Second Reading of the Patient (Assisted Dying) Bill


6th June 2003

For the full text of the debate, click here

Lord Alton of Liverpool: My Lords, the noble Lord, Lord Joffe, was good enough to say recently that we are usually on the same side of the argument. Although he knows that I am profoundly opposed to the underlying principles of the Bill, I commend the way in which he has introduced the arguments. At a number of meetings that we have jointly attended over the past few weeks, he has proved to be a very formidable and very honourable opponent. The tone of the debate in your Lordships’ House today has done justice to the claim that we always make: that the House is able to debate issues of this importance in a sober way, which helps to give a lead to those who follow the proceedings of this place.

During meetings outside your Lordships’ House and within its precincts, the arguments we have heard have been powerfully put by ethicists, medics and disabled people. I have been particularly struck by the views of doctors. The British Medical Association says that the Bill should be resisted. It states that,

    “there is consensus within the BMA that the law should not be changed to permit euthanasia or physician assisted suicide in the UK”.

As we have heard, the BMA has been joined by the Royal College of Physicians, the Royal College of Anaesthetists and the Academy of Medical Royal Colleges in opposing my noble friend’s Bill.The Royal College of Physicians, which has been cited by the noble Baroness, Lady Jay, and by my noble friend Lady Warnock, has stated that the Bill is “potentially dangerous”; that it is “composed of two ill-fitting parts”; and that,

    “key terms in the Bill are worryingly vague . . . it could be extended to apply to a very large number of patients beyond those whom the sponsors had in mind when they proposed it”.

Along with the Royal Colleges, the views of which we certainly should not simply dispose of, the hospice movement, to whom the noble Lord, Lord Phillips of Sudbury, referred earlier in a powerful speech, Help the Aged, Age Concern—from which I received a letter today signed by Gordon Lishman, its director— the Disability Rights Commission and an impressive array of religious leaders, including the most reverend Primate the Archbishop of Canterbury, the Archbishop of Westminster, the Chief Rabbi, Dr Jonathan Sacks, and the Islamic Medical Association have urged your Lordships to resist the Bill. I should say to my noble friend Lady Warnock that I do not believe that their views should any more be set aside merely because they are the views of religious leaders than the views of even the most eminent of our philosophers.Nor should we discount the views of doctors. The most recent poll of doctors, carried out on 13th May this year, established that almost three out of four doctors—some 74 per cent—would refuse to perform assisted suicide if it were legalised: the very point which has been adumbrated so well today that they would not want to be turned into destroyers of life rather than remain the defenders of life that they have always been. A clear majority also considers that it would be impossible to set safe bounds to euthanasia.

Not one single doctor involved in palliative care supported a change in the law. A significant majority supported both the BMA’s position and the conclusions of your Lordships’ Select Committee, which have been cited already. My noble friend Lord Walton of Detchant, who chaired that committee, still stands by its recommendations.

The arguments for and against euthanasia and assisted suicide were extensively considered by the Select Committee. Evidence, both oral and written, was taken from a host of witnesses representing a vast array of groups, charities, medical organisations and others. As we have heard today, the arguments have not really changed since then.

The committee’s report unanimously recommended at paragraph 278 that,

    “There should be no change in law to permit euthanasia”.

At paragraph 295 it stated:

    “We recommend no change in law on assisted suicide”.

However, since that report the campaign by the international pro-euthanasia movement to change the law has intensified. Yet the arguments themselves have not changed. The conclusions of the Select Committee are as pertinent now as they were nine years ago. We ignore them at our peril. There is a danger that you set up new committees when you do not like the findings of previous committees. The arguments have not changed; all that has been stated in your Lordships’ House is that the laws in Oregon, in Belgium and in Holland have been enacted. I shall return to that point a little later.The members of the Select Committee recognised that society’s prohibition of intentional killing,

    “is the cornerstone of law and of social relationships”.

That leads me to a second area that I wish to cover: the wrongfulness of intentional killing.The Select Committee correctly noted that the prohibition on intentional killing,

    “protects each one of us impartially, embodying the belief that all are equal”.

It had no wish to see that protection diminished, hence its conclusion that the law should not be changed to permit euthanasia.The Bill introduced by my noble friend seeks to abolish this “cornerstone of law and of social relationships”. That would be highly dangerous. It would fatally corrupt the doctor-patient relationship, which is founded on trust, and doctors would become killers as well as carers. Euthanasia is not suicide. It requires a doctor to collaborate in an act of killing, and doctors are certainly not demanding that change. The recent poll of doctors found that very few patients requested euthanasia. In the comments accompanying the poll, doctors set out their reasons for not wanting that change.

 

It is widely acknowledged that rules in our moral code against actively causing the death of another person are not isolated fragments. They are threads in a fabric of rules that support respect for human life. The more threads we remove the weaker the fabric becomes. That led the Select Committee to insist that the prohibition on killing is at the centre of morality, providing the cornerstone of whatever rights an individual may have.

Nowadays we hear much talk of autonomy—a point raised during the debate—and the right to do with one’s life as one chooses. “Autonomy” is one of the buzz words of the pro-euthanasia lobby and can clearly be seen in the wording of the Bill. However, autonomy is not an absolute right that each of us, as individuals, can exercise while living in our own little bubbles.

One cannot fail to be moved by the tragic cases we have heard about today. Those of us who oppose legalised killing recognise the suffering of patients with Motor Neurone Disease and similarly debilitating diseases, and we acknowledge the anguish of the families who care for loved ones with those conditions. But again I recall the conclusions of the Select Committee that,

    “individual cases cannot reasonably establish the foundation of a policy (the legalization of euthanasia) which would have such serious and widespread repercussions. Moreover dying is not only a personal or individual affair. The death of a person affects the lives of others . . . We believe that the issue of euthanasia is one in which the interest of the individual cannot be separated from the interest of society as a whole”.

Time is short but perhaps I may mention briefly the Dutch situation. My noble friend’s strongest argument is that because the Dutch have legalised euthanasia we should do so too. The Dutch first decriminalised their laws; then enacted voluntary euthanasia; then permitted involuntary euthanasia; and now it has become so routine that many doctors do not even bother to report it.I was in Holland last week when the Dutch Government officially reported that last year there were some 3,800 cases of euthanasia and that 900—one in four—were involuntary. So much for patient autonomy. Even more shocking, the Dutch Government also reported that in 2001,

    “just 54 per cent of such deaths were officially reported”.

The research concluded that,

    “the low percentage of reported euthanasia deaths was because doctors wished to avoid the administrative hassle of reporting a euthanasia case and were concerned they might have breached the regulations”.

So there we have it. We decriminalise; we move to voluntary euthanasia; we move on to involuntary euthanasia; and then, because it becomes so routine, we move on to non-reporting in some 50 per cent of cases.In War and Peace Leo Tolstoy wrote that,

    “the great thing is to accept death and to welcome life”.

All of us will have to one day accept death. What we should never accept is intentional killing other than for the requirements of justice. To do otherwise is unethical. It will destroy the doctor-patient relationship; increase the fear in our hospitals; create a subjective duty to die for the old; create a stigma for disabled people; and hinder progress in the palliative care that represents the real hope and comfort for the terminally ill and disabled. I hope your Lordships will resist the Bill.