Health: End of Life

Lord Purvis of Tweed Excerpts

Thursday 12th December 2013 Lords Chamber

[Lord Purvis of Tweed (LD)]

My Lords, I am new to your Lordships’ House but not new to this issue. It is a privilege to follow the noble Lord, Lord Joffe, as it was the fact that his Bill did not cover Scotland that was, in part, the reason for me lodging a Private Member’s Bill in the Scottish Parliament in 2005.

My Bill did not propose euthanasia, and nor did it concern all adults. It did not concern the elderly, the infirm or the depressed. It concerned mentally competent adults coming to the end of a terminal illness who were seeking to be able to choose the precise timing of their death. Many of those who opposed my Bill did so by opposing things that it did not stand for. The issue is now being carried forward ably in the Scottish Parliament by the independent MSP Margo MacDonald.

It is a personal sadness to me that in the eight years since my proposal people have continued to come to the end of their life without the legal protection for them to choose how to spend their final days. The law gives some protections, but they are primarily not for the patient.

After a landmark case in Scotland in 1996, the then Lord Advocate, the noble and learned Lord, Lord Mackay of Drumadoon, issued a statement that he would not authorise the prosecution of a doctor if the doctor, acting in good faith and with the authority of the Court of Session, withdrew life-sustaining treatment from a patient with the result that the patient died. Commenting on the case, Professor Sheila McLean of Glasgow University’s Institute of Law and Ethics in Medicine said:

“What our law does, therefore, is to endorse decisions which will result in the deaths of certain patients (most notably those who cannot express a preference) but not those who are competent to ask for aid in dying”.

There are further protections for the medical professions if they stop medical treatment that is keeping a patient alive but not making them better. Such futile treatment, as so defined, can be withdrawn, as they describe, without legal repercussion. Indeed, mention has been made in the debate of the double effect. However, if a mentally competent patient who is coming to the end of their life wishes to choose the precise timing of their death, no protection is allowed for—unless, of course, they wish to starve without hydration and to have their treatment withdrawn.

What is also indefensible is the current state of affairs in Scotland, where people do not even know if they may be prosecuted for supporting the choice of a patient to travel somewhere that does afford them that protection. As noble Lords will be aware, the DPP guidance does not apply to Scotland. The previous guidance had been provided for the medical professions, but successive Lord Advocates have repeatedly refused my calls for greater clarity for those who are coming to the end of their lives. This is quite simply a horrendous status quo, and the Scottish authorities need to act to remedy it.

I led a debate in the Scottish Parliament in similar terms to those of the noble Lord, Lord Dubs, to whom I pay sincere tribute for bringing this issue before us today. The debate was held in the Scottish Parliament on Wednesday, 26 March 2008. The preceding Saturday I had been with a lifelong friend and mentor of mine who was in palliative care in Berwick-upon-Tweed. In the debate I said:

“He is a man of strong faith. He told me that he knows that he is leaving this world for a better one, and that his time to do that is now upon him. He has asked for treatment to be withdrawn and is now receiving only increasing amounts of palliative medicines ... He told me that he is not afraid to die, and he has made the arrangements for his funeral. He has instructed that it will be forbidden for anyone to cry at his thanksgiving … My friend has celebrated life all his life and has helped others … he has asked us, if we remember his life when he is no longer with us, to ensure that other people’s wishes can be respected as they approach the end of their lives, if his wishes cannot be respected”,

in asking for assistance at the end of his. His refusing medication and then food and water finally took its toll and, three days after my debate, he died.

Let us in this place recognise that we enhance society, we strengthen life and the love of our loved ones, and we cherish life more, if those who request it are given the protection in their final days that is currently denied them.