Baroness Cass (CB)

My Lords, we know that people may have many of the problems that proponents of the Bill have described as reasonable justifications for why someone may want to end their life. They may already be a burden, as they see it, or incontinent, or under financial duress, or have pain from arthritis, or have a whole host of other things going on in their life. They may have fallen out with members of their family. There is a multitude of things. We have heard endlessly about that. Then, randomly, they get this ticket—the ticket that nobody wants—that says that they have only six months to live. Prognostic predictions such as that are based on averages, and the shocking fact, as we know, is that 50% of people are above average, so there will be a huge range. If you have been given a six-month prognosis, it could be anything from one month to 32 years, as we have heard. To say that that is your ticket to be allowed to have an assisted death, and then completely disconnect that fact from the reasons for your assisted death, makes no sense at all. There is no internal logic in that. The amendment from the noble Baroness, Lady Berger, is brilliant in getting us past the intolerable suffering to something that is plausible, tangible and clear. As I have said previously, doctors make judgments all the time. The judgment about the six-month rule is hugely inaccurate, as I have just described, but the one thing that the doctor can usefully do is determine whether there is plausibility that the symptoms that are distressing the patient are related to that illness. They do not have to be the only reason; there can be all those other factors going on. But if there is plausibility that there are symptoms related to that illness—be it pain, breathlessness, incontinence or whatever else happens to be distressing to that individual—that seems to me to be acceptable. However, personally, I would prefer it to be limited to pain, breathlessness and things that may not be amenable to treatment. None the less, that still gives the doctor some yardstick to determine that this is not just about coercion, even some internally driven coercion that the patient feels that it is their job to end their life. Anything else, and you are asking for somebody to make a judgment that is just not feasible. I cannot see—I have said this before —how it is feasible to assess whether the patient is feeling coerced in the way that the noble Baroness, Lady Fox, described in earlier discussions just because of the tutting and the head shaking at having to bring something to the patient or the person once again. This would give us something that is concrete, clear and defensible, which I think is what the public believe this Bill to be about.