Assisted Dying Bill [HL]

Lord Mawson Excerpts

Friday 18th July 2014 Lords Chamber

[Lord Mawson (CB)]

My Lords, it is good that we are having this debate today, but I am afraid that I cannot give the Bill my support. I will set out a few reasons why.

First, the Bill seems to assume that we live in a rational world and that families and individuals can be trusted to behave in a rational manner and make rational decisions when faced with the trauma of losing a loved one in the circumstances that the Bill describes. As a jobbing clergyman who has spent the past 35 years of my life working with probably some of the most vulnerable families in this country, and who has presided over what must be hundreds of family bereavements and funerals, which have been both a great privilege and a responsibility, I know from experience that reason and rational behaviour are often not what we are dealing with in crises like these. Individuals and families say and do many things when they are vulnerable, which they regret later but at the time seem all too clear.

Anomalies exist which show that people change their minds over whether they want to live or die. The body often needs time to adjust to severe injuries and illness. An intelligent debate has to acknowledge these anomalies. Life is not a simple process of rational judgement and behaviour—far from it. It is very complex.

In writing this speech, I am conscious of a number of people who have relayed their family stories to me in recent weeks. I think today of the young Bengali man who faced a moment such as that which this Bill seeks to legislate for. Life seemed to be at an end; the illness he was diagnosed with and the prognosis seemed at the time all too clear and he wanted to die. However, because of the present legislation, time was on his side. Only months later he made a considerable recovery and today lives a good life. Those who say they want to die are always profoundly tied up in a complex set of social, cultural and family relationships, and pressures that an outsider will have limited understanding of.

I always tell people who do not come from Yorkshire that to understand us, you have to be one of us—or forget it. Imagine a western doctor trying to understand the inner emotions and family conversations taking place with this Bengali man. I have worked with this community for 30 years and am still struggling to understand the inner workings of another culture I am not a part of. Are we saying in this case that it would have to be two Bengali doctors who make the decision and, if so, which bit of Bangladesh would they be expected to come from? Could we be certain that there would always be a Bengali doctor on hand? Indeed, if there was, how would we test what family connections there were and what family conflicts there had been in the past that the doctor might be unintentionally connected with? This is all subtle stuff for all of us, often unspoken and a can of worms. All our family cultures are a can of worms. What training do our doctors have to be able to demonstrate this wisdom of Solomon in our inner cities when we live in multicultural communities? When faced with a human circumstance like this, they will simply see the world through a biomedical prism. They will be unsighted, I suggest, on nine-10ths of the human picture that will affect the decision.

Secondly, we tend to have a blind faith that doctors and social workers will protect the vulnerable, yet we are given daily examples where we are failed by specialists. It has been my great privilege over many years now to work with some very good and trusted doctors, but it has also been my lot to have to sort out a number of doctors who were not trustworthy—indeed were downright dishonest—and had other agendas on their minds than that of the patient. Doctors are not gods, they are people, and the culture of the NHS is very prone to taking simple legal safeguards and slowly, over time, building a whole culture around them that has many unintended consequences. I have buried people who paid the price for this incompetence and cultural malaise. The health service is in some chaos at the moment, with healthcare professionals rushed off their feet, and the idea that doctors will have the time, let alone the competence and space, to deal with these very challenging matters properly seems fantasy to me. How will this work in practice in the present climate in the health service?

Finally, so much of this debate has been about, “Me, me, me; my rights, my life, my choice”. Yet we human beings are fundamentally social creatures; we are not islands floating aimlessly in a sea, but are part of a family, a community and a culture. What we do as individuals has profound rational and irrational affects upon us all. Human beings can achieve great things, but we can also behave like sheep, and once the herd starts to move on this it may well move together and we will not be able to stop or fully understand its inner logic. The people who will pay the price will be not the well meaning but the vulnerable.