Previous Section Back to Table of Contents Lords Hansard Home Page

Earl Russell: My Lords, I beg my noble friend's pardon, but as one who, having listened to a major part of the debate, has not yet managed to reach a conclusion, I wonder whether I could ask him for some help on priorities. It seems to me a debate in which both sides are right. When the noble Baroness, Lady Cumberlege, says, "Where there's a will, there's a relative", no historian would deny it. But when the noble Baroness, Lady Flather, says she could not insist on the infliction of further gratuitous pain, "Because I love him", I can see no answer to that. We cannot have

6 Jun 2003 : Column 1677

both these arguments at once. Can my noble friend tell us why one of these arguments is more valid than the other?

Lord Clement-Jones: My Lords, I can only reflect on personal experience. My late wife was a doctor who regularly treated terminally ill patients. One of the big issues for a young doctor is coming face to face with the fact that quite often you cannot actually do anything about the matter. We are not omnipotent. I do not want to give doctors the power of death over their patients simply because we believe there is no other solution. That seems in many ways to be at the core of the argument. We cannot solve every problem. Of course, in this society, where we all believe in choice and personal autonomy as far as possible, we should try and give that to people. But there are broader issues at stake here. I very much hope—

Baroness Flather: My Lords, I must ask the noble Lord's forgiveness, but it is not about giving the doctors the choice or giving society the choice, but giving the choice only to the patient.

Lord Clement-Jones: My Lords, I entirely accept what the noble Baroness says, but ultimately it is the doctors who will have to assist the patient. They will have the responsibility, under the legislation, of carrying out the patient's wishes. That places a considerable burden and responsibility on doctors.

Other polls of doctors have demonstrated pretty much the same in terms of the overwhelming desire of the medical profession not to have these powers. Other clinical professions, such as nurses, are relatively unpolled. I believe that the outcome of an opinion poll among most of the caring professions would have virtually the same outcome.

The noble Lord, Lord Joffe, has drafted the definitions and safeguards in the Bill extremely carefully. But as members of the Royal College of Physicians say, there are major issues surrounding the definitions. How will a doctor ascertain whether a patient is suffering a serious and progressive illness? What constitutes a serious and progressive illness? Would rheumatoid arthritis and diabetes fall within that category? Terminal illness is defined as an incurable and physical illness with a prognosis of death within six months. But this is a deeply uncertain area. My late wife had a prognosis of only three months, yet she lived a triumphant five years further, and set up CancerBACUP in the process. With progress in medicine, one never quite knows at what point the prognosis is correct. As a number of noble Lords have pointed out, the diagnosis of depression is deeply uncertain. It is a crucial area because, as another noble Lord, pointed out, one in four people suffer from it.

How will unbearable suffering be ascertained in any objective way? Surely it is unique to the patient, as the noble Baroness, Lady Finlay, pointed out. When does a clinician decide that that boundary is crossed? There is no duty under the Bill to notify the next of kin. I believe that, despite the safeguards in the Bill, it is a very uncertain instrument. Indeed, the noble Lord,

6 Jun 2003 : Column 1678

Lord Joffe, in commenting on the current regime, said that there is a gap between what the law says and what happens in practice. That would be very much the case if this legislation were passed.

Can euthanasia be policed effectively? As a result of the Bill as drafted, and the likely change in cultural climate, can we be sure that the lives of those who do not want to die will be protected? In its report, the Select Committee of the House of Lords said that,

    "it was virtually impossible to ensure that all acts of euthanasia are truly voluntary and that any liberalisation of the law in the United Kingdom could be abused".

I agree with that.

Finally, there is the potential cultural climate created by the Bill. I agree with the noble Baroness, Lady Masham. Sick and disabled people may be made to believe even more than they do today that they are a burden on society or their relatives. A climate would be created where euthanasia is seen not just as acceptable but perhaps as desirable. I believe that sick and disabled people would feel pressure. A negative climate towards terminal illness could be created; and there could be a major impact on the disabled.

The noble Lord, Lord Neill, spoke eloquently of the kinds of family pressures that could prevail. The Association for Palliative Medicine and the National Council for Hospice and Specialist Palliative Care Services say:

    "The evidence from all jurisdictions [is] that voluntary euthanasia leads to a rise in non and involuntary killings".

They claim that it represents a paradigm or cultural shift in attitudes to intentional killing. That is the key. The "slippery slope", "thin edge of the wedge" argument is not the point. It is the creation of a culture which changes society's attitude towards this kind of killing.

It is not surprising that there is a great deal of insecurity and unhappiness on the part of disabled people and their supporters about the Bill. But as noble Lords understand from those three key points, my grounds of opposition to the Bill are not moral or religious. They are essentially practical. The arguments I make are not conclusive. They are matters of opinion about risk. At the end of the day, therefore, I believe that we must keep to the status quo until we have good evidence to the contrary. We need to look carefully at the experience of those jurisdictions where euthanasia is now legal.

We have batted around various papers and evidence from Belgium, Holland and Oregon during the run-up and in the debate today. On those grounds alone, I support the suggestion of the noble Baroness, Lady Jay, of a Select Committee on the specific area of patient-assisted suicide. Despite what my noble friend Lord Taverne said, the current evidence is conflicting. Some recent papers say one thing; earlier papers say another. The methodology in those papers differs considerably.

All noble Lords have made the point—it is the one area of great unity—about the need across the country for universally good palliative care. Of course, there have been great advances in palliative care and the

6 Jun 2003 : Column 1679

treatment of terminal care, certainly over the past 15 years. If it were possible to go down this avenue, I am concerned that there would be less concentration on palliative care. I recognise that it is not possible for medicine to solve every problem. I simply do not believe for the sake of society that assisting death is the way forward in order to cure that specific problem.

Those who oppose the Bill come from a wide spectrum of opinion, far beyond the usual pro-life coalition. I refer to the British Medical Association, the Royal College of Physicians, the Disability Rights Commission and Help the Aged, in addition to the bulk of Church opinion. So although we may be extremely civilised in the treatment of the Bill, I hope that your Lordships will not allow the Bill passage through the House.

5.14 p.m.

Lord McColl of Dulwich: My Lords, I, too, thank the noble Lord, Lord Joffe, for the care with which he has prepared the Bill. He is clearly motivated by a deep compassion and has spent a great deal of time and expense in crafting the Bill.

This has been a long and serious debate but well balanced with a good sense of proportion, unlike a paediatrician colleague who got somewhat carried away at a conference on the care of the new-born, when he said, "The first few minutes of life are the most dangerous". An elderly man in the audience shouted out, "The last few minutes are pretty dangerous too".

Although we on this side of the House respect the noble Lord, Lord Joffe, the Conservative Party, like Her Majesty's Government, oppose the Bill. We are in good company, with the Royal College of Physicians, the World Medical Association, the British Medical Association, the Disability Rights Commission, Help the Aged and leaders of all the great faiths. We cannot support the Bill.

The reasons for opposing the Bill were well stated in the House of Lords Select Committee report on euthanasia, on which I had the privilege to serve. We have great sympathy with those who have motor neurone disease, in particular, but making law to deal with the plight of the few will jeopardise a large number of even more vulnerable people. As the noble Lord, Lord Phillips of Sudbury, stressed, hard cases make bad law. Samuel Johnson said much the same when he said:

    "Laws are not made for particular cases but for men in general".

It is the job of government to protect the weak, the vulnerable, the elderly and the dying. Our committee had no doubt that, no matter how carefully the Bill was worded, it would prove impossible to prevent intolerable pressure, either real or believed to be real, being put on elderly people to embrace euthanasia to reduce a family financial or nursing problem. The right reverend Prelate the Bishop of Oxford referred to that matter.

6 Jun 2003 : Column 1680

One of the more puzzling parts of the Bill is the Long Title, which states that the Bill makes,

    "provision for a person suffering from"—

a terminal illness—

    "to receive pain relief medication".

Doctors and nurses are giving pain relief medication every day. Perhaps the noble Lord, Lord Joffe, could explain why that is mentioned.

Next Section Back to Table of Contents Lords Hansard Home Page