Assisted Dying Bill [HL]

Lord Purvis of Tweed Excerpts

Friday 18th July 2014 Lords Chamber

[Lord Purvis of Tweed (LD)]

My Lords, I am conscious that I am a new Member of your Lordship’s House, but it is now 10 years since I proposed my Private Member’s Bill in the Scottish Parliament to amend the law in Scotland to allow a capable adult in the particular circumstance of coming to the end of terminal illness to access the means to die with dignity. The Bill of the noble and learned Lord, Lord Falconer of Thoroton, is in identical terms, with the same safeguards and only minor differences, given the differing legal jurisdictions in Scotland and the rest of the United Kingdom. For example, the 1961 Act has never applied in Scotland, and the law of culpable homicide would apply. In turn, both were informed by the law in the state of Oregon, which has now been in operation for 17 years.

I therefore strongly support the noble and learned Lord’s Bill, but in doing so acknowledge its scope only for England and Wales, and hope that progress for reform can similarly be made for Scotland in the Scottish Parliament, where even prosecutorial guidelines such as those that apply south of the border do not exist.

It is of sadness to me that in those 10 years some people who have come to the end of their terminal illness have endured their final days in a manner they did not want, with needless additional distress for them and their loved ones. Indeed, between debates in the Scottish Parliament for my proposal, a close friend and mentor of mine—a deeply religious man who had overcome disability for many years—endured that exact circumstance and would have availed himself of the reformed law in his last week, had it been open to him; instead, food and hydration were withdrawn.

In those 10 years in Oregon, a state not too different in size to Scotland, 907 people asked for medication to be prescribed to them under law so they could take it in the final days of their life, if they so chose; 581, or less than two-thirds, did so. Since the law came into operation in 1997, the number of people using the lethal medication in their last days has ranged between five and 22 deaths per 10,000. The median time between someone who made the formal request under the law and then using it was 47 days.

What does this 17-year history show us? There has been no slippery slope. The legislation allows someone to ask for the medication and have the knowledge that it is there should they need it, and should they choose to take it. A third never did but their final days were comforted and eased by the knowledge that they could have done so. It also shows that the medication is used when the patient is really towards the end of their life, in their final days. It is not a law that has been abused; it is not a law whose scope has been widened; and it is not a law that has had a damaging impact on the palliative care fraternity, medical profession, vulnerable people or disabled people, because it is about the choices that an individual can have at the very last days of their life, with legal protections, oversight and transparency in operation.

Among other research, I spent a week in Oregon, and have retained links since, speaking with families, doctors, palliative care workers, academics, lawyers, the police, the regulators and the public. That and the continuing very close interest I have taken in the past decade have given me the confidence that if we want to change the law in this country, then we have the capacity and ability to do it well. I simply do not agree with those who say we have the capacity to legislate for profoundly complex ethical issues on birth, stem cell research, withdrawing and removing treatment, food and hydration, mental capacity, or “do not resuscitate” classifications, but we cannot do so on this issue—the final days of a terminal illness.

I found that many people criticised my Bill not for what it was, but for what they claimed it to be. I suspect the same applies to the Bill of the noble and learned Lord, Lord Falconer. It is not about suicide, or vulnerable people being pressured into suicide, or about disabled people having any other consideration than abled people. But this is indeed a profound area to debate, touching on emotion, faith, medical ethics and personal choice and autonomy. A balance needs to be brought to all those issues, within the cold operation of the law; but after a decade of work in this area, and consideration of all aspects of it, I believe now, more than ever, that it is the duty and appropriate time for Parliament to conduct calm, confident lawmaking with evidence-based judgments. We temper that with a thread of humanity and compassion, and we should draw the conclusion that it is right that this Bill progresses.