Assisted Dying Bill [HL]

Lord Elton Excerpts

Friday 16th January 2015 Lords Chamber

[Lord Warner]

If we are really concerned with what the public understand, it is a bit presumptuous to assume that they have been following these debates for 10 to 12 years but have not understood what we have been talking about in terms of assisted dying. We get a lot of criticism in Westminster—

[Lord Elton (Con)]

My Lords—

[Lord Warner]

I realise that I have annoyed the noble Lord, but if I could just finish my sentence, it would be helpful, and it would probably speed up the business of the House if I could at least deploy my arguments before people interrupted them.

We have lived with this terminology of assisted dying for some time. I believe that it is patronising to the public to assume that they do not understand it. We are often criticised in Westminster and Whitehall for living in a special bubble. This seems to me a classic example of doing that. I must say that I am a little sceptical about this sudden enthusiasm for precision when we have not had much of that before.

--- Later in debate ---

[Lord Elton]

Before the noble Lord sits down, I would pick up his phrase “the Westminster bubble”. That is precisely the problem: we do live in the Westminster bubble. We think that the intellectuals who lead the political papers are the whole public; they are a tiny minority of it. The general public know what suicide is, just as they know what death is. We need to choose what the Bill is about, and a great many of us believe that it is about suicide, not assisted death.

[Lord Brown of Eaton-under-Heywood (CB)]

Of course the Bill is about assisted suicide, but equally obviously, it is expressly confined to the suicide of those who are already terminally ill—those who are therefore already actually in the process of dying; that is, dying in an altogether more meaningful sense than when one says that everybody is born to die and we are all dying. That is perfectly plain already in the Bill, as the noble Lord, Lord Pannick, said, but at the end of the day, for my part, I am entirely relaxed about this group of amendments. I urge that the House proceeds speedily to the critical issues on which the Bill should stand or fall, so that the public will in all this can be given effect. The public will not give a fig what Title is given to it.

--- Later in debate ---

[Lord McColl of Dulwich]

The problem is that when you give these very powerful drugs, the symptoms are relieved but the patient is subject to the complications of being in bed for a long time, including clots in the veins of the legs. These may dislodge, go to the lungs and kill them, or they may develop pneumonia because their breathing is not quite as effective. Those are the complications but I resist the idea that I am deliberately killing them; I am deliberately relieving all their symptoms.

[Lord Elton (Con)]

My Lords, the point has been made, as though this closes the need for a definition, that a definition in the form DS 1500, which the noble Lord, Lord Warner, and many others have referred to, has already been passed by Parliament. I merely want to say that the need for precision when it is a question of providing social services benefits in cash or in kind is much less demanding than the need for precision when the question is pulling the plug on somebody’s life. Therefore, it is not unreasonable to return to this issue.

[Lord Empey (UUP)]

My Lords, one is reluctant to become involved in a debate when so many noble Lords with senior medical and legal experience have been putting forward their interpretations. However, I want to deal with a couple of matters. With this amendment, the noble Lord, Lord Carlile, is clearly adding that a medical practitioner will have to have significant knowledge of the patient.

I want to speak on this issue because I feel that the Achilles heel of the whole Bill is that it is built on sand. It works only on the assumption that the medical profession will deliver it, whereas it is obvious to most of us that the vast majority of the medical profession do not want to deliver it. That leads us to what may be the essential contradiction or conflict in the amendment. A number of noble Lords have said that specifying six months would be an overburdensome requirement. Therefore, we have the dilemma that either you have a medical practitioner who knows the patient, knows the condition and knows how that patient is likely to react to certain drugs, or you have a complete stranger who comes in and makes a judgment on the spot, having read a medical file. I fear that a rent-a-doctor procedure will develop and will distil down to those who are prepared to do it, and that, in my view, will create a whole series of new problems.

I want to raise another point regarding these amendments. We talk about having conversations, discussions and processes. I represented an inner-city constituency for more than 25 years and my question is: with whom and at what time are people going to have these discussions, conversations and processes? At the moment, nurses hardly have time to feed patients on their ward, let alone to involve themselves in very complicated and difficult conversations, discussions and processes.

Therefore, looking at the modern-day NHS and all the pressures that it is under, to some extent we are adding a further pressure without the active support and consent of the medical profession. Also—this is the one thing that I worry about more than anything else—we are changing for ever the potential relationship between a doctor and a patient. In an inner-city area, the ordinary person will say, “Oh, here comes Dr Death. How can that person help me on the one hand and put my lights out on another?”. I fear that that is how this will be distilled down to street level.

In the amendment, the noble Lord is clearly trying to put in place the safeguard that the patient will at least be dealt with by somebody who knows him or her. I understand that and accept the rationale for it. However, there are practicalities, which have been raised by others. With inner-city practices, it is hard enough to get the patient to go to a doctor in the first place, but if they think that that doctor could at some point in their lives, as they would say, sign them off, will the amendment achieve the worthy objective for which it is meant?

The word “control” has been used a number of times. I think the noble Baroness, Lady Meacher, and others used it. One can see that people would want to have control over their lives. It could happen to any of us. But in the real world out there, many people who are seriously ill may not have the means. They do not have access to the courts, money or knowledge. Control may be all right for those of us in this House, but it is not always available to the ordinary person in the street. That is where I believe there is a fundamental weakness in this. Without the act of involvement of the medical profession who really want to do something, we are forcing them into a corner. It will inevitably boil down to a handful of doctors who will go around the country signing off people they do not know.