HL Deb 01 December 1936 vol 103 cc465-505

Order of the Day for the Second Reading read.


My Lords, may I be allowed at the outset, in moving the Second Reading of the Bill which stands in my name on the Order Paper, to express my regret that my place is not more worthily filled by my noble friend the late Lord Moynihan. He was to have moved this, and his untimely death has deprived not only the medical profession and those who were his patients of a great friend and a notable figure, but also many who, like myself, had no professional contact with him but enjoyed his charming intercourse, which he was ever ready to extend to those to whose sympathy he responded. His absence to-day is nothing short of a calamity for those who wish the promotion of this measure.

That I should have consented to move the Second Reading of this Bill may appear to many of your Lordships unwarrantably presumptuous, but I was pressed to do so as it was felt that further postponement might endanger the future prospects of the Bill. I suffer some disadvantage from not being equipped with special medical knowledge or, still more, with medical experience, but I have had the advantage of many talks with the late Lord Moynihan on the subject of this Bill, and while we may be deprived unfortunately of his presence, I shall be able to quote his words. At any rate, I trust that your Lordships will not only forgive what may seem my inadequate advocacy of the principle involved, but that you will not for that reason be prejudiced against the main proposal which is embodied in this Bill. I have allowed a considerable time to elapse between presenting this Bill and the Second Reading, purposely, in order that full time might be given for the study of the subject and the way we desire to deal with it, as it comes before Parliament for the first time.

Opinion, so far as I have been able to judge, by a great deal of correspondence, newspaper articles, and reports, seems to divide itself more or less into three categories. First, there are those who support the principle of the Bill and consider the safeguards provided to be adequate and not irksome; secondly, there are those who approve the principle of the Bill but are doubtful or critical of the safeguards embodied in it; and, thirdly, there are those who disagree fundamentally with the whole principle.

The movement in favour of drafting a Bill originated some four or five years ago in an address that was given by the President of the Society of Medical Officers of Health, Dr. Killick Millard, of Leicester. He found so much support for the proposals that he made that gradually a society was formed and a Bill promoted. I would like very rapidly to show your Lordships that this is not a measure which is supported by a few cranks and people of no account, but that it has the strong support of a good many notable men and women of different professions and callings in our community. Amongst laymen there are Dr. Julian Huxley, Dr. Havelock Ellis, Professor George Trevelyan, Mr. H. G. Wells, and Mr. Stephen McKenna. Amongst religious leaders, there are the present Dean of St. Paul's, the Dean of Canterbury, Canon Payne, Chancellor of Leicester, Canon Peter Green, Manchester, the late Dean of St. Paul's (Dr. Inge), Dr. Rhondda Williams, Chairman of the Congregational Union, and Dr. Norwood, President of the Free Church Council. Amongst doctors there are Sir Humphry Rolleston, Sir William Arbuthnot Lane, Sir Leonard Hill, Sir Walter Langdon-Brown, Sir James Purves-Stewart, Sir Frederick Menzies, and many others.

I know that the medical profession is not in full agreement with the provisions of this Bill, and we are fortunate in your Lordships' House in having two of the most eminent members of that profession amongst us. The noble Lord, Lord Horder, may take part in the debate. I am not quite sure what his view is, and probably he will be inclined to pounce on me, but as I know he is President of the Anti-Noise Society I have some hope perhaps that he will not speak at all! We have also the noble Lord, Lord Dawson of Penn, who is looking mysterious. I am not quite sure what his view is, but I would say that while this is a matter which concerns the medical profession very closely it is certainly not exclusively a medical question. It is an ethical, social, and legal question, and it is on those grounds that I would beg your Lordships, should the two noble Lords I have mentioned oppose the Bill, not to be swept away too rapidly by their eloquence.

I want first of all to discuss the general principle that lies behind this Bill. I do so by quoting words of the late noble Lord, Lord Moynihan: Briefly our desire is to obtain legal recognition for the principle that in cases of advanced and inevitably fatal disease, attended by agony which reaches, or oversteps, the boundaries of human endurance, the sufferer, after legal inquiry and after due observance of all safeguards, shall have the right to demand and be entitled to receive release. You will observe at once that most anxious scrutiny of all such cases must be made, and many questions must be asked. Are there, indeed, cases of which it may with unequivocal certainty be said that death is inevitable and that with all the many modern possibilities of treatment both medical and surgical, there is no slightest prospect of recovery? You will learn on highest authority that to this question we may confidently answer 'Yes.' I will take the general question of suicide. There has been a very great advance of public opinion on the question in the last generation or so, but still the law remains; attempted suicide is legally regarded as a Common Law misdemeanour. Generally speaking, a more lenient view is taken and coroners' juries now bring in a verdict of "Suicide while of unsound mind," which may be proved in a few cases, but in many more cases is not founded on any certificate of insanity and is not, strictly speaking, justified by the evidence. But that is becoming a common practice, showing the way that the law is being stretched. Suicide has been regarded throughout the ages by some minds not as a criminal offence. I need not go back into the far centuries, to the time of Seneca, but I should like to quote one who wrote a special treatise on the subject in the seventeenth century. I have mentioned two Deans of St. Paul's, I am going to quote another Dean of St. Paul's, John Donne, who was in St. Paul's from 1621–1631. He said: Since I may without flying or eating when I have means, attend an executioner or famine; since I may offer my life even for another's temporal good; since I must do it for his spiritual; since I may give another my hoard in a shipwreck and so drown, since I may hasten my arrival to heaven by consuming penances; it is a wayward and unnoble stubborness in argument to say, still I must not kill myself but I may let myself die. Again in a later century, the eighteenth, Hume wrote in his essays: Suppose that it is no longer in my power to promote the interests of society; suppose that I am a burden to it; suppose that my life hinders some person from being much more useful to society. In such cases, my resignation of life must not only be innocent but laudable. And, surely, my Lords, we all know cases of suicide which were not only innocent and laudable but very noble. When Father Damien went out to the land of the lepers, he knew he was going to kill himself. A very recent and striking example is that of Captain Oates. In the Antarctic Expedition, when he knew he was a burden on the Expedition and was holding them back because of his frostbitten feet, he went to the door of the tent and saw the blinding blizzard and said: "I am just going outside; I may be some time." And Scott, commenting on that, said it was the act of a brave man and of an English gentleman.

There is no hard and fast line. Your Lordships may say that the cases I have quoted are those of noble acts of self-sacrifice for others and the cases that come under this Bill will be the acts of people who are sparing themselves pain. I think that is a mistaken notion. I think in many of these cases consideration for others will be uppermost in the minds of the patient; in fact t go so far as to say that the consciousness of being a burden, the despairing view that you yourself are no longer of any use, the prolonged anxiety of others of which the patient is aware, may be as poignant as the suffering itself. This is exemplified by what I should say some of your Lordships had witnessed, that heroic pretence on the part of dying patients that they themselves are unaware of the hopelessness of their case, that pathetic attempt at cheerfulness, often successful in making those who are watching whisper to one another: "At any rate he does not know he is dying." He does; and he is heroically keeping up the pretence while he is being weighed down with the burden he feels himself to be on his friends and on those who love him.

Now I get to the medical point of view. As matters now stand we must acknowledge, and we know, that when life is threatened euthanasia in some form or other is given and that the onus that is on the doctors at present is intolerable. Dr. Harry Roberts puts it very well: What are we doctors to do in these circumstances? If we accede to our patient's wish we are, as the law stands, guilty of the crime of murder. Consequently, it is often cowardice rather than conscience or professional honour that leads us to observe the established convention. I suspect, however, that very many doctors do on occasions allow their sympathy and their feelings of pity to override their prudence. To a humane man the inclination to administer the merciful dose is often almost—not infrequently quite—irresistible. Narcotics are given to relieve pain. The narcotics are given, but they are detrimental to the prolongation of life, and, moreover, in the intervals, the pain can recur. The administration of the narcotic is not a satisfactory solution of this question, especially when it is left to the unfettered discretion of a single individual. It places a very heavy responsibility on the doctor. Dr. Millard says: Thanks to morphia and the hypodermic syringe we can do a good deal, especially if the medical attendant is not afraid of incurring the risk of going too far and so relieving the pain entirely. But the position is most unsatisfactory. The dose has to be increased again and again as tolerance is established. A merciful doctor literally hovers on the brink of manslaughter, and in cases where morphia is resorted to liberally and is long continued the effect, in many cases, is undoubtedly to shorten life. As to the religious point of view, that it is contrary to the principles of Christianity, well, my Lords, those whose names I have read out—and there are many others—have declared that they do not think so. I would be the last to argue this point, and I do not wish to say a single syllable which could in any way be interpreted as offending the noble Viscount who has put down the Motion for the rejection of the Bill. It is a question that is quite beyond argument and I am going to set it aside except to say to those who are adopting the Catholic position that a very notable Catholic, so notable that recently he has been canonised, Sir Thomas More, now St. Thomas More, said in his "Utopia": … if the disease be not only incurable, but also full of continual pain, and anguish; then the priests and the magistrates exhort the man, seeing he is not able to do any duty of life, and by over-living his own death is noisome and irksome to others, and grievous to himself: that he will determine with himself no longer to cherish that pestilent and painful disease. And seeing that his life is to him but a torment, that he will not be unwilling to die, but rather take a good hope to him, and either dispatch himself out of that painful life as out of a prison, or a rack of torment, or else suffer himself to be rid out of it by other. And in so doing they tell him he shall do wisely, seeing by his death he shall lose no commodity, but end his pain. That very eloquent plea has been interpreted by some as meaning that Sir Thomas More did not agree with it. There is not a shred of evidence to show that that was not what he considered to be the ideal when he wrote his "Utopia." Courage and fortitude in the face of pain is no doubt a virtue, but conjure up in your imagination, my Lords, all the other feelings which a patient dying in agony feels when he sees his friends around him and knows that he is only a burden to them.

May I now take the legal opinion? There is no doubt that a very much more enlightened view with regard not only to this type of case but others more extreme, which do not come under this Bill, is being taken by the legal profession. I want to give just two quotations because I really think that they will impress your Lordships, although they may be familiar to you. It was in 1927 that a man was tried for murder for drowning his little girl of four years old who had contracted tuberculosis and had developed gangrene in the face. Mr. Justice Branson said: It is a matter which gives food for thought when one comes to consider that had this poor child been an animal instead of a human being, so far from there being anything blameworthy in the man's action in putting an oral to its suffering he would actually have been liable to punishment if he had not done so. In another case, of a woman who killed her mother who was suffering from general paralysis of the insane, Mr. Justice Goddard hinted at a change in the law, so "that the passing of a person afflicted with an incurable disease either in mind or body might be expedited," but said there must be "rigorous safeguards."

As I said just now, the verdict of "temporarily insane" and the leniency displayed in these cases and in others that I could quote show that the law is being stretched in accordance with public opinion, and I feel sure that these pronouncements of the Judges I have quoted will be supported by everyone whatever his professional experience, his legal training or his religious beliefs. We have restricted our proposals in this Bill purposely, whatever our views may be about Mongolians, congenital idiots and senile dementia, where safeguards would have to be very much more strict and where there would be no doubt other great difficulties. In cases under this Bill initiative comes from the patient himself or herself. We are not opening any door, we are merely unlocking it. We are drawing the bolts by which prejudice and tradition have kept it closed. We want to be as merciful with one another as we are to our own animals. The degree of capacity of suffering pain in animals is unknown to us; amongst ourselves we know too well what it is. Perhaps few will take advantage of the Bill. That we can never know. I have heard of cases, and I know of cases. Only in the last few days an extremely painful case was brought to my notice, a case of cancer which continued after an operation, when the doctor declared that any further treatment was useless. Great pain and suffering was endured, only temporarily relieved by morphia, and the patient begged to be released, not so much—again I emphasise this point—because of the pain which he felt—that he might be able to endure—but because of the suffering, the anxiety, the burden he felt that he was imposing on those around him and those for whom he cared.

I will go through the clauses of the Bill as rapidly as I can in order to explain them. Clause 1 deals with the principle with which I have already tried to deal in my speech. In Clause 2 there are the conditions on which permission may be granted, and there is a provision that it shall not refer to anybody under tire age of 21. The question whether a patient is of sound mind seems one that is necessary to be decided, and perhaps it might be strengthened by a statement, with regard to the patient being of sound mind, which could be included in the form of a declaration under Clause 6 (1) (d), so that subsequent disputes might be avoided. The expression "severe pain" has been included, but the adjective need not necessarily be important. The patient himself, and his opinion endorsed by the doctor, can decide that point. Then we get two adjectives which may be disputable—"incurable" and "fatal." What is incurable to-day may be curable tomorrow, and then ipso facto this particular form of disease or illness will be cut out and will not come under the Bill. But I do not think there is anybody who will dispute that there are conditions, rather than diseases, in patients which show that they are incurable. I am not going to mention the illnesses, because there would be a dispute at once. Even over cancer, which has increased in the last ten years by 25 per cent., there may at once be a dispute and people may say: "Oh, but it can be cured in this case and that case."

The Bill meets the ease of the individual who, either by accident or through a malignant form of disease, is obviously declared to be incurable. Two medical certificates ire prescribed, just as for cremation. Clauses 3 and 4 deal with the official supervision, which is purposely inserted as a safeguard. I do not doubt that these clauses are capable of simplification. Provision is made for the official witness, but I do not very strictly abide by that provision or insist that it is necessary. All through this matter we have been trying to steer a course which will not be irksome or painful for the patient and yet at the same time will give the proper safeguard to the doctor. I do not know that the official witness is necessary, though the doctor may like to have one. Possibly in the list of people who may be witnesses, in Clause 7, the inclusion of the nurse is unwise.

The noble Earl, Lord Halsbury, who was in his place just now, has very courteously indicated some points in these clauses which ought to be amended, and I am inclined to agree with him. I think there should be a new subsection stating that the administration of euthanasia is not, legally speaking, suicide and that; therefore life insurance policies would not be rendered void. Mr. Bond says that these changes in the law as it affects coroners' courts: might also raise other questions for revision, such as the validity of life insurance policies or the disposal of property; but given a reasonable attitude of mind any difficulties in this direction could be overcome. He further says that in the Report of the Departmental Committee on Coroner's Law recommendations on these lines have been made. In Clause 6 we thought it right to have some sort of Parliamentary control over the regulations and to allow the Minister to draft his regulations in such a way that they may be published and receive the endorsement of Parliament. We do not desire to be too rigid, but we do not desire to be too lenient, especially as this is the first measure of its kind that has come before Parliament.

I shall be very ready to consider Amendments if we reach a Committee stage, and I should be ready to accept them if they improved the Bill. I am ready in all cases for anything that makes this Bill legally more simple, but I am not prepared for any extension which will bring under this Bill those who are suffering in the ways I stated earlier in my remarks—from terrible diseases which deprive them of their senses and therefore prevent them from initiating the move.

In these days, when so much of the time and attention of scientists and of officials is devoted to the improving and perfecting of engines for destroying healthy human lives on an enormous scale by methods which inevitably involve maiming and torture, may we not spare some part of our attention to help the relief, and the humane termination of the acute anguish, of those who themselves ask to be released from continued agonies from which there is no hope of recovery? May we not unlock the door of compassion and allow the cord to be cut which tethers them to a lingering agony of hopeless and helpless suffering? My Lords, may we not wish this for ourselves, should our turn come? I am asking you to give an affirmative reply to these questions by voting for the Second Reading of this Bill. I beg to move.

Moved, That the Bill be now read 2a.—(Lord Ponsonby of Shulbrede.)


My Lords, in rising to support the Motion before the House I desire first of all—and here I concur with my noble friend who has just sat down—to express sincere regret that Lord Moynihan is no longer with us. The late Lord Moynihan, as your Lordships know, was one of the foremost surgeons of our time. He took a keen interest in this question of voluntary euthanasia and I believe it was his intention to present a Bill in this House last Session. Had he been here, no doubt he would have introduced the Bill to-day. As it is, I think that the society responsible for the promotion of this Bill is fortunate in having obtained so able an advocate as my noble friend Lord Ponsonby to introduce it in this House. In the eloquent speech to which we have just listened he has clearly and concisely stated the case for the Bill, and I do not propose to acid very much to what he has so well said. I will merely endeavour to emphasise, if I can, one or two of the points he has made.

My noble friend has described the provisions of the Bill and has dealt with the question of safeguards, and I will not repeat what he has said in that connection. Nevertheless, to avoid misapprehension which may be felt outside this House with regard to this Bill, I should like to state what it is not proposed to do. It is not proposed, for example, that imbeciles and mental defectives should be deprived of life; that old people who have become a burden to their relatives should be done away with; and it is not proposed that any one who wishes to do so should be allowed, still less encouraged, to commit suicide. In Clauses 1 and 2, which are the main operative clauses of the Bill, it is proposed that individuals who are suffering from an incurable and fatal disease 3hould be allowed by law, if they so desire, and I ask your Lordships to note that condition, to substitute for a slow and painful death a quick and painless one. That is the real aim and object of this Bill.

It seems to me that in some respects, and certainly in this respect, we are more merciful in our treatment of animals than we are in our treatment of human beings. In the case of horses, say for example in the case of a hunter which breaks its leg or sustains other fatal injury, a veterinary surgeon is at once called in to put an end to it in the most humane way possible. On racecourses, as your Lordships will be aware, a veterinary surgeon is always in attendance, and it is his duty to put an end, without delay, to horses which have been fatally injured. In the case of dogs, in this country at all events, it would be unthinkable for the owner to let a dog linger in misery if it were fatally injured or suffering from an incurable disease. It is only in the case of human beings that we say: "Although the case may be hopeless and the suffering severe, as the law stands to-day, the last act of the grim tragedy must be played out to the bitter end."

There is another point to which I will briefly refer, and it is this. Of course it is difficult for those who speak rather from hearsay to say this emphatically, but it has been stated that euthanasia is already practised—I do not know to what extent—in this country to-day. That is to say, in crises of painful and incurable illnesses doctors, by means of an overdose of morphia or other powerful drug, have hastened the deaths of their patients. I dare say we may hear something on this point from the distinguished members of the medical profession who sit on the Cross Benches in your Lordships' House, and I can conceive that this may be used both for and against the Bill. I do not think my noble friend Lord FitzAlan will Use this argument, but I can imagine an opponent of the Bill saying: "If what you propose is already done, what is the use of introducing legislation on this point?" The answer to that is that as the law stands to-day a doctor does this as his own risk, and to him the risk is very serious—namely, the risk of criminal prosecution or of professional ruin. We who are in favour of this measure say that it is unfair and unjust that a doctor, for performing what is really an act of mercy, should be placed in this invidious position.

There is only one other point to which I would briefly allude, and that is the elect on the living of these sad cases we are discussing to-day. I would ask your Lordships to consider the case of people who are linked by ties of affection—it may be husband and wife, or mother arid daughter. I dare say such cases have been known to some of your Lordships, where those in health are obliged to sit idly by, able to do little to alleviate, and nothing at all to end, the sufferings of those they love. The mental stress endured by people in that unhappy situation may be severe, and I submit that this will be an added consideration for the passage of this Bill through your Lordships' House. These are some of the reasons why I have spoken in favour of this Bill, a task which, had he been here to-day, I would gladly have left to my noble friend Lord Newton, and I am able to say on his behalf that had be been here he would certainly have spoken and voted for this Bill. I will only add, in conclusion, that because I believe this Bill would do something, if passed into law, towards the alleviation of human suffering, I commend the principles contained in it to the consideration of your Lordships.

VISCOUNT FITZALAN OF DERWENT had given Notice that, on the Motion for the Second Reading, he would move, That the Bill be read 2a this day six months. The noble Viscount said: My Lords, both the noble Lords who have spoken in introducing this Bill have alluded to the late Lord Moynihan, and I wish to do the same. I wish to associate myself with what they said with regard to the deceased Peer, whose loss we all deplore, and I do so especially because it was my privilege to be on terms of personal friendship with him, which I greatly valued, and of which I shall always bear a happy memory. I wish to allude to him also in respect of another point. He is reported as having said, in a speech which he made on this question, that denominations of Christians who were opposed to this measure ought to stand aside, and not to interfere with or inhibit those in favour of any measure of euthanasia. I must be allowed to say, with the greatest possible respect, that I absolutely and entirely repudiate any such suggestion. Why any of us who oppose this measure on account of our religious tenets should also be deprived of opposition to it on the ground of its merits, and also because we may consider it detrimental to the welfare of our country, I cannot conceive.

I entirely object to any such argument whatever. Of course the religious question comes in. It cannot be ignored. I myself shall endeavour in a few moments to say a few words with reference to the religious side of this question. I do so with great diffidence and with great hesitation. It is very difficult for a layman in this House to speak of matters on religious grounds, and I would ask the friendly sympathy of your Lordships when I endeavour to make a remark or two upon them. At the same time, for the moment I would venture to say a word or two on other provisions of this Bill. There are the very complicated provisions for the administration of the Bill if it ever becomes an Act. I have no doubt they will be alluded to by other speakers, and I will not take up your Lordships' time by dwelling on them now, but would like to say that, notwithstanding the voluntary character of this Bill, if it became an Act I should be indeed sorry for the relatives of the patient, who would have great responsibility thrust upon them. I should be still more sorry for the doctors who would have placed upon them the responsibility of perpetrating the act; and I should be most sorry of all for the unfortunate patient, who would be exposed to the great mental strain and anxiety while all the formulas laid down by this Bill are being prepared for his demise.

It is quite true, as has been mentioned by the noble Lord opposite, that there is considerable weight of medical opinion in favour of this Bill, and he is fortunate in having here the two noble Lords, my noble friend Lord Dawson of Penn and my noble friend Lord Horder—if they are going to support this Bill. That I do not know. Whatever one does, I am certain the other will, because they always hunt in couples. But personally have never been rash enough to place myself under their professional care. I ought perhaps to hasten to admit that I have advised friends of mine to run the risk and, I think I may say, with more or less success. At the same time, notwithstanding the weight of medical opinion in this House, and outside it as well, in favour of the Bill, there is also a very great deal against. In my humble opinion the medical profession are very apt to be carried away by purely materialistic motives—naturally. They witness a great deal of pain and suffering and they are anxious to do all that can be done to alleviate it. But may I most respectfully point out to my two noble friends—if they are in favour of this Bill—that their business is to cure and not to kill, and I earnestly hope that the time may come when, with the advancement of science, of which I am sure they will take every heed, the alleviation of pain and suffering will be much greater than it is now.

Incidentally I should like to say that I cannot congratulate the noble Lord on the Title he has given to this Bill. Instead of giving it a cumbersome classical Title, I wish he had given it good plain English words, understandable by the people, and call the Bill what it is, a Bill to legalise murder and suicide, because, after all, that is what it amounts to. Many of your Lordships who have been interested in this question will have noticed that there have been many articles and letters in the Press on both sides of the question. The other day I came across a letter signed by an old country doctor—of forty years standing, he said. He was very critical of the Bill as a whole, but what struck me particularly in his letter was that he said we were getting too soft as a nation and too sensitive to pain. I have no wish to volunteer for any greater degree of pain or suffering than is likely to fall to my share, but I must say that when I read that letter I could not but feel that there was something in it; and when you think of the modern mania for luxury I cannot help thinking it is rather a warning to us against the danger of the degeneration of the race. I also noticed the other day that an eminent physician, a gentleman in the Civil Service, had expressed his opinion on euthanasia. He said that, even if it was voluntary, it was pregnant with criminal possibilities. I submit that we ought to be most careful in considering what the possibilities may be and the confusion that may arise if this Bill ever becomes law.

But now to return to the religious side of the question. It is quite true as regards my own faith that we are in an advantageous position in these matters, that owing to the teaching and authority of our Church we have certain safeguards and a guide and help in coming to a decision. But this is not entirely a matter for the Christian Churches. This Bill is not opposed only because it is condemned by the Church, it is not opposed only on Christian and moral grounds, it is opposed because it is contrary to the law of nature. We do not oppose it because the Church condemns it, but because the law of nature brands it as evil and a cowardly act. What about other people? What about the Jews? Are they in favour of this change? I am sure we all justly regard the Jews as being a humane race, but I am assured that there is not an orthodox Jew in the world who would not oppose this measure tooth and nail. What about the Mahomedans? Do they approve a measure of this kind? Not at all. They consider it to be contrary to the natural law and the law of God. Of course, if this question is to be considered, as I am sure it will not be by noble Lords in this House, as if there was no God, then the situation is different. Then we are driven back to being governed only by sentiment. Well, sentiment has its merits, and in many ways I think sentiment does much good. But if we allow it to run away with us, then it means an abandonment of principle, it means that we are governed by our emotions, and we sacrifice that great virtue of grit which has been such a great characteristic of our race.

This is no Party question. For generations the great majority of our predecessors in this House, of all creeds and all sections of opinion, have accepted the tradition that the Almighty reserved to Himself alone the power to decide the moment when life should become extinct. The noble Lord opposite comes down to-day with his Bill and asks us to usurp this right to ourselves, to ignore the Almighty in this respect, to insist on sharing this prerogative. I humbly submit that action of that kind partakes of the nature of an impertinence which we should do well to avoid, and I hope your Lordships will not allow the Second Reading of this Bill. I beg to move.

Amendment moved— Leave out ("now") and at the end of the, Motion insert ("this day six months").—(Viscount FitzAlan of Derwent.)


My Lords, may I at the outset thank the noble Lord, Lord Ponsonby, for the clarity and sympathy with which he has introduced this measure to your Lordships' House? In so doing he paid a gracious tribute to my noble friend the late Lord Moynihan, that master in the craft of surgery, which deepens my obligation. I think perhaps I could contribute best to this debate at this moment by referring to certain impressions that the speeches have made upon myself with regard to the question of pain in illness. I need hardly say that, for pain and suffering, compassion is not likely to be less amongst those who are constantly called upon to relieve pain. Your Lordships and the public outside might perhaps gain an impression that agonising pain is a more frequent characteristic of disease than is really the case.

In relation to cancer especially, it would not be correct to say that most cases of cancer are characterised by agonising pain. I should hate that an impression should go out from a debate in this House that that was a correct statement. For all the unfortunate people who have this dreadful visitation to carry, it would be still more distressing if they had before their minds the prospect of agonising pain. I think I should be correct in saying—and my noble friend Lord Horder will agree—that certainly in less than half the eases of fatal cancer is pain an outstanding feature. There has been in the last few years a steady growth of power on the part of my profession to assuage pain. We see it in the growth of the excellence of nursing and in the increase in the number of medicinal remedies, and it may be fairly said that there is much more control of pain to-day than existed years ago. The medical profession is primarily concerned with the causes, diagnosis and treatment of disease and, to the best of our minds, our undeviating purpose is to cure and to assuage suffering in so far as it is compatible with the attainment of that end.

That is our main purpose. But we have to face this fact, that there are diseases which are by their nature incurable. That is not to say that that disease is incurable at the outset, but a disease will reach a stage when we know that by its nature it cannot be cured. Surely, in such cases, our duty and our privilege is to do what we can to make that passage between a painful illness and the inevitable end as gentle as we can. One hears people say that we lack hardness in these days. That is not, my experience. I would say that this is a courageous age, but it has a different sense of values from the ages which have gone before. It looks upon life more from the point of view of quality than of quantity. It places less value on life when its usefulness has come to an end.

Perhaps I might try to give your Lordships an account of how medical opinion has changed on this question. If one goes back fifty years I think it will be true to say that the medical profession concentrated all its endeavours on the maintenance of life despite the nature of the illness and even despite sometimes the imminence of death. It was an accepted tradition that it was the duty of the medical man to continue the struggle for life right up to the end. With time that has changed. There has gradually crept into medical opinion, as there has crept into lay opinion, the feeling that one should make the act of dying more gentle and more peaceful even if it does involve curtailment of the length of life. That has become increasingly the custom. This may be taken as something accepted. If once you admit that you are going to curtail life by a single day, you are granting the principle that you must look at life from the point of view of its quality rather than its quantity under these special circumstances. We do not lay down edicts for these things. It is a gradual growth of thought and feeling that entwines itself into the texture of our thoughts, and it is fair to say that it is equally entwining itself into the texture of the thoughts of laymen. There is no disharmony in this matter, in the main, between the thoughts of the laity and the thoughts of the doctors.

When you pass from what I may call the act of dying, to lives which are burdened by incurable disease, and where the gap between that stage of illness and death becomes wider, it may be fully admitted that the difficulty is greater, yet I would give as my deliberate opinion that there is a quiet and cautious but irresistible move to look at life and suffering from the more humane attitude, and in face of a disease which is undoubtedly incurable, and when the patient is carrying a great load of suffering, our first thoughts should be the assuagement of pain even if it does involve the shortening of life. This steady and silent change of opinion, common to doctors and laity alike, is, I suggest, due firstly, to a growing regard for quality of life as distinct from mere quantity; and, secondly, to the greater importance and attention attached generally to the soothing and suppression of suffering in general, both of body and mind. Take, for instance, the multiplication of means—anæthetics in midwifery and dentistry, the inducement of sleep prior to anæthesia—and as for drugs to assuage pain and bring sleep and forgetfulness to the troubled mind, their name is legion.

For the most part, this silent change has been concerned with the act of dying, and most doctors, where there is pain or struggle, bring peace at the last despite curtailment of life, and with the support and even at the request of lay opinion. All this goes with the quieter and more dignified view of death which prevails to-day. When the gap between life burdened by incurable disease and death becomes wider, then greater difficulty presents itself, and greater variety in practice holds amongst individual doctors and patients. None the less there is in the aggregate an unexpressed growth of feeling that the shortening of the gap should not be denied when the real need is there. This is due, not to a diminution of courage, but rather to a truer conception of what life means and what the end of its usefulness deserves.

The medical profession moves with thought and caution in such matters. Opinion, tradition, even courts of conduct exert guidance. Is it not better thus? This is not a case where we assume advocacy, but rather give the sustenance of comradeship. Perhaps I cannot do better than explain this more tentative, less crystallised opinion by an example. A woman has endured a disease with incomparable bravery for nine years, has pursued her calling, and directed and sustained her home. At long last, by the extension of the disease and diminishing strength, she is crushed by pain and complete disability. She besought peace and kindly death, and called to witness how hard she had fought. Is submerging of her sufferings to be denied her because her life might be shortened by two or three months? That can only be decided by her doctors, who know the thoughts and feelings of the patient and the realities of her state. This is something which belongs to the wisdom and conscience of the medical profession and not to the realm of law. Protection from misuse can only derive from the profession itself. There is no enforcement of one view or the other. If any of our colleagues think that in the case I have mentioned the patient should struggle on to the end, he would act accordingly, and there would be no chiding amongst us. Out of tolerance truth will emerge. In all learned professions there are differences of opinion; without such progress would cease.

Resulting from our natural habit of freedom of thought and discussion considerable changes in standards of conduct, in the evaluation of morals and manners will evolve without prior or corresponding alterations in legal Statutes. I say this is all to the good. There are many things which had better evolve before Statute law tries to give them expression. I can give two examples. Nearly sixty years ago there was a prosecution, followed by conviction.

for publishing a book on contraception, and the language in which the indictment and the speech of prosecuting counsel, the late Lord Halsbury, was couched is astonishing. I will not delay your Lordships by quoting the unmeasured terms of condemnation of the defendant. I will only draw your attention to the contrast now, when contraception is not only a matter freely discussed, but is a widespread practice. Could the two points of view—then and now—be more diverse? And yet the law under which the prosecution was instituted remains unaltered.

The second example is that of medical abortion. I emphasise the word "medical." The law on abortion is in substance based on the Statute of 1861. That law contained no provision directly concerning medical abortion, but within tile medical profession there was clear understanding that the procuring of abortion was only justifiable if a woman's life were in danger. But since then opinion has slowly changed, so that abortion is now considered proper by most of the medical profession, if it be required in order to avoid injury to the health whether of body or mind, and whether actual or prospective. And this view is not—I speak with submission—out of harmony with present legal opinion. It has evolved without intervention or change of Statute. On the other hand, when implementation of enlightened opinion is unfortunately restrained by the law, deception or subterfuge is employed to circumvent the law. This is illustrated by the altered attitude towards suicides. Not so long ago a suicide was made an outcast in this world and the next. Now opinion would wish to treat him with consideration, but the law has unfortunately laid it down that his body cannot have a burial service within the Church of England; and so humanity compels a deception, and the verdict avers "temporary in sanity" by way of escape. Such matters would have been far better sealed within the Church itself.

And so it is with euthanasia. This is a matter the guidance of which properly lies within the medical profession itself: a profession very sensitive for its own honour and for the welfare and feelings of those whom it serves. The machinery of this Bill, not dissimilar from that employed for the certification of the insane, would turn the sick room into a bureau and be destructive of our usefulness. The very idea of the sick chamber being visited by officials and the patient, who is struggling with this dire malady, being treated as if it was a case of insanity—and the machinery is not very far from that—is something of which I hate to think. I believe I am right in saying—my noble friend may support me or not in this, but I think he will—that far from promoting that gentle growth of euthanasia in case of illness it would have the opposite effect. The doctors of this country would hesitate to touch it. They would not like to introduce such an atmosphere into the sick chamber, and I believe not only that the law would remain nugatory but that it would deter those who are, as I think, carrying out their mission of mercy.

May I say that one thing in the noble Viscount's remarks on the subject of his religion a little surprised me, because at the commencement I thought there was not very much difference between his view and the view I have been trying to put to your Lordships, for in a book written by a great authority in the Roman Church I read that it is lawful to use drugs to alleviate pain even though it be foreseen that these may shorten life, provided that the alleviation of pain, and not the shortening of life, is the primary purpose of the drug. That is what we feel would be the right attitude of mind. We have not in mind to set to work to kill anybody at all. What we say is, if we cannot cure for heaven's sake let us do our best to lighten the pain. We think of the suffering, we do not think of the life, and we should see to it now, not by treatment that is lawful in the case of a dog or a cat, that the passage takes place more easily and more rapidly than otherwise it would have done. I do not see myself that there is anything disharmonious between the view that I have raised and what I may call, broadly, the practice of medicine. My profession has first of all to be actuated by knowledge, and with that knowledge it must have complete freedom for the exercise of its work. That freedom is equally necessary for the exercise of those gifts of understanding, courage and gentleness, without which the art of medicine would be but a tinkling cymbal. For those reasons I ask your Lordships not to give this Bill a Second Reading.


My Lords, I hesitate very much to speak after the extremely interesting speech which we have just heard from my noble friend Lord Dawson or to intervene between your Lordships and the noble Lord, Lord Horder, who I understand will speak after I have sat down. They can speak on such a matter with far greater ability and authority that I can command; but I do not intend to keep your Lordships for any length of time. May I say at the outset that I associate myself most cordially with every word that has been spoken about that brilliant surgeon, Lord Moynihan, with whom I enjoyed a friendship for forty-six years.

I must confess that this, to me, is a very difficult question, one in which principle and compassion contend, so that I find it not at all easy to make up my mind. I think it must be approached on the broad basis of the clear moral principle that no man is entitled to take his own life. I fully admit that there must be exceptions even to that principle. Is there any moral principle in, the world which in the infinitely varied and tangled circumstances of human life does not admit of some exceptions? I remember a discussion with that very shrewd judge, the late Master of Balliol, Dr. Jowett, on the question whether it was ever right to tell a lie. When a certain circumstance was put before him I remember him saying: "In these circumstances I should certainly tell a lie, but I should be very careful afterwards not to justify my action by logical reasons." I think that is about the common sense of the matter.

There must be cases we can all imagine when life may be voluntarily laid down without blame, and indeed with praise, for the sake of others. In my own mind, as in that of the noble Lord who introduced this Bill so persuasively, there immediately arose the memory of that most gallant English gentleman who in the South Arctic went out into the blizzard, walking into death in order to save the lives of his comrades. But, it is one thing to admit exceptions to the principle that a man may not lay down his life, and it is another thing to give public statutory authority to the counter principle and to say that in certain cases a man, in his own interests and for his own sake, may bring his life to an end. Can we dismiss from our minds the possibility that advantage might be taken of any such public recognition of the counter principle in cases, different indeed from those contemplated by this Bill but which would not be regarded as morally different? Suicide, as the noble Lord, Lord Ponsonby, pointed out, is on the increase and, as he rightly said, the growing sensitiveness to the miseries and tragedies of human life leads to a much more impartial judgment than was common at another time.

But if this Bill passed might not a man say: "The law has now expressly recognised that if a man finds the continuance of life intolerable and of no sort of value to him he may take steps to bring it to an end. I find that this shame or this sorrow which has come to me would make my life henceforth intolerable, deprive it of any sort of value, and therefore I claim the right to bring it to an end"? The particular circumstances and safeguards specified in this Bill would not in the least affect his moral judgment. I know that the noble Lord opposite went so far even as to make an eloquent plea for suicide in certain circumstances, but I do not think that your Lordships' House would contemplate the possibility of encouraging this growth, and I suggest that we cannot dismiss from our minds the possible unforeseen effects upon the public conscience of, for the first time, giving definite legal encouragement to the principle that there are circumstances in which a man for his own sake may bring his life to an end.

Great stress has been laid by the noble Lord who introduced the Bill upon the requirement that anyone who takes action under it shall be entirely voluntary in that action. But I wonder whether a man who is confessedly racked with pain and full of drugs is capable of making a sound moral judgment. Would not the procedure contemplated by this Bill impose an almost intolerable strain in cases where the strain, God knows, is sufficient already: when a man has to ask for himself and those who are dear to him, "Am I or am I not to avail myself of this legal provision that is now possible for me?"? Moreover, I do not think we can dismiss from our minds the possibility of illegitimate pressure being brought to bear upon a sick man by relations from motives which may not at all be motives of compassion. Then, again, we have to consider the future which may attend for the first time the legal recognition of the principle that a man may take his own life for his own interests. I am not usually much impressed by the arguments of the thin end of the wedge, but still we cannot dismiss from our minds the fact that many of those who are behind the noble Lord in bringing forward this Bill definitely contemplate its after-extension to other cases which for the present he has ruled out. He says that this Bill is merely to unlock the door, but if the door is once unlocked it will soon be opened wide.

That, however, is not the whole of the mater. I must admit that cases may occur when the quality of mercy must not be strained, and that some means of shortening life in such cases as we are contemplating in this discussion may be justified. I cannot for myself accept the point of view which is often expressed by those who oppose such legislation as this, that pain and the duration of pain must needs be accepted as of Divine appointment or as a means of moral and spiritual discipline which no man may rightfully decline. As my noble friend Lord Dawson has pointed out, the whole increasing, marvellous, far-reaching and beneficent use of anæsthetics points entirely the other way. But I would submit that, if there be extreme cases where it is morally legitimate to shorten a life of pain, they should be left to be dealt with by the medical profession. It is here that I associate myself with what has just been said by my noble friend. This seems to be a region which belongs to the relationship of mingled intimacy and responsibility which exists between the doctor and the patient. If in some extreme instances a doctor decides, for example, that he will refrain from using means that will prolong life, or even that he will make use of means which he knows might possibly shorten it; if, in other words—they are the words of my noble friend—measures taken for the assuagement of pain may be known not improbably to lead to a shortening of life; is it not a perversion of language to say that such a doctor could regard himself as guilty of murder or manslaughter, or could ever be charged with it?

I cannot but think that it is better to leave this most difficult and delicate matter in the hands of the medical profession, exercising its intimate and responsible judgment, rather than, as this Bill would propose to do, to drag it into the open and regulate it by elaborate official procedure. It seems to me a situation which must be dealt with from inside, by the confidential relations of the doctor and the patient; not from outside by the procedure which is contemplated in this Bill. I confess that in this matter I would trust the judgment and honour of the medical profession. My noble friend Lord FitzAlan was a little cynical in his allusions to that great profession. I owe to it too much, and not least, if I may say so, to my noble friend that I am able to address your Lordships this afternoon, to have anything but the most profound admiration for that profession, and I think that this is a trust which it will not abuse. It seems to me to be of all others a profession which keeps true to those two maxims of the French language, which are so hard to translate into our own, of esprit de corps and noblesse oblige. It is therefore in their hands that I would prefer to leave all those possible circumstances to which the noble Lord, Lord Dawson, called our attention.

I need not elaborate these considerations. It is easier to understand them than to discuss them. I venture to put the reasons which make me shrink from this Bill. Perhaps they are instincts rather than reasons But instincts have a, very deep rationality of their own, and whether it be by instinct or by reason, I cannot bring myself to do otherwise than support the noble Viscount in his Motion that this Bill should be read this day six months.


My Lords, I wish in the first place to add my tribute to those which have already been made to the memory of my old friend and distinguished colleague Lord Moynihan, to whose interest in this Bill reference has been made. It would be anomalous if, as a medical man, I. did not engage your Lordships' attention for a few moments in the debate on this Bill. May I remind your Lordships in parenthesis that it is needless noise which the League over which I have the honour to preside aims at suppressing? I should like to say that I do not consider this matter to be one upon which the medical profession should be asked to give a lead. No doubt your Lordships and the public will look to the medical profession for certain facts, perhaps for guidance, but not, I hope, for a decision. Indeed, I am a little sorry that medical men have joined in this movement and have associated themselves with a certain amount of propaganda before this Bill came before your Lordships. And I may say, for the interest of the noble Viscount who moved the rejection of the Second Reading of this Bill, that until I listened to my noble friend I did not know what views the President of the Royal College of Physicians was going to express to your Lordships.

We doctors, at least in this country, are very sympathetic towards those modern efforts at securing biological control before life begins and while life lasts, because all such control assists us greatly ill the more humanist of our efforts. But into this matter of putting an end to life, surely a new principle enters, and I submit that this principle is outside the doctor's reference. If I may use that word, surely the doctor's "reference" is very clear, very brief, and very generally accepted. It is "to cure his patients of their diseases, and to cure them safely, pleasantly and quickly." If that ideal cannot be achieved, then the doctor's duty is to prolong life so far as may be, and to relieve pain, that worst of evils, both bodily and mental. Be it observed that the good doctor is aware of the distinction between prolonging life and prolonging the act of dying. The former comes within his reference, the latter does not.

I should regard with great concern any sanctions which led to a different orientation with respect to the doctor's functions, and yet it is very difficult to see how such a re-orientation could be avoided if this Bill became law. It is true that the Bill makes provision for the act of euthanasia to be administered by other than the customary practitioner who has been attending the patient during the illness; but is not that very fact a serious consideration in itself? If I am correct in supposing that it is intended to replace the intimate relations, to which some references have already been made, which exist in the great majority of cases between doctor and patient, especially towards the close of the patient's life, by the introduction of two, or it may be more, strangers from Whitehall, I naturally ask myself if this substitution is really going to be in the patient's interest. What exactly is it suggested that the doctor should answer in the future to the requests so frequently made to him by the stricken patient: "You will stand by me, won't you, doctor?"?

If we turn to the Bill as at present drafted we find that the patient must make application in writing, in the form set out in the Schedule, and must sign the application in the presence of two witnesses; that the Minister shall appoint one or more persons to act as a referee or referees; that a euthanasia referee to whom an application has been submitted must satisfy himself, by means of a personal interview with the patient and otherwise, that the conditions prescribed by the Bill have been fulfilled; that euthanasia shall be administered in the presence of an official witness; and that the Minister may make regulations for the issue of licences to administer euthanasia; for prescribing the duties of a euthanasia referee and the fees payable to him; and for prescribing the procedure to be followed in administering euthanasia. That is to be in the future, as I read it, the doctor's answer to the question that is so full of meaning both to his patients and to himself. I cannot contemplate without misgivings this suggested intervention of the Bureau, as replacing that complete confidence and understanding which is one of the most satisfactory of all human relationships. My noble friend Lord Dawson has eloquently stressed this relationship, and I am not surprised to find that the experience of Lord Dawson tallies with my own. His Grace the Archbishop has also referred to this relationship in somewhat similar terms, and be it remembered that this relationship with the patient is one the surety of which keeps the patient's morale intact—a vital point. It enables him to put quietly and undemonstrably out to sea.

Noble Lords have made it quite clear in a general sense what are the cases in which legalised euthanasia may be sought. I suggest, all the same, that the criteria which justify the decision to terminate life will be found to be extremely difficult in particular cases—so difficult indeed that I should myself hesitate to undertake such a grave responsibility as the Bill places upon the Minister's referee. Let me briefly review these criteria. As regards the fatal character and incurability of the patient's illness, I would remind your Lordships that incurability of a disease is never more than an estimate based upon experience, and how fallacious experience may be in medicine only those who have had a great deal of experience fully realise. Lord Dawson referred to cancer. I concur in the views which he expressed, that in a large percentage of cases of this disease pain is not a conspicuous feature. All the same, if this Bill became law, it would be in the main to cases of cancer to which it would apply, for it is almost only in cancer that the three criteria laid down could be thought to be fully established and although it is common knowledge that the essential causative factors of cancer still elude us, there are patients to day suffering from this disease, not only living but free from pain, who would not hate been living ten years ago, and this as the result of advances made in treatment. This being so, and with the prospect of still further advances in the near future, it is clear that the criterion of fatality, if not the criterion of incurability, will become more, and not less, difficult to establish as time goes on.

In the matter of the second criterion, that of severe pain, I again desire to endorse the statement of my noble friend and colleague that we never possessed so many means of relieving pain as we do to-day, and these means may be expected to increase in the future. The Bill makes no distinction between physical and mental pain. The assumption is that it is physical pain that is intended, but it is too often mental pain with which the doctor has to deal. In the case of the patient who is stricken with a mortal disease there is that state of misère which calls for psychological help quite as much as, or together with, the use of chemical anodynes.

When we turn to the third condition that the Bill makes essential to the administration of euthanasia, soundness of mind on the part of the patient, the difficulty facing the referees will be no less than in the case of the other two criteria. It is not that the mind of the patient suffering from a lethal illness is unsound in the legal sense of the word; it is that the patient's mind is uncertain, variable—no certainty or clearness of purpose. During the morning depression he will be found to favour the application under this Bill, later in the day he will think quite differently, or will have forgotten all about it. The mental clarity with which noble Lords who present this Bill are able to think and to speak must not be thought to have any counterpart in the alternating moods and confused judgments of the sick man.

And should not we envisage another possible situation if this Bill become law, and one which I suppose is quite unintended? Will not some persons who are smitten with lethal illness misinterpret the raised eyebrows of some of their friends, and feeling, as did the English monarch, apologetic for being so long in dying, will they not consider that they ought to avail themselves of this legalised permit to ring down the curtain? I am reminded of that picture your Lordships will remember, drawn by Browning—the sick man whose approaching end and even whose obsequies were the subject of whispered conversation among his friends: And still the man hears all and only craves He may not shame such tender love and stay. For we must distinguish very carefully between the agony of friends and the agony of the patient. To live is his, and not their, inalienable right. I was surprised to hear the noble Lord who introduced this Bill mention, and even stress, the patient's consciousness of being a burden as being important—even, the noble Lord said, the most important condition for legalised euthanasia. I fail to find any reference to this condition in the Bill. Are we to understand that this condition alone is regarded as adequate for a successful application under the Bill? From my own experience I would say that although his morale give again and again yet in most cases deep down in his heart the patient would feel: I would hate that death bandaged my eyes, and forbore, And bade me creep past. Illness and even pain are for many people a new and a not unhappy experience of the spirit, and we know that it is well within the ambit of the doctor's conscience to see that the fight is not too hard to be borne; and to call this function of the doctor an intolerable burden to the doctor, as did the noble Lord in his opening speech, is untrue. It is also a disparagement of the way in which doctors generally carry out a very necessary part of their work. In conclusion may I repeat my main thesis? The two extremes of dying in pain and being killed do not exhaust the possibilities for the stricken patient, because there is a middle position created by a kindly and skilful doctor who gives assistance to an equally kindly Nature, and that is what is at present implicit in the patient's question: "You will stand by me, won't you?" and the doctor's assurance: "Yes, I will."


My Lords, we have the advantage in discussing this measure that it in no way involves our general view on political matters. Each individual in your Lordships' House, without respect to the Party of which he may be a member, will feel that he is entitled to give an independent opinion on this subject. We all know that for many years past suggestions have been made of some form of legalised homicide, apart from anything that follows a decision in a Court of Law, that is to say, persons whose lives are shown to have no value to them or to anybody else might properly be removed from the world. The noble Lord who moved the Second Reading did not attempt to start on that dangerous path. He has confined himself entirely to suggesting a form of legalised suicide and, persuasively moved as the measure was by him, I have no doubt that not a few of your Lordships were inclined to sympathise with the principle involved, apart from the provisions of the particular Bill.

I must say that I am glad personally that I had not to take part in the debate until I had heard the last four speeches that have been delivered, by my noble friend Lord FitzAlan, who was able to speak for the Church of which he is a distinguished member, the most reverend Primate, and my two noble friends who stand high in the ranks of the medical profession. I am glad to follow the various arguments which they have used. In the first place there is the religious argument which was put forward by Lord FitzAlan and he stated it with his usual force and fairness. On that I would only say this, that to all who do not take a purely materialistic view of life the existence of pain, the amount of pain in the world, remains a complete mystery. It is no doubt sometimes conceived that pain may be a needed discipline of character, and in others it may apply to an unthinking mind the power of sympathy with others who suffer. But it is difficult to suppose that Divine mercy could desire the long continuance of a condition of pain which ex hypothesi could have neither of the results of which I have spoken. As the noble Lord, Lord Ponsonby, pointed out, there are no doubt some absolutely simple and straightforward cases in which the processes detailed in the clauses of this measure could be carried out without much difficulty, but it appears to me that there is a very much larger number of border-line cases in which the proposed action would be far more difficult.

As both the noble Lords who speak with medical knowledge have made clear, this Bill would throw a very heavy burden of responsibility on the medical profession. The noble Lord, Lord Ponsonby, made it clear that he was thinking not merely of the pain induced by a particular disease but of the moral and mental anguish from which the patient might independently be suffering. As I think my noble friend Lord Horder pointed out, there is not a word of that in the Bill. Nothing whatever is said except of illness "involving severe pain." It seems to introduce an entirely fresh set of considerations if the habitual medical adviser, before agreeing to this form of legalised suicide, has to decide whether the feelings of the patient are such as those that Lord Ponsonby mentioned of his being a heavy material burden to a poor family, and such other similar considerations as might be thought would have to be borne in mind, as well as the character of the illness and the amount of severe suffering which it involves.

When the fatal character of an illness is mentioned I do not think the noble Lord made it clear within what period of time it was expected that the fatal result was bound to follow. Would the patient be entitled to undergo euthanasia if the fatal result might very probably not take place for a number of years? There is another possibility which I think would throw a very severe responsibility on the doctors. Every now and then cases occur of altogether unanticipated cures. I can recall two cases which came under my own observation of people suffering from quite different diseases who were seen by more than one highly competent doctor and both of whom were informed they had a very short time to live. In the event both these persons outlived by many years all the doctors who were concerned in their cases. One was a case, which is liable to occur even with the most highly skilled doctor, of a mistaken diagnosis. The other was cured in a way I was never able to understand, by a completely novel and unauthorised remedy which no practitioner would have suggested. It may be said that even if such a case were to occur under the provisions of this measure it would not really matter to anybody but the patient, because it is difficult to prove one way or the other whether he or she would have recovered, but I merely cite it as making it likely that in certain cases of doubt the medical attendant would be very slow to give the necessary authority for calling in the other practitioner who is to superintend.

There is a third possibility for which I see no provision whatever in the measure. Supposing a patient, after having asked to be subjected to euthanasia, should change his mind within the period of time, which would not be I fancy a very short one, set up by the Bill. Something might actuate his mind. He might be greatly relieved from pain for a period of time. Some event might be impending—a marriage of a son or daughter or the expected birth of a child of another generation. The patient might say: "I am feeling decidedly better than I was, and although I do not want to live very long I should greatly prefer to put off this process of euthanasia for six months or so." That would introduce, I think the noble Lord would admit, a highly inconvenient complication into the process which is clearly laid down in the Bill.

I confess I have been greatly impressed by what fell from my noble friend behind me (Lord Dawson of Penn) and the noble Lord on the Cross Benches (Lord Horder) and also from the most reverend Primate. I quite appreciate the attraction of the principle involved, but I cannot see how it would be usefully applied, particularly in view of the statement of my noble friend Lord Dawson with regard to the existing practice in the profession—a practice which must vary in every individual case according to the needs of the patient as they appear to the medical man. For that reason I am bound to say that it would be impossible for me to vote in favour of the noble Lord's Bill.


My Lords, I think we are very much indebted to the two very distinguished members of the medical profession for the light they have thrown upon this very important subject. They have imparted a good deal of technical knowledge to those of us who can only take a more or less common-sense view of the whole issue. My noble friend Lord Horder certainly put his finger upon a weak point in the Bill when he pointed out the dreadful responsibility that it would lay upon those who would be responsible for authorising this act of voluntary suicide. Moods vary. The mood of the patient will vary, as Lord Horder pointed out, and certainly the views of those who surround the patient may vary. The whole thing would be mixed up with so much uncertainty that no one could feel that he was standing upon any very safe ground.

Then it has occurred to me that all these elaborate safeguards, which occupy so great a part of the Bill, show a certain doubt on the part of its supporters as to whether they have arrived at a right solution for dealing with this difficult subject. I feel a certain sympathy with the large and broad view that my noble friend Lord Dawson has taken in urging us not suddenly to stereotype public opinion but to leave it to grow, and grow in a right direction. We all know that one of the practices of the great medical profession is that they always share with one another all the best that they have discovered. They do not keep their discoveries to themselves, and there is no profession in which public confidence grows more securely, and no profession in which the thoughts of the leaders of the profession more readily percolate, without any secrecy, among those who look to them as leaders. I cannot believe that we have any right to argue from the way in which we feel that we should treat incurable animals. We know very little about the way in which they do or do not feel pain, and certainly we know there is something higher in man which differentiates him wholly from the other creatures.

I would not myself entirely use the language used by the noble Viscount who has urged the rejection of this Bill. It does not seem to me to be, strictly speaking, quite a religious question, or indeed quite an ethical question. My hesitation in the matter is that we are called upon by this Bill to act in a sphere in regard to which we can really know nothing. We may see the pain of the sufferer, but when we come to the terms and the issues of life and death, that is quite another matter. There is only One who ever came back from that "bourn from which no traveller returns" with any knowledge of the further side. We do not possess that knowledge, and I do not think that we should be wise to legislate as if we did. It is urged, I know, that in the case of the law it does inflict a death penalty in certain cases, but there is no real relevance in that. Here we are speaking of the voluntary euthanasia of the sufferer. There we are speaking of death inflicted from the outside. This is not the time or the place in which to speak of the whole subject of punishment; but it is quite clear that in the case we are considering, as in many other cases, the range of the reasons would reach far beyond the actual sufferer. We cannot, therefore, then say that if we impose death in one case we are entitled to allow people to choose death in another case.

I should be very sorry if in any way in any speeches that have been made against the Bill introduced by the noble Lord, Lord Ponsonby, there should be any kind of impression that we look upon suffering with indifference. I am perfectly certain that that is not the case, and that we all feel very much for those called upon to suffer pain. We are very much indebted to the noble Lord, Lord Dawson, for the way in which he put pain first in his remarks. He pointed out that it may be right to alleviate pain and that there may be risks in alleviating pain, but that the alleviation of pain is the important thing, and that those able members of his great profession who are alleviating pain are not engaged in bringing an end to life, pretending to do one thing when they are really after another. I feel sure we are all indebted to the noble Lord who introduced this Bill for the sympathy of his words, though I for one could not support him, because I feel certain that I have no right upon that mysterious ground that lies beyond. Still we are very grateful to him for giving us the opportunity of making it quite plain that we do not look on with callous indifference to those who are called upon to suffer excruciating pain which is beyond even medical science to alleviate. For the reasons I have given, I shall myself vote with the noble Viscount, Lord FitzAlan.


My Lords, I should like in the first place to associate myself with all those noble Lords who have expressed their deep regret at the absence of the noble Lord, Lord Moynihan, from the debate this afternoon. His loss is mourned by none more deeply than by those who have been associated with him in the past in this work of attaining what we believe to be an easy release for the dying. I am speaking this afternoon as a vice-president of the Society for the Legalisation of Voluntary Euthanasia, a post that I have had the honour to hold for some time in a body whose principal object has been to enlist the support of public opinion for the principle of this Bill and, when the time is ripe, to carry a Bill of this kind through both Houses of Parliament. I think that your Lordships are never happier than when you are enjoying a holiday from Party politics and the debate this afternoon is no exception to the general rule. I should like first of all to say how glad are those of us who support this Bill that the most important religious denominations in this country should have been represented directly or indirectly in this debate. We are naturally fully aware that this whole matter is one of the utmost controversy and that there is considerable difference of opinion, particularly in religious circles. We are therefore very glad that the considerable volume of public opinion which is behind those who have expressed that view should have obtained such an ample and eloquent mouthpiece this afternoon.

At the same time, I wish to try and win over your minds from the spell that has no doubt been cast upon them by the speeches to which you have just listened. It was an interesting fact that the noble Lord, Lord Dawson, and the most reverend Primate were both in favour of the taking of human life in certain circumstances. The noble Lord, Lord Dawson, went so far as to say that he was in favour of the principle of voluntary euthanasia, while of course opposing this Bill. The most reverend Primate described how in certain cases of great heroism there might be ample justification for what many people would call suicide. The noble Lord, Lord Horder, expressed the view that in certain circumstances a doctor might act on his own initiative in the matter of terminating the suffering of his patient. What is the consequence of what I think I might describe, with the agreement of the speakers themselves, as this very interesting attitude? Those who have adopted this view would have things remain as they are, and what does that mean? It means in the first place an extremely heavy burden of responsibility on the medical practitioner, and a far heavier burden than this Bill could conceivably place upon him.

The medical man is being asked to use his own initiative, to take the risk of being turned out of his profession, of losing the means of livelihood of himself and his dependents, to perform an action which is at the present moment contrary to the law, and in fact criminal, in order to satisfy his moral conscience. That is surely the gravest possible responsibility which could be imposed upon any one—that he should have to risk his good name, his liberty, his means of livelihood it circumstances of this kind. What would be the consequence of that? Surely that in a great majority of cases medical practitioners, who I have no doubt have just as high a sense of responsibility and just as sensitive a conscience as any one else, will hesitate profoundly before taking a line of action that would be justified on moral grounds. That means that a great majority of those who expire in this way at the moment will continue to do so in time to come. I should like to point out, with the utmost respect for the considered opinions of those who oppose this view and are in favour of retaining the status quo, that they are themselves accepting the responsibility of condemning a number of people—not a very large number, but in this case it is not numbers but the acuteness of individual suffering that counts—every year to days and perhaps months of acute agony. I do not say that noble Lords will change their view, I am only saying that they hold this view, and I sincerely trust that they are fully aware of the tremendous personal responsibility that they are assuming.

At this stage in the debate I intend to be very brief. I should only like to say that those of us who support this measure, and who have been advocating the principle that it embodies, are most anxious to persuade devout people of every denomination that in point of fact what we recommend is in accordance with everything that they believe. As the noble Lord, Lord Ponsonby, pointed out, there are a number of people in the leading Churches of this country who are already on the side of the Bill, and we believe that by propounding the arguments in its favour we shall be able to win over religious opinion. There is, I think, one argument that appeals most of all to those who profess the Christian faith, to whatever denomination they belong, and it is that, from the very inception of Christianity, the cardinal point of the Christian ethic has been the exercise of charity. Any Bill that would extend this principle of charity, of pity and compassion is surely one that is in harmony with the main body of the Christian tradition.

I believe, if you examine on their merits the arguments for and the arguments against this Bill, that the great increase of the exercise of the spirit of pity and compassion, and the large decrease in the volume of human suffering which would follow on the passage of this Bill, should suffice to banish all other arguments from your minds. That is why I sincerely recommend this Bill to your Lordships and hope that you will give it a Second Reading. I think there are many points that could be altered on the Committee stage, but I am perfectly certain that none of your Lordships who vote in favour of the principle of this Bill will have anything to regret when you look back upon this occasion when you took a practical step to decrease suffering among human beings and to promote on a larger scale the beneficent action of the spirit of charity.


My Lords, I would ask leave to repudiate with emphasis the charge just made by the noble Earl that those who oppose this Bill are condemning people to lives of acute suffering. Will he allow me to say that there could be no grosser travesty of the speeches, to which I hope he listened, from Lord Dawson, from Lord Horder and from the most reverend Primate? On the contrary, this Bill is drawn in such a way, is so misconceived from a psychological point of view, that it will cause more suffering than it relieves. I contemplate with horror the strife and the dissension which this Bill is going to bring into every family to which the Bill applies. The family will be riven in twain by this Bill: one section will take one view, another will take the other, and there will be offence which will be unforgivable because unforgettable.

I contemplate with profound distress the unconscious pressure which will be placed upon the sick man to persuade him that he is in the way and that he should evacuate this life. I contemplate that pressure with a distress which I can scarcely express to your Lordships. Finally, I contemplate with disgust the intrigue and the combinations which will take place to bring pressure to bear upon some wretched person to sign this document, to make these affidavits, and to take good care that he does so on the right date. These are aspects of suffering which do not seem to be contemplated by the noble Earl, Lord Listowel, when he brings these charges against those of us who oppose this Bill. For my part I think that we lay people are much too ready to intervene in these medical matters, upon which we have not been fully educated, and I for one should profoundly deplore the dangers which must arise from the interposition of an Act of Parliament which has all the complications, all the clumsiness and all the tactlessness which are associated with an, ill-conceived measure.


My Lords, I think it has been made clear in the course of this debate that the principle of the Bill offends, or is likely to offend, the religious convictions of at least one section of the community, and it may be that others not of the same persuasion share those views for the same reason. In such circumstances I do not think that any Government would desire to be dogmatic. Accordingly we propose, so far as the main principle of the Bill is concerned, to leave the verdict to the free vote of your Lordships' House. At the same time I must point out that, if the Bill were to receive a Second Reading, the Committee stage would undoubtedly involve consideration of a number of administrative points where the Government would be closely concerned.

Under the Bill my right honourable friend the Minister of Health is entrusted with various responsibilities and duties which in turn affect his relations with the medical profession. We have been told to-day that, while some of the doctors approve of this measure, others disapprove of it, and if this is so we should naturally hesitate before appearing to impose on a section of the medical profession an obligation to do something which they might consider morally wrong or repugnant. Again, we have heard on the highest authority that medical science normally alleviates the sufferings of these incurable patients by means of drugs and sedatives. Safeguards against the abuse of such methods are provided by the present law and by the jealously-guarded standards of professional conduct. At present we are unaware of any body of opinion that condemns the use of drugs to relieve the suffering of incurables on the ground that, in spite of these safeguards, there are risks involved. But we should have to consider very carefully the probable results of placing new and much more precise responsibilities on the shoulders of the doctors.

I need not go into detail as to what those new responsibilities are; they have already been explained very thoroughly, particularly by the noble Lord, Lord Horder. What would be the reactions of these proposed new official formalities on the relationship between the doctor and the patient? What would be the influence of the patient's relatives? Would it be easy to certify officially the condition of the patient's mind in these somewhat abnormal circumstances? I What would happen if the patient changed his mind? I am not attempting to argue any of these points or to present an exhaustive list of the difficulties which might perhaps occur to my right honourable friend. All I am suggesting is that, apart altogether from the question of whether this Bill is right or wrong, there are a large number of highly controversial administrative questions that would have to be investigated before it would be possible to determine either that the patient the doctor was really helped by the Bill. In these circumstances, although the Government will consider with great attention and interest what has been said in this debate—I think it has been a remarkable debate—yet in the present congested state of business we could not make a very definite guarantee of what facilities could be afforded for this measure in another place. In conclusion I should like to associate myself with the regrets that have been expressed at the absence from the debate of the noble Lord, Lord Moynihan.


My Lords, I should like to thank the noble Viscount for his reply, and especially for the decision to which he has come with the Minister of Health that this is a question mooted for the first time which may be left to the decision of your Lordships' House without the Government Whips. As to the attitude of the Government on this question, I perfectly understand that a new question of this sort, which cuts through all Party divisions, is not one on which the Government can be expected to make any pronouncement at all at the present time. I certainly do not regret having initiated this debate. I think it has been an extremely interesting discussion of an entirely new problem, and the speeches, one and all, have been sympathetic and interesting, with the exception, perhaps, of that of the noble Earl, Lord Crawford, who made a short travesty of the measure in order to object to it. I must say that the speech of the noble Lord, Lord Dawson of Penn, impressed me very much, because all he said with regard to agreement with the principle, coming from him, was most impressive and most helpful. In his final conclusion I very humbly beg to disagree with him. To allow the idea to grow—and to encourage it, as a great many speeches have—that doctors should use their discretion in administering euthanasia, seems to me a most dangerous principle to adopt, and I am convinced from what I have heard that a very large section of the medical profession resent very much this burden being cast upon them.

I am not at all sure that some of these speeches which have been delivered here to-day will not enlarge this practice in a way that may not be desirable. They will say: "Oh! great figures in Parliament consider that this practice is permissive, is condonable, and therefore we may do it a little more riskily." I am perfectly certain that the time will come when Parliament will have to regulate this matter. I am perfectly certain that a measure of this kind will in time be accepted, and that those who are opposing it now will in time to come feel that they look back, as we look back upon those who opposed the use of chloroform in childbirth, to a time when there was a less enlightened view taken on these crucial matters. I am going to ask you to go to a Division, because I think it is as well that the decision of your Lordships in this year of 1936 should be taken. I am afraid that.

Resolved in the negative, and Bill to be read 2a this day six months.