Domestic Abuse Bill

Lord Ribeiro Excerpts

Report stage
Wednesday 10th March 2021 Lords Chamber

[Baroness Butler-Sloss (CB) [V]]

I should have declared earlier an interest as chairman of the National Commission on Forced Marriage.

I thank the Minister very much for listening and for what she said in response to the debate on an earlier amendment on forced marriage. I agree entirely with what the noble Baroness, Lady Finlay of Llandaff, said. I would just add that mental health issues should include people who are forced into marriage, most of whom are very young and some of whom are under 18.

[Lord Ribeiro (Con) [V]]

My Lords, it is a pleasure to follow the noble and learned Baroness, Lady Butler-Sloss, who supports this amendment. Like the noble Baroness, Lady Finlay, I acknowledge the helpful letter on this amendment that we received today from my noble friend the Minister.

Accommodation-based support, as proposed in government Amendment 22, is highly relevant because domestic abuse can take place in settings other than the home. Alcohol intoxication increases vulnerability because it makes victims less physically able to get away from an aggressor and more likely to make poor decisions. Likewise, alcohol increases the chances of the aggressor assaulting someone in the home or other accommodation-based settings. We know that the more intoxicated someone is, the greater their chance of sustaining serious injuries.

We should also be concerned about the effects of domestic abuse on children—the hidden victims of domestic abuse, as the noble Baroness, Lady Benjamin, noted in the debate on the first group of amendments. Witnessing domestic violence and alcohol abuse are major events in childhood and may lead to an anti-social lifestyle of offending, truancy and violent behaviour in the years ahead.

As a surgeon, I treated many patients with injuries sustained following domestic disputes, nearly all of them fuelled by alcohol. Some were horrific injuries to the chest and abdomen; others were less serious but, none the less, led to long-term complications—particularly injuries to the face from the assailant’s fists or a blunt weapon. The consequences lead to long-term disfigurement, and the sight every day in the mirror of a broken nose or missing teeth is a constant reminder of the abuse suffered. Children, too, may suffer injuries as part of the collateral damage. Many choose not to admit to the assault outside the home.

I am grateful to Professor Jonathan Shepherd, a surgeon and professor at Cardiff University’s Crime and Security Research Institute, for providing me with his publications in the journals of both the Royal College of Surgeons and the Royal College of Psychiatrists and his position statements on the management of alcohol abuse and the mental health impacts of violence. My noble friend the Minister may wish to consider these in the formal consultation after Royal Assent.

In conclusion, where alcohol is concerned, it is important not to view physical injuries in isolation. All too often, the two are inextricably linked. I would welcome the opportunity to share these Royal College policies with my noble friend the Minister, in the hope that they may influence national policy in providing alcohol abuse and mental health support, as this amendment proposes.

Assisted Dying Bill [HL]

Lord Ribeiro Excerpts

Friday 18th July 2014 Lords Chamber

[Lord Ribeiro (Con)]

My Lords, I am speaking today as a doctor to express the views of some of the medical royal colleges which believe that the law as it stands should remain. They represent the doctors who will have to implement and execute this Bill, unlike the rest of us, who are nearly all retired.

My own college, the Royal College of Surgeons, of which I was president from 2005 to 2008, in a council minute of February 2005, stated:

“The Assisted Dying for the Terminally Ill Bill was discussed by council in July 2004. It was felt that the college should not take a position as this was a matter for individual fellows and members to decide”.

However, in 2011, in its response to the Commission on Assisted Dying, which was chaired by the noble and learned Lord, Lord Falconer, the RCS made a very clear statement:

“The law as it currently stands should not be changed and no system should be introduced to allow people to be assisted to die. The college does not recognise any circumstances under which it should be possible for people to be assisted to die”.

The RCS believes that the Assisted Dying Bill would fundamentally alter the role of the doctor-patient relationship. Doctors should preserve and improve life. If they are also involved in taking life, a damaging conflict of interest will occur, which patients will not understand. My noble friend Lord Sheikh stressed that there is a danger that a right to die may become a responsibility to die, making vulnerable people more vulnerable.

On 16 July, the Royal College of Physicians, stated:

“Today RCP Council reaffirmed its position on assisted dying—that it does not believe a change in the law is necessary. This policy is based on a 2006 survey, in which 73.2% of … fellows”,

and members voted for no change. A new survey will be conducted in the autumn and we should wait for that.

The Royal College of General Practitioners surveyed 1,700 members during a four-month consultation: 77% opposed any change to the law. Finally, as we have heard many times today, the British Medical Association, of which I am a member and, I have to say, a critical friend, opposes legalising assisted dying. The chairman of the BMA’s council, Dr Porter, added:

“Our focus must be on making sure every patient can access the very best of palliative care, which empowers patients to make decisions over their care”.

We have all received countless letters and we have all recited them, but I was struck by a paragraph in a letter from an oncologist at St Bartholomew’s Hospital, which is a leading cancer centre. He said:

“I am appalled at the negative implications of this Bill for my patients with advanced cancer. In my speciality of lung cancer and melanoma, we are currently experiencing a revolution in medical advances that would have been unimaginable 10 years ago. We should remember that many patients with advanced ‘terminal’ cancer have been cured due to the medical advances that this Bill would deny our patients … from children with leukaemia to adults diagnosed with advanced ‘terminal’ melanoma, that have been cured with novel immune therapies in recent years”.

I plan to table amendments in Committee to Clause 4(4)(b) where the term “a medical device” is mentioned. The Explanatory Notes make reference to “a syringe driver” and we need to be absolutely clear what these devices are intended to do.

The debate highlights the need for better and more widespread palliative care with a focus on individual patients’ needs rather than a focus on assisting a few to die. The noble Lord, Lord Cavendish, referred to mercy killing on compassionate grounds. Perhaps we should revert to this term in the context of this Bill, which also invokes compassion. We should take note of the concerns of doctors and nurses who will, after all, have to implement the Bill.