Terminally Ill Adults (End of Life) Bill Debate

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Department: Home Office

Terminally Ill Adults (End of Life) Bill

Lord McCrea of Magherafelt and Cookstown Excerpts
Lord McCrea of Magherafelt and Cookstown Portrait Lord McCrea of Magherafelt and Cookstown (DUP)
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My Lords, we have heard a variety of opinions, and I wish to express mine on what is a vital issue: that of life and death. As a gospel minister, I have been present at the sick and dying beds of so many of my fellow travellers to eternity. It can be a difficult and heart-breaking experience for the individual and their loved ones. But sickness is a reality for us all at some time in our lives and death is inevitable; we all must needs die. Death passes no dwelling, whether the occupant be rich or poor. It is a great leveller.

I thank those who sent me numerous letters and emails, from deeply concerned individuals, health professionals and organisations expressing various viewpoints. We in this House must made a decision about the legislation presented to us. I unashamedly state that I believe that human beings are unique among God’s creatures in being made in the image of God. When our first parents rebelled against the revealed will of God, they chose their own way and nothing has changed, for the accepted opinion of society today is “It’s my body, my life and nobody can and should tell me what to do”. As in the Book of Judges, every man did that which was right in his own eyes. I know that philosophy is very popular today. Not one of us decided when we would be born, and the cardinal question is: have we the right to decide when we should die? Again, the word of God says that it is appointed unto men once to die, not appointed by them. We live in a secular society that has pushed God out of its reckonings, and it wanders on aimlessly and hopelessly, seeing little reason or meaning in life itself.

Each of us can mention individual harrowing cases of the severe struggles endured in life and the pain of death suffered by our fellow human beings. Some conclude that the answer to these stories of human suffering is to assist the person to end their life, rather than improve the management of the end of life.

The Bill makes it a legal right for patients to access assisted dying, but does not mandate a comparable right to access other end-of-life services. We are aware that patients with a diagnosis of a terminal illness are very vulnerable and weak, and that elderly people are at serious risk of coercion and left to feel that they are only a burden to their families. I have heard that so many times in my ministry.

Estimating how long a patient will survive is also, at best, very difficult, even for specialists. I know of patients who were given a three or six-month prognosis who are still alive today three years later, enjoying life and making cherished memories with their loved ones. Were they to act on a similar prognosis using the Bill, that decision would be fatal and final.

The legislation before us is called the Terminally Ill Adults (End of Life) Bill, but, in reality, it is assisted suicide. Euthanasia is killing and, in most countries, killing another person is considered murder, even if the intention is to ease the pain or if the person has a terminal illness. Giving one category of sick people a legal right to exercise autonomy by killing themselves logically opens the door to, and creates the legal conditions for, expanding it to others. Indeed, an expansion has already been supported by some of the groups that are supporting the Bill.

It was only last Wednesday that we marked World Suicide Prevention Day. Today we are debating a Bill that creates an exception. One day we tell them, “Don’t give up”, but at the same time we make legislation to allow the NHS to give drugs to make people end their lives. Some years ago, Parliament rejected capital punishment on the basis that, if one innocent life was taken, it would be one too many. I ask: how many innocent elderly or sick people will die through this legislation if it is enacted? I have no doubt that the number will be great and I strenuously oppose the Bill.

Terminally Ill Adults (End of Life) Bill

Lord McCrea of Magherafelt and Cookstown Excerpts
Lord Shinkwin Portrait Lord Shinkwin (Con)
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My Lords, I thank the noble Baroness, Lady Finlay of Llandaff, for her amazing dedication to her patients. That is beyond question. I hope we are united as a House in paying due respect to that fact and also to the fact that her professional experience is a tremendous asset to this House.

The noble Baroness, Lady Finlay, spoke of her professional experience, and I will speak very briefly of my lived experience on the other side of the table—or the bedside—as a patient. She mentioned Dame Cicely Saunders and the reference to total pain. I simply say that I have been there. My disability has taken me there far more times than I would like to remember. It is awful. The bottom falls out of your world, and your capacity to think clearly, rationally and normally evaporates. So I simply say that it is crucial that patients have the ability to choose: the choice between assisted death and specialist palliative care—a choice that they do not currently have.

I simply finish on this point. Other noble Lords have mentioned the Royal College of Psychiatrists. I ask the Committee to take note of the fact that the Royal College of Psychiatrists states that applying the Mental Capacity Act to the decision to end one’s life is an entirely novel test—in “uncharted territory”, with “no experience or precedent”.

Lord McCrea of Magherafelt and Cookstown Portrait Lord McCrea of Magherafelt and Cookstown (DUP)
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My Lords, earlier on in the debate, there was a discussion concerning members of the committee, on who was or was not called, or who was denied the right to be called to it. I suggest that the straitjacket of the time this House allocated probably did not allow the relevant committee the appropriate time to call everyone that it thought was appropriate. It ought to have been given more time, but it seems that it had to be rushed.

Concerning the Mental Capacity Act, Margaret Flynn, chair of the National Mental Capacity Forum, said it was designed to protect us

“when others start to make decisions about our lives … Assisted dying was not on the table during the Law Commission’s consultation which resulted in the MCA”.

Therefore, the suitability of the Mental Capacity Act 2005 as a test for a decision to end one’s life is a major source of debate. I believe the many experts and professionals arguing that it is insufficient for this specific irreversible decision.

The MCA was not designed for assisted dying. It was created to safeguard people who lack capacity in decisions about their care, treatment or finances. Assisted dying was not on the table during the Law Commission’s consultation. The Royal College of Physicians, as the noble Lord said a moment ago, said that applying the MCA to the decision to end one’s life is an entirely novel test in uncharted territory with no experience or precedent. It is a very low threshold. The Royal College of Physicians argues that assessing a person’s mental capacity to decide to end their life is an entirely different and more complex determination, requiring a higher level of understanding than assessing capacity for treatment decisions.

Lord Scriven Portrait Lord Scriven (LD)
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I have listened very carefully to the noble Lord and a number of others. I am still struggling to understand what the higher test of ability would be, over and above the Mental Capacity Act. Will the noble Lord let the House know what that higher test is that people would have to go through on ability rather than capacity?

Lord McCrea of Magherafelt and Cookstown Portrait Lord McCrea of Magherafelt and Cookstown (DUP)
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The noble Lord knows that I am not a proposer of the change of words. I am dealing with capacity. Therefore, I am also dealing with the fact that professionals within the field have stated that to use the Mental Capacity Act for a decision to end one’s life is an entirely novel test and uncharted territory for which there is no experience or precedent. That is not my statement; that is the statement of professionals within the field. They say also that to decide to use it for the decision to end one’s life is an entirely different and more complex determination requiring a higher level of understanding than assessing capacity for treating decisions.

Capacity can fluctuate in terminally ill patients due to physical fatigue, illness, medication or delirium, making the irreversibility of the decision risky under this framework. Therefore, I ask this Committee to think carefully in trying to base its whole argument on this being good legislation because mental capacity is the deciding factor.

Lord Deben Portrait Lord Deben (Con)
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I wonder whether I can help the Committee. I think we may be discussing two rather different things, so I suggest that we decide which of them to discuss.

There is the discussion as to whether the word “capacity” really includes all the things that people are pressing for when they use the word “ability”. That is the point that the noble Lord, Lord Pannick, was clearly making when he expressed the nature of the word “capacity” as used in law. It is perfectly understandable that people would want to say, “Here is a word that we use. It’s a word which is defined and has been defined over a long period of time. Therefore, it’s stood the test of time”. I understand the noble Baroness, Lady Andrews, who rightly mentioned the amount of time that had been taken to deal with that.