NHS: Death at Home

Lord Blair of Boughton Excerpts

Thursday 8th November 2012 Lords Chamber

[Lord Blair of Boughton]

My Lords, I need to declare an interest, in that I was a member of the Commission on Assisted Dying chaired by the noble and learned Lord, Lord Falconer. It was a very moving experience; it was also a very educative experience. I do not think it was something to which I had given much thought. I was a bit in agreement with Woody Allen, who said, “I don’t mind dying; I just don’t want to be there when it happens”. The Bill will be brought forward by the noble and learned Lord, Lord Falconer, in the new year. The right to die at home—the subject of this debate—seems to be just one small part of thinking about our approach to death.

First, I want to reflect on something said at a Dignity in Dying conference in July, which I was asked to address as a member of the commission to discuss its findings. It was followed by a lobby of Parliament, which noble Lords may remember. One of the speakers said that after anti-slavery, women’s rights, the abolition of capital punishment, the legalisation of abortion and gay rights, thinking of ways to die, to ease death and to give more choice about death is the next great liberal cause. I agree with those sentiments. I note that the chair of one of the major medical bodies recently said that a botched death should now rank with a botched abortion as a medical disaster.

Ann McPherson was a wonderful Oxford general practitioner who founded the organisation Healthcare Professionals for Assisted Dying before she was diagnosed herself with pancreatic cancer. She gave evidence to the commission, but died at the end of May. Ann’s daughter has written an account of her death at home; it is available on the internet. It was a terrible death, but the important point that she wrote about was that it was at home. If a death as complicated as that could be managed at home, then that is the point of this debate.

Being able to choose to die at home or where people live should be a first starting point in the end-of-life care. I support the views put forward by many noble Lords, particularly by the noble Lord, Lord Warner, in this debate. Norman Lamb MP, Minister for Care and Support, recently stated that a review in 2013 of progress in the end-of-life care strategy,

“will inform us when a right to choose to die at home, including a care home, might feasibly be introduced”.—[Official Report, Commons, 30/10/12; col. 149W.]

I hope it comes soon.

Above all, I think we need to talk about this a lot more. Very few people who came before our commission seemed to know about the choices mentioned by the noble Viscount, Lord Craigavon, of advance decisions, lasting powers of attorney, advance statements and advance care planning. Not enough people seem even to know the term “palliative care”, let alone be able to access it. It is a common saying that the only two certainties in life are death and taxes. It seems to me that in this great Chamber, we spend a much greater amount of time talking about taxes than we do about death. As the noble Lord, Lord Dubs, said, we should talk about it more. As the Times put it in the leader already referred to this week:

“Without discussing how we die, we have not truly explored how we live”.

I thank the noble Lord for organising this debate and I look forward to further discussions about these matters when the Bill to be put forward by the noble and learned Lord, Lord Falconer, enters this House.