Assisted Dying Bill [HL]

Lord Mance Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Lord Mance (CB)]

My Lords, in my former judicial capacity in the Supreme Court in the case of Nicklinson, which the noble Baroness, Lady Bakewell, has mentioned, I was one of the clear seven-to-two majority who said that this was not a matter for judges but for Parliament to decide. In my current legislative capacity, I welcome the opportunity to join in this debate.

Suicide is decriminalised, yet assisting suicide remains criminal—probably a unique exception to the principle that you can only be an accomplice to an act that is itself criminal. If a person may choose freely to commit suicide, what justifies a refusal to allow them to obtain willing assistance? The question arises in the tragic context of imminent death where many will wish to determine the hour and manner of their death when, as we have heard, their palliative drugs may not always alleviate, and it needs answering with reference to the interests of society at large as well as all concerned.

Some may believe that the underpinning principle remains that suicide is still really a wrong, an offence against the sanctity of life even by the person committing it. Its decriminalisation is then a matter of simple pragmatism, a recognition of the incongruity of punishing people whose attempts at suicide fail. I think everyone agrees that the sanctity of life is certainly an important principle, but everyone also agrees that individual autonomy and dignity in life and in dying are two other important principles, and they can tug in different directions. A balance has to be struck.

There are many examples, some already touched on by the noble Lord, Lord Purvis of Tweed: the right of a patient to refuse or insist on the withdrawal of medical treatment, and the power of doctors, with the imprimatur of the court, to withhold further life support or sustenance and medical treatment in a case where the patient is in a state meaning that they can no longer choose for themselves, as in the famous case of Bland and the case of the conjoined twins, which I am sure noble Lords know. One important distinction drawn in those cases is between the voluntary decision of an informed adult of sound mind to do an act, including one that will or may lead to death, and the means that another person may have provided to enable that informed decision. Again, a decision in the judicial House of Lords to which I was a party, Kennedy in 2008, identifies that distinction with clarity: the second person providing the means cannot be regarded as causing the voluntary act or death of the former person.

The present Bill is very careful to recognise and give effect to that basic distinction. All that it permits is the provision of assistance to a person wishing voluntarily to commit suicide, wishing freely to choose to do that—see Section 4. Amending the Bill to refer to “euthanasia” rather than “assisted suicide” would therefore be an exercise in deliberate linguistic distortion. The Bill should not be killed by misdescription.

In summary, the Bill requires us to weigh a balance of factors: the clearly established and pressing considerations of autonomy and dignity in life and death for a narrowly defined group of persons who wish to exercise free will, and on the other hand the risks generally stated to others, particularly vulnerable members of society, who it is feared may be or feel pressured to commit suicide. In that connection, it is of fundamental importance that the Bill contains careful provisions for comprehensive medical and judicial involvement. I do not share the scepticism of the noble Lords, Lord Gold and Lord Hastings of Scarisbrick—although this is not my field—about judicial involvement. Lord Wilson in Nicklinson had no concern and indeed recommended some of the precautions that the noble Baroness, Lady Meacher, has taken on board.

Subject to listening to the rest of the debate, my present view is therefore that Parliament should accept the present carefully limited and balanced Bill. It is certainly not committing itself to striking the same balance in some other context or tailcoating on the position in Canada.