Assisted Dying Bill [HL]

Baroness Finlay of Llandaff Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare all my roles in the register. My experience extends to caring for several thousand dying patients. The horror stories we have heard today must be followed up. But here Parliament is being asked to sign a blank cheque for the unscrupulous. As the noble Lord, Lord Wilson of Dinton, warns, be realistic—never assume the best of human nature when legislating. At first sight, the Bill is seductively simple, but its safeguards are bland statements for an ideal world out of touch with reality, and it seems potentially incompatible with Clause 60 of the Mental Capacity Act.

Thirty years ago, three senior doctors and I predicted that a distressed man desperate for euthanasia had three months to live. However, today he is glad of the years of joy and sadness—prognosis is a guess. The criteria drawn from Oregon are very elastic and case law will expand them rapidly—as in Canada—as some today have already indicated. Very few palliative medicine doctors would be prepared to be involved in any part of gatekeeping for lethal drugs. In Canada they are leaving the specialty, and in Oregon most doctors will not touch it. Therefore, 90% of people are stewarded by campaign groups to a willing prescriber of lethal drugs, who knows nothing about them beyond their case notes—no basis for sound decision-making. Last year one such doctor wrote 31 lethal prescriptions.

Nothing in the Bill plugs deficits in care. The experience of other countries shows that palliative care does not flourish, nor do violent non-assisted suicide rates fall—they do not—when such legislation is in place. When explored, public support reveals that 42% of people think it allows people to stop treatment and 10% that it is hospice care. Two-thirds of hospice doctors report that people think that hospices practise euthanasia and are already getting frightened.

The Bill will not solve suffering or improve care. It suggests to terminally ill people that ending your life is something you should consider. Even the strongest are vulnerable to influence when fearful or when their lives are shattered by disease. Some 53% of people dying by lethal drugs in Oregon were concerned at being a burden; pain was way down the list. Two-thirds of Oregon hospices do not take part in assisting suicide. In Belgium, two-thirds of all dying people do not access specialist palliative care. In Canada, as we have already heard, hospice funding was withdrawn for hospices that refused to participate. Belgium and the Netherlands have had no growth in palliative care services since 2012. Now in parts of the Netherlands one in 19 of all deaths is assisted. In Belgium, one in 60 deaths is non-voluntary euthanasia. Numbers escalate everywhere—up 281% in Oregon in the past 10 years—with reports relying on a tick box after the event.

It is not always a quick and easy death. The eight who reawakened did not repeat the experience. Last year, over half took more than three-quarters of an hour to die; some, more than four days; and 6% had complications—higher than the 4% of difficult symptoms referred to in the debate. Doctors know that they cannot make many of the life or death judgments that the Bill asks. This is not a job for doctors already on their knees after the pandemic, in a country where palliative care provision to provide dignity in dying remains largely outside the NHS, reliant on voluntary donations, leaving 320 people daily not getting the care they deserve. Modern symptom control is moving fast: you do not have to kill the patient to kill the pain. No law stops pain control, but ignorance does. The Bill is not safe.