Assisted Dying Bill [HL]

Debate between Lord Carlile of Berriew and Baroness Finlay of Llandaff

Friday 7th November 2014 Lords Chamber

[Lord Carlile of Berriew]

I am grateful to the noble Lord, who has great experience in law, for asking that question. It is one that I considered carefully. It seems to me that in cases where one human being is having their life ended deliberately by another, the court should have the safeguard in all cases of an independent expert, albeit that that expert may in the end be able to deal with the matter briefly.

Amendments 67 and 68 also deal with the way in which the assisted suicide, if it takes place, is to take place. It seems a wise, safe course that the independent person who oversees any act of assisted suicide should submit a report to the chief coroner. I think that it is the view of most lawyers, at least, that the chief coroner—currently, his honour Judge Peter Thornton—is doing an absolutely superb job and has shown how the coronial system can be made to work much better than it ever did in the past, so that seems to be a reasonable provision.

I turn finally to Amendment 172, because I referred to Amendment 175 briefly in the earlier debate. Amendment 172 provides for a form of declaration which in my respectful view should go with every one of these decisions, if they are to be made, and which will stand as a record of what occurred not only for the court but as an explanation to the individual’s family and descendants as to why he or she decided to act as they did.

Those are the very brief reasons why these amendments, in my respectful submission to your Lordships, have merit. Despite the passing of the earlier amendment in the name of the noble Lord, Lord Pannick, these are issues that remain for consideration. I repeat that I do not propose any votes in this House on any of these issues today. These are serious matters which require debate and then reflection. I reserve the position as to what would happen on Report.

[Baroness Finlay of Llandaff]

My Lords, I stated earlier that I saw merit in the amendments tabled by the noble Lord, Lord Carlile, because they took doctors out of the gatekeeping role. I would like to expand on that briefly now.

The advantage of an independent medical expert is that you will know that you have somebody who has been properly trained, whose assessments are audited and, where there is monitoring in the process, that they have to be updated in that area and discipline—and that they carry credentials, as well as being able to negotiate the court process. As part of that assessment, it seems essential that others affected by the death are also considered in the process—in particular, children. I have spoken before in this House about the problems for children who are bereaved. I do not think that the House should underestimate the emotional problems for a child whose parent has committed suicide or had an assisted suicide, or the difficulties that they may go on to feel: that their love was inadequate to support the person whom they loved—their parent—through the last days, weeks or months of their life, and how damaging that can be for the rest of their lives.

I also strongly support the concept of having a court-appointed person who could take the drugs out to the person who has gone through the process and for whom assisted suicide is being agreed. The way that the Bill of the noble and learned Lord, Lord Falconer, is written at the moment is completely impractical because in reality not all patients die rapidly on ingesting their drugs. Some die within minutes but the median time is actually 25 minutes, if we base it on the Oregon experience. However, some take 41 hours to die. That is going to tie people up for a very long time.

We are talking not about therapeutic drugs but about a massive overdose of a drug at a fixed point. Later we will come on to debate lethal drugs and the difference between those and medication. There can also be monitoring of whom the drugs go to when they go out, and the return of drugs to a central point if they have not been used—as well as having someone who is trained to deal with the complications that occur, which has not been addressed and which, I respectfully point out to the House, almost no doctors are equipped to cope with at the moment. Yes, they may learn, but that would be at the expense of patients.

The other reason why I see the merit of having a completely independent process of assessment is, as I said before, that it does not contaminate the care that is being given to the person by the clinicians. It allows conversations to go on without the patient feeling that they have locked themselves in—that in a way they can pursue a parallel track. They can be assessed by the court but they can still have their own practitioner working to improve their quality of life, not believing that, now they are applying to fix a date for their death, some of the interventions feel pointless and futile.

Police Reform and Social Responsibility Bill

Debate between Lord Carlile of Berriew and Baroness Finlay of Llandaff

Thursday 16th June 2011 Lords Chamber

[Baroness Finlay of Llandaff]

My Lords, this amendment obviously concerns the Advisory Council on the Misuse of Drugs, and I must declare an interest, having been a member of the technical committee of the ACMD until last month.

This committee, as everyone knows, has gone through some turbulent times. One can, in some ways, see why the Government’s proposed wording to amend the Misuse of Drugs Act is as it is, because it aims to provide greater flexibility and to avoid situations where the council could not meet if the constitution was too rigid.

I understand that the Government have said that they will publish a working protocol governing their relationship with the ACMD, but that has not, as yet, been produced. It is likely to include a list of areas of expertise to which the Home Secretary will have regard when making appointments to the ACMD, and the protocol will be placed in the Library. Unfortunately, my understanding is that the protocol will not be available until after the Bill has received Royal Assent, which is why the amendment is important. We need to know what is to happen. The protocol may not be a sufficient safeguard in the longer term to ensure that there is a well-balanced ACMD. A future Home Secretary would be under no obligation to follow the principles of the working protocol. If it was guidance, they could simply decide to ignore it.

The reason for specifying the groups in the amendment is to try to be broadbrush, without being too prescriptive. Having been a member of the technical committee, I became acutely aware of how important the scientists, the drug control people and the behavioural scientists were to that committee. They brought a dimension and understanding to some things that the rest of us did not have, however much we tried to read around the subject. One of the people from whom I learnt the most was a member of the police force on the technical committee, who brought a degree of insight into the functioning of the outputs of the committee that I found most helpful, as, I think, did others. We invited experts to give us evidence, but the collective memory that formed around the table was important.

I question the Minister about exactly how the process of appointing new members to the council will be conducted. The experience of appointments made in January this year and the subsequent cancellation of one of those appointments, that of Doctor Hans-Christian Raabe, suggests that improvements could be made to the appointments process. When non-scientific appointments are being made, will the Government ensure the expertise available to the appointment panels to assess the competencies of those who are applying? They might look good on paper, but if the appointment panel cannot ask the appropriate questions, it may miss out on the person who could contribute most to the panel.

Under the amendment, I seek assurance about the present safeguards to ensure that appointees have the appropriate level of experience, and about how they will be transferred when the Bill comes into force, to avoid a repetition of some of the unfortunate incidents that have occurred recently, and the bad publicity that goes with that, which undermines the credibility not only of the committee but, more importantly, of its decisions. I beg to move.

[Lord Carlile of Berriew]

My Lords, although not wanting to repeat the eloquent and informed moving of the amendment by the noble Baroness, I shall speak briefly in support of it. I can well understand why the Government want to be rid of the six specified disciplines in existing law. They are too prescriptive. However, the noble Baroness in her amendment has set out in a much broader way the activities and experience of people who should be members of the advisory council.

I find it difficult to understand why the protocol has not yet been published. It cannot be too long a document and it cannot take too great a time to prepare. I hope that we will hear something positive from the Minister about the future of the council. In particular, it would be very helpful if my noble friend could tell the House that at least the spirit of the noble Baroness’s amendment will be incorporated in the protocol. Above all, perhaps she could assure the House that the prediction that the protocol will not be produced until after Royal Assent is quite wrong and that it will in fact be produced quickly, we hope, so that it is available to Members of this House by Report.