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My Lords, I had the privilege of being a member of the Select Committee which took evidence on Lord Joffe's Bill and I should like to put on record my gratitude - in particular to the noble Lord, Lord Mackay, who chaired us with remarkable and judicious fairness, and to all my colleagues on that Committee. I learnt a huge amount from each of them.

As a Committee I think we were agreed about one thing, that no-one should suffer unbearably, and we all recognised that in those circumstances where someone may be suffering unbearably towards the end of their life, we would want medicine to intervene. But it was at that point that we parted company. I and others wanted to ensure that the very best palliative care would be available, care which would surround the person: physically, mentally and spiritually. Those supporting Lord Joffe wanted a further provision, that the patient should have the right enshrined in law to have their life ended or to be helped to commit suicide.

I could not go that far - and why not? Firstly, because the philosophical basis for this legislation is, I believe, profoundly flawed. It is based on the notion that the exercise of personal autonomy is the highest moral good. But a moment's thought will reveal that the exercise of personal choice is not what gives life value. What gives life value, and the highest value, is being in a relationship of love with another person, with one's family, with children and grandchildren, with one's friends and neighbours. All those songs and poems about love through the centuries, from Song of Songs to Kylie Minogue, exist because they are a celebration of the joys and pleasures of life, of things that make life worth living. They aren't an aberration. Apart from Frank Sinatra's I Did It My Way, and nothing could be more kitsch and self-centred, when did you last hear a song about the joys and importance of personal autonomy?

But what is this personal autonomy which is being demanded? The argument seems to run in a curiously syllogistic form:

1. Medicine exists to cure illness and relieve suffering

2. I am ill and suffering

3. I have personal rights

4. Therefore I have the right to demand that the purveyors of medicine kill me.

The argument has serious holes in it. Firstly, you can only give the patient that sort of right by infringing the rights of doctors. It's no answer to this to say that any law would contain a 'conscience clause' whereby physicians could opt out of this. We heard these arguments when the Abortion Act of 1967 was being debated, and yet there are reports that gynaecologists with conscientious objections to abortion are passed over for consultancy posts. For the plain fact is, my Lords, that doctors become doctors to heal the sick and to relieve suffering, not to kill. That this is so, is shown in opinion poll after opinion poll. Yes, there is a minority of doctors who would be prepared to do this. But the great majority, and especially those who know about the care of the dying, don't want it foisted onto them. Imagine, if the Bill went through, the ward round. The first caller is the clerk taking your order for breakfast: 'Would you like cornflakes or porridge? The next caller is the doctor who would be required to offer you a series of options, including euthanasia or assisted suicide. To call it a 'therapeutic option', as some proponents have done, is to see language values twisted out of all recognition. Is this really what we want?

Secondly, there are the rights of other terminally ill people to be considered. It is simply naïve to suggest that because any law would allow assisted suicide or euthanasia for volunteers only, that that is what would happen in practice. After all, what is a volunteer? The Committee was told that the number of people who are really serious about having their lives ended is very small indeed. And yet the figures which are coming out of Holland suggest that the practice has gone well beyond a determined minority of strong-willed people. If we shut our eyes to the risks that elderly people will ask for this out of a sense of mistaken obligation and a wish to remove a burden from their children's shoulders, or that others will sign up for it when their judgment is clouded by depression or feelings of helplessness or fear of suffering, then we are not living in the real world. These are the people whom the present law protects. We need, my Lords, to think of their autonomy as well as that of the small minority who are clear what they are about.

Thirdly, whose autonomy would really be exercised here? One of our witnesses, who was opposed to Lord Joffe's Bill, described assistance with suicide as like 'a psychological push from the bridge.' His argument was that if we saw a man about to jump from a bridge and end his own life, we would intervene; so, he argued to us, we shouldn't encourage terminally ill people to take their own lives. But, when I put the same question to another witness, a supporter of Lord Joffe's Bill, his answer was rather different. Faced with the situation of the man about to jump from the bridge, he said he would intervene. But he added (and I quote):

The principle of beneficence would rise above the principle of autonomy until you sort through what is going on.

And then he made clear what he meant (I quote his words again):

In the situation of a person who is terminally ill and has unbearable suffering, then I think autonomy starts to push into the front.

In other words, he was saying that whether or not we intervene to stop someone taking his own life depends not on whether that person is suffering unbearably (both the man on the bridge and the man who is terminally ill were deemed to be suffering unbearably), but on a value which we place on the one life or the other. To stop one suffering person from committing suicide and to assist another is to communicate an important value judgment about each of them. In the relatively rare cases where a terminally ill person is crystal clear that he wants to end his life, such a value judgment probably has little effect. But in the much more common situation, where terminally ill people are simply desperate, and don't know where or to whom to turn, and are frightened - in these much more numerous cases, a doctor who complies with a patient's request to set the process in train, is sending a powerful signal that the patient is making the right decision. And in that sense, he is interfering with his patient's autonomy by taking sides in an argument which is still in progress within the patient himself. But he also is exposed to the invidious effects that killing someone may have upon himself: will not his sensibilities be inevitably blunted and his judgment flawed?

My Lords, there is a story in the Scriptures which has shaped the civilisation of our country ever since it was first heard; it is the story of Cain and Abel. You know that after Cain had killed Abel, the Lord asked Cain a question: 'Where is your brother, Abel?' Cain replied: 'I do not know. Am I my brother's keeper?'

The answer to that question has shaped our society and challenges each generation. Because we have recognised the authentic moral force of the question, we have, so far, answered with a resounding: 'Yes – I am my brother's keeper'. If we allow this Bill to proceed, we shall be overturning some of the most cherished and profound values by which we, as individuals and as a society, live.

I urge the House, for the sake of society and for the sake of the most vulnerable, to reject the Bill. But that alone is not enough. What we have to do is to recognise that the desire to be compassionate, which all of us on the Select Committee share, should be given expression, not through euthanasia or assisted suicide, but by ensuring that everyone in our country has available to them the best palliative care in the world. Nothing less will do.

© Christopher William Herbert, 2005