had to cope with the emotional distress of three emotional distress of three Now, in the last analysis, we might want to acknowledge that it is the person's decision. It is their life and their death. But I can't help asking what it says about those precious human relationships being terminated along with that life will stop Martin Luther is said to have said that we believe alone and we die alone.
Well, yes, but also know. -- no. We can only Helder -- hold our heads up in defending this bill if it is holistically focused. Above all, and so many of us have already said this, palliative care must be integral to any satisfactory approach. To that I would add the crucial importance of mature societal discussion of what dying well means. We need to move beyond the bare assertion of a libertarian principle and beyond our sanitising euphemisms about death.
There is no way of making this simple and it cannot just be a matter for lawyers, legislators and care professionals. It is also a matter for conversation and families, in schools, in religious groups, of course, in humanist discourse, and for all of us, in fact. I will support Baroness Berridge's's motion. I want to see inappropriate act on the statute books in a reasonable timeframe. But if this is as important as everyone says it is, then we should devote the time needed, including, dare I say, the Fridays and the New Year right.
And if a terminally ill person of sound mind and settle disposition wishes to end their suffering and dying dignity, I do not think that in principle that should be a criminal offence to assist them. Secondly though, I share the worries of many of your noble Lords about encouraging a climate of suggestibility, which subtly or not so subtly influences the vulnerable. But I want just to tell a story, which in effect raises the opposite issue. This occurred in a jurisdiction notorious for its relatively loose framework of legislation about assisted dying.
I disguise the details somewhat because this is still raw for those intimately concerned. But a person with terminal cancer decided to die in dignity. A family meal was held to celebrate the life, all drank a glass of champagne, but then the person went to the next room and the doctors were ready to administer the dose. In the aftermath, the spouse was grief stricken and depressed, the grandchildren were in floods of tears and demanding to know why the grandparent had done this.
The parents, struggling with their own bereavement, had to cope with the emotional distress of three emotional distress of three Now, in the last analysis, we might want to acknowledge that it is the person's decision. It is their life and their death. But I can't help asking what it says about those precious human relationships being terminated along with that life will stop Martin Luther is said to have said that we believe alone and we die alone.
Well, yes, but also know. -- no. We can only Helder -- hold our heads up in defending this bill if it is holistically focused. Above all, and so many of us have already said this, palliative care must be integral to any satisfactory approach. To that I would add the crucial importance of mature societal discussion of what dying well means. We need to move beyond the bare assertion of a libertarian principle and beyond our sanitising euphemisms about death.
There is no way of making this simple and it cannot just be a matter for lawyers, legislators and care professionals. It is also a matter for conversation and families, in schools, in religious groups, of course, in humanist discourse, and for all of us, in fact. I will support Baroness Berridge's's motion. I want to see inappropriate act on the statute books in a reasonable timeframe. But if this is as important as everyone says it is, then we should devote the time needed, including, dare I say, the Fridays and the New Year right.
13:18
Baroness Verma (Conservative)
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Baroness Verma (Conservative)
I refer to my interest in the register is the founder of the social care business. Over 25 years, I have seen many times people have needed to be looked after at the end of their lives. I only have a few points to make. I have listened to the excellent contributions from around the House but my mind still remains firmly that we need to be a society that is willing to care to the last minute of every single human being that comes into this world.
I am a Sikh with Hindu practices. It is at the core of my practices. It is at the core of my faith to serve and protect. And to uphold the law. I would not uphold a law that tells me to take a lie. I do not want to see a change in relationship between the medical practitioners and the patients. I feel that we are really slipping down a very slippery slope if we start introducing things that afterwards we have little control over.
I was pleased to hear from my noble friend Lord McCall when he said in his expertise that everything can be managed. We don't need to give pain relief when pain is too much. It's at the beginning when pain starts to ease the pain, to make sure that the person is comfortable. A few years ago, my uncle was given a diagnosis of stomach cancer. He was really, really well looked after by Mick willing nurses -- Macmillan nurses. When he felt he wanted to come home, because he knew he was coming to the end of his time, he came home and his family were around him to see him slip away.
It wasn't an easy death. It was one where we all shared time with my uncle. My Lords, it is hard for me to stand here and say that all people will be well informed when I know that there are many among my own community where women often, they have been in relationships where they have suffered abuse, coercive behaviour. How can they be given the option to make those choices for themselves when most of their decision-making will not be in their hands? I worry very much all -- I worry very much for those people who have no control over their circumstances.
They will not be able to make those decisions. I really want to make sure that whatever we pass, whatever we do has protections for those in our communities that do not have control over their lives as we all think we should have. I will finally finish with the wonderful words of my noble friend Baroness Berridge. The family, the village that we live in is surrounded by the people we love. We would never knowingly want to inflict pain on anyone but what we would knowingly do -- willingly do is stand by and help everyone in our family to help make the journey go
I am a Sikh with Hindu practices. It is at the core of my practices. It is at the core of my faith to serve and protect. And to uphold the law. I would not uphold a law that tells me to take a lie. I do not want to see a change in relationship between the medical practitioners and the patients. I feel that we are really slipping down a very slippery slope if we start introducing things that afterwards we have little control over.
I was pleased to hear from my noble friend Lord McCall when he said in his expertise that everything can be managed. We don't need to give pain relief when pain is too much. It's at the beginning when pain starts to ease the pain, to make sure that the person is comfortable. A few years ago, my uncle was given a diagnosis of stomach cancer. He was really, really well looked after by Mick willing nurses -- Macmillan nurses. When he felt he wanted to come home, because he knew he was coming to the end of his time, he came home and his family were around him to see him slip away.
It wasn't an easy death. It was one where we all shared time with my uncle. My Lords, it is hard for me to stand here and say that all people will be well informed when I know that there are many among my own community where women often, they have been in relationships where they have suffered abuse, coercive behaviour. How can they be given the option to make those choices for themselves when most of their decision-making will not be in their hands? I worry very much all -- I worry very much for those people who have no control over their circumstances.
They will not be able to make those decisions. I really want to make sure that whatever we pass, whatever we do has protections for those in our communities that do not have control over their lives as we all think we should have. I will finally finish with the wonderful words of my noble friend Baroness Berridge. The family, the village that we live in is surrounded by the people we love. We would never knowingly want to inflict pain on anyone but what we would knowingly do -- willingly do is stand by and help everyone in our family to help make the journey go
13:22
The Earl of Oxford and Asquith (Crossbench)
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The Earl of Oxford and Asquith (Crossbench)
matters of detail. On the issue of principle, I believe this bill will radically alter our society's view of the value of life by introducing utilitarian value. As the noble Lord Lord Frost and others have said, if assisted dying is to be determined assisted dying is to be determined by this, it will become acceptable. That will fundamentally change the culture and the therapeutic role of doctors and carers which we have accepted for millennia. Assisted dying is not a medical treatment.
Ending life is not a therapeutic Secondly, the supposed defence of autonomy or optimality is perhaps not what it may seem on first sight. Once you legalise the option for assisted dying, within no time you will have created a right to die. Not one of us has exercised an option to be born. Indeed, and ancient Greek thinker in one of his gloomier moments suggested that if we were offered a choice to be born, we should be best bias to refuse it come on the grounds that suffering is endemic to humankind.
Once we establish a choice to die, then to withhold such a right will amount to discrimination against a person, and once discrimination law rises in the ascendant, there is no limit to its zenith. On matters of detail, I have very severe doubts about the criteria for eligibility in this bill. And other countries, as we have heard, we see the rapid expansion of eligibility criteria. It has become discriminatory to restrict assisted dying to the terminally ill who learn of assisted dying being offered to sufferers from many non-terminal physical and mental afflictions.
As it stands, I now wonder whether we may have to reject the bill itself effectively to prevent incremental expansion of eligibility criteria alone. Secondly, there is abundant evidence that there is no possibility of providing 100% safeguarding against coercive influence. This is probably one of the biggest questions to which this bill cannot offer an answer. Coercion is always likely to be present if he cannot get the basic rate -- care you need. We spoke in a great deal about palliative care.
The noble Lord lawmakers -- the noble Lord told us there is no alternative. He may be right in the short term but I do not think that to abandon such an aspiration can be endorsed as a justification for an action. The strongest motive among terminally ill patients for requesting assisted dying is not so much insufferable pain but they are feeling abandoned, pain but they are feeling abandoned, cast aside onto the scrapheap. If they can be helped to feel valued, their mentality can entirely change.
Feeling about and is one of the strongest motives for suicide. Of this bill were explicitly to address intolerable suffering, then perhaps assisted dying could more respectably be presented as the last result for intractable suffering, but in that case, palliative care should assume far greater prominence. Of the 0.5 million people who die in this country per people who die in this country per year, thousands do not have proper palliative care in the last two months of their lives. These are people who most need our attention.
The bill does not address this issue at all at present. Many speakers at all at present. Many speakers have already brought a conscientious objection, the consequences for hospitals, delegating powers, certification of drugs and legal substances and the absence of a coroner. Many speakers have argued that the pleasant law is untenable -- present law is untenable. If passed into law, it will be seen to have numerous untenable consequences of the years. I have some sympathy with the view of the noble Lord pattern -- Lord Patten and Baroness false.
-- Baroness Butler-Sloss. I suspect more and more amendments will make this bill unworkable. My Lords, the noble prize winning physicist wrote that we must never judge political movements or legislative initiatives by the aims, however sincerely upheld but only by the means used to realise these the means used to realise these aims. In my judgement, this bill is not say. There are just too many defects in it that need to be dealt with. Most fundamentally, is the ultimate aim of the bill is to relieve suffering, then self- evidently the means proposed is not
**** Possible New Speaker ****
therapeutic. I must make it clear that I
**** Possible New Speaker ****
I must make it clear that I oppose this bill. Morally and ethically, this is a most fearful
Ending life is not a therapeutic Secondly, the supposed defence of autonomy or optimality is perhaps not what it may seem on first sight. Once you legalise the option for assisted dying, within no time you will have created a right to die. Not one of us has exercised an option to be born. Indeed, and ancient Greek thinker in one of his gloomier moments suggested that if we were offered a choice to be born, we should be best bias to refuse it come on the grounds that suffering is endemic to humankind.
Once we establish a choice to die, then to withhold such a right will amount to discrimination against a person, and once discrimination law rises in the ascendant, there is no limit to its zenith. On matters of detail, I have very severe doubts about the criteria for eligibility in this bill. And other countries, as we have heard, we see the rapid expansion of eligibility criteria. It has become discriminatory to restrict assisted dying to the terminally ill who learn of assisted dying being offered to sufferers from many non-terminal physical and mental afflictions.
As it stands, I now wonder whether we may have to reject the bill itself effectively to prevent incremental expansion of eligibility criteria alone. Secondly, there is abundant evidence that there is no possibility of providing 100% safeguarding against coercive influence. This is probably one of the biggest questions to which this bill cannot offer an answer. Coercion is always likely to be present if he cannot get the basic rate -- care you need. We spoke in a great deal about palliative care.
The noble Lord lawmakers -- the noble Lord told us there is no alternative. He may be right in the short term but I do not think that to abandon such an aspiration can be endorsed as a justification for an action. The strongest motive among terminally ill patients for requesting assisted dying is not so much insufferable pain but they are feeling abandoned, pain but they are feeling abandoned, cast aside onto the scrapheap. If they can be helped to feel valued, their mentality can entirely change.
Feeling about and is one of the strongest motives for suicide. Of this bill were explicitly to address intolerable suffering, then perhaps assisted dying could more respectably be presented as the last result for intractable suffering, but in that case, palliative care should assume far greater prominence. Of the 0.5 million people who die in this country per people who die in this country per year, thousands do not have proper palliative care in the last two months of their lives. These are people who most need our attention.
The bill does not address this issue at all at present. Many speakers at all at present. Many speakers have already brought a conscientious objection, the consequences for hospitals, delegating powers, certification of drugs and legal substances and the absence of a coroner. Many speakers have argued that the pleasant law is untenable -- present law is untenable. If passed into law, it will be seen to have numerous untenable consequences of the years. I have some sympathy with the view of the noble Lord pattern -- Lord Patten and Baroness false.
-- Baroness Butler-Sloss. I suspect more and more amendments will make this bill unworkable. My Lords, the noble prize winning physicist wrote that we must never judge political movements or legislative initiatives by the aims, however sincerely upheld but only by the means used to realise these the means used to realise these aims. In my judgement, this bill is not say. There are just too many defects in it that need to be dealt with. Most fundamentally, is the ultimate aim of the bill is to relieve suffering, then self- evidently the means proposed is not
**** Possible New Speaker ****
therapeutic. I must make it clear that I
**** Possible New Speaker ****
I must make it clear that I oppose this bill. Morally and ethically, this is a most fearful
13:28
Lord Magan of Castletown (Conservative)
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Lord Magan of Castletown (Conservative)
ethically, this is a most fearful piece of proposed legislation, but he owned that, this bill is very deeply flawed. The floors are -- we must not lose sight of the bill's multiple deficiencies. It is clearly unacceptable to a significant majority of conscientious medical practitioners. It's no surprise that so many leading medical organisations and medical schools have expressed very significant concerns. The bill itself includes no requirement for a person to be suffering or in pain to be eligible for an assisted suicide.
And it is now notable that majority in GB opposition has continued to increase significantly. There is a huge risk that this right to die will quickly translate into an expect nation, even a duty of healthcare workers to facilitate death when requested. And there are no effective legal safeguards to perfect -- to protect the elderly and vulnerable. The overriding necessities for the provision of universally accessible, high-quality supportive and palliative and end-of-life care have been swept aside.
It is particularly striking that an overwhelming majority between 70 and 85% of palliative care doctors are opposed to assisted suicide. Crucially, there are no built-in checks to protect against the inevitable risks of coercion. People with disabilities, particularly older persons, may feel subtly pressurised to end their lives. The replacement of High Court judicial oversight judicial panel, psychiatrist, social worker, brings an uncontrolled risk that such panels will become staffed by those who favour assisted suicide. Such judicial panels are clearly not qualified to overrule the joint view of expert medical practitioners.
Further, those are -- those who are not actually dying would be eligible for assisted suicide and the term terminal illness is not actually clearly defined. The law could be applied to those who have years of life ahead of them. We must also recognise that there has been totally insufficient pre-legislative scrutiny of this bill. No public consultation and no proper engagement with a medical professional -- with the medical profession. Most amendments tabled in the other place were not even debated.
There is silence as to where necessary funding will come from. Most likely, it will have to be found from existing, Taking funds from palliative support actually relieve suffering and saves lives. There is also a real fear that funding will be subcontracted out, leading to a... And Carlos profit driven system. -- And Carlos. It is now unsurprising that, contrary to Lord Faulkner's contention, support for assisted suicide from the general public is significantly waning. Rarely has our role in this House as a scrutiny and revising chamber been so important.
It is imperative that we do not give succour to this charter for the culture of death.
And it is now notable that majority in GB opposition has continued to increase significantly. There is a huge risk that this right to die will quickly translate into an expect nation, even a duty of healthcare workers to facilitate death when requested. And there are no effective legal safeguards to perfect -- to protect the elderly and vulnerable. The overriding necessities for the provision of universally accessible, high-quality supportive and palliative and end-of-life care have been swept aside.
It is particularly striking that an overwhelming majority between 70 and 85% of palliative care doctors are opposed to assisted suicide. Crucially, there are no built-in checks to protect against the inevitable risks of coercion. People with disabilities, particularly older persons, may feel subtly pressurised to end their lives. The replacement of High Court judicial oversight judicial panel, psychiatrist, social worker, brings an uncontrolled risk that such panels will become staffed by those who favour assisted suicide. Such judicial panels are clearly not qualified to overrule the joint view of expert medical practitioners.
Further, those are -- those who are not actually dying would be eligible for assisted suicide and the term terminal illness is not actually clearly defined. The law could be applied to those who have years of life ahead of them. We must also recognise that there has been totally insufficient pre-legislative scrutiny of this bill. No public consultation and no proper engagement with a medical professional -- with the medical profession. Most amendments tabled in the other place were not even debated.
There is silence as to where necessary funding will come from. Most likely, it will have to be found from existing, Taking funds from palliative support actually relieve suffering and saves lives. There is also a real fear that funding will be subcontracted out, leading to a... And Carlos profit driven system. -- And Carlos. It is now unsurprising that, contrary to Lord Faulkner's contention, support for assisted suicide from the general public is significantly waning. Rarely has our role in this House as a scrutiny and revising chamber been so important.
It is imperative that we do not give succour to this charter for the culture of death.
13:32
Lord Grade of Yarmouth (Non-affiliated)
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Lord Grade of Yarmouth (Non-affiliated)
What a privilege but what a responsibility to be a part of this debate. And I think it is clear from every speaker that we all feel that responsibility. If this legislation passes into law and subsequently proves, like all legislation, to be defective in some respect, there is no way that subsequent revisions can restore the lives of those who have succumbed to its provisions. Nearly all noble Lords for or against expressed huge anxiety about the so-called safeguarding clauses in the Bill.
I urge your Lordships to reread these clauses. Surely they must alarm us all. Why are these clauses necessary at all? Because I think all sides agree there are real think all sides agree there are real dangers of coercion, mistakes, wrong judgements, undisclosed facts, that surface after the death warrants are signed. These clauses are not and can never be a guarantee of fair play. No drafting can eliminate the life-and-death risks arising from this bill. These clauses represent an acceptance that there will be circumstances where mistake, greed, ignorance, coercion and other ignorance, coercion and other factors are known -- unknown are at play after enactment.
Despite the fatal consequences of drafting errors and omissions, supporters of the Bill asking this House to believe that there safeguarding clauses will work exactly as drafted. That doctors can always know when you will die. No, this bill, like all bills, will not be perfect when enacted. In real life, it is certain to prove defective in some ways unforeseeable. And like other legislation -- unlike other other legislation -- unlike other registration, there is no redress, certainly not from the grave.
I cannot support this bill, it is a risk to far. I listen to the frontline palliative care specialist who concerns easily outweigh the elegant pleadings of the lawyers and others a long way from the frontline. These are my practical objections and the reason why I believe this legislation should be put out of its misery. I will finish with some words on the underlying principle. Not my words but the words of one Mr James Wicks of Esher in Surrey, who wrote to 'The Daily Telegraph' as follows.
"Sir, assisted suicide is not a private medical matter, it is a moral line. If Parliament crosses it, the message will be clear, some lives are no longer worth living. No person, institution or machine is worthy to make that judgement. Yet we now find ourselves debating it, as though it were just another healthcare policy. The terminally ill -- the Terminally Ill Adults (End of Life) Bill is not about compassion, it is the logical end of a society that is relay's, shared moral foundations with individual subjectivity and duty with personal preference.
We do not and cannot fully understand the mystery of life. It's beginning, its purpose or indeed its end. From that uncertainty blows a duty to protect life, not to authorise the termination. MPs who are wavering should recognise this legislation for what it is. A profound statement about who we are and what we value. I urge them to vote against it and uphold the principle that life is not ours to dismiss." On evidence of
**** Possible New Speaker ****
this debate, Mr Wicks, I believe, speaks for the majority of this House. I want to focus today on the
**** Possible New Speaker ****
I want to focus today on the group of people that this Bill actually relates to, those terminally ill patients with terminally ill patients with capacity whose death in consequence of that illness or disease can reasonably be suspected within six months. We can argue about whether the Bill should be wider or narrower the Bill should be wider or narrower in scope or not at all but our key focus should be on scrutinising this bill, not speculating about legislation which may or may not come to us in future.
Some time ago I sat with a very dear friend in an oncologist office in South Africa, as he learned his prostate cancer as he learned his prostate cancer had spread and was no longer treatable. Just over a year ago, he treatable. Just over a year ago, he told me that the pain is becoming unendurable. Shortly afterwards, his daughter contacted me to say he had died. She also sent me his death certificate, I thought that strange, certificate, I thought that strange, but then I read it and I understood why.
Because under the cause of why. Because under the cause of death it states cancer, prostate but above it, another cause is listed, above it, another cause is listed, organophosphate poisoning. My friend would not have benefited from this Bill because he lived in another country. I share his experience only because several noble Lords have sought to restart this Bill as assisted suicide will and like -- assisted suicide bill and like Baroness Thornton a Baroness Royall thing that is quite wrong. My friends death cannot in any meaningful way be described as suicidal is that he did not choose death over life, he wanted more than anything to live but that was not an option open to him.
His choice was between the kind of death he was to have and immediate tragic and painful one or a prolonged and agonising death he had decided was unendurable. So we should be clear,
I urge your Lordships to reread these clauses. Surely they must alarm us all. Why are these clauses necessary at all? Because I think all sides agree there are real think all sides agree there are real dangers of coercion, mistakes, wrong judgements, undisclosed facts, that surface after the death warrants are signed. These clauses are not and can never be a guarantee of fair play. No drafting can eliminate the life-and-death risks arising from this bill. These clauses represent an acceptance that there will be circumstances where mistake, greed, ignorance, coercion and other ignorance, coercion and other factors are known -- unknown are at play after enactment.
Despite the fatal consequences of drafting errors and omissions, supporters of the Bill asking this House to believe that there safeguarding clauses will work exactly as drafted. That doctors can always know when you will die. No, this bill, like all bills, will not be perfect when enacted. In real life, it is certain to prove defective in some ways unforeseeable. And like other legislation -- unlike other other legislation -- unlike other registration, there is no redress, certainly not from the grave.
I cannot support this bill, it is a risk to far. I listen to the frontline palliative care specialist who concerns easily outweigh the elegant pleadings of the lawyers and others a long way from the frontline. These are my practical objections and the reason why I believe this legislation should be put out of its misery. I will finish with some words on the underlying principle. Not my words but the words of one Mr James Wicks of Esher in Surrey, who wrote to 'The Daily Telegraph' as follows.
"Sir, assisted suicide is not a private medical matter, it is a moral line. If Parliament crosses it, the message will be clear, some lives are no longer worth living. No person, institution or machine is worthy to make that judgement. Yet we now find ourselves debating it, as though it were just another healthcare policy. The terminally ill -- the Terminally Ill Adults (End of Life) Bill is not about compassion, it is the logical end of a society that is relay's, shared moral foundations with individual subjectivity and duty with personal preference.
We do not and cannot fully understand the mystery of life. It's beginning, its purpose or indeed its end. From that uncertainty blows a duty to protect life, not to authorise the termination. MPs who are wavering should recognise this legislation for what it is. A profound statement about who we are and what we value. I urge them to vote against it and uphold the principle that life is not ours to dismiss." On evidence of
**** Possible New Speaker ****
this debate, Mr Wicks, I believe, speaks for the majority of this House. I want to focus today on the
**** Possible New Speaker ****
I want to focus today on the group of people that this Bill actually relates to, those terminally ill patients with terminally ill patients with capacity whose death in consequence of that illness or disease can reasonably be suspected within six months. We can argue about whether the Bill should be wider or narrower the Bill should be wider or narrower in scope or not at all but our key focus should be on scrutinising this bill, not speculating about legislation which may or may not come to us in future.
Some time ago I sat with a very dear friend in an oncologist office in South Africa, as he learned his prostate cancer as he learned his prostate cancer had spread and was no longer treatable. Just over a year ago, he treatable. Just over a year ago, he told me that the pain is becoming unendurable. Shortly afterwards, his daughter contacted me to say he had died. She also sent me his death certificate, I thought that strange, certificate, I thought that strange, but then I read it and I understood why.
Because under the cause of why. Because under the cause of death it states cancer, prostate but above it, another cause is listed, above it, another cause is listed, organophosphate poisoning. My friend would not have benefited from this Bill because he lived in another country. I share his experience only because several noble Lords have sought to restart this Bill as assisted suicide will and like -- assisted suicide bill and like Baroness Thornton a Baroness Royall thing that is quite wrong. My friends death cannot in any meaningful way be described as suicidal is that he did not choose death over life, he wanted more than anything to live but that was not an option open to him.
His choice was between the kind of death he was to have and immediate tragic and painful one or a prolonged and agonising death he had decided was unendurable. So we should be clear,
13:40
Lord Oates (Liberal Democrat)
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Lord Oates (Liberal Democrat)
we are discussing an assisted dying bill, not an assisted suicide bill. Although I believe strongly in the right of individuals to take right of individuals to take decisions about their own lives, particularly when denying such rights may make them suffer rights may make them suffer intolerable pain in the way my intolerable pain in the way my friend did, I do not discount the concerns of those who oppose this Bill. Because alongside my belief in Bill. Because alongside my belief in individual autonomy, I have uninformed scepticism about the state and its institutions.
I take seriously the concerns raised by the noble Lord recent Eastern and others last Friday, about inequities in the NHS treatment, particularly impacting black and minority ethnic groups and people on lower incomes and the dangers of introducing and the dangers of introducing assisted dying in such a system. -- assisted dying in such a system. -- Lord Rees. I was struck by the compelling speech of my noble friend Baroness Parminter that alerted us Baroness Parminter that alerted us to the risk of people suffering eating disorders and I also wonder about the lack of value that is often put on the lives of older often put on the lives of older people and the serious concerns expressed by disabled groups.
Clause 5, two of the Bill that allows a medical practitioner to initiate a conversation with a patient about assisted dying is particularly problematic to me. Not because I believe the medical profession is full of people who want to end the lives of their patients, but simply because I know it is full of human beings. As such, it will have its share of bad actors but more pertinently, it will have far more than its share of tired and overstretched professionals, juggling competing priorities and resources.
Finally there is the issue of coercion. Of course most families act in the best interests of their relatives and many make huge sacrifices to do so. But there will always be some that do not. We must make sure that the safeguards in the Bill are workable and effective. I close by thanking all those who have written to me or spoken to me with great conviction on either side of the debate. In many ways IMB their certainty, not because I lack clarity on where I stand on the principle of the Bill because I find it harder to discount the laws both in the existing state of the law and in the Bill that is before us.
I therefore welcome the agreement to hold a Select Committee today evidence and I look forward to detailed deliberations of the bill.
I take seriously the concerns raised by the noble Lord recent Eastern and others last Friday, about inequities in the NHS treatment, particularly impacting black and minority ethnic groups and people on lower incomes and the dangers of introducing and the dangers of introducing assisted dying in such a system. -- assisted dying in such a system. -- Lord Rees. I was struck by the compelling speech of my noble friend Baroness Parminter that alerted us Baroness Parminter that alerted us to the risk of people suffering eating disorders and I also wonder about the lack of value that is often put on the lives of older often put on the lives of older people and the serious concerns expressed by disabled groups.
Clause 5, two of the Bill that allows a medical practitioner to initiate a conversation with a patient about assisted dying is particularly problematic to me. Not because I believe the medical profession is full of people who want to end the lives of their patients, but simply because I know it is full of human beings. As such, it will have its share of bad actors but more pertinently, it will have far more than its share of tired and overstretched professionals, juggling competing priorities and resources.
Finally there is the issue of coercion. Of course most families act in the best interests of their relatives and many make huge sacrifices to do so. But there will always be some that do not. We must make sure that the safeguards in the Bill are workable and effective. I close by thanking all those who have written to me or spoken to me with great conviction on either side of the debate. In many ways IMB their certainty, not because I lack clarity on where I stand on the principle of the Bill because I find it harder to discount the laws both in the existing state of the law and in the Bill that is before us.
I therefore welcome the agreement to hold a Select Committee today evidence and I look forward to detailed deliberations of the bill.
13:41
Lord Freyberg (Crossbench)
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Lord Freyberg (Crossbench)
Over the past two days of debate, we have had sincere and often moving contributions from every side of the House. The arguments for and against assisted dying touch on the most profound questions of life, death, autonomy and compassion. I have also received a large number of letters and emails from the public, some urging reform, others expressing grave concern. What unites them is a strength of feeling and the urgency strength of feeling and the urgency of this issue.
The case against change is serious. Many fear that legalising assisted dying would undermine the sanctity of life, send the wrong message to those who feel themselves a burden or a road the doctor-patient relationship. Some point to examples abroad where overtime laws have been expanded and ask whether we can ever be certain that similar pressures will not emerge here. Others remind us of the patchy provision of palliative care and argue that real choice does not exist until every dying person can be confident of the very best care at the end of life.
These concerns deserve to be heard with respect. And yet the arguments in favour are no less compelling. For all our advances in medicine, palliative care cannot always relieve suffering. Too many families have watched a love one ensure a prolonged and degrading death or else travelled abroad, often alone to places like Switzerland, because the law here forces them into exile. Those who cannot travel sometimes resort to desperate means. In these cases, the current law does not protect vulnerable, it abandons them. It is regrettable that no government has yet established a Royal commission to examine this question fairly, despite clear and enduring need.
For over 20 years, efforts to legislate have drawn on international evidence and proposed careful safeguards but each has faltered, leaving the cost borne not bias in Parliament, but by dying people and their families. That failure of political will should not failure of political will should not prevent us from addressing the issue now but alongside reform, we must also act to strengthen existing provision. I therefore hope the government will do more to ensure palliative care is properly and fairly funded. So that nobody feels full stint or a choice by a lack of support.
-- Nobody feels forced. We can draw on the experience of others, we are not without guidance. Over 300 million people worldwide are living jurisdictions where assisted dying is legal for the terminally ill. No country has taken this cautious route has ever reversed its law and the evidence shows that far from undermining palliative care, such laws often strengthen it. This Bill seeks to offer choice, not compulsion, under the tightest safeguards ever proposed. Multiple medical assessments and independent multidisciplinary panel and new coercive offences carrying life sentences.
It has been scrutinised for over hundreds of hours in the Commons, amended repeatedly and now comes to us for further examination. I therefore welcome and support the initiative of Baroness Berger and Lord Faulkner to establish a select committee, so further evidence can be gathered and considered without delaying the bill's progress. The question before us is not whether dying people should suffer, none of us wish that, whether we should if them that right under strict conditions to decide for themselves when suffering from unbearable condition.
To deny them that choice is to oppose our values at the most intimate moment of another's life. Grant it shows compassion, respect, autonomy and to protect the vulnerable through law, rather than turning a blind eye. That is why after weighing both sides, I will support the bill.
The case against change is serious. Many fear that legalising assisted dying would undermine the sanctity of life, send the wrong message to those who feel themselves a burden or a road the doctor-patient relationship. Some point to examples abroad where overtime laws have been expanded and ask whether we can ever be certain that similar pressures will not emerge here. Others remind us of the patchy provision of palliative care and argue that real choice does not exist until every dying person can be confident of the very best care at the end of life.
These concerns deserve to be heard with respect. And yet the arguments in favour are no less compelling. For all our advances in medicine, palliative care cannot always relieve suffering. Too many families have watched a love one ensure a prolonged and degrading death or else travelled abroad, often alone to places like Switzerland, because the law here forces them into exile. Those who cannot travel sometimes resort to desperate means. In these cases, the current law does not protect vulnerable, it abandons them. It is regrettable that no government has yet established a Royal commission to examine this question fairly, despite clear and enduring need.
For over 20 years, efforts to legislate have drawn on international evidence and proposed careful safeguards but each has faltered, leaving the cost borne not bias in Parliament, but by dying people and their families. That failure of political will should not failure of political will should not prevent us from addressing the issue now but alongside reform, we must also act to strengthen existing provision. I therefore hope the government will do more to ensure palliative care is properly and fairly funded. So that nobody feels full stint or a choice by a lack of support.
-- Nobody feels forced. We can draw on the experience of others, we are not without guidance. Over 300 million people worldwide are living jurisdictions where assisted dying is legal for the terminally ill. No country has taken this cautious route has ever reversed its law and the evidence shows that far from undermining palliative care, such laws often strengthen it. This Bill seeks to offer choice, not compulsion, under the tightest safeguards ever proposed. Multiple medical assessments and independent multidisciplinary panel and new coercive offences carrying life sentences.
It has been scrutinised for over hundreds of hours in the Commons, amended repeatedly and now comes to us for further examination. I therefore welcome and support the initiative of Baroness Berger and Lord Faulkner to establish a select committee, so further evidence can be gathered and considered without delaying the bill's progress. The question before us is not whether dying people should suffer, none of us wish that, whether we should if them that right under strict conditions to decide for themselves when suffering from unbearable condition.
To deny them that choice is to oppose our values at the most intimate moment of another's life. Grant it shows compassion, respect, autonomy and to protect the vulnerable through law, rather than turning a blind eye. That is why after weighing both sides, I will support the bill.
13:45
Baroness Mobarik (Conservative)
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Baroness Mobarik (Conservative)
The assisted dying bill presents one of the most profound moral and legal questions of our time. How to balance the personal autonomy with the duty to protect society's most vulnerable. It asks whether we can lawfully offer people a choice over the manner and timing of their death, preventing pressure, abuse or error that would put the frail and dependent at risk. That tension between respecting individual liberty and safeguarding life demands legislation that is morally clear, legally robust and equipped with adequate -- uncompromising This bill is presented as compassionate but it sets us on a dangerous drift.
And other countries what began as legislation for the terminally ill has become legislation for the chronically ill etc. One point that has been made numerous times in this debate is that vulnerable old people could be caused by their children or other relatives driven by selfish interest into prematurely choosing assisted suicide. My concern is for those who have no children because in reality, most children love their parents deeply and will go to any levels to protect and help them.
Increasingly, many young people are choosing to remain single and childless. That is their choice but to rings with a deep vulnerability. Of safeguards a road, we risk reaching a point where strangers such as doctors, officials, or even the state could decide that certain people are expendable, especially when there is no one left to protect or speak for them and they are merely seen as a burden and cost to this -- to the state. This bill leaves too many safeguards unclear.
At what precise point with professionals have legal permission to end lives. I can we be certain that concern is wrong consent is genuine and not born of fear, depression or loneliness. These are not minor details, they are matters of life and death. Let are matters of life and death. Let not -- let us not assume... Legal injections can take far longer than intended visible suffering. If even executions by professionals sometimes go horribly wrong, is it unrealistic to assume that assisted dying under the spell will always be safe or dignified.
On a personal note, my light -- my late parents who were exceptional people of strong faith would say that the time of death, the place of death and the manner of each person's dying are preordained. For from being a cause of fear, such beliefs allow people to live with courage, knowing that the end is not ours to determine. I'm aware that even as we speak, there are those in terrible pain and suffering but true compassion is not found in death, it is found in ensuring that no one dies in pain and no one dies alone, with proper investment and palliative care, pain relief and social support, especially for those who have no family to care for them.
This debate is not just about individual choice, it is a question of what future generations will inherit, whether we remain society that protects the vulnerable and onerous life in all vulnerable and onerous life in all of its frailty or whether we enable a quiet erosion of the value of life.Responsibility is to preserve the intrinsic value of every individual and that is why I cannot support this bill.
**** Possible New Speaker ****
I watched as my late husband and partner of 31 years died, knowing there was a better, more humane way. When my dear friend of many, many When my dear friend of many, many years suffered for months, she knew there was another way and she
And other countries what began as legislation for the terminally ill has become legislation for the chronically ill etc. One point that has been made numerous times in this debate is that vulnerable old people could be caused by their children or other relatives driven by selfish interest into prematurely choosing assisted suicide. My concern is for those who have no children because in reality, most children love their parents deeply and will go to any levels to protect and help them.
Increasingly, many young people are choosing to remain single and childless. That is their choice but to rings with a deep vulnerability. Of safeguards a road, we risk reaching a point where strangers such as doctors, officials, or even the state could decide that certain people are expendable, especially when there is no one left to protect or speak for them and they are merely seen as a burden and cost to this -- to the state. This bill leaves too many safeguards unclear.
At what precise point with professionals have legal permission to end lives. I can we be certain that concern is wrong consent is genuine and not born of fear, depression or loneliness. These are not minor details, they are matters of life and death. Let are matters of life and death. Let not -- let us not assume... Legal injections can take far longer than intended visible suffering. If even executions by professionals sometimes go horribly wrong, is it unrealistic to assume that assisted dying under the spell will always be safe or dignified.
On a personal note, my light -- my late parents who were exceptional people of strong faith would say that the time of death, the place of death and the manner of each person's dying are preordained. For from being a cause of fear, such beliefs allow people to live with courage, knowing that the end is not ours to determine. I'm aware that even as we speak, there are those in terrible pain and suffering but true compassion is not found in death, it is found in ensuring that no one dies in pain and no one dies alone, with proper investment and palliative care, pain relief and social support, especially for those who have no family to care for them.
This debate is not just about individual choice, it is a question of what future generations will inherit, whether we remain society that protects the vulnerable and onerous life in all vulnerable and onerous life in all of its frailty or whether we enable a quiet erosion of the value of life.Responsibility is to preserve the intrinsic value of every individual and that is why I cannot support this bill.
**** Possible New Speaker ****
I watched as my late husband and partner of 31 years died, knowing there was a better, more humane way. When my dear friend of many, many When my dear friend of many, many years suffered for months, she knew there was another way and she
13:50
Lord Cashman (Non-affiliated)
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Lord Cashman (Non-affiliated)
implored me to help, and I did. I was prepared to break the law as I conducted clinics in the Netherlands and Switzerland, however, it was to come to nothing. But these are the words of an observer. I would rather you hear the words of someone facing death. My dear friend, Elise. She writes, "And 51 years old and I have secondary cancer of the lungs, liver and bones. Or to put it kindly, I'm dying. -- Bluntly, I'm dying.
My medical team are very reluctant to give me a number but I've been told that people with similar conditions can expect to live for around two years. I will let you do the maths. I have just been told that my life extending drugs have stopped working and I'm in a horrible limbo, awaiting test results to determine the next course of action and hoping against hope that my liver holds out until I can get onto a different medication. I'm absolutely I'm not telling you this to garner pity.
Believe me, I am living my very best end-of-life. I'm surrounded by beautiful family and friends and immersing myself in art and culture, and genuinely having as much fun as is humanely possible. I tried to find the joy in every single day. But some days, that is harder than others, not least because I know that one day things will start to deteriorate and the pain, which on bad days is already pretty bad, will become intolerable. I have witnessed terminal illness close-up.
I've seen a long, painful, drawnout death. It was deeply traumatic. I still have my ears about it. I can still smell it and taste it. I do not want that for myself. Indeed, I do not want that for anyone. This bill is urgent. The stakes could not a higher. It is 100 years in the making and it cannot come soon enough, and as much as I'd love to be a medical miracle and defy the odds, if it does pass, it will probably come too late for me.
But I'm asking peers to vote in favour in the hope that it will save the unnecessary pain and suffering that hundreds, indeed thousands of people like me and their families. Since becoming part of the campaign, I've heard the most harrowing end of life experiences from people I now consider my friends. People like Gareth, whose father blew his head off with a shotgun. And Lucy whose partner, Tom, eventually suffocated after hours of faecal vomiting. Every single story breaks my heart all over again.
Not least because there could have been another way. And that is why this vote is so important. It's a vote for another way, a more progressive, compassionate way. A vote for choice for terminally oh people. I do not want to die, of course I don't. I'm having the time of my life right now. Truly. There is something about a terminal diagnosis that makes you a terminal diagnosis that makes you really live life to the pool -- full. But I do have to face the reality.
I've had a good life and I want a good death. I deserve a good death. I would challenge any peer who votes against to look me in the eye and tell me why I don't deserve that, why I don't deserve to die in dignity." These are the words of my friend, Elise Burns, about a bill that does not impose choice but allows it.
My medical team are very reluctant to give me a number but I've been told that people with similar conditions can expect to live for around two years. I will let you do the maths. I have just been told that my life extending drugs have stopped working and I'm in a horrible limbo, awaiting test results to determine the next course of action and hoping against hope that my liver holds out until I can get onto a different medication. I'm absolutely I'm not telling you this to garner pity.
Believe me, I am living my very best end-of-life. I'm surrounded by beautiful family and friends and immersing myself in art and culture, and genuinely having as much fun as is humanely possible. I tried to find the joy in every single day. But some days, that is harder than others, not least because I know that one day things will start to deteriorate and the pain, which on bad days is already pretty bad, will become intolerable. I have witnessed terminal illness close-up.
I've seen a long, painful, drawnout death. It was deeply traumatic. I still have my ears about it. I can still smell it and taste it. I do not want that for myself. Indeed, I do not want that for anyone. This bill is urgent. The stakes could not a higher. It is 100 years in the making and it cannot come soon enough, and as much as I'd love to be a medical miracle and defy the odds, if it does pass, it will probably come too late for me.
But I'm asking peers to vote in favour in the hope that it will save the unnecessary pain and suffering that hundreds, indeed thousands of people like me and their families. Since becoming part of the campaign, I've heard the most harrowing end of life experiences from people I now consider my friends. People like Gareth, whose father blew his head off with a shotgun. And Lucy whose partner, Tom, eventually suffocated after hours of faecal vomiting. Every single story breaks my heart all over again.
Not least because there could have been another way. And that is why this vote is so important. It's a vote for another way, a more progressive, compassionate way. A vote for choice for terminally oh people. I do not want to die, of course I don't. I'm having the time of my life right now. Truly. There is something about a terminal diagnosis that makes you a terminal diagnosis that makes you really live life to the pool -- full. But I do have to face the reality.
I've had a good life and I want a good death. I deserve a good death. I would challenge any peer who votes against to look me in the eye and tell me why I don't deserve that, why I don't deserve to die in dignity." These are the words of my friend, Elise Burns, about a bill that does not impose choice but allows it.
13:54
Lord Robathan (Conservative)
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Lord Robathan (Conservative)
Anything I say will probably have been said before. I shall not speak for long. On both sides, there have been some outstanding speeches and I think we can all appreciate that this is hugely complex. People very often tend to speak from the on position and I've spoken to several older peers. I've had innumerable emails and letters from people on both sides. Some were very informative and a majority was informative and a majority was For me, there are two big issues with the bill.
First, for some reason, society strives far too hard to keep a very ill, dying people to keep a very ill, dying people alive. We shall die and we must all accept that. Is a question, I have no idea if there is an afterlife. Perhaps the bishops might fill me in. I do know that I shall die. I hope that I can die without pain. Harold Shipman... Doctors would increase morphine for very sick patients which led to a relatively simple and comfortable death.
The idea that you could prosecute a doctor for assistant and aiming -- assisting an imminent death... We must not cling to life. The pandemic experience... Most of them were in the 80s. It's an example of how we should be aware that people will die and we should accept that. The second major issue against this bill relates to coercion and that coercion may be unintended. Continuing life will reduce the prospects, the inheritance for their children. Indeed, children might not wish the elderly parent to die but the parent might decide it was best for them.
Some 30 odd years ago, I was a new MP and the Major government introduced a scheme were people entering care would have to sell their houses to pay for the care. This remains a big issue for governments. I recall a queue of people coming to my advice session and they would say, "And her mother wants us to inherit her house." To hint, encourage or push a relative to go to assisted suicide to avoid bills. Finally, this bill is seriously flawed.
This is an extraordinary change to our law. Changes the general attitude to death and doctors. It changes the basic tenets of our society. Suicide was a criminal act until 1961, which was in my lifetime. This is assisting suicide. This will destroy the Hippocratic oath. It has been brought forward without the proper consideration. It has been pointed out there are huge weaknesses, especially regarding proper regulation scrutiny. I cannot support the bill although I can see the merit of allowing suffering people to die more peacefully.
First, for some reason, society strives far too hard to keep a very ill, dying people to keep a very ill, dying people alive. We shall die and we must all accept that. Is a question, I have no idea if there is an afterlife. Perhaps the bishops might fill me in. I do know that I shall die. I hope that I can die without pain. Harold Shipman... Doctors would increase morphine for very sick patients which led to a relatively simple and comfortable death.
The idea that you could prosecute a doctor for assistant and aiming -- assisting an imminent death... We must not cling to life. The pandemic experience... Most of them were in the 80s. It's an example of how we should be aware that people will die and we should accept that. The second major issue against this bill relates to coercion and that coercion may be unintended. Continuing life will reduce the prospects, the inheritance for their children. Indeed, children might not wish the elderly parent to die but the parent might decide it was best for them.
Some 30 odd years ago, I was a new MP and the Major government introduced a scheme were people entering care would have to sell their houses to pay for the care. This remains a big issue for governments. I recall a queue of people coming to my advice session and they would say, "And her mother wants us to inherit her house." To hint, encourage or push a relative to go to assisted suicide to avoid bills. Finally, this bill is seriously flawed.
This is an extraordinary change to our law. Changes the general attitude to death and doctors. It changes the basic tenets of our society. Suicide was a criminal act until 1961, which was in my lifetime. This is assisting suicide. This will destroy the Hippocratic oath. It has been brought forward without the proper consideration. It has been pointed out there are huge weaknesses, especially regarding proper regulation scrutiny. I cannot support the bill although I can see the merit of allowing suffering people to die more peacefully.
13:58
Baroness Finlay of Llandaff (Crossbench)
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Baroness Finlay of Llandaff (Crossbench)
I must declare my role in caring for thousands of dying patients over decades. This bill as written does not improve patient choice or control. True choice would ensure patients get the care they need. Control will rest with the doctors who can initiate the conversation and other gatekeepers on eligibility for drugs. Supporting a patient who wants to stop treatment is not assisted suicide. Stopping unwanted treatment allows life to close in a timely way.
The person dies of an underlying disease. It is good care. Training and palliative care is lamentably poor. Symptom control management is widespread across the globe. Morphine to control pain does not kill, although some mistakenly think it does. It provides comfort think it does. It provides comfort as life slips away. Palliative care can save millions a year to the NHS through care that meets the needs substantially and improves well- being and comfort, and avoids unnecessary interventions. Does not keep people alive who don't want to keep living.
The bill's impact assessment suggests there will be up to 4.5 thousand assisted deaths a year then -- by year 10. Many with needs not addressed but wanting to live better right to the end of their lives. They are unheard. They are already often made to feel like a burden and persuaded to take legal drugs. It is unethical for us to pass poor legislation for a state- provided NHS assisted death service while leaving the care of 0.5 million dying people to be patchy, often inadequate and at subsidised ad hoc by struggling charities.
Throughout, we've heard horror stories of bad care, in a liquid or appalling management, especially out appalling management, especially out of hours. -- Inadequate, appalling management. Doctors may know nothing about the conditions of the person. Who cannot detect and you influence or coercion and whose motivation may be opaque. Prognosis is a gas and diagnostic errors are common. -- With no oversight of their assessment, how can a panel approved the death without any certainty when there is no ability to appeal against a panel approval and no coroner oversight? How many wrongful deaths are year is acceptable? No system can be completely safe, providing massive drug overdoses in a licensed way to end a life is not a therapeutic act and has no place in health and social care provision.
Evidence not heard in the other place from other jurisdictions reveals complications, slow deaths, and profound clinical distress. Whether or not you feel some people should be able to have an assisted death or even euthanasia, this bill as written is deeply flawed. It must have essential scrutiny. Some lords have suggested that a timetable has been agreed. That isn't the case. It has been agreed for Select Committee to complete its work in November allowing a committee of the whole house to get underway promptly, to undertake that scrutiny which is absolutely essential.
absolutely essential.
The person dies of an underlying disease. It is good care. Training and palliative care is lamentably poor. Symptom control management is widespread across the globe. Morphine to control pain does not kill, although some mistakenly think it does. It provides comfort think it does. It provides comfort as life slips away. Palliative care can save millions a year to the NHS through care that meets the needs substantially and improves well- being and comfort, and avoids unnecessary interventions. Does not keep people alive who don't want to keep living.
The bill's impact assessment suggests there will be up to 4.5 thousand assisted deaths a year then -- by year 10. Many with needs not addressed but wanting to live better right to the end of their lives. They are unheard. They are already often made to feel like a burden and persuaded to take legal drugs. It is unethical for us to pass poor legislation for a state- provided NHS assisted death service while leaving the care of 0.5 million dying people to be patchy, often inadequate and at subsidised ad hoc by struggling charities.
Throughout, we've heard horror stories of bad care, in a liquid or appalling management, especially out appalling management, especially out of hours. -- Inadequate, appalling management. Doctors may know nothing about the conditions of the person. Who cannot detect and you influence or coercion and whose motivation may be opaque. Prognosis is a gas and diagnostic errors are common. -- With no oversight of their assessment, how can a panel approved the death without any certainty when there is no ability to appeal against a panel approval and no coroner oversight? How many wrongful deaths are year is acceptable? No system can be completely safe, providing massive drug overdoses in a licensed way to end a life is not a therapeutic act and has no place in health and social care provision.
Evidence not heard in the other place from other jurisdictions reveals complications, slow deaths, and profound clinical distress. Whether or not you feel some people should be able to have an assisted death or even euthanasia, this bill as written is deeply flawed. It must have essential scrutiny. Some lords have suggested that a timetable has been agreed. That isn't the case. It has been agreed for Select Committee to complete its work in November allowing a committee of the whole house to get underway promptly, to undertake that scrutiny which is absolutely essential.
absolutely essential.
14:02
Baroness Bray of Coln (Conservative)
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Baroness Bray of Coln (Conservative)
It is a privilege to participate in this important debate. I would like to add my words to those of many colleagues who have already spoken of their deep concerns about this assisted dying Bill, not out of a lack of compassion but worry about the legal moral and practical consequences of what it proposes. Effectively, it says the government should take on a new role which requires it to layout rules and procedures to facilitate what is in essence suicide with the cooperation of the medical profession.
This would be a profound and troubling move. Once the state begins legislate for the ending of life, however well-intentioned, it takes on the responsibility for deciding when life is no longer worth living. At the moment, it would only apply to patients with terminal conditions and prognosis for six or fewer months of life left but in other countries where governments have already gone down this route, the conditions of eligibility have constantly been widened over time to include other non-terminal conditions.
It is highly likely if this assisted dying bill were to happen, it would widen its scope. I seriously doubt that the medical government would change for many in the medical profession have expressed their concern. Doctors trained to save lives and heal were profitable. The Hippocratic oath still remains. There is another crucial dimension here. In previous generations, patients often have much longer standing relationships with their GPs upon years of trust and understanding. A doctor who is supposed to patient the years often decades might indeed ascertain the true wishes knowing the history and needs.
It would have made them well placed to navigate end-of-life care sensitively, including one patient was truly ready to go. But as we all know, that reality has all but disappeared in today's NHS. Quite often, patients are lucky if they see the same doctor twice. Assisted dying could easily be made by professionals with little or no personal knowledge of the patient making the request which must increase the risk of misjudgment. It is pretty clear to us all the NHS is already under immense strain as we have been hearing with long waiting times and huge gaps in palliative and end-of-life care.
Surely this additional procedure would create considerable new demands on staffing facilities which could only throw doubt on the smooth and gentle manner of support which anyone would want for those undergoing the assisted dying process. This leads me onto the greatest concern of all. How do we safeguard the process against coercion? How can we ever be certain that a person seeking an assisted death is not doing so because they feel a burden on the family, on society, or even on the system that is keeping them alive.
The choice to die is a fragile thing. It can be heavily influenced by fear or loneliness. No set of procedural safeguards could fully take account of that complexity without the input of the GP who properly knows the patient. Surely the true mark of a compassionate society is not whether we give people a way out of life but whether we support them to live with dignity even when life becomes difficult. We need to ensure that sufficient funding is ring fenced for high quality palliative care with far greater access for all who need it, rather than legislating for death to become a treatment option.
become a treatment option.
This would be a profound and troubling move. Once the state begins legislate for the ending of life, however well-intentioned, it takes on the responsibility for deciding when life is no longer worth living. At the moment, it would only apply to patients with terminal conditions and prognosis for six or fewer months of life left but in other countries where governments have already gone down this route, the conditions of eligibility have constantly been widened over time to include other non-terminal conditions.
It is highly likely if this assisted dying bill were to happen, it would widen its scope. I seriously doubt that the medical government would change for many in the medical profession have expressed their concern. Doctors trained to save lives and heal were profitable. The Hippocratic oath still remains. There is another crucial dimension here. In previous generations, patients often have much longer standing relationships with their GPs upon years of trust and understanding. A doctor who is supposed to patient the years often decades might indeed ascertain the true wishes knowing the history and needs.
It would have made them well placed to navigate end-of-life care sensitively, including one patient was truly ready to go. But as we all know, that reality has all but disappeared in today's NHS. Quite often, patients are lucky if they see the same doctor twice. Assisted dying could easily be made by professionals with little or no personal knowledge of the patient making the request which must increase the risk of misjudgment. It is pretty clear to us all the NHS is already under immense strain as we have been hearing with long waiting times and huge gaps in palliative and end-of-life care.
Surely this additional procedure would create considerable new demands on staffing facilities which could only throw doubt on the smooth and gentle manner of support which anyone would want for those undergoing the assisted dying process. This leads me onto the greatest concern of all. How do we safeguard the process against coercion? How can we ever be certain that a person seeking an assisted death is not doing so because they feel a burden on the family, on society, or even on the system that is keeping them alive.
The choice to die is a fragile thing. It can be heavily influenced by fear or loneliness. No set of procedural safeguards could fully take account of that complexity without the input of the GP who properly knows the patient. Surely the true mark of a compassionate society is not whether we give people a way out of life but whether we support them to live with dignity even when life becomes difficult. We need to ensure that sufficient funding is ring fenced for high quality palliative care with far greater access for all who need it, rather than legislating for death to become a treatment option.
become a treatment option.
14:06
Lord Brennan (Non-affiliated)
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Lord Brennan (Non-affiliated)
Saturday last week, the Times newspaper, I was centre page editorial which had the headline. The assisted dying Bill may prove irreparable. It should not have fallen to the Lords to protect the public. What follows is putting it kindly harsh. Putting it bluntly, necessary. In its present form, this is not conducive to the common good. We have no idea of its scope. In medical terms. Cancer, cardiac, immobility. Where is the end? Who's going to be trained in these different specialities? Which one is going to be preferred if it is suggested by the government? None of the colleges have adopted plainly support for this bill.
Particularly the mental state of a patient to hear assisted dying is offered. So the scope is big. Who is going to pay for it? This is part of the NHS budget? If so, how much? If it is private, how will the two divide? There is a section in the bill about advertising. Do we want to finish up with the public system, private or public, the death next? What do professionals say about this? Doctors.
Are they going to sign up to do this course? Nursing staff might help. Technical staff might be part of the preparation of the point or lethal dose to whatever is given to kill that person. This is putting people to death, whether they want it or not. And in the bill, we find we have to amend the suicide act. Otherwise we will be legislating for unlawful killing, aiding and abetting the person who wants to die.
So the scope is enormous. The effect on the professions is on them. The effect on palliative care and so on could be deeply damaging and so on could be deeply damaging to all users. This is a topic of in complication. The highest level of importance in which the duty is to serve those people represented in serve those people represented in these chambers no matter what. And what about the Hippocratic oath? First, do no harm.
Hippocrates said that several thousand years ago. And doctors to a similar extent take this oath to serve us. How does assisted suicide fit in to do no harm? I'm concentrating on difficulties because this is probably one of the most serious matters that can affect the public to be considered a Parliament. House of parliament, the Minister for Justice, the Minister for Health, the NHS, they are both against the bill at that stage. How on earth is this going to be resolved? And the final point.
If we vote at some further stage when we've got something serious, coherent and plausible to consider.
Particularly the mental state of a patient to hear assisted dying is offered. So the scope is big. Who is going to pay for it? This is part of the NHS budget? If so, how much? If it is private, how will the two divide? There is a section in the bill about advertising. Do we want to finish up with the public system, private or public, the death next? What do professionals say about this? Doctors.
Are they going to sign up to do this course? Nursing staff might help. Technical staff might be part of the preparation of the point or lethal dose to whatever is given to kill that person. This is putting people to death, whether they want it or not. And in the bill, we find we have to amend the suicide act. Otherwise we will be legislating for unlawful killing, aiding and abetting the person who wants to die.
So the scope is enormous. The effect on the professions is on them. The effect on palliative care and so on could be deeply damaging and so on could be deeply damaging to all users. This is a topic of in complication. The highest level of importance in which the duty is to serve those people represented in serve those people represented in these chambers no matter what. And what about the Hippocratic oath? First, do no harm.
Hippocrates said that several thousand years ago. And doctors to a similar extent take this oath to serve us. How does assisted suicide fit in to do no harm? I'm concentrating on difficulties because this is probably one of the most serious matters that can affect the public to be considered a Parliament. House of parliament, the Minister for Justice, the Minister for Health, the NHS, they are both against the bill at that stage. How on earth is this going to be resolved? And the final point.
If we vote at some further stage when we've got something serious, coherent and plausible to consider.
14:11
Lord Bailey of Paddington (Conservative)
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Lord Bailey of Paddington (Conservative)
I rise with deep concern to oppose this bill, not out of indifference to suffering but I fear will place the most vulnerable at the greatest risk. We should be clear that this is not just assisted dying. This is assisted suicide. Far from offering genuine choice, it risks becoming a pathway where people struggle with poverty, or depression, seeing it as their only option. This is not dignity and it is not compassion. I want to put on record their voices, those voices that are worried about where this bill is leading us.
I cannot cover all the points that they raise but I would like to cover a few. There is no requirement for suffering. The only requirement is illness and a prognosis of six months. Extraordinarily as it may seem, there is no consideration of palliative care or pain relief. A person could qualify even if they are not suffering at all, and for my own community, a working community, a poor community, this is deeply troubling where many face social pressures every day.
To add a law that allows assisted suicide without any requirement for suffering could turn hardship into a reason for death itself. This is where coercion is born from. Research in Oregon shows that nearly one in 10 people who opted for assisted death did so partly because of financial pressures. We cannot allow a situation where people feel forced to death because they cannot afford life. Coercion is not only about another person's influence. They can also be about the crushing weight of poverty, isolation, fear, loneliness.
Listening to the great speech made by my noble friend Lord Banner and, this bill already has mission creep built in. Research by Marie cure palliative research department found that prognosis can be accurate only 23% of the time. Many patients are given six months to live who survive and even thrive for years. In a community like mine, that struggles, the danger is doubled with a prognosis that may make people feel the pressure to give up too soon.
Because of financial worries. This combination could be lethal. To legislate with such weak foundations is reckless. This bill cannot and should not pass into law. It is built on a flawed assumption and will expose the most vulnerable in our society to irreparable harm. We are told that it is about choice, but for the poor, the sick, the isolated, terrified, people have grown up relying on this system, not like us in this room who benefit from it, people who rely opted and trust in it and believe in it.
It could leave those people to see this as a burden, a pressure, even a duty to take their own life. We cannot allow a situation where we expose the poorest people in this country, the people most dependent on us to do the right thing for them to this poorly thought out legislation. It will devastate communities. Communities that many of us have never been to or understand. We will be placing something down that will become a myth in that community, will be pre-legislated for their early death because their lives have As the bill stands, instead of working for vulnerable people it will make more people vulnerable.
We must choose life over fear.
I cannot cover all the points that they raise but I would like to cover a few. There is no requirement for suffering. The only requirement is illness and a prognosis of six months. Extraordinarily as it may seem, there is no consideration of palliative care or pain relief. A person could qualify even if they are not suffering at all, and for my own community, a working community, a poor community, this is deeply troubling where many face social pressures every day.
To add a law that allows assisted suicide without any requirement for suffering could turn hardship into a reason for death itself. This is where coercion is born from. Research in Oregon shows that nearly one in 10 people who opted for assisted death did so partly because of financial pressures. We cannot allow a situation where people feel forced to death because they cannot afford life. Coercion is not only about another person's influence. They can also be about the crushing weight of poverty, isolation, fear, loneliness.
Listening to the great speech made by my noble friend Lord Banner and, this bill already has mission creep built in. Research by Marie cure palliative research department found that prognosis can be accurate only 23% of the time. Many patients are given six months to live who survive and even thrive for years. In a community like mine, that struggles, the danger is doubled with a prognosis that may make people feel the pressure to give up too soon.
Because of financial worries. This combination could be lethal. To legislate with such weak foundations is reckless. This bill cannot and should not pass into law. It is built on a flawed assumption and will expose the most vulnerable in our society to irreparable harm. We are told that it is about choice, but for the poor, the sick, the isolated, terrified, people have grown up relying on this system, not like us in this room who benefit from it, people who rely opted and trust in it and believe in it.
It could leave those people to see this as a burden, a pressure, even a duty to take their own life. We cannot allow a situation where we expose the poorest people in this country, the people most dependent on us to do the right thing for them to this poorly thought out legislation. It will devastate communities. Communities that many of us have never been to or understand. We will be placing something down that will become a myth in that community, will be pre-legislated for their early death because their lives have As the bill stands, instead of working for vulnerable people it will make more people vulnerable.
We must choose life over fear.
14:15
Baroness Watkins of Tavistock (Crossbench)
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Baroness Watkins of Tavistock (Crossbench)
My Lords, I thank all those who have given information, and declare my interest as a registered nurse and a fellow of the Royal College of Nursing, which has adopted a neutral stance on the bill. Recognising the wide disparity of opinion. The fury expressed by some people that they will be coerced into asking for assisted dying is real. The concerns are particularly strong amongst marginalised communities, as so aptly demonstrated by the previous speaker. Many people with severe disabilities believe they may become a burden to other family members, or those living alone who express fear about the future and difficulties of living with a progressive condition.
However, considerable safeguards within the bill are designed to ensure that undue pressure concerning assisted dying is never placed on individuals. If the patient is given the opportunity to discuss their future options when planning the last months of their life, this should include the right to refuse further treatment and receive compassionate palliative care. Patients must be given the chance to explore the options available to them. One of the many issues raised in this House, and in correspondence with the public, is that many people fear the uncertainty about dying.
Not necessarily about when they will die but how their health and bodily functions including continence and mental capacity will deteriorate. People report being fearful of incontinence, speech difficulties, and losing capacity so that they are unable to express their wishes as they become increasingly dependent. Let's encourage society to discuss and complete advanced directives relating to their future care, in the way we are encouraged to make wills. This approach will enable those who would never want to discuss or consider assisted dying to make it clear within their personalised advanced directive, and vice versa.
Nurses and care workers are often those who were asked by patients frequently during intimate procedures, including for example changing soiled bedding and washing. When is a district nurse I recall one patient saying something similar to this to me. "My kind husband can't cope with washing me so I wait for you and I do not tell him I am dirty below. But just lie here in it. He does not know, nurse, because he does not sleep in the bed with me anymore.
We were so happy together. We are worn down with it. Can't you hurry it up for me? " The Royal College of Nursing has published excellent guidance on how to respond to such a request to hasten death. It states that nurses should acknowledge and act on all concerns raised. Instigating and escalating them to the doctor responsible for the patient's care and treatment. The bill is designed to establish a system for terminally ill adult to access the systems. Yet no mention is made in the bill of responsibility of health professionals to refer patients to an appropriate medical practitioner for preliminary discussion to be recorded in the persons notes when such requests are made.
When the process works well and advanced directives have been made, agreed active treatment may be stopped and excellent palliative care be accelerated. Early clarity on the patient's position on assisted dying would be up to everyone. However, if the patient's wishes have not been recorded and they choose an assisted dying pathway in the late stages of their illness, should the bill pass, there could be challenges from relatives who are against assisted dying for religious and or ethical reasons.
I'm broadly supportive of the bill. But I would hope that we can consider the two issues I have raised on advanced directives and other healthcare professionals
**** Possible New Speaker ****
involved. I would like to present five races of rejection to the bill this afternoon. The first will be the evolution of this bill in the other evolution of this bill in the other place. We can hardly call that to be Parliament at its best. It was deemed to be a Private Members' Bill deemed to be a Private Members' Bill but I'm sorry to say, I think we are being Foulquier. It is quite obviously a government bill in obviously a government bill in disguise.
I have to say that Lord Falconer indicated this last week Falconer indicated this last week when he referred to the Civil Service assistance he has had to
However, considerable safeguards within the bill are designed to ensure that undue pressure concerning assisted dying is never placed on individuals. If the patient is given the opportunity to discuss their future options when planning the last months of their life, this should include the right to refuse further treatment and receive compassionate palliative care. Patients must be given the chance to explore the options available to them. One of the many issues raised in this House, and in correspondence with the public, is that many people fear the uncertainty about dying.
Not necessarily about when they will die but how their health and bodily functions including continence and mental capacity will deteriorate. People report being fearful of incontinence, speech difficulties, and losing capacity so that they are unable to express their wishes as they become increasingly dependent. Let's encourage society to discuss and complete advanced directives relating to their future care, in the way we are encouraged to make wills. This approach will enable those who would never want to discuss or consider assisted dying to make it clear within their personalised advanced directive, and vice versa.
Nurses and care workers are often those who were asked by patients frequently during intimate procedures, including for example changing soiled bedding and washing. When is a district nurse I recall one patient saying something similar to this to me. "My kind husband can't cope with washing me so I wait for you and I do not tell him I am dirty below. But just lie here in it. He does not know, nurse, because he does not sleep in the bed with me anymore.
We were so happy together. We are worn down with it. Can't you hurry it up for me? " The Royal College of Nursing has published excellent guidance on how to respond to such a request to hasten death. It states that nurses should acknowledge and act on all concerns raised. Instigating and escalating them to the doctor responsible for the patient's care and treatment. The bill is designed to establish a system for terminally ill adult to access the systems. Yet no mention is made in the bill of responsibility of health professionals to refer patients to an appropriate medical practitioner for preliminary discussion to be recorded in the persons notes when such requests are made.
When the process works well and advanced directives have been made, agreed active treatment may be stopped and excellent palliative care be accelerated. Early clarity on the patient's position on assisted dying would be up to everyone. However, if the patient's wishes have not been recorded and they choose an assisted dying pathway in the late stages of their illness, should the bill pass, there could be challenges from relatives who are against assisted dying for religious and or ethical reasons.
I'm broadly supportive of the bill. But I would hope that we can consider the two issues I have raised on advanced directives and other healthcare professionals
**** Possible New Speaker ****
involved. I would like to present five races of rejection to the bill this afternoon. The first will be the evolution of this bill in the other evolution of this bill in the other place. We can hardly call that to be Parliament at its best. It was deemed to be a Private Members' Bill deemed to be a Private Members' Bill but I'm sorry to say, I think we are being Foulquier. It is quite obviously a government bill in obviously a government bill in disguise.
I have to say that Lord Falconer indicated this last week Falconer indicated this last week when he referred to the Civil Service assistance he has had to
14:20
Lord Mackinlay of Richborough (Conservative)
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Lord Mackinlay of Richborough (Conservative)
Service assistance he has had to date. I have to say that is more than unusual for any Private Members' Bill. The Committee stage from the start and the other place was stilted in its composition, and the fact that many respected institutions that will be operating in the space of this bill were denied their opportunity for input. I think what worried me more than anything else was that joyously tear inducing celebrations by some parliamentarians of the passing of the bill.
Which is able of death. I found that quite bizarre and chilling. But I suppose I should not be surprised as many of the same people are jubilant in a similar way for the opportunity to hone conduct abortions up to full term. I rather celebrate life rather than death. The bill as it was originally drafted had 16 Henry VIII clauses. It has now grown to 42. Including many that will allow ministerial powers set on legislation to create criminal sanction.
Mike noble Lords will be aware that this is just not right in legislation was to this should not happen without really great cause to criminal sanction by secondary legislation was to my second objection is the reality where, what we have seen in other jurisdictions, we have seen a loosening throughout, whether that be in Australia or Canada, or Belgium. Lord Falconer last week rejected that only 1% of deaths would be through legalised suicide. Within 10 years. That does not fit well with Australia's 3% and Canada's just under 5%.
In all jurisdictions, the "I don't want to be a burden" has become bigger and bigger. In Belgium, children as young as nine are being euthanised under similar legislation. Let me say that again, in Belgium, children at the age of nine are being euthanised under similar legislation. I have grave concerns about the human rights industry in this country where, whatever happens in parliament, it is overturned through judicial activism. And I can be absolutely sure that this would be watered-down to death on the state on demand in due course.
That is my great fear. Further, my third grave concern is inheritance. I am professionally trained and licensed to do probate work to the Institute of Chartered Accountants. And believe me, battles post death on inheritance can get very ugly. I'm very fearful of the coercion of the elderly and vulnerable. It is obvious, it is so obvious. I'm worried about time, the six months. We have a similar thing in DWP for end-of-life PIP. You have to have an assessment that you may only live up to 12 months.
The reality is very different. The averages over two years, and commonly people live for three. When the assessment was just one year. So are we really going to terminate lives earlier than May the case? Lord Forsyth gave a fine speech last week, a personal account of his father. I think what he is looking for, what I would be looking for, is that very end-of-life solution where things can be put right, the making comfortable that we know happens today. If that is the bit that is codified into legislation, we should be considering that.
Finally, the NHS. I am concerned that we want to embed an option for death within the NHS where modus operandi should be for life. And for doing its bit when palliative care is needed. To have this as an option is very dangerous was top I would like to see if we have to have this at all, a separation because unfortunately NHS will have skin in the game in terms of costs and staff problems. This is an unconscionable bill and I will oppose it.
Which is able of death. I found that quite bizarre and chilling. But I suppose I should not be surprised as many of the same people are jubilant in a similar way for the opportunity to hone conduct abortions up to full term. I rather celebrate life rather than death. The bill as it was originally drafted had 16 Henry VIII clauses. It has now grown to 42. Including many that will allow ministerial powers set on legislation to create criminal sanction.
Mike noble Lords will be aware that this is just not right in legislation was to this should not happen without really great cause to criminal sanction by secondary legislation was to my second objection is the reality where, what we have seen in other jurisdictions, we have seen a loosening throughout, whether that be in Australia or Canada, or Belgium. Lord Falconer last week rejected that only 1% of deaths would be through legalised suicide. Within 10 years. That does not fit well with Australia's 3% and Canada's just under 5%.
In all jurisdictions, the "I don't want to be a burden" has become bigger and bigger. In Belgium, children as young as nine are being euthanised under similar legislation. Let me say that again, in Belgium, children at the age of nine are being euthanised under similar legislation. I have grave concerns about the human rights industry in this country where, whatever happens in parliament, it is overturned through judicial activism. And I can be absolutely sure that this would be watered-down to death on the state on demand in due course.
That is my great fear. Further, my third grave concern is inheritance. I am professionally trained and licensed to do probate work to the Institute of Chartered Accountants. And believe me, battles post death on inheritance can get very ugly. I'm very fearful of the coercion of the elderly and vulnerable. It is obvious, it is so obvious. I'm worried about time, the six months. We have a similar thing in DWP for end-of-life PIP. You have to have an assessment that you may only live up to 12 months.
The reality is very different. The averages over two years, and commonly people live for three. When the assessment was just one year. So are we really going to terminate lives earlier than May the case? Lord Forsyth gave a fine speech last week, a personal account of his father. I think what he is looking for, what I would be looking for, is that very end-of-life solution where things can be put right, the making comfortable that we know happens today. If that is the bit that is codified into legislation, we should be considering that.
Finally, the NHS. I am concerned that we want to embed an option for death within the NHS where modus operandi should be for life. And for doing its bit when palliative care is needed. To have this as an option is very dangerous was top I would like to see if we have to have this at all, a separation because unfortunately NHS will have skin in the game in terms of costs and staff problems. This is an unconscionable bill and I will oppose it.
14:25
Baroness Porter of Fulwood (Conservative)
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Baroness Porter of Fulwood (Conservative)
My Lords, there is nothing easy about confronting mortality or dealing with suffering. The number of us who have chosen to speak at second reading of this bill is a reflection of the importance of these issues and how universally relevant they are. Every one of us in this place has been touched and shaped by losing people we have loved. See what they have gone through as they reach the end of their life. I value the stories people have written to me over recent months.
And hearing from practitioners who work with families at the end of people's lives. Whether the law is in the right place as it stands today, whether it can be improved, is an important discussion to have. This is not the right time to have it. The noble Lord Lord Stevenson could not have put it better when he said " Palliative care are not be the answer but it has to be part of the answer. " Unfortunately that is just not the case across England and Wales as we speak today.
Until we are confident that palliative and end of life care in the UK is functioning as well as it possibly can be, this debate cannot be had sensibly. It is clear that if assisted dying were to be brought in if we have better provision of care, there is too great a risk of people being forced to end their life prematurely because they believe there to be no reasonable alternative. Too many people who could supported better at the end of their life today, they are simply not receiving that care.
Clause 47 of the bill, to oblige the provision of an assessment of the availability, quality, distribution of palliative care within year of its passing is a tacit acknowledgement of this point. But it is the wrong way round. We need to do the work now on palliative care provision. And then come back to this bill and have this discussion later on. There have been numerous reports and analysis published recently showing just how inadequate current resource figures. To quote from just one of these, a Marie Curie report that was published this time last year painted a deeply concerning picture.
The findings reveal patchy and inconsistent provision of care for people approaching the end of life. While there were examples of excellent care the overall picture is of overstretched services, with health and care staff lacking enough time to provide care, and where coordination and communication are inadequate. This means that people lack timely management of symptoms, and family carers spend precious time struggling to access, navigate, and manage different services. In addition to providing much of the care needed themselves, this leaves carers feeling unprepared, unsupported, traumatised, and let down, which has lasting consequences into bereavement.
Another report, this time by Kings College academics, called for a compressive plan to look at care for people in the final stage of their life. All from earlier access to palliative care right through to better support for informal carers. It is clear that current provision is woefully inadequate. There are numerous issues with this bill which have already been raised for the definition of mental capacity through to the relatively arbitrary six month terminal prognosis threshold. The lack of detail around the practicalities of what would be administered or how it would be supervised.
That is before we even consider the deeper cultural challenges around how to ensure that such a piece of legislation does not lead to a redefinition culturally of how we view people's worth. The overseas evidence of people feeling a burden is particularly troublesome. There are profound and practical questions that need to be looked at, but we cannot even begin to have this discussion sensibly until we are confident that people, no matter where they live in this country, and what community they are part of, have greater access to support and care as they reach the end of their life than is available to them today.
And hearing from practitioners who work with families at the end of people's lives. Whether the law is in the right place as it stands today, whether it can be improved, is an important discussion to have. This is not the right time to have it. The noble Lord Lord Stevenson could not have put it better when he said " Palliative care are not be the answer but it has to be part of the answer. " Unfortunately that is just not the case across England and Wales as we speak today.
Until we are confident that palliative and end of life care in the UK is functioning as well as it possibly can be, this debate cannot be had sensibly. It is clear that if assisted dying were to be brought in if we have better provision of care, there is too great a risk of people being forced to end their life prematurely because they believe there to be no reasonable alternative. Too many people who could supported better at the end of their life today, they are simply not receiving that care.
Clause 47 of the bill, to oblige the provision of an assessment of the availability, quality, distribution of palliative care within year of its passing is a tacit acknowledgement of this point. But it is the wrong way round. We need to do the work now on palliative care provision. And then come back to this bill and have this discussion later on. There have been numerous reports and analysis published recently showing just how inadequate current resource figures. To quote from just one of these, a Marie Curie report that was published this time last year painted a deeply concerning picture.
The findings reveal patchy and inconsistent provision of care for people approaching the end of life. While there were examples of excellent care the overall picture is of overstretched services, with health and care staff lacking enough time to provide care, and where coordination and communication are inadequate. This means that people lack timely management of symptoms, and family carers spend precious time struggling to access, navigate, and manage different services. In addition to providing much of the care needed themselves, this leaves carers feeling unprepared, unsupported, traumatised, and let down, which has lasting consequences into bereavement.
Another report, this time by Kings College academics, called for a compressive plan to look at care for people in the final stage of their life. All from earlier access to palliative care right through to better support for informal carers. It is clear that current provision is woefully inadequate. There are numerous issues with this bill which have already been raised for the definition of mental capacity through to the relatively arbitrary six month terminal prognosis threshold. The lack of detail around the practicalities of what would be administered or how it would be supervised.
That is before we even consider the deeper cultural challenges around how to ensure that such a piece of legislation does not lead to a redefinition culturally of how we view people's worth. The overseas evidence of people feeling a burden is particularly troublesome. There are profound and practical questions that need to be looked at, but we cannot even begin to have this discussion sensibly until we are confident that people, no matter where they live in this country, and what community they are part of, have greater access to support and care as they reach the end of their life than is available to them today.
14:29
Baroness Whitaker (Labour)
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Baroness Whitaker (Labour)
My Lords, I had not intended to join this long list of speakers but it has become increasingly clear that it would be right register full testimony in support of this bill. I was not at first in favour of it, as I thought it could result in the exploitation of the elderly or infirm people with all abilities. But as I saw the evidence, particularly from people with disabilities, I came to the conclusion this choice must be made available. I should declare that I am a patient of Humanist UK.
My conclusion was not determined by the admirable way they have set out the systematic exposition of the issues. My views were further strengthened by experience. I am in my 90th year, and I have seen too many of my friends and their partners which, under all-consuming stress and suffering, having to postpone an inevitable death in greater continuing pain and increasing loss of capacity. I well understand those feelings myself. Those caring for people in those last prolonged stages are taken over by helpless compassion and powerlessness.
I have seen instances, their dying companion explicitly wanted to I would like to relieve my family as well as myself of intolerable suffering so how could I deny it to others. I recalled in one of the debates that you had in your Lordships house on the subject, why should not all people be allowed to be altruistic? I spent a large part of my adult life putting the interests of my children at heart and I don't see why should stop now, and this does not feel to me like altruism, just a continuation of normal service.
The last point I want to make is the part played by other people's opinions. Like most of your Lordships, I received many letters and emails about this bill. It was striking that almost all of the ones against were professionally informed, well marshalled arguments, often with unusually similar turns of phrase, many coming from the same email address. In contrast, those for largely road from lived an agonising experience. Some not very articulate, and are not very educated handwriting.
All through my civil service career, I was conscious of less powerful voices, less well organised as it was difficult to reach and who were in the majority. Rather like the evidence for national funding of assisted dying, reflecting of course the verdict of their elected representatives in the other place. People whom we need to pay attention to. I would like to do that now and make available the compassionate choice about the last momentous event in people's lives. I conclude that it is nationally important that this bill should pass for all its status.
My conclusion was not determined by the admirable way they have set out the systematic exposition of the issues. My views were further strengthened by experience. I am in my 90th year, and I have seen too many of my friends and their partners which, under all-consuming stress and suffering, having to postpone an inevitable death in greater continuing pain and increasing loss of capacity. I well understand those feelings myself. Those caring for people in those last prolonged stages are taken over by helpless compassion and powerlessness.
I have seen instances, their dying companion explicitly wanted to I would like to relieve my family as well as myself of intolerable suffering so how could I deny it to others. I recalled in one of the debates that you had in your Lordships house on the subject, why should not all people be allowed to be altruistic? I spent a large part of my adult life putting the interests of my children at heart and I don't see why should stop now, and this does not feel to me like altruism, just a continuation of normal service.
The last point I want to make is the part played by other people's opinions. Like most of your Lordships, I received many letters and emails about this bill. It was striking that almost all of the ones against were professionally informed, well marshalled arguments, often with unusually similar turns of phrase, many coming from the same email address. In contrast, those for largely road from lived an agonising experience. Some not very articulate, and are not very educated handwriting.
All through my civil service career, I was conscious of less powerful voices, less well organised as it was difficult to reach and who were in the majority. Rather like the evidence for national funding of assisted dying, reflecting of course the verdict of their elected representatives in the other place. People whom we need to pay attention to. I would like to do that now and make available the compassionate choice about the last momentous event in people's lives. I conclude that it is nationally important that this bill should pass for all its status.
14:32
Viscount Astor (Conservative)
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Viscount Astor (Conservative)
I have listened to many of the speeches over the two days of the debate and I have carefully read Hansard of those missed. My conclusion is whatever the issues surrounding assisted dying, what occurred to me is that it should have been the government. There should have been pre-legislative scrutiny, and as we've had, impact assessments through the Commons. The bill clearly gives excessive use of designated powers and we all know how difficult it is to amend secondary legislation in this house.
More surprising, it gives rights for implementation. I'm not sure of many other who have such power. This is a private bill not covered by any convention as we know. Therefore, I'm sure it will be subject to amendment. I do understand the moral arguments against assisted dying but one cannot help but be moved by the terrible tales of excruciating pain and suffering that could be avoided. We all have personal experience of friends or family suffering in such a way.
I don't believe that assisted dying means that we leave some lives are not worth living as we recognise the prolonging extreme suffering can be promptly remedied with safeguards. The very fact that over 50 people go abroad a considerable extent cannot be ignored compared with the many who cannot afford such an outcome. And of course, the many who already take their own lives in this country as we've heard. Against this, palliative care and end-of- life care in this country is not good enough.
We cannot allow those suffering to feel that they must end their life due to lack of resources or lack of decent care or guilt or burden on their families, or even burden on the state. At the end of the day, it is about choice, individual choice. The decision- maker those who seek an end to suffering on medical grounds of prolonged severe pain. A choice made by no other. An outcome that is certainly better than the painful alternative of some who have refused food and medicine.
Pain is subjective and personal. I support subjective and personal. I support those who wish to end their life as palliative care does not always reduce the pain or the mental anguish. But I do have a nagging doubt that better care, better pain management, would make assisted
**** Possible New Speaker ****
dying unnecessary except only in extreme circumstances. We've had three arguments against
**** Possible New Speaker ****
We've had three arguments against the bill. From those of hoeing assisted dying in principle, others
More surprising, it gives rights for implementation. I'm not sure of many other who have such power. This is a private bill not covered by any convention as we know. Therefore, I'm sure it will be subject to amendment. I do understand the moral arguments against assisted dying but one cannot help but be moved by the terrible tales of excruciating pain and suffering that could be avoided. We all have personal experience of friends or family suffering in such a way.
I don't believe that assisted dying means that we leave some lives are not worth living as we recognise the prolonging extreme suffering can be promptly remedied with safeguards. The very fact that over 50 people go abroad a considerable extent cannot be ignored compared with the many who cannot afford such an outcome. And of course, the many who already take their own lives in this country as we've heard. Against this, palliative care and end-of- life care in this country is not good enough.
We cannot allow those suffering to feel that they must end their life due to lack of resources or lack of decent care or guilt or burden on their families, or even burden on the state. At the end of the day, it is about choice, individual choice. The decision- maker those who seek an end to suffering on medical grounds of prolonged severe pain. A choice made by no other. An outcome that is certainly better than the painful alternative of some who have refused food and medicine.
Pain is subjective and personal. I support subjective and personal. I support those who wish to end their life as palliative care does not always reduce the pain or the mental anguish. But I do have a nagging doubt that better care, better pain management, would make assisted
**** Possible New Speaker ****
dying unnecessary except only in extreme circumstances. We've had three arguments against
**** Possible New Speaker ****
We've had three arguments against the bill. From those of hoeing assisted dying in principle, others
14:35
Baroness Hayter of Kentish Town (Labour)
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Baroness Hayter of Kentish Town (Labour)
assisted dying in principle, others saying it will undermine pressure for palliative care, or that this bill is faulty. There is not much I can say to those whose objections are deeply religious disagree with the Rev pellet that enabling a dying person to end their own life means we as a society believe that some lives are not worth living. No. It means we value our fellow human beings and their choice to hasten the inevitable at a time of their choosing.
I acknowledge the views of the noble Lady though I don't think she should prevent others from exercising a different view. And I disagree with her that, as a society, we believe that suicide is wrong. As the noble Lord says, it is legal. There are no safeguards. Particular when people go to Switzerland. We have heard from former DPP and chief constable that the current need to interrogate the loved ones of those who have legally taken their own lives is a situation none of us would want.
And as the noble Lord and others have said, this bill is not about people choosing to die. They are dying. This bill is about helping them make those final days easy for those who so choose. It is about dying people who want a loved one because this bill is allowing that. It is not just about a medical intervention. About those who want a loved one with them if they choose to end their own lives. When the pain, the discomfort, the indignity or the scale of intervention just becomes unbearable.
Now some noble Lords claim that the bill would undermine pressure for palliative care. There is no evidence for that. Bill has already led to more discussion of dying and its need for dignity, support and health, and may even have increased the likelihood of improved provision. So I say to those, campaign away for palliative care but don't do that at the expense of those for all of the palliative care they have had who then want help in their final hours to die.
Palliative care is about improving the quality of the last part those approaching death by managing pain and other symptoms often in their own home. Why, when those symptoms are no longer manageable shouldn't professional help equally be available at a time and manner that a person chooses. In their own surroundings and surrounded by those they love. I turned to this bill isn't right argument. From those who would otherwise support assisted dying rather than those who never would. Our task is not to undermine the clear public desire and the common support for this measure.
Our task here is to ensure that it achieves its ends but with proper safeguards. Albeit not with so much bureaucracy as that defeats its purpose. We should look for genuine improvements helped by a timely special committee and then by the whole house but without derailing its timetable. And then let the Commons have the final word. There is a right to die. That is already in law. This is about helping those who, in their final days, when the inevitable is coming, can have the comfort of professional help with even more of their families around them as they choose to end their lives.
I acknowledge the views of the noble Lady though I don't think she should prevent others from exercising a different view. And I disagree with her that, as a society, we believe that suicide is wrong. As the noble Lord says, it is legal. There are no safeguards. Particular when people go to Switzerland. We have heard from former DPP and chief constable that the current need to interrogate the loved ones of those who have legally taken their own lives is a situation none of us would want.
And as the noble Lord and others have said, this bill is not about people choosing to die. They are dying. This bill is about helping them make those final days easy for those who so choose. It is about dying people who want a loved one because this bill is allowing that. It is not just about a medical intervention. About those who want a loved one with them if they choose to end their own lives. When the pain, the discomfort, the indignity or the scale of intervention just becomes unbearable.
Now some noble Lords claim that the bill would undermine pressure for palliative care. There is no evidence for that. Bill has already led to more discussion of dying and its need for dignity, support and health, and may even have increased the likelihood of improved provision. So I say to those, campaign away for palliative care but don't do that at the expense of those for all of the palliative care they have had who then want help in their final hours to die.
Palliative care is about improving the quality of the last part those approaching death by managing pain and other symptoms often in their own home. Why, when those symptoms are no longer manageable shouldn't professional help equally be available at a time and manner that a person chooses. In their own surroundings and surrounded by those they love. I turned to this bill isn't right argument. From those who would otherwise support assisted dying rather than those who never would. Our task is not to undermine the clear public desire and the common support for this measure.
Our task here is to ensure that it achieves its ends but with proper safeguards. Albeit not with so much bureaucracy as that defeats its purpose. We should look for genuine improvements helped by a timely special committee and then by the whole house but without derailing its timetable. And then let the Commons have the final word. There is a right to die. That is already in law. This is about helping those who, in their final days, when the inevitable is coming, can have the comfort of professional help with even more of their families around them as they choose to end their lives.
14:39
Lord Taylor of Holbeach (Conservative)
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Lord Taylor of Holbeach (Conservative)
It is a pleasure to follow the noble Baroness. We often debate and not necessarily agree. We don't on this occasion. I wish I had been participating in the second reading of a government bill but we are where we are. And most of us will have found ourselves examining our prejudices, our experiences, of the issues which underline this bill. May I say at the outset that my views are conditioned by my convictions and also from my experiences.
At the bottom lies a belief that life is a precious gift from God. I think these views are widely shared and not just from the Episcopal bench. We have heard them from my noble friend Lady May. We heard them today. In terms of my direct experience, a number of you will know that I was, for 18 years before coming here, chairman of the hospital trust. A community charity. In 1988, I headed up a group of concerned individuals from my hometown who were shaken by the health authority's decision to close Holbeach hospital leaving us with a district general hospital 14 miles away with no direct bus route between the people of Holbeach.
With the support of the local community, we formed a charitable trust. We bought and took over the hospital as a community hospital, providing many facilities including nursing care with 13 beds including six doctors beds, and now with further local support, we have 47 beds, increasing the need for palliative and end-of- life care has become more acute. And it is very much valued by the local community. 25 years ago, my own father died there and I was able to be with him and I knew the care that he had been given and it was a hugely emotional experience.
As many people have had as they described their views on this bill. Listening to contributions of the debate, I conclude that the principal concern is the unavailability and the lack of funding by the NHS. End-of-life care. To my mind, the role and funding of palliative care cannot be underestimated as explained by the noble Baroness Findlay earlier today. And many noble Lords have also mentioned it in their speeches. I think it is self-evident that it is a key element which the NHS has not been able to fund properly.
And as the noble Lord Stevens of Birmingham explains, thank God for the hospice movement. We should listen to them. We know they are not supported by this bill. Baroness Warwick described how this is a messy business. But as it stands, we don't have the information and this bill runs the risk of too much legal work into little medicine. Running the commitment to what is needed by the implementation of this bill. That is why it should have been a government bill because they needed a commitment from government for this bill to be safely passed.
We need time to build the greater consensus, not just in this house, but in the other place as well. And I will support the noble Baroness in her proposer to setup a committee to report back to this house when it has examined the bill thoroughly before we set out to amend it. We need time to make sure it is fit for purpose in ways almost every speaker has suggested and we will be using parliamentary processes to do so.
At the bottom lies a belief that life is a precious gift from God. I think these views are widely shared and not just from the Episcopal bench. We have heard them from my noble friend Lady May. We heard them today. In terms of my direct experience, a number of you will know that I was, for 18 years before coming here, chairman of the hospital trust. A community charity. In 1988, I headed up a group of concerned individuals from my hometown who were shaken by the health authority's decision to close Holbeach hospital leaving us with a district general hospital 14 miles away with no direct bus route between the people of Holbeach.
With the support of the local community, we formed a charitable trust. We bought and took over the hospital as a community hospital, providing many facilities including nursing care with 13 beds including six doctors beds, and now with further local support, we have 47 beds, increasing the need for palliative and end-of- life care has become more acute. And it is very much valued by the local community. 25 years ago, my own father died there and I was able to be with him and I knew the care that he had been given and it was a hugely emotional experience.
As many people have had as they described their views on this bill. Listening to contributions of the debate, I conclude that the principal concern is the unavailability and the lack of funding by the NHS. End-of-life care. To my mind, the role and funding of palliative care cannot be underestimated as explained by the noble Baroness Findlay earlier today. And many noble Lords have also mentioned it in their speeches. I think it is self-evident that it is a key element which the NHS has not been able to fund properly.
And as the noble Lord Stevens of Birmingham explains, thank God for the hospice movement. We should listen to them. We know they are not supported by this bill. Baroness Warwick described how this is a messy business. But as it stands, we don't have the information and this bill runs the risk of too much legal work into little medicine. Running the commitment to what is needed by the implementation of this bill. That is why it should have been a government bill because they needed a commitment from government for this bill to be safely passed.
We need time to build the greater consensus, not just in this house, but in the other place as well. And I will support the noble Baroness in her proposer to setup a committee to report back to this house when it has examined the bill thoroughly before we set out to amend it. We need time to make sure it is fit for purpose in ways almost every speaker has suggested and we will be using parliamentary processes to do so.
14:44
Baroness Hollins (Crossbench)
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Baroness Hollins (Crossbench)
What an extraordinary two days. After last Friday's debate, I went to a Beatles tribute band with my disabled son. We sang all we need is love. Compassion is love and it means journeying alongside someone, even at the end-of-life. As I did when my husband died from motor neuron disease earlier this year. Nursing him with the help of FastTrack NHS continuing care funding, with hospice and district nurses, and the brilliant Epsom rapid response team which aims to keep frail and dying people at home.
MND is often called the most feared disease. Martin just smiled, told his grandchildren and his friends that he was just fading away as his paralysis increased. Someone this bill to pass because they are afraid of dying even though most of us will During my 40 year career as a doctor in the NHS, I worked on the front line both as a GP and psychiatrist. Two of the specialties both affected by the bill as it stands today.
As a medical student I was taught by Dame Cicely Saunders, the founder of the hospice movement. Hospices should be up pride and joy. We are world leaders in palliative care. The evidence from the Association of to palliative care is that growth slows. Could the noble Lord with details on the anticipated impact on the availability of home care services if assisted dying is introduced in this country? And what measures would need to be put in place to prevent this happening? In a highly centralised healthcare systems such as the NHS, integration of assisted dying would risk subtle systemic coercion.
Institutional endorsement would normalise the practice and implicitly shape the patient decisions. The existence of statutory powers can over time drive their own use beyond original policy intentions. Just look at what has happened in psychiatry. Where an increase in coercive measures cannot just be explained by clinical demand. It must also be understood in terms of the institutional and cultural momentum generated by the availability of the powers in the Mental Health Act. Could that noble and learned Lord Mac explain what safeguards will prevent coercion by doctors? Does he support the contention by doctors that assisted dying is not a treatment? Or, if he thinks it is a treatment, why are there no plans to license and regulate the experimental lethal substances that would be used, rather than leaving it to the Secretary of State? If I could correct an earlier assertion about suicide.
There is substantial evidence in 10 US states that legalisation is associated with a considerable rise in suicide. I support the Select Committee proposed by Baroness Berger and we must listen to the evidence and not rush. The evidence taken in the other place was partial. At first attempting to exclude even the Royal College of Psychiatrists, despite psychiatrists been given a key role in the current bill. The lawyers and campaigners have made their mark on this bill, but there is considerable and more relevant expertise your Lordships House.
Members who could competently question witnesses on areas such as capacity assessments, coercion, psychological issues at the end-of-life. The role of doctors, licensing and monitoring of legal substances, and more. Expertise that could be harnessed to see how the bill could be amended to make it fit for purpose. The other place has left a lot of work to do full stop the bill is neither safe nor workable as it stands today.
**** Possible New Speaker ****
My Lords, it is an honour to follow Baroness Collins. I speak for myself and knowing that I represent myself and knowing that I represent views held by many not just Christian leaders but faith leaders Christian leaders but faith leaders across our nation with whom I have been in discussion, and have written to me. Jesus teaches us that how we to me. Jesus teaches us that how we live our lives in relationship to others is vital for the health of our society, and our own personal our society, and our own personal well-being.
We belong with, and for each other. This bill is wrong because it ruptures relationships. Serving one need by creating many Serving one need by creating many others. Lord Baker and several others in this important and moving debate gave the game away early on. debate gave the game away early on. No government will be prepared to provide palliative and social care provide palliative and social care in the way needed. Thus revealing that the impact of this bill would that the impact of this bill would be economic as well as social.
Several speakers said there were too many safeguards, others that many safeguards, others that provision for assisted dying ought to be expanded. As Lord Harris to be expanded. As Lord Harris pointed out, if this is where compassion leads, then the logic of compassion demands the scope compassion demands the scope widened. On this side of the argument, and also motivated by compassion, we must say that, whilst we share the same anguish as we witness the death of a loved one and long for the suffering to end, there is a moral universe of difference between doctors and clinicians in consultation with families withdrawing treatment in the last days of someone's life, to picking out six months as the point at which life full some can be extinguished.
If we do this, we unleash into our society a fundamental change in our
MND is often called the most feared disease. Martin just smiled, told his grandchildren and his friends that he was just fading away as his paralysis increased. Someone this bill to pass because they are afraid of dying even though most of us will During my 40 year career as a doctor in the NHS, I worked on the front line both as a GP and psychiatrist. Two of the specialties both affected by the bill as it stands today.
As a medical student I was taught by Dame Cicely Saunders, the founder of the hospice movement. Hospices should be up pride and joy. We are world leaders in palliative care. The evidence from the Association of to palliative care is that growth slows. Could the noble Lord with details on the anticipated impact on the availability of home care services if assisted dying is introduced in this country? And what measures would need to be put in place to prevent this happening? In a highly centralised healthcare systems such as the NHS, integration of assisted dying would risk subtle systemic coercion.
Institutional endorsement would normalise the practice and implicitly shape the patient decisions. The existence of statutory powers can over time drive their own use beyond original policy intentions. Just look at what has happened in psychiatry. Where an increase in coercive measures cannot just be explained by clinical demand. It must also be understood in terms of the institutional and cultural momentum generated by the availability of the powers in the Mental Health Act. Could that noble and learned Lord Mac explain what safeguards will prevent coercion by doctors? Does he support the contention by doctors that assisted dying is not a treatment? Or, if he thinks it is a treatment, why are there no plans to license and regulate the experimental lethal substances that would be used, rather than leaving it to the Secretary of State? If I could correct an earlier assertion about suicide.
There is substantial evidence in 10 US states that legalisation is associated with a considerable rise in suicide. I support the Select Committee proposed by Baroness Berger and we must listen to the evidence and not rush. The evidence taken in the other place was partial. At first attempting to exclude even the Royal College of Psychiatrists, despite psychiatrists been given a key role in the current bill. The lawyers and campaigners have made their mark on this bill, but there is considerable and more relevant expertise your Lordships House.
Members who could competently question witnesses on areas such as capacity assessments, coercion, psychological issues at the end-of-life. The role of doctors, licensing and monitoring of legal substances, and more. Expertise that could be harnessed to see how the bill could be amended to make it fit for purpose. The other place has left a lot of work to do full stop the bill is neither safe nor workable as it stands today.
**** Possible New Speaker ****
My Lords, it is an honour to follow Baroness Collins. I speak for myself and knowing that I represent myself and knowing that I represent views held by many not just Christian leaders but faith leaders Christian leaders but faith leaders across our nation with whom I have been in discussion, and have written to me. Jesus teaches us that how we to me. Jesus teaches us that how we live our lives in relationship to others is vital for the health of our society, and our own personal our society, and our own personal well-being.
We belong with, and for each other. This bill is wrong because it ruptures relationships. Serving one need by creating many Serving one need by creating many others. Lord Baker and several others in this important and moving debate gave the game away early on. debate gave the game away early on. No government will be prepared to provide palliative and social care provide palliative and social care in the way needed. Thus revealing that the impact of this bill would that the impact of this bill would be economic as well as social.
Several speakers said there were too many safeguards, others that many safeguards, others that provision for assisted dying ought to be expanded. As Lord Harris to be expanded. As Lord Harris pointed out, if this is where compassion leads, then the logic of compassion demands the scope compassion demands the scope widened. On this side of the argument, and also motivated by compassion, we must say that, whilst we share the same anguish as we witness the death of a loved one and long for the suffering to end, there is a moral universe of difference between doctors and clinicians in consultation with families withdrawing treatment in the last days of someone's life, to picking out six months as the point at which life full some can be extinguished.
If we do this, we unleash into our society a fundamental change in our
14:52
The Lord Archbishop of York (Bishops)
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The Lord Archbishop of York (Bishops)
relationship. The relationship between death and life. Between doctor and patient, between parent doctor and patient, between parent and child, between citizen and and child, between citizen and state. And I saw this first hand in Canada last year where priest after Canada last year where priest after priest told me heart rendering stories of people choosing an stories of people choosing an assisted death because it was better for their family than spending an already meagre inheritance on already meagre inheritance on expensive care, and sometimes feeling forced into this choice, feeling forced into this choice, they felt it was their duty to die.
I know this is not what we want I know this is not what we want here, but this is what we are proposing. Do we seriously think proposing. Do we seriously think that if this bill was passed, palliative care won't be palliative care won't be detrimentally impacted? Or that six months won't, in due course, become months won't, in due course, become 12? I think we can do better than 12? I think we can do better than this. Of course I don't want anyone to die a painful agonising death, but nor two I want poor and vulnerable people to be faced with vulnerable people to be faced with such agonising choices.
Better palliative care can massively ease the first dilemma. Assisted death will turbocharge the latter. Before I trained for ordination, I worked for a year at some Christopher's Hospice, probably the most formative years of my life. My first day on the wards, I was terrified. All I could see was cancer and death. But during that year, I learnt that it is possible to live until you die, and although there are some illnesses so hideous that they cannot be completely controlled, in most cases, they can.
Honouring people's dignity and upholding their value, as someone made in the image of God until their life's end. Why, I ask Lord Falconer, does the bill deny the right of hospices to opt Amendment. I want to say alongside the Bishop of London, if this bill does reach 1/3 reading, we on these benches would be able to table an amendment to offer us a vote. Meanwhile I give the last word to Dame Cicely Saunders. " You matter because you are.
And you matter to the end of your life. We will do all we cannot only to help you die peacefully, but to live until you die. "
**** Possible New Speaker ****
My Lords, I rise to speak at the end of this important and significant debate. I'd like to thank Kim Leadbitter MP and Lord Falconer for leading this significant private lenders. significant private lenders. Parliament. I must add that this is a free vote on these benches and I'm a free vote on these benches and I'm therefore not speaking on behalf of my party. We have heard passionate speakers on both sides of this speakers on both sides of this debate, and many members flagging important issues that they want to important issues that they want to see looked at, to ensure processes work and safeguards are in place.
And I have every confidence that And I have every confidence that these will be addressed at Committee stage. And I really want to emphasise how it was particularly emphasise how it was particularly moved by the very personal stories last week of Lord Mitchell and Lord last week of Lord Mitchell and Lord Alderdice. Throughout our life we are able to make decisions about are able to make decisions about most things that affect us. Where to live, what to eat, how to live your life, what to do each day and so on.
life, what to do each day and so on. And yet, the one thing that we don't have any control over is our end of have any control over is our end of life. When someone has been diagnosed with a terminal illness, I diagnosed with a terminal illness, I believe it is only right, with the necessary safeguards in place, for them to be able to choose at the time and place that is right for them to end their life. The BBC News ran a very moving package earlier this year about a man in the United States, the gentleman was terminally ill.
But having seen relatives die terrible drawnout deaths, in significant pain, he wanted to die on his terms. The safeguards were strong, his family supported his wishes, and he did indeed die at home with his family around him, as he had wanted. This should be a right here too. As we have heard from others across the chamber, this is already happening here now. Loved ones who are able to travelling to Switzerland, or staying at home and taking their own lives.
And the devastation this leaves for families picking up the pieces afterwards, and haunted by the experience. I have been overwhelmed, like colleagues in this House, by the many personal letters and emails I have received from people across the country with their own stories. I would like to thank each person for taking the trouble to share their personal thoughts on this issue. I am at an age where I have lost my father-in-law and my mother-in-law in the last two years. Two long drawnout illnesses.
And my own mother sadly has terminal cancer. I would have liked all of them to have had the option to be able to decide if they wanted the right moment for them to go to sleep and leave this world. And I know my father-in-law certainly wanted this. I don't want people to have to suffer in pain and discomfort, as many do now. Even with the palliative care services that exist. And I want to stress that investment in palliative care services sit side-by-side this legislation.
It is not as an alternative. This bill is about improving health at a time of suffering. It's about being able to live with dignity, and to die with dignity. And for those people with a terminal diagnosis, this is not a choice between life-and-death. But a choice between death and death. To have some control over the dying process, and to be able to die on your own terms has to be a rights. I want people to have that choice, that control, and that freedom.
This legislation has been through a line by line rigourous scrutiny of the elected chamber will stop and on a free vote, our MPs have voted for this bill. It is not for this House to obstruct this legislation which has been supported by elected members of Parliament. I hope this chamber will play its proper role in reviewing the legislation, but does not seek to prevent this bill from moving forward. I support the rights of individuals to be able to choose their end-of-life I hope this House will do the same.
**** Possible New Speaker ****
It is a privilege to follow the noble Lady and to take part in this noble Lady and to take part in this important debate. We have had two days of discussion with many fine days of discussion with many fine speeches. Those we heard today are still ringing in our ears. But let me take a moment to remind the House me take a moment to remind the House of a few of the contributions from last week. I will never forget the last week.
I will never forget the exchange between Lord Forsyth and exchange between Lord Forsyth and his late father. I will never forget the tragic story of Lord Mitchell's parents-in-law. I remember the parents-in-law. I remember the points made by Lord Stevens of Birmingham with all of his experience. That without proper
I know this is not what we want I know this is not what we want here, but this is what we are proposing. Do we seriously think proposing. Do we seriously think that if this bill was passed, palliative care won't be palliative care won't be detrimentally impacted? Or that six months won't, in due course, become months won't, in due course, become 12? I think we can do better than 12? I think we can do better than this. Of course I don't want anyone to die a painful agonising death, but nor two I want poor and vulnerable people to be faced with vulnerable people to be faced with such agonising choices.
Better palliative care can massively ease the first dilemma. Assisted death will turbocharge the latter. Before I trained for ordination, I worked for a year at some Christopher's Hospice, probably the most formative years of my life. My first day on the wards, I was terrified. All I could see was cancer and death. But during that year, I learnt that it is possible to live until you die, and although there are some illnesses so hideous that they cannot be completely controlled, in most cases, they can.
Honouring people's dignity and upholding their value, as someone made in the image of God until their life's end. Why, I ask Lord Falconer, does the bill deny the right of hospices to opt Amendment. I want to say alongside the Bishop of London, if this bill does reach 1/3 reading, we on these benches would be able to table an amendment to offer us a vote. Meanwhile I give the last word to Dame Cicely Saunders. " You matter because you are.
And you matter to the end of your life. We will do all we cannot only to help you die peacefully, but to live until you die. "
**** Possible New Speaker ****
My Lords, I rise to speak at the end of this important and significant debate. I'd like to thank Kim Leadbitter MP and Lord Falconer for leading this significant private lenders. significant private lenders. Parliament. I must add that this is a free vote on these benches and I'm a free vote on these benches and I'm therefore not speaking on behalf of my party. We have heard passionate speakers on both sides of this speakers on both sides of this debate, and many members flagging important issues that they want to important issues that they want to see looked at, to ensure processes work and safeguards are in place.
And I have every confidence that And I have every confidence that these will be addressed at Committee stage. And I really want to emphasise how it was particularly emphasise how it was particularly moved by the very personal stories last week of Lord Mitchell and Lord last week of Lord Mitchell and Lord Alderdice. Throughout our life we are able to make decisions about are able to make decisions about most things that affect us. Where to live, what to eat, how to live your life, what to do each day and so on.
life, what to do each day and so on. And yet, the one thing that we don't have any control over is our end of have any control over is our end of life. When someone has been diagnosed with a terminal illness, I diagnosed with a terminal illness, I believe it is only right, with the necessary safeguards in place, for them to be able to choose at the time and place that is right for them to end their life. The BBC News ran a very moving package earlier this year about a man in the United States, the gentleman was terminally ill.
But having seen relatives die terrible drawnout deaths, in significant pain, he wanted to die on his terms. The safeguards were strong, his family supported his wishes, and he did indeed die at home with his family around him, as he had wanted. This should be a right here too. As we have heard from others across the chamber, this is already happening here now. Loved ones who are able to travelling to Switzerland, or staying at home and taking their own lives.
And the devastation this leaves for families picking up the pieces afterwards, and haunted by the experience. I have been overwhelmed, like colleagues in this House, by the many personal letters and emails I have received from people across the country with their own stories. I would like to thank each person for taking the trouble to share their personal thoughts on this issue. I am at an age where I have lost my father-in-law and my mother-in-law in the last two years. Two long drawnout illnesses.
And my own mother sadly has terminal cancer. I would have liked all of them to have had the option to be able to decide if they wanted the right moment for them to go to sleep and leave this world. And I know my father-in-law certainly wanted this. I don't want people to have to suffer in pain and discomfort, as many do now. Even with the palliative care services that exist. And I want to stress that investment in palliative care services sit side-by-side this legislation.
It is not as an alternative. This bill is about improving health at a time of suffering. It's about being able to live with dignity, and to die with dignity. And for those people with a terminal diagnosis, this is not a choice between life-and-death. But a choice between death and death. To have some control over the dying process, and to be able to die on your own terms has to be a rights. I want people to have that choice, that control, and that freedom.
This legislation has been through a line by line rigourous scrutiny of the elected chamber will stop and on a free vote, our MPs have voted for this bill. It is not for this House to obstruct this legislation which has been supported by elected members of Parliament. I hope this chamber will play its proper role in reviewing the legislation, but does not seek to prevent this bill from moving forward. I support the rights of individuals to be able to choose their end-of-life I hope this House will do the same.
**** Possible New Speaker ****
It is a privilege to follow the noble Lady and to take part in this noble Lady and to take part in this important debate. We have had two days of discussion with many fine days of discussion with many fine speeches. Those we heard today are still ringing in our ears. But let me take a moment to remind the House me take a moment to remind the House of a few of the contributions from last week. I will never forget the last week.
I will never forget the exchange between Lord Forsyth and exchange between Lord Forsyth and his late father. I will never forget the tragic story of Lord Mitchell's parents-in-law. I remember the parents-in-law. I remember the points made by Lord Stevens of Birmingham with all of his experience. That without proper
14:59
Lord Wolfson of Tredegar (Conservative)
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Lord Wolfson of Tredegar (Conservative)
experience. That without proper provision of palliative care, you don't really have freedom of choice. At the same time, as I recall the warning from Lord Baker of Dorking, but proper government funding for palliative care might remain elusive. I know that the whole House will share my admiration for the brave moving and extremely personal speech made by my noble friend Baroness Prentice of Banbury. And will join me in wishing her well in the months ahead. Although I am winding up for the Official Opposition, we don't have an official position.
These benches have a free vote, and I speak for myself and my conscience. Two points flow from that. First of all, we all bring to this debate our background, our education, our professional or other knowledge. Our faith or lack of it. And our personal experiences of the fact of death and the experiences of the dying. And I suggest that it is as wrong to discount an opinion because it is informed by religious faith as it is to ignore an opinion grounded in a sincere belief in the irrelevance of faith.
Because both the supporters and the opponents of this bill sincerely believe in the validity of their arguments. There is no doubt in particular the noble and learned Lord Lord Falconer of Thornton places this bill before us in perfect good faith. But to repeat a point made by Lord Pollock, in the name of Chief Rabbi Lord Sacks, can I say on a personal note, I miss him especially on days like this. He said, " Purity of motive has never guaranteed righteousness of guaranteed righteousness of We do not sit here as moral philosophers as theologians.
Over the past few weeks, I have looked deeply into the learning of my own tradition. I've read the letter from the current chief rabbi from orthodox thinkers. I've considered articles from modern reform rabbis. I've studied the response from legal traditions extending over 3000 years, and yet I confess to your Lordships, I vacillate on the Lordships, I vacillate on the I feel that I ought to have clarity on the underlying moral and philosophical questions, but if I may borrow from another biblical tradition, on this issue, I see through a glass darkly.
But this is the key point. We sit here as legislators and it is as a legislators and it is as a legislator that I look at this bill. It will be on whether this bill should become law, and my answer to that question is no, and certainly not in the state in which this bill is now in. I contrast, my answer to the question should anybody put it, whether this bill should get a second reading, would be of course it should.
And I say that for two reasons. First, because this is a serious and seriously flawed bill which merits this houses careful consideration in committee. And second, because the other house did pass this bill and handed it over to us. But that is the limit of the fourth of the point that the House of Commons passed this bill. Some suggested that because the House of Commons passed the bill, we should not reject it. For my part, I reject that contention. I accept that this house should not unceremoniously dispose of a bill passed by the House of Commons, so the fact that the House of Commons passed the bill means that we need to take it seriously, and we are taking it seriously.
It is not mean that we have to pass the bill as it is or even as it might be following amendment. That is right as a matter of constitutional principle, but it is especially right in the case of this bill were a number of members of the other place only passed the bill on the basis that it would be the subject of detailed scrutiny here. So, in those circumstances, the idea that we should critically refer to the House of Commons seems to me to be the parliamentary equivalent of heads I win, tails you lose.
Now let me make for substantive points about the bill. First, a number of us have made the argument repeatedly that because some people in this country have the option of paying to go to Switzerland, this bill is needed for those who cannot afford that option. But that is superficially part of a conceptual problem. The fact that Switzerland offers suicide and offers it to non-Swiss residents doesn't mean that we have to follow because of that. Otherwise the fact that any country in the world adopted the Swiss model would mean that we should also pass such legislation, and I would suggest that is not a sound basis on which to legislate.
The second is a practical problem. This bill would not cover many of those who travel to Switzerland because if you have a degenerative disease that says you have more than six months to live. You can go to Switzerland but you outside the scope of this bill, and that also means that the story we have heard of relatives who are anguished as to whether something may happen to them if they assist relatives to go to Switzerland would still be in that predicament even if that bill were to pass.
The second point is to respond to a speech who will listen to anything I said with particular care. He made two points. First, the law already rejects the absolute sanctity of life and recognises the right to suicide. Second, citing the decision in the case, he drew an analogy between the right to refuse life-saving treatment which is our right and which I support, and the right to demand an assisted death. As to the first point, I don't think it is correct to say that the law recognises a right to suicide.
Suicide is no longer unlawful but that doesn't mean there is a right to commit suicide. Indeed, that point was recognised in the earlier case, announced the second point, I accept the Lord rejects the absolute sanctity of life, but that is a strawman. All religious and philosophical ideas reject the absolute sanctity of life. No one will suggest we should tax everybody in the country out of half of their wealth to give one person another three months of life. Absolute sanctity of life as a strawman, but the law does respect the sanctity of life.
The sanctity of life is a religious and philosophical principle and that means, in our law, all human life is intrinsically valuable and we do not deliberately terminate a life, even if the patient so consents, and that is at the heart of the decision where the detail will be happy to hear to await committee. But we referred to the principles of law of which the first was the fundamental principle of the sanctity of life, and he drew a clear and crucial distinction between the withdrawal of life supporting treatment and actively causing death.
It is the key point is that withdrawal of treatment by doctors does not cause death. It is the underlying disease that causes death. Doctors do not have any intention to kill. They want to discontinue something which is of no benefit to the patient. And it is on that basis that most religious traditions support the withdrawal of treatment in those circumstances. The authoritative response where he draws the same distinction as Lord Cotter does between removal of impediments to death in one hand and hastening death or assisted suicide on the other.
And so my answer to the question if you can refuse treatment, why can't she demand to be provided with barbiturates? This is contrary to the basic and support that human life is inviolate, even if the person in question has consented to its violation. Third, I have carefully read the human rights memorandum which accompanies this bill. But I have not seen any response to the point why is the lawn drawn at six months. The legal challenges going to go along the following lines.
One, my personal statement for the purposes of article 14 discrimination is how long I have to live. Two, I can't access assisted suicide at more than six months even though my suffering may thus be longer than somebody who only has six months to live. Three, there is no obvious reason why six months has been chosen. Perhaps that is a lawyers way of putting the slippery slope argument legal slopes in my professional experience are exceptionally slippery.
And it seems to me that once you are on the slope, you will slide inexorably to where anyone with a terminal illness should be committed to avail themselves of the provisions of this bill. And we do have here a contradiction between the supporters of the bill. My noble friend accepted that the logical outcome was that anyone with a terminal illness should be permitted to avail themselves and at the same time, we are told that the six month limit is a fundamental protection.
Both points can't be right at the same time. Finally, let me say a word about an absent friend. The High Court judge who we were told when this bill was introduced would stand as Guardian to make sure everything works as it should. But our judges have their work cut out, making sure that we live in peace and that they didn't like the idea of having to make sure that we die in peace as well. So the High Court judge has gone to be replaced with what is now being euphemistically called an expanded panel.
Well, it has been expanded and that there were more people on it, but it has been diminished because one member does not have to be a judge. A Kings Council is sufficient. I am the last person to denigrate the ancient and honourable status of one of his man councils in the law, but the fact is that there is no minimum period of practice before you apply to take cell, and it is not immediately apparent to me why a barrister over 12 years he was taken so classed week beyond the panel, but the senior partner of an international firm of solicitors cannot.
The truth I suggest is that this judicial. Two stories. It is too complex for the normal straightforward case. While it is not equipped with anything like sufficient powers for the more difficult cases. I'm not sure what the answer is, but the current proposal is neither fish nor fowl. It is something of a statutory red herring. To repeat, although I've spoken from the despatch boxes, I've spoken only for myself and I look forward to the forthcoming stages so that if and when the house has to decide whether this bill should pass into law, the bill is by then in the best possible state, but as matters stand today, this bill is not fit for the statute book.
**** Possible New Speaker ****
Let me start by thanking all noble Lords for an extensive, noble Lords for an extensive, passionate and insightful debate. As noble Lords have observed throughout noble Lords have observed throughout this debate, its quality and its conduct has been exemplary and that
These benches have a free vote, and I speak for myself and my conscience. Two points flow from that. First of all, we all bring to this debate our background, our education, our professional or other knowledge. Our faith or lack of it. And our personal experiences of the fact of death and the experiences of the dying. And I suggest that it is as wrong to discount an opinion because it is informed by religious faith as it is to ignore an opinion grounded in a sincere belief in the irrelevance of faith.
Because both the supporters and the opponents of this bill sincerely believe in the validity of their arguments. There is no doubt in particular the noble and learned Lord Lord Falconer of Thornton places this bill before us in perfect good faith. But to repeat a point made by Lord Pollock, in the name of Chief Rabbi Lord Sacks, can I say on a personal note, I miss him especially on days like this. He said, " Purity of motive has never guaranteed righteousness of guaranteed righteousness of We do not sit here as moral philosophers as theologians.
Over the past few weeks, I have looked deeply into the learning of my own tradition. I've read the letter from the current chief rabbi from orthodox thinkers. I've considered articles from modern reform rabbis. I've studied the response from legal traditions extending over 3000 years, and yet I confess to your Lordships, I vacillate on the Lordships, I vacillate on the I feel that I ought to have clarity on the underlying moral and philosophical questions, but if I may borrow from another biblical tradition, on this issue, I see through a glass darkly.
But this is the key point. We sit here as legislators and it is as a legislators and it is as a legislator that I look at this bill. It will be on whether this bill should become law, and my answer to that question is no, and certainly not in the state in which this bill is now in. I contrast, my answer to the question should anybody put it, whether this bill should get a second reading, would be of course it should.
And I say that for two reasons. First, because this is a serious and seriously flawed bill which merits this houses careful consideration in committee. And second, because the other house did pass this bill and handed it over to us. But that is the limit of the fourth of the point that the House of Commons passed this bill. Some suggested that because the House of Commons passed the bill, we should not reject it. For my part, I reject that contention. I accept that this house should not unceremoniously dispose of a bill passed by the House of Commons, so the fact that the House of Commons passed the bill means that we need to take it seriously, and we are taking it seriously.
It is not mean that we have to pass the bill as it is or even as it might be following amendment. That is right as a matter of constitutional principle, but it is especially right in the case of this bill were a number of members of the other place only passed the bill on the basis that it would be the subject of detailed scrutiny here. So, in those circumstances, the idea that we should critically refer to the House of Commons seems to me to be the parliamentary equivalent of heads I win, tails you lose.
Now let me make for substantive points about the bill. First, a number of us have made the argument repeatedly that because some people in this country have the option of paying to go to Switzerland, this bill is needed for those who cannot afford that option. But that is superficially part of a conceptual problem. The fact that Switzerland offers suicide and offers it to non-Swiss residents doesn't mean that we have to follow because of that. Otherwise the fact that any country in the world adopted the Swiss model would mean that we should also pass such legislation, and I would suggest that is not a sound basis on which to legislate.
The second is a practical problem. This bill would not cover many of those who travel to Switzerland because if you have a degenerative disease that says you have more than six months to live. You can go to Switzerland but you outside the scope of this bill, and that also means that the story we have heard of relatives who are anguished as to whether something may happen to them if they assist relatives to go to Switzerland would still be in that predicament even if that bill were to pass.
The second point is to respond to a speech who will listen to anything I said with particular care. He made two points. First, the law already rejects the absolute sanctity of life and recognises the right to suicide. Second, citing the decision in the case, he drew an analogy between the right to refuse life-saving treatment which is our right and which I support, and the right to demand an assisted death. As to the first point, I don't think it is correct to say that the law recognises a right to suicide.
Suicide is no longer unlawful but that doesn't mean there is a right to commit suicide. Indeed, that point was recognised in the earlier case, announced the second point, I accept the Lord rejects the absolute sanctity of life, but that is a strawman. All religious and philosophical ideas reject the absolute sanctity of life. No one will suggest we should tax everybody in the country out of half of their wealth to give one person another three months of life. Absolute sanctity of life as a strawman, but the law does respect the sanctity of life.
The sanctity of life is a religious and philosophical principle and that means, in our law, all human life is intrinsically valuable and we do not deliberately terminate a life, even if the patient so consents, and that is at the heart of the decision where the detail will be happy to hear to await committee. But we referred to the principles of law of which the first was the fundamental principle of the sanctity of life, and he drew a clear and crucial distinction between the withdrawal of life supporting treatment and actively causing death.
It is the key point is that withdrawal of treatment by doctors does not cause death. It is the underlying disease that causes death. Doctors do not have any intention to kill. They want to discontinue something which is of no benefit to the patient. And it is on that basis that most religious traditions support the withdrawal of treatment in those circumstances. The authoritative response where he draws the same distinction as Lord Cotter does between removal of impediments to death in one hand and hastening death or assisted suicide on the other.
And so my answer to the question if you can refuse treatment, why can't she demand to be provided with barbiturates? This is contrary to the basic and support that human life is inviolate, even if the person in question has consented to its violation. Third, I have carefully read the human rights memorandum which accompanies this bill. But I have not seen any response to the point why is the lawn drawn at six months. The legal challenges going to go along the following lines.
One, my personal statement for the purposes of article 14 discrimination is how long I have to live. Two, I can't access assisted suicide at more than six months even though my suffering may thus be longer than somebody who only has six months to live. Three, there is no obvious reason why six months has been chosen. Perhaps that is a lawyers way of putting the slippery slope argument legal slopes in my professional experience are exceptionally slippery.
And it seems to me that once you are on the slope, you will slide inexorably to where anyone with a terminal illness should be committed to avail themselves of the provisions of this bill. And we do have here a contradiction between the supporters of the bill. My noble friend accepted that the logical outcome was that anyone with a terminal illness should be permitted to avail themselves and at the same time, we are told that the six month limit is a fundamental protection.
Both points can't be right at the same time. Finally, let me say a word about an absent friend. The High Court judge who we were told when this bill was introduced would stand as Guardian to make sure everything works as it should. But our judges have their work cut out, making sure that we live in peace and that they didn't like the idea of having to make sure that we die in peace as well. So the High Court judge has gone to be replaced with what is now being euphemistically called an expanded panel.
Well, it has been expanded and that there were more people on it, but it has been diminished because one member does not have to be a judge. A Kings Council is sufficient. I am the last person to denigrate the ancient and honourable status of one of his man councils in the law, but the fact is that there is no minimum period of practice before you apply to take cell, and it is not immediately apparent to me why a barrister over 12 years he was taken so classed week beyond the panel, but the senior partner of an international firm of solicitors cannot.
The truth I suggest is that this judicial. Two stories. It is too complex for the normal straightforward case. While it is not equipped with anything like sufficient powers for the more difficult cases. I'm not sure what the answer is, but the current proposal is neither fish nor fowl. It is something of a statutory red herring. To repeat, although I've spoken from the despatch boxes, I've spoken only for myself and I look forward to the forthcoming stages so that if and when the house has to decide whether this bill should pass into law, the bill is by then in the best possible state, but as matters stand today, this bill is not fit for the statute book.
**** Possible New Speaker ****
Let me start by thanking all noble Lords for an extensive, noble Lords for an extensive, passionate and insightful debate. As noble Lords have observed throughout noble Lords have observed throughout this debate, its quality and its conduct has been exemplary and that
15:12
Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
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Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
conduct has been exemplary and that has allowed the expression of differing and deeply held views. And I would like to thank my noble friend for his work in introducing this bill to the house, and I know that many noble Lords are waiting to hear from Lord Faulkner as the sponsor. We have all heard the debates across the country where campaigners on both sides have made their cases with conviction and care. We have also had the debates in the other place and we know the previous consideration that this house has given to the topic of assisted dying.
Now, it is our turn to scrutinise this legislation. I want to turn 1st to the role of the government which relates in some part to the motion in the name of the noble Lord Lord Forsyth and the amendment to it from Lord Carlile. The government is neutral on the principle of assisted dying. It is a matter of conscience. Whether this bill becomes law is a decision for Parliament. My role is to help ensure that if this legislation is passed, it is legally and technically effective and workable.
So, as with any legislation, if Parliament chooses to pass this bill, the government will be responsible for its implementation. The noble Lords motion refers to time being made available for consideration of amending stages. Scheduling is a matter for my noble friend the government Chief Whip who will keep this under review. The government has a duty of care for the statute book and as such, my officials and there in the Ministry of Justice have worked with my noble friend Lord Faulkner and the Commons sponsor to offer drafting support and work ability advice.
This full continue throughout the passage of the bill and is an has been usual practice. Turning to the motions in the name of my noble friend.
**** Possible New Speaker ****
Could she explain why despite requests from the sponsors of the bill and despite the precedent which bill and despite the precedent which has been taken with other bills that are Private Members' Bills that matter of conscience, why is the government not prepared to provide time so that this house can ensure time so that this house can ensure that it is properly scrutinised and
**** Possible New Speaker ****
that it is properly scrutinised and I only repeat the point I made
**** Possible New Speaker ****
I only repeat the point I made that the government Chief Whip will listen to the will of Parliament and will review as necessary. My Lords, I would like to turn to the emotions in the name of my noble Friend in the name of my noble Friend Baroness Berger. These motions refer to a Select Committee reporting to the House ahead of Committee of the the House ahead of Committee of the whole House of commencing. The committee should report by Friday committee should report by Friday seventh of November.
The outcome of these motions and any other are these motions and any other are indeed a matter for this House to indeed a matter for this House to decide on. To the point that noble Lords have raised over whether this Lords have raised over whether this matter should have been one for a Private Members' Bill or for a government Bill, I would suggest, and remind us all that, on matters of societal change, the Private Members' Bill, with government neutrality, has long been used as the right vehicle to handle matters of sensitivity and importance such as this one.
And on this point of neutrality, I do hope therefore that noble Lords will understand my role and why it is not appropriate or possible for me as the Government Minister responding to respond to every point raised during the debate. I would my Lords like to thank the delegated power and Regulatory Reform Committee and the Constitution Committee for their scrutiny of this bill. As many noble Lords have highlighted, these recommendations will be important in consideration. The content of this bill and any delegated power Zaroo matter for the sponsor, and a matter for Parliament.
And I am grateful to both committees because their recommendations will inform the scrutiny of your Lordships House. As noble Lords have already heard during the opening remarks, my noble friend Lord Falconer has already, and will continue to consider, these reports. Many noble Lords have spoken about the importance of high quality palliative care for all those who need it. I want to be clear that, irrespective of any legislation on assisted dying, everyone must be provided with high quality compassionate care through to the end of their life.
Whilst the majority of palliative and end-of- life care is provided by the NHS, we do recognise the vital role played by the voluntary sector, in supporting people at the end of their life. Which is why we are providing the hospice sector with £100 million of capital funding for eligible adults and Children's Hospital. To ensure that the best physical environment for care is available. We recognise that more could be done to support people who need palliative and end of life care, as a number of noble Lords have raised.
We are looking at how to improve the access, the quality, and the sustainability of all age palliative and end-of-life, in line with recently published 10-Year Health Plan. And to make the shift from hospital to community, including, making that care as part of the work of neighbourhood health teams. I would like to thank noble Lords once again for their engagement, for their care, and for their thoughtfulness during this debate. As I have said, the government remained neutral on whether this bill becomes law.
And should Parliament pass this legislation, I can say to your Lordships House that it will be our responsibility to ensure it can be
**** Possible New Speaker ****
implemented safely and effectively. My Lords I draw attention to my
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My Lords I draw attention to my entry in the register of members interests which refers to the fact that I'm an assistant funded by that I'm an assistant funded by Bernard Lewis to assist in the conduct of this bill and Dignity and conduct of this bill and Dignity and Dying funded the printing of it. I apologise for not mentioning this in my opening speech. My Lords, this my opening speech. My Lords, this has been a debate of the highest quality, probably the highest quality I have heard in 28 years in quality I have heard in 28 years in this House.
Your Lordships brought passion, expertise, and a wisdom to passion, expertise, and a wisdom to the issue. Every single speech that was made I thought rose to the was made I thought rose to the gravity of the occasion. I would wish to refer to every speech but I wish to refer to every speech but I cannot. Could I pay particular tribute however to those of your tribute however to those of your Lordships on both sides, who have identified their own personal suffering in relation to this.
I pay tribute to all of those speeches. tribute to all of those speeches. Could I mention just two speeches? First of all, the speech of Baroness First of all, the speech of Baroness Prentice of Banbury, which was a very striking speech. She will know that she has the wishes of the whole House with her. Could I also mention the speech of Baroness Falkner of, she has the wishes of the whole house with her. The debate shows beyond doubt that this House will bring both expertise and human understanding to the important task of scrutiny that we must now undertake.
I express genuinely my gratitude to your Lordships Constitution Committee and the Delegated Powers and Regulatory Reform Committee respectfully, as I indicated in my opening speech, I will bring forward amendments to deal with many of the recommendations that were raised. And my experience as a government minister was that both those committees frequently made recommendations of the sort made by the committee requiring changes. I hope in consultation with the government I will be able to make those changes. Could I also mention the status of this bill? This is a Private Members' Bill.
Because it is a matter of conscience. No major political party agrees on whether or not they support assisted dying, and I don't find that surprising. It has to remain a Private Members' Bill for that reason. I should say, as my noble friend the baroness has referred to, I have had assistance, as has my friend at the other place, the Member for Spen Valley. She has had assistance as well from the government, civil servants and lawyers, seeking to ensure that the bill is workable, and that explains many of the changes that have taken place.
But ultimately, this is a Private Members' Bill. And must be treated as such. I believe, just as happened in the Commons, that the comments were very capable and proved able to properly scrutinise this bill. They gave this bill 100 hours of scrutiny. We are looking in this House at the same time the education and well-being bill which, as it happens is longer. And it got 40 hours of scrutiny. We are looking at a bill in the Commons where every clause was debated.
Not just those that were reached before the guillotine fell. Looking at a bill that has had a very large number of select committees look at it. The last one reported in the Commons in March March 2024. So we have got a job of work to do. But I would earnestly ask your Lordships not to approach this bill on the basis that it has not been properly scrutinised
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apologise. I thank the noble Lord. I wanted
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I thank the noble Lord. I wanted to say that a number of members have said the bill did not receive proper said the bill did not receive proper scrutiny of the other place. They also said they expected it would receive scrutiny in this place because that is what we do. I think because that is what we do. I think it is a profoundly important thing I don't think what the noble Lord has just said is absolutely correct. I would say the number of amendments tabled in the number of MPs who wanted to speak and were not wanted to speak and were not permitted to do so.
I think that is reflected in reflective of the fact the bill did not receive proper scrutiny the other place.
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scrutiny the other place. I am grateful to the noble Baroness. I have laid before the Baroness. I have laid before the House the facts. I recognise that House the facts. I recognise that some members of Parliament say it wasn't given proper scrutiny. I wonder if those members did not agree with the conclusion, I don't agree with the conclusion, I don't know, but I have laid the volume of time that was spent and it has had
Now, it is our turn to scrutinise this legislation. I want to turn 1st to the role of the government which relates in some part to the motion in the name of the noble Lord Lord Forsyth and the amendment to it from Lord Carlile. The government is neutral on the principle of assisted dying. It is a matter of conscience. Whether this bill becomes law is a decision for Parliament. My role is to help ensure that if this legislation is passed, it is legally and technically effective and workable.
So, as with any legislation, if Parliament chooses to pass this bill, the government will be responsible for its implementation. The noble Lords motion refers to time being made available for consideration of amending stages. Scheduling is a matter for my noble friend the government Chief Whip who will keep this under review. The government has a duty of care for the statute book and as such, my officials and there in the Ministry of Justice have worked with my noble friend Lord Faulkner and the Commons sponsor to offer drafting support and work ability advice.
This full continue throughout the passage of the bill and is an has been usual practice. Turning to the motions in the name of my noble friend.
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Could she explain why despite requests from the sponsors of the bill and despite the precedent which bill and despite the precedent which has been taken with other bills that are Private Members' Bills that matter of conscience, why is the government not prepared to provide time so that this house can ensure time so that this house can ensure that it is properly scrutinised and
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that it is properly scrutinised and I only repeat the point I made
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I only repeat the point I made that the government Chief Whip will listen to the will of Parliament and will review as necessary. My Lords, I would like to turn to the emotions in the name of my noble Friend in the name of my noble Friend Baroness Berger. These motions refer to a Select Committee reporting to the House ahead of Committee of the the House ahead of Committee of the whole House of commencing. The committee should report by Friday committee should report by Friday seventh of November.
The outcome of these motions and any other are these motions and any other are indeed a matter for this House to indeed a matter for this House to decide on. To the point that noble Lords have raised over whether this Lords have raised over whether this matter should have been one for a Private Members' Bill or for a government Bill, I would suggest, and remind us all that, on matters of societal change, the Private Members' Bill, with government neutrality, has long been used as the right vehicle to handle matters of sensitivity and importance such as this one.
And on this point of neutrality, I do hope therefore that noble Lords will understand my role and why it is not appropriate or possible for me as the Government Minister responding to respond to every point raised during the debate. I would my Lords like to thank the delegated power and Regulatory Reform Committee and the Constitution Committee for their scrutiny of this bill. As many noble Lords have highlighted, these recommendations will be important in consideration. The content of this bill and any delegated power Zaroo matter for the sponsor, and a matter for Parliament.
And I am grateful to both committees because their recommendations will inform the scrutiny of your Lordships House. As noble Lords have already heard during the opening remarks, my noble friend Lord Falconer has already, and will continue to consider, these reports. Many noble Lords have spoken about the importance of high quality palliative care for all those who need it. I want to be clear that, irrespective of any legislation on assisted dying, everyone must be provided with high quality compassionate care through to the end of their life.
Whilst the majority of palliative and end-of- life care is provided by the NHS, we do recognise the vital role played by the voluntary sector, in supporting people at the end of their life. Which is why we are providing the hospice sector with £100 million of capital funding for eligible adults and Children's Hospital. To ensure that the best physical environment for care is available. We recognise that more could be done to support people who need palliative and end of life care, as a number of noble Lords have raised.
We are looking at how to improve the access, the quality, and the sustainability of all age palliative and end-of-life, in line with recently published 10-Year Health Plan. And to make the shift from hospital to community, including, making that care as part of the work of neighbourhood health teams. I would like to thank noble Lords once again for their engagement, for their care, and for their thoughtfulness during this debate. As I have said, the government remained neutral on whether this bill becomes law.
And should Parliament pass this legislation, I can say to your Lordships House that it will be our responsibility to ensure it can be
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implemented safely and effectively. My Lords I draw attention to my
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My Lords I draw attention to my entry in the register of members interests which refers to the fact that I'm an assistant funded by that I'm an assistant funded by Bernard Lewis to assist in the conduct of this bill and Dignity and conduct of this bill and Dignity and Dying funded the printing of it. I apologise for not mentioning this in my opening speech. My Lords, this my opening speech. My Lords, this has been a debate of the highest quality, probably the highest quality I have heard in 28 years in quality I have heard in 28 years in this House.
Your Lordships brought passion, expertise, and a wisdom to passion, expertise, and a wisdom to the issue. Every single speech that was made I thought rose to the was made I thought rose to the gravity of the occasion. I would wish to refer to every speech but I wish to refer to every speech but I cannot. Could I pay particular tribute however to those of your tribute however to those of your Lordships on both sides, who have identified their own personal suffering in relation to this.
I pay tribute to all of those speeches. tribute to all of those speeches. Could I mention just two speeches? First of all, the speech of Baroness First of all, the speech of Baroness Prentice of Banbury, which was a very striking speech. She will know that she has the wishes of the whole House with her. Could I also mention the speech of Baroness Falkner of, she has the wishes of the whole house with her. The debate shows beyond doubt that this House will bring both expertise and human understanding to the important task of scrutiny that we must now undertake.
I express genuinely my gratitude to your Lordships Constitution Committee and the Delegated Powers and Regulatory Reform Committee respectfully, as I indicated in my opening speech, I will bring forward amendments to deal with many of the recommendations that were raised. And my experience as a government minister was that both those committees frequently made recommendations of the sort made by the committee requiring changes. I hope in consultation with the government I will be able to make those changes. Could I also mention the status of this bill? This is a Private Members' Bill.
Because it is a matter of conscience. No major political party agrees on whether or not they support assisted dying, and I don't find that surprising. It has to remain a Private Members' Bill for that reason. I should say, as my noble friend the baroness has referred to, I have had assistance, as has my friend at the other place, the Member for Spen Valley. She has had assistance as well from the government, civil servants and lawyers, seeking to ensure that the bill is workable, and that explains many of the changes that have taken place.
But ultimately, this is a Private Members' Bill. And must be treated as such. I believe, just as happened in the Commons, that the comments were very capable and proved able to properly scrutinise this bill. They gave this bill 100 hours of scrutiny. We are looking in this House at the same time the education and well-being bill which, as it happens is longer. And it got 40 hours of scrutiny. We are looking at a bill in the Commons where every clause was debated.
Not just those that were reached before the guillotine fell. Looking at a bill that has had a very large number of select committees look at it. The last one reported in the Commons in March March 2024. So we have got a job of work to do. But I would earnestly ask your Lordships not to approach this bill on the basis that it has not been properly scrutinised
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apologise. I thank the noble Lord. I wanted
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I thank the noble Lord. I wanted to say that a number of members have said the bill did not receive proper said the bill did not receive proper scrutiny of the other place. They also said they expected it would receive scrutiny in this place because that is what we do. I think because that is what we do. I think it is a profoundly important thing I don't think what the noble Lord has just said is absolutely correct. I would say the number of amendments tabled in the number of MPs who wanted to speak and were not wanted to speak and were not permitted to do so.
I think that is reflected in reflective of the fact the bill did not receive proper scrutiny the other place.
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scrutiny the other place. I am grateful to the noble Baroness. I have laid before the Baroness. I have laid before the House the facts. I recognise that House the facts. I recognise that some members of Parliament say it wasn't given proper scrutiny. I wonder if those members did not agree with the conclusion, I don't agree with the conclusion, I don't know, but I have laid the volume of time that was spent and it has had
15:25
Lord Falconer of Thoroton (Labour)
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Lord Falconer of Thoroton (Labour)
time that was spent and it has had more scrutiny than Government bills. May I say what the essence of this bill is. The essence of this bill is that those who are terminally ill, and that means they have a diagnosis that they will die within the next six months, that if they are terminally ill in that sense, they should have the option, subject to safeguards, to be assisted to take their own life. One of the features of this debate was the personal experience of so many people, of how, had that option been available, it would have ended terrible suffering.
Suffering that is not often about the pain, but about the lack of dignity. And a profound desire to keep control, because that is what people want. I believe from my own experience, and from talking to so many people, that that option is an important one to have. The points that have been made against it, which I have listened to incredibly carefully, are essentially not that people should not have that choice, but that it brings dangers with it.
And the dangers are, first, that people will be over persuaded, and secondly, it will affect society in other ways. First, that people will be over persuaded. The bill provides for first of all a conversation with a doctor, in which all the options, including the palliative care options are laid out. Secondly, that a doctor decides it is a free choice. Thirdly, that a second doctor decides that it is a free choice. And then fourthly, that a panel consisting of senior judge or a king's counsel, a psychiatrist, and a social worker concludes that the person is not being coerced.
But they are capable of making the decision, and that it is their free choice. As it happens, that is probably the most safeguarded procedure in the whole of the healthcare system. It is certainly the most safeguarded process when compared with other terminal illness bills in other countries in the world. I profoundly believe that people should have this choice. I profoundly believe, not based on either my spirituality or my lack of spirituality, but by looking at evidence in other countries.
That this will not lead to people being over persuaded. I have in mind those countries which already have a Terminal Illness Bill. The one that has been enforced for longest is the one in Oregon. But there are many other states in the United States of America that have terminal illness bills that have been in force for 20 years or more. They do not have those safeguards. They do have annual reports, and record-keeping of the highest sort about assisted of the highest sort about assisted death.
They show no evidence of the coercion that people in this debate referred to. I would have expected, if there was real evidence of that, that somebody in the course of the debate would have referred to a case from one of those countries showing that there was coercion. There was none. I am convinced, first of all that this bill has had proper scrutiny in the other place. Secondly, that there is no real danger in relation to coercion. But thirdly, I have completely accepted every single person in this debate who said they wanted more palliative care.
I want more palliative care. We should do everything we can to promote palliative care. But, as so many people say, it is not either or, it is both. 75% of people in Victoria, Australia who have had assisted death have had palliative care. 92% in Oregon have palliative care. The Select Committee of the Commons to which I referred, which reported in 2024, said that palliative care in many jurisdictions went up in terms of its resource. In answer to the question that was raised, would be the effect on palliative care, on the basis of other jurisdictions it will get better.
And this debate here has in fact provoked the government to spend more money on Many people have talked about language. I make no point about language. I simply say this over 20 years, over 10 years, I have been a gate in this debate, nothing upsets people more who are terminally ill and want an assisted death, that is suicide. They hate that because of the impact it has on those they leave behind. What they feel is that they are dying anyway.
And what they want is some degree of control over when and how it may happen. Can I move briefly to what will happen next? I welcome the motion to set out that can hear evidence. I very much welcome because it was indicated to every that it allows the bill to go through its phases. The motion for the setting out the Select Committee. We have got a job of work to do. I agree with everybody that this house must plainly give the bill a second reading.
We must then listen to the evidence for the Select Committee which will supply, and we must then do what we do so well which is scrutinise and amend the bill as necessary. And send it back to the other place. I've heard people say that we can say no to this bill. Ultimately, on an issue such as this, in our system, somebody has got to decide and it is not the electorate because it is never in the manifesto with the exception of the Greens.
Therefore, Parliament has got to decide, and ultimately, in our system, that means it will have to be those who are elected, not those who are unelected. Could I end by expressing my profound gratitude to this house for the attention and quality they gave to this bill? I commend this bill to
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the house. I don't know if I'm alone in being frequently asked by people
Suffering that is not often about the pain, but about the lack of dignity. And a profound desire to keep control, because that is what people want. I believe from my own experience, and from talking to so many people, that that option is an important one to have. The points that have been made against it, which I have listened to incredibly carefully, are essentially not that people should not have that choice, but that it brings dangers with it.
And the dangers are, first, that people will be over persuaded, and secondly, it will affect society in other ways. First, that people will be over persuaded. The bill provides for first of all a conversation with a doctor, in which all the options, including the palliative care options are laid out. Secondly, that a doctor decides it is a free choice. Thirdly, that a second doctor decides that it is a free choice. And then fourthly, that a panel consisting of senior judge or a king's counsel, a psychiatrist, and a social worker concludes that the person is not being coerced.
But they are capable of making the decision, and that it is their free choice. As it happens, that is probably the most safeguarded procedure in the whole of the healthcare system. It is certainly the most safeguarded process when compared with other terminal illness bills in other countries in the world. I profoundly believe that people should have this choice. I profoundly believe, not based on either my spirituality or my lack of spirituality, but by looking at evidence in other countries.
That this will not lead to people being over persuaded. I have in mind those countries which already have a Terminal Illness Bill. The one that has been enforced for longest is the one in Oregon. But there are many other states in the United States of America that have terminal illness bills that have been in force for 20 years or more. They do not have those safeguards. They do have annual reports, and record-keeping of the highest sort about assisted of the highest sort about assisted death.
They show no evidence of the coercion that people in this debate referred to. I would have expected, if there was real evidence of that, that somebody in the course of the debate would have referred to a case from one of those countries showing that there was coercion. There was none. I am convinced, first of all that this bill has had proper scrutiny in the other place. Secondly, that there is no real danger in relation to coercion. But thirdly, I have completely accepted every single person in this debate who said they wanted more palliative care.
I want more palliative care. We should do everything we can to promote palliative care. But, as so many people say, it is not either or, it is both. 75% of people in Victoria, Australia who have had assisted death have had palliative care. 92% in Oregon have palliative care. The Select Committee of the Commons to which I referred, which reported in 2024, said that palliative care in many jurisdictions went up in terms of its resource. In answer to the question that was raised, would be the effect on palliative care, on the basis of other jurisdictions it will get better.
And this debate here has in fact provoked the government to spend more money on Many people have talked about language. I make no point about language. I simply say this over 20 years, over 10 years, I have been a gate in this debate, nothing upsets people more who are terminally ill and want an assisted death, that is suicide. They hate that because of the impact it has on those they leave behind. What they feel is that they are dying anyway.
And what they want is some degree of control over when and how it may happen. Can I move briefly to what will happen next? I welcome the motion to set out that can hear evidence. I very much welcome because it was indicated to every that it allows the bill to go through its phases. The motion for the setting out the Select Committee. We have got a job of work to do. I agree with everybody that this house must plainly give the bill a second reading.
We must then listen to the evidence for the Select Committee which will supply, and we must then do what we do so well which is scrutinise and amend the bill as necessary. And send it back to the other place. I've heard people say that we can say no to this bill. Ultimately, on an issue such as this, in our system, somebody has got to decide and it is not the electorate because it is never in the manifesto with the exception of the Greens.
Therefore, Parliament has got to decide, and ultimately, in our system, that means it will have to be those who are elected, not those who are unelected. Could I end by expressing my profound gratitude to this house for the attention and quality they gave to this bill? I commend this bill to
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the house. I don't know if I'm alone in being frequently asked by people
15:33
Lord Forsyth of Drumlean (Conservative)
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Lord Forsyth of Drumlean (Conservative)
being frequently asked by people from time to time what is the point of an unelected House of Lords? And I now have the absolutely mind blowing answer which is to refer to them to these two days of debate which we have had on this really difficult subject. People may have forgotten what it said, but what it said was that it called upon his match government in light of the 32nd report from the dedicated powers and regulatory to allow sufficient time available for consideration of amending stages of this bill and to provide full support at ministerial and official level to the in charge of the bill and its remaining stages in the House of Lords.
Despite the differences that we have heard in this two days of debate, there is a clear consensus. There is an absolute consensus across the house. This bill is in need of amendment. This bill is in need of further scrutiny. Now, I listen very carefully to the speech in the debate, and I see her amendment. I am a little doubtful as to how a Select Committee which is not really a Select Committee because it is not producing a report or simply her evidence.
I'm a little doubtful as to how that will change or alter the opinion having listened to a speech on this matter. Or indeed, anyone else's opinion. What it does do is that it means that we can't actually start that task until 7 November. That we have lost some time. As many speeches appointed out, none of us know when and how we are going to die. None of us here know when the end of the session is going to be. So between 7 November and the end of the session, listening to all of the speeches and thinking of the number of issues that are going to have to be addressed, I would venture to suggest that for Friday's four private legislation is not going to be sufficient time.
And therefore, it seems to me that it is essential that the government provides time. I understand why the government doesn't want to do that. If I were in government and the prime ministers office, I would be saying that means that we won't have time for this that and the other. This is an absolutely life-and-death issue and it is important that it is considered possibly and put on the statute book if it will be on the statute island if we will satisfy Lord Wilson in his brilliant speech where he showed what we're doing here is actually making legislation and we should put legislation on the statute book which has been properly thought through.
And that I think means it has to be government time. The speech that struck me because I happen to know that the Cabinet Sec advised the government that this should be treated in the way that all Private Members' Bills like abortion, like the death penalty, like the decriminalisation of homosexuality. They were Private Members' Bills which the government took on board to assure they have proper times are properly supported, and I do not understand why that should not apply to this bill having listened to these two days of debate.
I suspect it might be because the Health Secretary and the justice secretary were opposed to the bill, but then we are told that the government is neutral and I don't see why the government should not provide that time in order to satisfy those people who have written to us on both sides of the debate. I have to say to the noble pallet who threatened to vote down the bill at third reading, I hope you will think again about that.
I hope you will think again about that because the expectations are skyhigh and to vote down a bill which has not been properly considered and has not been given enough time I think would be to put this house in a very awkward position for no good reason. Our duty is to scrutinise the bill, to send back to the House of Commons and to ensure that we have the time
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to do a proper job. Your Lordships may recall but I
Despite the differences that we have heard in this two days of debate, there is a clear consensus. There is an absolute consensus across the house. This bill is in need of amendment. This bill is in need of further scrutiny. Now, I listen very carefully to the speech in the debate, and I see her amendment. I am a little doubtful as to how a Select Committee which is not really a Select Committee because it is not producing a report or simply her evidence.
I'm a little doubtful as to how that will change or alter the opinion having listened to a speech on this matter. Or indeed, anyone else's opinion. What it does do is that it means that we can't actually start that task until 7 November. That we have lost some time. As many speeches appointed out, none of us know when and how we are going to die. None of us here know when the end of the session is going to be. So between 7 November and the end of the session, listening to all of the speeches and thinking of the number of issues that are going to have to be addressed, I would venture to suggest that for Friday's four private legislation is not going to be sufficient time.
And therefore, it seems to me that it is essential that the government provides time. I understand why the government doesn't want to do that. If I were in government and the prime ministers office, I would be saying that means that we won't have time for this that and the other. This is an absolutely life-and-death issue and it is important that it is considered possibly and put on the statute book if it will be on the statute island if we will satisfy Lord Wilson in his brilliant speech where he showed what we're doing here is actually making legislation and we should put legislation on the statute book which has been properly thought through.
And that I think means it has to be government time. The speech that struck me because I happen to know that the Cabinet Sec advised the government that this should be treated in the way that all Private Members' Bills like abortion, like the death penalty, like the decriminalisation of homosexuality. They were Private Members' Bills which the government took on board to assure they have proper times are properly supported, and I do not understand why that should not apply to this bill having listened to these two days of debate.
I suspect it might be because the Health Secretary and the justice secretary were opposed to the bill, but then we are told that the government is neutral and I don't see why the government should not provide that time in order to satisfy those people who have written to us on both sides of the debate. I have to say to the noble pallet who threatened to vote down the bill at third reading, I hope you will think again about that.
I hope you will think again about that because the expectations are skyhigh and to vote down a bill which has not been properly considered and has not been given enough time I think would be to put this house in a very awkward position for no good reason. Our duty is to scrutinise the bill, to send back to the House of Commons and to ensure that we have the time
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to do a proper job. Your Lordships may recall but I
15:38
Lord Carlile of Berriew (Crossbench)
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Lord Carlile of Berriew (Crossbench)
will remind you just in case you have forgotten that I tabled an amendment to amend the noble Lord for sites amendment. I tabled that amendment because it seemed to me that Lord Forsyth wanted to turn this bill into a government bill and to give it all the authority of the government bill with the minister in charge of the bill of putting the noble Lord in the position of being the Minister. But I have listened to the noble and learned Lords and he has said absolutely rightly that I totally agree with him, and I agree with Lord Wilson as well, that this is absolutely what should be and should remain a Private Member's Bill.
I have also looked at the potential effect of the potential amendment to the commitment motion by the noble Baroness Burj who I think has approached the spell with great energy, superb intelligence, and has done great credit to the house. Having considered that and the state play as it is now, I think it is right that I should beg leave to withdraw my amendment so that we can move quickly on to other more substantive matters.
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Is at your Lordships pleasure that the amendment be withdrawn? The amendment is by leave withdrawn. Terminally else adults end-of-life bill amendment Lord Forsyth.
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bill amendment Lord Forsyth. I beg leave to withdraw my amendment. Is at your Lordships pleasure
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Is at your Lordships pleasure that this amendment be withdrawn? The amendment is by leave withdrawn. The question is that this bill be The question is that this bill be now read a second time? As many of now read a second time? As many of that opinion will say content. I think the contents have it. The question is that this bill be committed to a committee of the
I have also looked at the potential effect of the potential amendment to the commitment motion by the noble Baroness Burj who I think has approached the spell with great energy, superb intelligence, and has done great credit to the house. Having considered that and the state play as it is now, I think it is right that I should beg leave to withdraw my amendment so that we can move quickly on to other more substantive matters.
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Is at your Lordships pleasure that the amendment be withdrawn? The amendment is by leave withdrawn. Terminally else adults end-of-life bill amendment Lord Forsyth.
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bill amendment Lord Forsyth. I beg leave to withdraw my amendment. Is at your Lordships pleasure
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Is at your Lordships pleasure that this amendment be withdrawn? The amendment is by leave withdrawn. The question is that this bill be The question is that this bill be now read a second time? As many of now read a second time? As many of that opinion will say content. I think the contents have it. The question is that this bill be committed to a committee of the
15:40
Baroness Berger (Labour)
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whole house. I beg to move the amendment standing in my name on the Order standing in my name on the Order Paper. I have spoken already about how my experience as a member in the other place has made me very concerned about the spell and more determined that it must not be a cause of further harm to vulnerable people. There are many unanswered questions about the bill before us that have been raised in the course of this important debate which is why I have tabled the amendment and the following motion to hold a Select Committee before Committee of the whole House begins.
This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight but there are serious shortcomings as both a Select Committee on the constitution and the delegated powers and Regulatory Reform Group have noted in their reports last week. Indeed, I am concerned that the legislative process has been asked to compensate for the absence of robust policy- making before this bill was published. No comprehensive review, no public consultation or prior engagement with professionals and other stakeholders, no Green Papers or White Paper which we have seen that been a government bill, and I understand the case but that has diminished what is before us today and no published analysis of international experiences.
Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without groundwork. The Institute on the principle of assisted dying back in March said that we are expecting common scrutiny to do far too much, things simply can't do. Common scrutiny is not being left to solve problems it isn't equipped to deal with, and we have seen the safeguards like the review by a High Court judge and clauses and schedules to replace them with very little opportunity for thorough scrutiny.
It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated powers. We know 42 delegated powers are included within this bill, where the government will work out the details later with Parliament largely excluded from the conversation. The result is a build that is today substantially different from when the bell committee and the other place took evidence in January of this year. But now with less clarity.
I don't wish to detain the house any longer than is necessary but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the bill we have before us today. We need this information before we commence line by line scrutiny. Noble Lords will have received a letter setting out the witnesses that we believe this house must hear from, including my noble and friend Lord Faulkner and those who will bear the responsibility for delivering the bill should it pass and how they would use the delegated powers.
The secretary of state for health and social care, the Chief Executive of NHS England, the chief secretary of the Treasury. We must also take evidence from the possession of bodies whose members will be asked to carry out the functions that the bill sets out. The Royal quite psychologist, of precisions, general practitioners, the British Association of social workers and the Law Society. We are not able to hear from serving members of the judiciary that may hear from the former chief coroner hear from the former chief coroner of England.
And we must also ensure that they understand the impact of the bill on hospices in care homes through hospice UK, the Association of palliative care and care England. A previous suggestion of a Select Committee in parallel alongside a committee of the whole house would
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not achieve. I didn't want to detain the house
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I didn't want to detain the house longer than necessary but can I ask one question on the evidence before one question on the evidence before the Select Committee? What that evidence be published at Select Committee? Just to clarify for Lords Committee? Just to clarify for Lords
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Committee? Just to clarify for Lords The answer is yes, absolutely. The evidence collated and amassed The evidence collated and amassed will be published for all the House to consider in advance of us going to consider in advance of us going into committee of the whole House. Just to confirm that the reason why this Select Committee could not be this Select Committee could not be taking place in parallel is to ensure that we receive evidence on ensure that we receive evidence on vital parts of the bill before we go into debates.
We are not in the into debates. We are not in the unenviable position of knowing what was wrong with the bill being unable to amend it. My Lords, my motion to amend it. My Lords, my motion provides that Select Committee will be a focused piece of work hearing be a focused piece of work hearing vital evidence rather than a more time intensive open exercise. And it time intensive open exercise. And it may report by simply publishing that evidence before we go into committee of the whole House.
In order to inform a detailed consideration of the bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks with two panels of witnesses on each of the days, to begin the week commencing 20th of October. Allowing it to conclude I seventh of November. Revised timetable ensures that the bill can progress to its next stage and still maintain the opportunity for four sitting Fridays before Christmas. We have over the past two Fridays shown the determination of your Lordships House to discuss this bill in the considered and constructive way.
It is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the motion that will contain the detail I set out. I'm grateful to my noble and
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friend Lord Faulkner. ... This will give evidence, is
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... This will give evidence, is that finally determined or would it be possible to add the Royal College of Nursing?
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of Nursing? I thank the noble member for the
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I thank the noble member for the intervention. As I understand it, it is within the gift of the Select is within the gift of the Select Committee to determine who will be called for evidence. I have sought to set out who I believe the key to set out who I believe the key people are, but there will be many more suggestions. See conscious of more suggestions. See conscious of the tight timetable, we won't be able to have an extensive list, but I'm sure the chair, and when they I'm sure the chair, and when they are appointed consider the suggestion that has been made.
I was expressing my gratitude to my noble expressing my gratitude to my noble and friend Lord Faulkner, for prepared to work with me to reach an agreement that would allow the House to engage carefully with the substance of what is being proposed, substance of what is being proposed, and the powers we are asked to bestow a Ministers. I'm grateful to the many noble Lords who have already indicated during the course of our debate their support for my amendment and motion during their amendment and motion during their
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speeches. My Lords I beg to move. The original question was that this bill be now committed to a Committee of the whole House. Since Committee of the whole House. Since when an amendment has been moved at the end to insert the words set out on the Order Paper. As many are of on the Order Paper. As many are of that opinion say, "Content". Of the contrary, "Not content". The contrary, "Not content". The contents have it. The question is that that commitment motion is that that commitment motion is amended degree to.
As many are of that opinion say, "Content". Of the contrary, "Not content". The contrary, "Not content". The contents have it. Motion for a Select Committee on aspects of the
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Select Committee on aspects of the bill. Baroness Berger. My Lords, I beg to move the
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My Lords, I beg to move the Motion sandigo my name on the Order Paper.
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Paper. The question is that the motion in the name of Baroness Berger be agreed to. As many are of that opinion say, "Content". Of the opinion say, "Content". Of the contrary, "Not content". The contents have it.
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contents have it. My Lords, it has been a long day
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My Lords, it has been a long day at the end of a very long week, and we have made good progress on the legislation before the House. I thank the usual channels most
Baroness Berger (Labour)
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whole house. I beg to move the amendment standing in my name on the Order standing in my name on the Order Paper. I have spoken already about how my experience as a member in the other place has made me very concerned about the spell and more determined that it must not be a cause of further harm to vulnerable people. There are many unanswered questions about the bill before us that have been raised in the course of this important debate which is why I have tabled the amendment and the following motion to hold a Select Committee before Committee of the whole House begins.
This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight but there are serious shortcomings as both a Select Committee on the constitution and the delegated powers and Regulatory Reform Group have noted in their reports last week. Indeed, I am concerned that the legislative process has been asked to compensate for the absence of robust policy- making before this bill was published. No comprehensive review, no public consultation or prior engagement with professionals and other stakeholders, no Green Papers or White Paper which we have seen that been a government bill, and I understand the case but that has diminished what is before us today and no published analysis of international experiences.
Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without groundwork. The Institute on the principle of assisted dying back in March said that we are expecting common scrutiny to do far too much, things simply can't do. Common scrutiny is not being left to solve problems it isn't equipped to deal with, and we have seen the safeguards like the review by a High Court judge and clauses and schedules to replace them with very little opportunity for thorough scrutiny.
It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated powers. We know 42 delegated powers are included within this bill, where the government will work out the details later with Parliament largely excluded from the conversation. The result is a build that is today substantially different from when the bell committee and the other place took evidence in January of this year. But now with less clarity.
I don't wish to detain the house any longer than is necessary but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the bill we have before us today. We need this information before we commence line by line scrutiny. Noble Lords will have received a letter setting out the witnesses that we believe this house must hear from, including my noble and friend Lord Faulkner and those who will bear the responsibility for delivering the bill should it pass and how they would use the delegated powers.
The secretary of state for health and social care, the Chief Executive of NHS England, the chief secretary of the Treasury. We must also take evidence from the possession of bodies whose members will be asked to carry out the functions that the bill sets out. The Royal quite psychologist, of precisions, general practitioners, the British Association of social workers and the Law Society. We are not able to hear from serving members of the judiciary that may hear from the former chief coroner hear from the former chief coroner of England.
And we must also ensure that they understand the impact of the bill on hospices in care homes through hospice UK, the Association of palliative care and care England. A previous suggestion of a Select Committee in parallel alongside a committee of the whole house would
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not achieve. I didn't want to detain the house
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I didn't want to detain the house longer than necessary but can I ask one question on the evidence before one question on the evidence before the Select Committee? What that evidence be published at Select Committee? Just to clarify for Lords Committee? Just to clarify for Lords
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Committee? Just to clarify for Lords The answer is yes, absolutely. The evidence collated and amassed The evidence collated and amassed will be published for all the House to consider in advance of us going to consider in advance of us going into committee of the whole House. Just to confirm that the reason why this Select Committee could not be this Select Committee could not be taking place in parallel is to ensure that we receive evidence on ensure that we receive evidence on vital parts of the bill before we go into debates.
We are not in the into debates. We are not in the unenviable position of knowing what was wrong with the bill being unable to amend it. My Lords, my motion to amend it. My Lords, my motion provides that Select Committee will be a focused piece of work hearing be a focused piece of work hearing vital evidence rather than a more time intensive open exercise. And it time intensive open exercise. And it may report by simply publishing that evidence before we go into committee of the whole House.
In order to inform a detailed consideration of the bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks with two panels of witnesses on each of the days, to begin the week commencing 20th of October. Allowing it to conclude I seventh of November. Revised timetable ensures that the bill can progress to its next stage and still maintain the opportunity for four sitting Fridays before Christmas. We have over the past two Fridays shown the determination of your Lordships House to discuss this bill in the considered and constructive way.
It is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the motion that will contain the detail I set out. I'm grateful to my noble and
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friend Lord Faulkner. ... This will give evidence, is
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... This will give evidence, is that finally determined or would it be possible to add the Royal College of Nursing?
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of Nursing? I thank the noble member for the
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I thank the noble member for the intervention. As I understand it, it is within the gift of the Select is within the gift of the Select Committee to determine who will be called for evidence. I have sought to set out who I believe the key to set out who I believe the key people are, but there will be many more suggestions. See conscious of more suggestions. See conscious of the tight timetable, we won't be able to have an extensive list, but I'm sure the chair, and when they I'm sure the chair, and when they are appointed consider the suggestion that has been made.
I was expressing my gratitude to my noble expressing my gratitude to my noble and friend Lord Faulkner, for prepared to work with me to reach an agreement that would allow the House to engage carefully with the substance of what is being proposed, substance of what is being proposed, and the powers we are asked to bestow a Ministers. I'm grateful to the many noble Lords who have already indicated during the course of our debate their support for my amendment and motion during their amendment and motion during their
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speeches. My Lords I beg to move. The original question was that this bill be now committed to a Committee of the whole House. Since Committee of the whole House. Since when an amendment has been moved at the end to insert the words set out on the Order Paper. As many are of on the Order Paper. As many are of that opinion say, "Content". Of the contrary, "Not content". The contrary, "Not content". The contents have it. The question is that that commitment motion is that that commitment motion is amended degree to.
As many are of that opinion say, "Content". Of the contrary, "Not content". The contrary, "Not content". The contents have it. Motion for a Select Committee on aspects of the
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Select Committee on aspects of the bill. Baroness Berger. My Lords, I beg to move the
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My Lords, I beg to move the Motion sandigo my name on the Order Paper.
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Paper. The question is that the motion in the name of Baroness Berger be agreed to. As many are of that opinion say, "Content". Of the opinion say, "Content". Of the contrary, "Not content". The contents have it.
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contents have it. My Lords, it has been a long day
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My Lords, it has been a long day at the end of a very long week, and we have made good progress on the legislation before the House. I thank the usual channels most
15:50
Lord Kennedy of Southwark (Labour)
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Lord Kennedy of Southwark (Labour)
thank the usual channels most sincerely and all members. I'm sure all noble Lords will join with me in thanking the catering staff, the tenders, the clerks, the Hansard staff, the broadcasting unit, the security staff, and the police, and the doorkeeper is for the excellent support keeping the House operating and keeping us safe. I recognise as government Chief Whip the pressure this places on the staff of the House and will continue my discussions across the House to ensure proper support is always in place when we return on 13th October.
I wish everyone a well deserved break as we move into the Conference season. Everyone attending a party conference, whether that be in Bournemouth, Liverpool, Manchester or elsewhere, I wish an enjoyable time. For those not attending a party conference, you have probably got the best deal. We also wish you well. I beg to move the House do now adjourn.
I wish everyone a well deserved break as we move into the Conference season. Everyone attending a party conference, whether that be in Bournemouth, Liverpool, Manchester or elsewhere, I wish an enjoyable time. For those not attending a party conference, you have probably got the best deal. We also wish you well. I beg to move the House do now adjourn.