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However, the articles in the British press, as well as highlighting those who have gone to Dignitas, have also importantly exposed just what has been going on at Dignitas. Ludwig Minelli, its founder manager, wrote to me and the letter is in the Library. He said that he felt that he should make sure that suicides were complete because of the healthcare costs of failed suicides. His nurse, Soraya Wernli, who was working for him when the Select Committee visited, has blown the whistle and gone to the Swiss authorities, having become so disturbed by what she has witnessed. The attorney-general of the canton of Zürich warned the Select Committee that there is no surveillance and no state control, yet this amendment encourages more British people to place their relatives in the hands of Mr Minelli.

The noble and learned Lord, Lord Falconer, said that at present there is nothing to stop people going off to Switzerland without any check on their mental or physical state. Therein he recognises that there are no adequate controls at Dignitas, yet he proposes that we facilitate people going there. In the past 10 years we have had 37,000 suicides in this country and 27,000 open verdicts. Suicides are tragic. Those were all people who felt that they would be better off dead. The amendment invites us to endorse the view that for some, the terminally ill, there should be assistance. Should we really be setting less value on the lives of those who are seriously ill than on those who feel that their lives, for whatever reason, hold for them no value and no future? The law sends a signal. This amendment will preferentially attract those whose motives are dubious in assisting the foreshortening of a relative's life through suicide because its so-called safeguards are illusory. I understand that this would be the only time someone would have immunity from potential prosecution in advance of an event.

No matter what you feel about assisted suicide or euthanasia, we have a duty to look very carefully at the words before us. The amendment provides far fewer safeguards than earlier assisted suicide Bills put forward by the noble Lord, Lord Joffe, and the House rejected those as unsafe. It should give the same response here.

Baroness O'Neill of Bengarve: Most of the arguments that I would have wished to put have already been put very much better by other noble Lords with medical and legal knowledge. The most impressive argument is that we have to take account not merely of compassionate assistance but of interested assistance and it is extraordinarily difficult to imagine any drafting that would do that.

I wish to draw attention to one aspect of the drafting of the amendment, about which I am still very unclear. In subsection (1)(a) the safeguard is that,

An intention which is solely or principally for a certain purpose gives one the idea that what is at stake is one last holiday in Switzerland and is perhaps solely or principally for the purpose of travel. We all know that the circumstance which we are discussing is not solely or principally for assisting travel. It is principally for

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assisting someone to reach a territory where they can have assisted dying. Therefore, I cannot see that there could be cases that would meet the provision of this amendment in its own terms.

Lord Elystan-Morgan: I should like to follow the point made by the noble Baroness, Lady O'Neill, and suggest that the most important word in subsection (1)(a) of the amendment is the word "travel". However, my point is slightly different from her point. As the noble Lord, Lord Lester of Herne Hill, said, the sole limit of this amendment is to exculpate those people who assist in making travel arrangements and who travel. I see the noble Lord nodding. If that is literally the case as the amendment has been drafted, as I believe it inevitably to be, then it must mean that the amendment will totally fail in its purpose of exculpating persons who go with their loved ones to a clinic in Switzerland or somewhere else for this purpose.

Imagine that the family has arrived in Zurich at Ludwig Minelli's clinic. The travel is over. They see a doctor; there is consultation. They are there to give moral support and presence to their loved ones. They are there at events leading up to death. They are clearly giving aid and comfort-as is their very purpose, the purpose of their presence there. But the travel is over. That means that all those acts-and they are the crucially important acts-would be beyond the scope of this amendment.

Lord Falconer of Thoroton: I apologise for interrupting the noble Lord. There are two separate answers to that and perhaps he would like to consider them in his reply. First, acts that take place outside Britain altogether at the moment are not thought to be a crime anyway under the Suicide Act. Secondly, subsection (4) of my amendment deals with it.

Lord Elystan-Morgan: Those two submissions raise a number of different questions and, in any event, it probably would have been possible by a very simple amendment to have corrected the difficulty. However, I raised that point because it is one that obviously calls for far greater consideration.

The main argument put forward by the noble and learned Lord is that the law, in relation to the 115 families that have gone to Zurich, has fallen into desuetude. I do not think I am doing them a disservice by summarising it in that way. The noble and learned Lord says the law has not been operating-but the law is being operated. Each and every one of those cases is examined by the Director of Public Prosecutions. He is not oblivious to what is happening; he is charged with a specific task. He is charged with a task and responsibility of acting in a quasi-judicial capacity to determine whether prosecutions should take place. That is not unique in any way to this particular law, nor indeed to dozens of other laws that we still have on our statute book. There is nothing capricious in the function of the Director of Public Prosecutions in that case: he is exercising a judicial role in a very disciplined and consistent way. Therefore, to pretend in some way that the law has fallen into desuetude and that consequently there is not only justification, but even demand, for this amendment is wholly fallacious.

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Again, it is wholly fallacious to say that this is just a cosmetic change- a minor matter which acknowledges the situation as it exists at the moment. Not at all. Is there anybody in this House who believes that, if this amendment were carried, it would not inevitably lead to legalising physician-assisted death in the United Kingdom? Many slippery-slope arguments are less than worthy, but I believe it wholly inevitable that that is what would happen. What one has to consider are not the compassionate arguments-and there are compassionate arguments in relation to this huge problem. I saw my mother wither and die when I was a small boy and I saw my wife go through the same torture about two and a half years ago. I am not without feeling for people who are in the situation of being in extremis. But what we have to consider is the effect that it has.

John Donne said:

"Any man's death diminishes me, for I am involved with mankind."

He was not speaking as a priest of the Anglican Church, which he was: he was speaking as a humanist. He was saying that the institution of life itself is diminished by every single death. How much more is it diminished by a deliberate death? That is the situation. We have to ask ourselves, "What messages would reverberate from this House if this amendment were to be carried tonight?"

What of the hundreds of thousands of people who at this very moment may be saying, "Well, life isn't worth it. I'm hanged if I know if I can face the very next day, let alone the next week". What effect would it have on those people? Logically, there is no causal connection between this amendment and their state of mind, but one knows psychologically that there will be. Logically, there is no reason why palliative care should be regarded as less important than it is. Britain has made splendid and honourable strides in that field, but psychologically it could well have that effect because people could say, "There is a very clear exit that is an alternative to it". What would happen in the nightmare situation in a place like Bridgend? This amendment certainly will not help that.

6.15 pm

Lord Turnberg: I speak simply as a medical practitioner when I say I have every sympathy for those unfortunate patients and carers who find themselves in the horrible position of those examples we have been hearing about. However, when one hears of what goes on at Dignitas-where, in an unregulated hotel room, an unregulated non-medical enthusiast helps anyone who wishes it to commit suicide-it is difficult to have much confidence that this is what we should be encouraging.

I have another concern. I refer to the effect of accepting this amendment on any future Bills which are likely to come before this House along the lines of the assisted dying Bill that we have hitherto rejected. Imagine the discussion we will have, and the clearly illogical and somewhat ludicrous position we will then be in, where a relative can quite legally take a person abroad for assisted suicide, but could not do so in the United Kingdom. Passing this amendment here and

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now would make it quite inconsistent of us not to pass such a Bill in the future. It would, in effect, short-circuit the sort of detailed and considered debate that we will need about the pros and cons of an assisted suicide.

For that reason, I believe we should await a fuller consideration at that stage. If a new assisted dying Bill was to be passed after a full debate, then we would not need this amendment. For that reason, I oppose it.

Lord Goodhart: In 1961, we in the United Kingdom were humane enough to remove suicide itself from the list of crimes. That prevented the possibility that people who had failed in a suicide attempt could find themselves facing a trial in court. I doubt whether anyone would want to revert to making suicide itself a crime. The Suicide Act 1961 left aiding or abetting suicide as a crime. I believe it was quite right to do that. Most people who commit or attempt suicide do so because they are suffering from severe depression or because they have been overwhelmed by some crisis in their personal lives. These people should not be helped to commit suicide; they should be helped out of their wish to kill themselves and restored to normal life.

Terminal illness is not in itself a justification for assisting a victim's suicide. Most of us will, at the end of our lives, suffer from a terminal illness, but few of us, I suspect, will commit suicide. Many people who become terminally ill will receive palliative care. For many people, and many diseases, it works, and all of us respect the noble Baroness, Lady Finlay, for the work that she has done in that field. However, for a small number of people and a small number of diseases-notably, motor neurone disease-palliative care is in many cases insufficient. The last weeks of the people who suffer from those diseases will be grim, painful and degrading, and I do not believe that they are acting wrongly in wanting to commit suicide to cut short a horrible ending. If they need help, I do not think that their helpers are acting wrongly in giving them that help. That is why I support the amendment.

The noble and learned Lord, Lord Mackay of Clashfern, based his argument on respect for human life. My argument is also based on respect for human life. When someone close to the end of their life, in pain and distress, wants to die, it is no respect for their life to force them to stay alive. That is why I believe that the amendment is justified.

Baroness Campbell of Surbiton: Before I begin, I need to remind the Committee that the usual channels have allowed my noble friend Lady Wilkins to finish my speech should I be unable to do so, but I hope to be able to do it myself, as I have a lot to say on this issue.

I shall speak against the amendment moved by the noble and learned Lord, Lord Falconer. It is the overarching intention of the amendment that I want to address; I shall leave the detail of the legal implications to my noble and learned friends. The culture that the amendment will bring about is something that I think noble Lords need to think about. I simply point out that if we go with the amendment, we turn the traffic lights from red to green on state-sanctioned assisted dying, albeit in another country.

Be under no illusion that this is not about disability. It is. I tick every box of the definition of the noble and learned Lord, Lord Falconer, for going to Switzerland

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to die. I could go tomorrow and, believe me, I would have no problem persuading two doctors. Indeed, three years ago, two doctors persuaded me that my life was at an end and that it was time for me to go on my way, as they put a DNR notice on my medical records. So it is about disabled people, and it is about people with terminal conditions.

Many of your Lordships will remember that these issues were discussed in much detail when the Assisted Dying for the Terminally Ill Bill, introduced by the noble Lord, Lord Joffe, was debated in 2004. I did not have the honour of being a Member of your Lordships' House at the time, so I was not in the Chamber. However, I was not far away. I was across the road in Old Palace Yard with more than 100 other disabled people with terminal conditions-motor neurone disease, multiple sclerosis; you name it, we were there. We were protesting against that Bill. We were not alone. Many people joined us.

Why were the terminally ill there? Why were disabled people there? After all, the noble Lord, Lord Joffe, had stated time and again that his aimed was to help us. We were there for a very simple reason: because we feared for our lives and the lives of hundreds of other disabled people if the Bill were to become law. Our belief was that if the state were to sanction any person to assist another in the ending of that person's life, it would switch the mindset of doctors and those who would help us in this country to thinking that that is what we really want-the very people who need every encouragement to live and not to succumb to society's prevalent view that our situation is so tragic, so burdensome, so insufferable that surely we must want to die. It takes an extraordinary will to rise above such views, and many do not, especially when those views are held by our loved ones. That is when it is the hardest.

Concern about the Assisted Dying for the Terminally Ill Bill led to the formation of an organisation that we naughtily called, Not Dead Yet UK. I have T-shirts at home; you can have one if you like. The name is taken from the long-established group of disabled and terminally ill people in the United States. Their experience of Oregon, and the potential for other states to adopt similar legislation, has heightened the fear of disabled and terminally ill people in America. It has not lessened it. It does not bring comfort, as so many people think that the amendment will bring in this country.

Noble Lords will be aware that not a single organisation of or for terminally ill people or older people supports this assisted dying legislation. That includes organisations that advocate on behalf of people with motor neurone disease and multiple sclerosis-two disabling conditions that are often referred to when describing who would benefit most from the legislation. Today, an open letter imploring noble Lords to resist the amendment was delivered to a newspaper with more than 20 signatories from disabled leaders and organisations for disabled people, including the chief executives of Radar and the National Centre for Independent Living.

With the exception of a few vocal-and, I have no doubt, sincere-disabled individuals, assisted dying is not supported by the very people whom it is intended to benefit. Its advocates are people who fear disability

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and terminal illness: people who have witnessed the progressive nature of disability or illness but who have not experienced it-a natural reaction, you may think, to any dramatic circumstance, but to suggest assisted dying or this amendment is to abandon hope and to ignore the majority of disabled and terminally ill people whose lives benefit us all.

6.30 pm

Baroness Wilkins: This House has repeatedly taken the view that it cannot support assisted dying. Proponents for a change in the law have brought several Bills to this House, each more tightly drawn than the last. However, your Lordships have seen through that tactic and held firm. I believe that these amendments are being used in another attempt to find a chink in your Lordships' armour. The justification given is that they are merely devices to bring the law into line with current practice. I do not believe that. I believe that they are intended to establish the precedent that assisted dying be sanctioned by the state. Where the deed is done is irrelevant.

I am sorry that some see this as merely a legal puzzle that can be solved with precise drafting of legislation and that it is possible to help the few while protecting the many. That is not the experience in either the Netherlands or Oregon, where the laws have been used to establish death as an option for all disabled and terminally ill people to consider. Legalising premature death as a treatment option plants a seed of doubt about one's right to demand help to live with dignity and undermines the state's responsibility to ensure that all citizens can live with dignity.

If this amendment were to succeed, it would place a new and invidious pressure on disabled and terminally ill people who think that they are close to the end of their lives. Some will consider death as preferable to fighting for support to live with dignity. It will be the cheapest, quickest and simplest option. Think of older people who are anxious not to cause their families any distress. Evidence from research in this country and abroad shows that most people who seek assisted suicide give "not wanting to be a burden" as the principal reason for seeking death. The increased-choice argument is not valid until we live in a society that values us equally, where we can live with dignity and do not feel burdensome-a society whose health system offers genuine pain relief for everyone.

Baroness Campbell of Surbiton: Lastly, if these amendments were to succeed, despair would be endorsed as a reasonable expectation for which early state-sanctioned death is an effective remedy. Is this really the message that we wish to give disabled and terminally ill people? Is this really the future that we wish to offer those who become terminally ill? Those of us who know what it is to live with a terminal condition are fearful that the tide has already turned against us. If I should ever seek death-there have been times when my progressive condition challenges me-I want a guarantee that you are there supporting my continued life and its value. The last thing that I want is for you to give up on me, especially when I need you most. I urge your Lordships to reassure us by rejecting this amendment.

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Baroness Kennedy of The Shaws: It may come as a surprise to many in this House that I am against the amendment. Although I am a great believer in individual liberty and in the autonomy of the individual, I also believe strongly in the symbolic nature of law. The laws of a nation say a great deal about who we are and what we value. One of the ways in which cultural shifts take place in a society is by changing law. Many of us who have argued that changes in attitude follow changes in law did so particularly around issues of discrimination. We made arguments for changes in the law on racism and other discrimination such as gender, sexuality and disability. When others argued against us and said that racism was about beliefs and that the law could not bring about the changes that we sought, we countered by saying that the law sends out powerful messages. We know that in this House. The law matters and has the power of changing our society.

Before we introduce this legislation, therefore, I would like us to be sure of what the cultural implications might be. Legal changes made for benign reasons can have unforeseen and negative consequences. The consequence that concerns me, as it concerns the noble Baroness, Lady Campbell, is that with this legal amendment we create a climate in which the terminally ill, the disabled and the elderly who are sick feel even more profoundly vulnerable or feel that there is an expectation that they should take steps to end their lives.

As a criminal lawyer, I have acted for a family whose members were prosecuted for manslaughter. They were accused of failing to act to prevent the suicide of an elderly relative. I am conscious therefore of the anguish that cases of that kind can bring. As a criminal lawyer, however, I am also cognisant of the ways in which malign pressure is brought to bear on the vulnerable when they are at their most vulnerable and that this is done in criminal ways. We have well developed legal processes for making difficult and sensitive decisions about when to prosecute. The Director of Public Prosecutions has indicated that no prosecution in this area will be brought where there is no prima facie case of bad faith or ill intent. No prosecution has been brought against any accompanying person in the Swiss cases. In my view, it is right that the responsibility for commencing a prosecution should rest with the director.

For eight years, I chaired the Human Genetics Commission. We produced a report on reproduction and genetics, which, interestingly, picked up on one of the things that the right reverend Prelate spoke of. One of the alarming pieces of evidence that came through in producing that report was that genetic tests happened as, or were becoming, a matter of course and that pregnant women felt required to have genetic tests to determine whether they were carrying an embryo that was less than perfect. Many described to us in evidence a sense that somehow they were being required to consider whether they should proceed with a pregnancy where a baby would be born with a disability such as Down's syndrome.

Choice can, if we are not very careful, in the end mean no choice. Choice has real meaning in a society only if we really care for those who have disability and

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really provide the right level of resource for those who are dying. The good society should be resourcing palliative care in the way that we have heard about.

I am opposing this amendment because I think that it could so readily lead to a coarsening of our societal values and a diminishment of our commitment to the ill, to the disabled and to those who are terminally ill. I understand the good intentions of those who presented this amendment but I am afraid that I think that it is ill-conceived. I hope that the Committee will vote against it.

Baroness Warnock: I entirely agree with the noble Baroness, Lady Kennedy, on the symbolic value of the law. We should try to return to the whole purpose of this amendment, which is very narrow. I know that many of your Lordships have said that, if this amendment were to be carried, it would inevitably follow that we would have another discussion on the much wider issue of assisted suicide becoming legal in this country. However, that is not inevitable. It is perfectly possible that somebody may put up such a Bill but it is entirely up to Parliament whether that Bill is even given a Second Reading. Last time in this House, the Bill was not given a Second Reading. That process can go on again and again.

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