Assisted Dying Bill [HL]

Baroness Brinton Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, we have had an extraordinarily moving debate from both sides of the argument as well as from all parts of the House. It is typical of your Lordships’ House that we have respected one another’s views even if we disagree.

I thank the noble Baroness, Lady Meacher, for her Bill and for the way in which she set out why an assisting dying law is urgently needed in the United Kingdom to address the unacceptable suffering of dying people and the dangerous lack of protections in the current law, but also for explaining how protections and safeguards are stronger than in former Bills that have come to Parliament. Safety and end-of-life choice are not mutually exclusive. That is why I support the Bill.

I congratulate the noble Baroness, Lady Davidson of Lundin Links, on her maiden speech, a moving picture of her journey from officially opposing former Bills in Scotland to welcoming this one. I say to her that she has joined the right legislature if she wants to break convention; I think Prime Ministers of all Governments in recent decades regard your Lordships’ House as a place to challenge conventions. She will feel at home here very quickly.

As a Christian, I thank the most reverend Primate for his comment that people of faith hold different views. Polling by Populus in 2019 showed that 80% of people of faith also supported assisted dying, and evidence from around the world—such as Spain, 10 states in America and Australia—shows that where there are strong communities of faith there can also be a right to an assisted death. There is nothing sacred about suffering nor holy about agony. Yes, life is precious and God-given, but we can still help people avoid a terrible death at the end of that precious life, when death is near anyway.

No one who supports the Bill sees palliative care as needing less support. We all want to see the work of the noble Baroness, Lady Finlay, and others fully funded, so that everyone who needs it can have access to it. In a perfect world, no one’s final days—or, as the noble Lord, Lord Ramsbotham, said very movingly, over a year in the case of his wife—should be in continuous agony or severe distress.

Various speakers have talked about palliative care funding being reduced after the introduction of assisted dying legislation. When the Australian states of Victoria, Western Australia and Queensland passed their assisted dying legislation, their Governments increased funding for palliative care services by between 17 million and 170 million Australian dollars; that is between £9 million and £90 million. Research from the United States has found that assisted dying laws contribute to open conversations and careful evaluations of end-of-life options, more appropriate palliative care training for doctors and greater efforts to increase access to hospice care. These benefit all dying people, not just those who want an assisted death. The fact is that states with assisted dying have very few people who choose to use it.

As a disabled woman, I was moved to hear the noble Baronesses, Lady Campbell of Surbiton, Lady Masham and Lady Grey-Thompson, and the noble Lords, Lord Campbell-Savours, Lord Low and Lord Shinkwin. Like others in this House, they are divided in their views, but their and many other speakers’ key issues about the protection and the rights of the disabled are absolutely vital. The noble and learned Lord, Lord Neuberger, was right to point out that if legislation and regulations are abused, it is up to Parliament to legislate against that abuse and our police to ensure that it stops.

The noble Baroness, Lady Lister, reminded us that the disabled community in Victoria, Australia, was involved in designing the legislation. Disability Rights Oregon has never received a single complaint about any negative aspect of Oregon’s assisted dying legislation.

Opponents to the Bill talked about people in countries where assisted dying is legal citing that they feel a burden on family and loved ones. The vast majority of people who have an assisted death in places where it is legal cite the loss of autonomy and dignity as the two major contributing factors for wanting an assisted death. Not wishing to be a burden is a concern among all dying people but is cited relatively infrequently by those requesting an assisted death. It is certainly there, but behind concerns over autonomy and effective pain relief.

My noble friend Lord Purvis talked about visiting both Oregon and Washington. In those states, these concerns are recorded by doctors based on conversations with the person requesting an assisted death. They are not reasons for seeking an assisted death, nor motivations given directly by the terminally ill person.

The noble and right reverend Lord, Lord Eames, and my noble friends Lady Smith of Newnham and Lord Clement-Jones spoke movingly about balance and the need for strong safeguards. UK clinicians already assess life expectancy and decision-making capacity and, hopefully, detect coercion. Under the Bill, this process goes further and will be done in triplicate: two independent clinicians and a High Court judge. If five states in Australia, New Zealand and 11 states in the US are able to develop, implement and monitor their assisted dying laws, which balance protection and autonomy, we can too.

We know from front-line clinicians in Australia and the US that open, honest end-of-life care conversations that include the discussion of all available options, including palliative care, are of great value and comfort to the patient. They often result in the patient deciding not to choose assisted dying, and that is just as it should be. If only we had a culture in our country of open, honest end-of-life care conversations. We have much to learn.

Claims that the current law works well and protects vulnerable people do not stand up to scrutiny. If we are serious about the risks to vulnerable people, we must accept that, under existing law, a hypothetical bad relation could encourage an elderly or disabled person to bring their life to an end. There are far fewer safeguards on, for instance, withdrawal of treatment, “Do not attempt resuscitation” orders, or voluntarily stopping eating and drinking in comparison to the safeguards provided in the Bill, where the decision is in the hands of the individual, not other people.

I thank my noble friend Lady Harris of Richmond and others for letting us hear the voices of those whose loved ones’ deaths have not been good. Three years ago, my sister in Spain was in hospital with terminal and multiple cancers. Her doctor did not believe in deep sedation, and my young nephew and niece had to watch as their mother lived her final days in total agony. This year, Spain has introduced assisted dying with proper safeguards and, just as importantly, a complete change in the way it handles end-of-life care. The two can go hand in hand. Deaths like my sister’s should not happen again.

That is why a clear law, as proposed in the Bill, would protect vulnerable people, as no one could access an assisted death without going through multiple up-front safeguards; any potential coercion that could be detected in advance, rather than after someone has died, would be stopped. As my noble friend Lord Glasgow said, assisted dying is a moral and clinical issue whose time has come, and the UK public agree.

The many personal stories told today add to the clear evidence that the blanket ban on assisted dying is dangerous and cruel. I believe the Bill proposes a robust, safe and compassionate alternative. I hope your Lordships’ House will give it a Second Reading and move it on to Committee.