Assisted Dying Bill [HL]

Baroness Murphy Excerpts

Friday 18th July 2014 Lords Chamber

[Baroness Murphy (CB)]

My Lords, I am afraid that the noble Lord, Lord Gordon, will be disappointed that I am one of those members of the medical profession who would be proud to be associated with the Bill. I certainly would not desist from becoming an expert under a code of practice to administer medication to those who had requested it, if the Bill was passed. Many members of the medical profession feel, as I do, that at the moment the provisions are fudged, the system does not work and it depends on regular, 24-hour hypocrisy to deliver the care that we are currently obliged to pretend that we give.

Last time we debated this topic in the House, I rather lost my temper—egged on, I have to say, by the noble Baroness, Lady Boothroyd—so I have promised myself that I will not do so this time. However, one of the things that trouble me about debates in this House is that we go endlessly for emotional anecdote, talking about our experience, or talking about other jurisdictions as if we have looked at the evidence. I have sat here as a simple medical scientist—I was a practising psychiatrist and academic for 30 years, working with elderly people in the most deprived community in south-east London—and I have to tell noble Lords that I do not recognise any of the fears from evidence.

And there is evidence. Only one jurisdiction in the world has adopted the legislation that we are proposing here today: Oregon, which has now had it for 17 years. There are not only the annual reports on Oregon, which have very clear statistics on the issues we are talking about, on depression, and so on, but there is also—I will also refute what the right reverend Prelate the Bishop of Bristol recently said—a lot of independent research evidence from people outside the direct system who have gone to look at it and have done serious research. I am concerned about serious research evidence, not the anecdotes. There has been talk about the risk or fear about the doctor-patient relationship, but the country in the world that has the best trust in its doctors is the Netherlands. That is research evidence.

Returning to respecting individuals’ choice, I have heard it said here today that we must set that aside because of the profound effect on others. However, we already accept people’s decision to reject life-saving treatments if they have the mental capacity, regardless of any effects their subsequent deaths may have on those they leave behind, and we are happy to allow doctors to assess mental capacity for that purpose. I have heard other noble Lords say how difficult it is, and no doubt in the future others will say the same. The fact of the matter is that the Mental Capacity Act and the Mental Health Act and a lot of other legislation regarding mental health patients are totally predicated on doctors’ ability to assess capacity, and they do so every day of the week. Therefore let us have none of that.

On the code of practice, no legislation on health and social care puts on the face of the Bill the detail of how the Act is to be implemented. We always ask for the professions, and of course the Department of Health involves the professions and the independent professional bodies in trying to deliver a code of practice that is acceptable to the professions which have to deliver the care. It will be the same in this Bill as in any other. I say that having spent a good part of my life on codes of practice for the mental health legislation.

I will make my last point on the issue of depression. The right reverend Prelate the Bishop of Bristol said that 60% had symptoms of depression. That is not true. One in six has some symptoms of depression. People who are terminally ill have symptoms of depression. However, that does not mean that they have a clinical depressive illness which can be treated, and there are ways of excluding that. Again, noble Lords will hear differently, and I ask them please to read the research evidence. We should make our decisions on evidence that exists today, not on supposition.