Assisted Dying Bill [HL]

Lord Bishop of Carlisle Excerpts

Friday 16th January 2015 Lords Chamber

[Lord Harries of Pentregarth (CB)]

My Lords, I have put my name down to Amendments 129, 130, 132 and 152 in this group, which are all concerned to achieve the same purpose as the amendment moved by the noble Baroness, Lady O’Neill—clarity and honesty.

The point has already been made that this is an amendment to the Suicide Act and therefore consistency alone demands that we use a word such as “suicide” rather than “dying”. Before the Bill started to be discussed, if you asked the average person what the phrase “assisted dying” meant, I think most people would say that it would be to try to help a person who is dying be comfortable and out of pain, and that they had somebody with them to accompany them in this process, this journey out of this world. That is what “assisting” them would be. It would be totally different from taking active steps to end their life. I am rather surprised by the conviction with which the supporters of the Bill are opposing what we are asking for, which is simply clarity, honesty and a doing-away of the cloak of these euphemisms—it occurs not just in the case of the word “suicide” but, as we will discuss later, in the use of the term “medicine” instead of “lethal drugs”. Let us go for clarity and honesty. Even supporters of the Bill should approve of that.

[The Lord Bishop of Carlisle]

My Lords, I speak in support of the comments made by the noble Lords, Lord Cormack, Lord Winston and Lord Deben. As the noble and right reverend Lord, Lord Harries, has just made clear, the Bill seeks to amend Section 2 of the Suicide Act 1961. This should be made explicit throughout the Bill: it will allow doctors to assist in the suicide of a terminally ill patient. Regardless of a person’s state of health, if they deliberately end their own life, they are committing suicide rather than simply hastening the process of dying. Anyone else involved in this act is assisting a suicide.

In making this as clear as possible, the amendments in this grouping, some of which have my name attached to them, are seeking to be constructive. As has been mentioned, some strident voices in society claim that this is a euthanasia Bill; it is clearly not. But outside this place, there is some confusion about what the Bill is seeking to legalise, which must be dispelled. First, doctors must understand exactly what the Bill will require of them. Secondly, the terminally ill, who might seek to take advantage of provisions within the Bill, must understand that ultimately they will be required to take their own lives. Finally, society must understand the change to the law that Parliament is considering.

The amendments encourage us to move beyond mere slogans. They introduce an element of clarity which is a prerequisite for proper scrutiny. They also bring sharply into focus what the Bill seeks to do and what it does not.

[Lord Howarth of Newport]

My Lords, it is a besetting vice of politics to use language which is designed to achieve the maximum of impact and the minimum of definition; I very much agree with the words spoken just now by the noble Lord, Lord Deben. In doing so, we degrade our politics. One expects that in advertising; one does not expect it in politics and in government, and it is very bad for the confidence of the public in politics and the legislative process.

There is a better model that it would be worth looking at for a moment. A Bill was brought into the Scottish Parliament by Margo MacDonald entitled the Assisted Suicide (Scotland) Bill; it was not entitled the assisted dying Bill. There is the model of precision, accuracy and candour which the Committee should follow. We should support the amendment in the name of the noble Baroness, Lady O’Neill.

--- Later in debate ---

[Lord Blair of Boughton (CB)]

My Lords, I declare an interest in that I was a member of the Commission on Assisted Dying, chaired by the noble and learned Lord, Lord Falconer. I want to respond to Amendments 17 and 21 by mentioning specifically that at the conclusion of the two years in which we heard evidence, our initial position was that this prognosis period should be 12 months. We based that on the GMC guidance to which the noble Lord, Lord Warner, has just referred. It was based on the time at which a doctor could begin to discuss end-of-life care with his or her patient. We decided to reduce the period to six months because we thought that this decision was even more dramatic than the 12-month position of possibly dying. Now that we are into six months, we are much closer.

With all respect, it seems that the noble Baroness, Lady Meacher, has made the right point in relation to these amendments. We are looking at this from the wrong end. As the noble Lord, Lord Berkeley, has just said, there is no certainty but this is aimed at those individuals who themselves believe, with mental capacity, that what lies ahead of them in suffering and indignity is unbearable to them. It may not be unbearable to somebody else but, for them, it is unbearable and they want to have a discussion. We have been told about people who are going to recover because a new treatment will appear. These are people of mental capacity who are making clear judgments. Is it very likely that those people, if they start to feel better, will say, “No, I still want to die because I decided that I wanted to a little while ago although I now feel better”? That is a completely nonsensical position.

There is one provision of this Bill that people do not seem to notice. In Oregon, when the decision is made, the medicine is handed to the patient and he or she wanders off and puts it in the cupboard. That is not the case in the Bill. The medicine, such as it is, will be in a pharmacy. It will not be released to the patient until everybody is absolutely clear that all the processes have been gone through and that the person still has a settled determination to end their own life. It will then be released to a medical practitioner or nurse and if that patient does not take it within 24 hours, it is not left in the house. It goes back to the pharmacy and the discussion starts again. These are reasonable provisions. There is the idea that we should tie it to the uncertainty of a medical prognosis. We have to have some limits but, after two years of deliberation and knowing the GMC guidelines, six months struck those of us in the commission as a reasonable compromise. I recommend it to the House.

[The Lord Bishop of Carlisle]

My Lords, very briefly, I support Amendment 13, proposed by the noble Lord, Lord Carlile, and the other amendments in this group.

I note the detailed points made by the noble Baroness, Lady Brinton. Like the noble Lord, Lord Berkeley, I am struggling a bit with them. However, it seems to me that these amendments are generally sensible and important. The arguments in favour have been very well and movingly advanced. They would make this proposed legislation safer, as the noble and right reverend Lord, Lord Harries, suggested.

I shall take this opportunity to point out that our support for these and other amendments does not in any sense signify the Church of England’s support for the overall intention of the Bill. I am sure this applies to other Members of your Lordships’ House. Some suggestion has been made, not least in the media, that our position lacks clarity. Nothing could be further from the truth. We have every sympathy with and respect for—I cannot emphasise this too much—the honourable and compassionate motives that inspire the Bill’s proponents, as the noble Lord, Lord Cormack, indicated.

The church’s stance on assisted dying was made abundantly clear by the General Synod in 2012. When this subject was debated then, not a single member of it opposed a motion to keep the current law. Of course, some individual church members may and clearly do disagree but, to avoid any misunderstanding as we debate these amendments, that remains our corporate stance for reasons of principle and pragmatism that have already been very well rehearsed in this House.

[Baroness Hayman (CB)]

My Lords, reference has been made to the GMC, and therefore I should perhaps draw attention to my interest as a member of that body, although I, of course, speak today purely personally and not on behalf of the GMC.

I want to address two issues relating to doctors. First, I support Amendment 15 on changing from a registered to a licensed medical practitioner, which is an important safeguard and correction.

However, I have severe concerns about Amendment 13. The right reverend Prelate said that he thought it would make the Bill safer for patients. I have to disagree. I think it would make the Bill impractical and restrictive. The reasons for that are partly the reasons outlined by the noble Baroness, Lady Brinton. People who are desperately ill who receive a diagnosis one or two years before their death very often think about moving. They sometimes move to be near relatives or into a care home, but moves even half a mile up the hill, as I learnt recently, can mean the severing of a long-term relationship with a GP practice. It is impractical and unfair to ask people who have moved in these circumstances to rule themselves out of access to the provisions of this legislation.

It is also impractical in terms of doctors themselves. We were taken back to the days of Dr Finlay in many ways by the speeches of the noble Lords, Lord Carlile and Lord Cormack. Very few people these days have a decades-long relationship with a single general practitioner. I am very nervous, because my legal education ended in 1969, of taking on the noble Lord, Lord Carlile, but he spoke about the realities of multiple partners in general practices in the National Health Service today. Certainly, my experience in my new practice is that you will be seen by any one of a number of partners there. However, the amendment says very specifically that the person must have been registered with one of the two doctors,

“for medical care for at least six months immediately prior”,

not at the practice but with that specific doctor. That is very difficult for people to comply with.

Equally, like patients, doctors also move. They move to different parts of the country, and they retire. You can imagine many circumstances in which reading and applying those specific provisions would simply rule out for patients the ability to access this legislation. For that reason I oppose this amendment.