On 7th November 2014, the House of Lords held the Committee Stage of Lord Falconer of Thoroton’s Assisted Dying Bill. The Bishop of Bristol, the Rt Revd Mike Hill, spoke to two amendments that he sponsored and co-sponsored. The amendments sought to strengthen the decision-making process surrounding the application and ingestion of the drugs that would be used to enable someone to commit suicide. Following a short debate on the amendments, Lord Falconer agreed to bring back amendments at Report Stage dealing with the period of time between application and ingestion. However, he did not agree to make further changes to his Bill, as he claimed that the Bishop’s concerns were dealt with elsewhere in the Bill.The Bishop did not press his amendments to a vote.
The Lord Bishop of Bristol: My Lords, I may not be the only one who is a bit confused about what is happening. I stand to speak in support of Amendment 12 tabled by my noble friend Lord McColl, but I would like to address noble Lords’ attention to Amendment 77, which stands in my name. I rather hoped it might have been grouped with Amendment 85, but they stand separately grouped now. I would like to reserve the right to come back to Amendment 85 at a later occasion and I hope a later occasion will occur for that to happen.
Amendment 77 deals with something slightly different. Quite rightly, most of our debate today has focused on the decision to apply for assisted suicide and to sign the declaration. However, it is fair to say that the request for assistance with suicide involves two different and discrete decisions: first, there is the decision to apply for it, and then there is the decision to ingest fatal drugs. The Bill makes it clear that there has to be a minimum of 14 days between the application and the actual ingestion of the drugs, except in the case of somebody who is given a prognosis of a month or less and then the time lag reduces to six days.
I want to draw noble Lords’ attention to the fact that there can be quite a considerable time lag between requesting assistance and the act of having the drugs administered. I do not like to keep going back to Oregon because, quite clearly, there are some good things about the Oregon experiment. However, it does need to be said that in Oregon the range between the first request and death has been a minimum of 15 days and a maximum of 1,009 days. In Washington, there has been a range of between three weeks and 150 weeks.
Amendments 77 and 85 are an attempt to try at least to give the opportunity to the person, as they come to the moment when they will actually have the drugs administered, to return to that decision to make sure it is robust. In a sense, it asks questions about two things: the settled nature of their decision but also their continued capacity, given that there are two aspects to the decision that is going to be made. Each decision ought to be subject to some level of scrutiny. Clearly, the first one needs to be subject to a very high degree of scrutiny, but we need to give some attention as to whether the second decision also needs a degree of scrutiny.
These decisions will be made, as I say, at the very least after a 14-day interval in most cases, but some will likely occur after a much longer gap. Consequently, it is necessary to reconfirm that the conditions by which assistance was granted still apply. It is also necessary to confirm that the decision to accept assistance is free from,
“pressure, coercion or duress from others or from a sense of duty or obligation to others”,
and that there exists a level of,
“capacity commensurate with the decision”.
The actual decision to ingest a prescribed dose of lethal drugs should be subject to the same, or very near the same, scrutiny that the initial request for a prescription was.
Baroness Nicholson of Winterbourne: My Lords, I support Amendment 77, to which I have added my name. I am sure that many noble Lords will have had instances in which patients known to them, whom they are looking after or caring for in some way or another, have declared that, yes, they would want to commit suicide and would want help to do it. Then there is a gap. When the decision comes—when the decision is, “Do they actually want to take those drugs? —the decision is frequently no. I have known several instances of that. I therefore firmly support the proposal by the right reverend Prelate in Amendment 77, and I very much hope that the Committee will accept it.
Lord Falconer of Thoroton: My Lords, I congratulate the right reverend Prelate the Bishop of Bristol on focusing on the amendments, including one that is not even in the group—but I will happily deal with it anyway. As I understand it, he is saying in Amendment 77 that the lethal dose should be delivered only once requested by the patient. I see no difficulty with that. Perhaps I can think about the wording and come back at Report.
Amendment 85 is not in this group, but let us deal with it anyway, as the right reverend Prelate spoke to it—it is in a group of its own. I am against it because, as we discussed earlier, when I had the support of the noble and learned Lord, Lord Mackay of Clashfern, the point is dealt with by Clause 4(2)(c), which provides that the health professional has to confirm that the person has not revoked and does not wish to revoke their declaration.