Health: End of Life

Lord McColl of Dulwich Excerpts

Thursday 12th December 2013 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, if it was possible to choose the occasion of one’s death by electing to be killed, it would create an escape route at the onset of an illness which, given time, would take away one’s independence and one’s mind. It would be an escape route from the fear of indignity and suffering. I understand that fear only too well. My wife, Jean, died last year having had dementia.

I have drawn two conclusions from my experience. First, it is imperative that we care for those who are suffering in this way and that we treat them with dignity. We need to create a society in which such care and treatment is the norm. I am so grateful to those of your Lordships and, especially, the doorkeepers and security officers who treated Jean with dignity and extended many kindnesses to her. It is so important to invest our time and resources to ensure that dementia patients receive proper care. Secondly, dependence is natural at certain stages in life. All of us were dependent on others at birth and for a considerable time thereafter. Dying is part of living and during that time we may be dependent on others. Why should that be a fearful thing? It is probably because our society prizes independence and schools us into it at an early age. We need to revisit this and to be educated to appreciate that dependence is no cause for shame.

The choice that I would like people to be able to make at the end of life is a choice to go on living in the assurance that they will be cared for with compassion and not ignored or regarded as a burden. All sides of this debate recognise that if assisted suicide is to be legal, there must be safeguards. Many of us believe that it is not possible to legislate for adequate safeguards. That aside, it is pertinent to ask whom the safeguards are intended to protect. It is sometimes assumed that it is only the would-be suicide who needs protection. Indeed, he or she does need protection, but society as a whole is also in need of protection from changes in the law which may have a deleterious effect.

There is a danger of confusing the role of the health professional and undermining the trust which exists between doctor and patient. At present, the health carer’s mandate is crystal clear. It is always to care and never to kill or assist in killing. One cures by treating the patient and eliminating the disease. Eliminating the patient is not treatment, no matter what the patient may request. Where one cannot cure, society should provide care. At present, the provision of adequate care is patchy and uncertain, and this needs to be addressed urgently.

If one was to legalise assisted suicide, one would be setting up independence as a quality whose worth is greater than life itself. What would such a society be saying to disabled people and the mentally ill? As the New York State Task Force on Life and the Law reported:

“The legalization of assisted suicide would itself send a message that suicide is a socially acceptable response to terminal or incurable disease. Some patients are likely to feel pressured to take this option, particularly those who feel obligated to relieve their loved ones of the burden of care. Those patients who do not want to commit suicide may feel obligated to justify their decision to continue living”.

While those who champion the legalisation of assisted suicide do so, I am sure, with the best of motives, I believe it to be a profound mistake. For these reasons and others, which time does not permit me to address, I believe that our energies and resources are best spent on improving the care that is available so that people can choose to go on living with confidence that they will not be neglected.