My Lords, it is indeed an honour to open the second day of our debate on the Terminally Ill Adults (End of Life) Bill. I pay tribute to my honourable friend Kim Leadbeater, who represents the seat in which I was born, for bringing the Bill to us from the Commons. I thank my noble and learned friend Lord Falconer for the clarity and excellence of his introduction to, and leadership on, this Bill.
As my noble friend the Chief Whip said, last Friday’s debate was outstanding and the House of Lords at its best. There are many questions to be addressed as we do our job in scrutinising the Bill, and the questions posed come from those of us who support the Bill and those who do not.
I am greatly relieved that my noble friend Lady Berger and my noble and learned friend Lord Falconer, in their joint email to all Peers, say that their agreement will allow the Bill to go through all its stages in your Lordships’ House. With respect to those who disagree in principle with assisted dying, it is important that we remember that the Bill came to us from the Commons, and has undergone significant scrutiny and change. Our job is to scrutinise it further and improve it if we need do so. It is not our job to kill this Bill.
I was saddened last week when the noble Baroness, Lady May, spoke about this being a suicide Bill. People have written to me in the last week, very distressed. They add things such as, “We are not suicidal—we want to live—but we are dying, and we do not have the choice or ability to change that. Assisted dying is not suicide”.
I hope that today the House will continue to conduct this debate with compassion. I shall read an extract from one of the many letters that I have received, which explains the importance of compassion; I cannot better it. This concerns a woman, Pamela Fisher, a lay preacher in the Church of England and who has terminal cancer. I am reading these words with Pamela’s permission. She says:
My Lords, the House will know that I have a moral position on this, but I am not going to talk about that.
This has been a most remarkable debate, and all of us from both sides have learned from what has been said. What has come out of it seems to be, first, that this is a very difficult issue. Secondly, although other countries have tried to do this, no one has produced an example of saying, “That’s where it works”. Instead they say, “That needs to be changed” or “There’s a problem”. Yet we are trying to debate this serious matter on a Private Member’s Bill that was inadequately dealt with in the Commons and has been criticised seriously by two of our expert committees.
What we are trying to do is momentous because we are seeking to depart from what has always been our attitude—apart from the question of capital punishment, which I fought against for many years—by empowering the state to kill. You can argue that, but let us realise just how serious it is.
I was an MP for 40 years and met wonderful people in both my urban and rural constituencies, but I also met people who felt that their old relations were a terrible burden and were spending money that would be much better left to them. I do not think we can ignore that fact, and I disagree with my friend, the noble Lord, Lord Dubs, when he suggested that somehow or other this was inconceivable. I put it to the House that not only is it conceivable but it is increasingly dangerous, because many families who have never seen any real money now see an aged relative who has a house worth £200,000 and more. There is a temptation for those people, whom I know and have met, to say to that person, “You really have a duty to save this money for your family. You know that Roger’s got a real problem and you can help him. This is what you should do”. No doctor is going to be able to analyse what has happened over a long time; the incident that we are discussing is very often at the end of a long period, when people come to that decision with that kind of pressure.
I support the intent of the Bill to increase personal autonomy for those with life-limiting illnesses, but good legislation must provide adequate protection for the vulnerable, including those with eating disorders. The malnutrition that accompanies anorexia means, as the noble Baroness, Lady Debbonaire, said, that if treatment is delayed or refused, the physical condition of someone with a mental illness can deteriorate to a life-threatening degree.
Starvation of the brain causes distorted thinking and severely impairs how a person weighs up information. I remember vividly when our daughter was in the grips of severe anorexia. She could debate proportional representation with me, but she was adamant that she would rather die than put on weight. Yet, in countries where assisted dying is legal, lethal drugs are being given to people with this condition, which has a well-established link to depression and suicidality, despite the fact that, with the right treatment and support, recovery is possible even after many years of having the disease.
According to a systematic review of the available evidence of assisted dying published in Frontiers in Psychiatry, eating disorders are being classed as terminal, and at least 60 people with them have been helped to die. To be clear, that is in countries where, as this legislation proposes, assisted dying is legal only for those with a terminal illness.
In the debates in the Commons, Kim Leadbeater MP said she did not want people with anorexia to be included within the scope of the Bill and I agree, but, as it stands, they are. The Royal College of Psychiatrists has called for the Bill to be amended so that it explicitly states that the physical effects of a mental illness such as an eating disorder would not make a person eligible. I urge noble Lords to heed that call. Vulnerable lives must be protected if we are to take this momentous step.
My Lords, it is a great honour to follow the noble Baroness, Lady Parminter. We are at a crossroads and must decide what kind of a nation we want to be. We have long believed that human life is sacred, worthy of dignity and respect. This has been enshrined in the biblical foundation of our laws. Some would say that this belief in the sanctity of human life is outmoded, and only compelling if you hold old-fashioned religious views. As a Christian, I strongly adhere to those beliefs. What happens if we reject this fundamental principle, which has served this nation so well for so long? Is it not time to bin this old-fashioned view of life? To do so, in my view, would undermine the very foundation of our societal values.
Writing in the Times recently, Matthew Parris argued that the elderly and infirm are a drain on resources and that it would be “a good thing” if they felt the unspoken pressure that their “time is up”. This kind of attitude will lead to an economic evaluation of human life, carried out against the backdrop of the crushing weight of the pressure on the NHS and the nation’s finances. There is absolutely no question that the Bill, if passed, will devalue the importance of human life, and economics will become part of the decision-making process.
The NHS will save money, and families will protect their inheritance, as the noble Lord, Lord Deben, said. It has been estimated that the Canadian Government and their provinces are now saving at least $150 million a year as a result of assisted suicide. As we know, the scope for eligibility continues to be expanded there, and the same will happen here. I am not at all reassured by the Bill’s sponsors about restricted eligibility. The slippery slope will become a reality, for sure.
We must not dismiss the deep concerns that many in the medical profession have expressed about the Bill. So many individuals and organisations have flagged that they are either opposed to the Bill or extremely worried about aspects of it, including most of the royal societies, as has been mentioned a number of times in the debate. This is deeply concerning.
My Lords, it is a privilege to follow the noble Lord, Lord Curry. I begin by acknowledging reverence for all contributors to this debate, which touches on our deepest emotions: lacrimae rerum, the things of which tears are made.
The noble Lord, Lord Carlile of Berriew, reminded us that, since the end of capital punishment, causing the death of another citizen is not allowed in our law, other than in war. The noble Lord, Lord Herbert of South Downs, was not alone in describing the introduction of a provision in law to cause death as a “crossing the Rubicon” moment. Although the right to life, enshrined in law, is a moral principle consistent with the Christian faith, it should not be regarded as the imposition of Christianity on the pluralist democracy we are proud to be. However, many Christians, including myself, see the Bill as crossing the Rubicon, and this is why.
Christians derive commitment to the sanctity of life from our understanding of the very nature of God as Trinity: three persons, not begotten or made of material substance, one in nature and omnipotence, but distinct persons in the relationship of Father, Son and Holy Spirit. Distinctness and relationality in God also become characteristic of how and what, in love, God makes us to be as human beings, endowing us with free will and the capacity to use or misuse God’s gift of life in all its dimensions. A unique likeness to God, which encompasses an immaterial, spiritual dimension, subsists equally, we believe, in the flesh and blood of every human being. This is a foundational contribution to the common-law prohibition of homicide, and it consequently inhibits us as Christians from supporting legislation to take the life of another person, as envisaged in the Bill.
Furthermore, the Bible repeatedly identifies compassion as essential to the nature of God, so human suffering, especially around the end of life, compels us to press ever more urgently for significant, increased and sustained investment in palliative care and to learn lessons from the hospice movement’s attention to the qualities of distinctive, individual needs and relationships, in sharp contrast to the complex bureaucratic processes outlined in the Bill.
My Lords, I have spoken in favour of assisted dying in previous debates in this House, and that is still my position. Therefore, I am grateful to Kim Leadbeater MP for her work in steering the Bill through the Commons. We must not forget that the elected House has supported it; our task is to scrutinise, not reject it.
Like my noble friend Lady Thornton, I was concerned at proposals last week for a Select Committee, which might undermine the agreed timetable for such scrutiny in Committee. After so many years considering assisted dying, whether in Select Committees or Private Members’ Bills, it is now important that we complete the process. Therefore, I am grateful that my noble friend Lady Berger has agreed to a committee that is limited in scope and time, allowing the Bill to go through all stages before this Session ends.
With a view to improving the Bill, I welcome the opportunity to look into procedures and safeguards, calling evidence from experts. I am impressed by many of the contributions made so far, including some speeches from those not in support of the Bill. However, I regret the language used sometimes, such as references to the “killing Bill” or the “assisted suicide Bill”. Because of my personal experience, I am affronted by this.
When my former husband, in hospice care, was dying of stomach cancer at the age of 44, in agonising pain, with terrible nausea, too, he desperately wanted it to “come to an end”, as he put it, and asked for my help. I tried to persuade his carers to speed up his death, but failed. Is this “killing”? Was his wish to die “suicide”? Surely not. He loved life and had not wanted to die, but he was dying and, when life became truly unbearable, he longed for death. Because of the law, I could not help him end his torture.
As legislators, we have a duty to consider public opinion. Rigorous surveys all report high support for the Bill, ranging from 73% to 80%. The Nuffield Council on Bioethics set up a citizens’ jury on assisted dying earlier this year. Support for law change actually grew over the eight weeks of deliberations, when participants heard views from all sides. There are also large majorities in favour of assisted dying among Christians and those of other faiths, as well as disabled people.
My Lords, I have two points that I wish to make. First, I do not support the Bill in its stated aims; neither do I support the increasingly strange and weird way it has proceeded before Parliament, mutating into some sort of ever-changing hybrid Private Member’s Bill invention. HMG have been giving some covert, and now more overt, help to these beleaguered measures, rather than taking their own responsibilities, which they should have done from the start.
It was truly prescient of Cardinal Nichols when he said on 5 February that there was
“something deeply lacking in a government that isn’t prepared to guide and sponsor, if it wants to, this process of legal change”.
If I may say so, I think His Eminence has been proved spot on in what he said then. This unholy legislative mess can be helped—a bit—only by the excellent and still to be consummated proposals of the noble Baroness, Lady Berger, and all that she has suggested for a time-limited Select Committee. That must be a help to improve it.
My second point after procedure is on palliative care. I am not in favour of suicide facilities being provided by the state in the face of possible terminal illness. Illness is not always accurately diagnosed in the first instance. I do not believe there is some automatic choice between dying badly and, if you do not want to do that, having some self-styled assisted suicide. Rather, we must look after the very seriously ill with great compassion, and so much better than we do now.
We need much greater protection from, and legal penalties against, coercion to die. Families are not always very nice places in the way in which they behave, alas. The domestic setting can sometimes be one for domestic abuse, elder abuse, abuse of the mentally disabled, which I am very worried about indeed, and the physically disabled. We need a much more precautionary effort to protect and safeguard those at risk, maximising the opportunities to safeguard the vulnerable, which I think the Bill fails to do in what it has said so far.
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“I live in terror at the prospect of how my final weeks of life may be. I have seen other family members (brother and father-in-law) at the end of their cancer journey, and I know what may lie ahead. Even the best palliative care has its limits. This is the dead weight of fear that I carry around with me, all the time.
I am not asking anybody to help me to shorten my life. In supporting the Bill, I seek to have the choice to shorten my death in my final weeks should my pain and suffering prove unbearable. As a Christian, I believe in loving my neighbour as myself and, on this basis, I seek the same choice for eligible others.
As a lay preacher, I cannot reconcile Christian compassion with the status quo that obliges people to suffer a drawn-out process of dying in pain when this is against their will and they have the capacity to choose. Church leaders often apply the concept of the ‘sanctity of life’ to resist assisted dying. The sanctity of life is rightly central to Christian faith. For me, the sanctity of life is about honouring the life of every individual, and this necessarily includes providing the care and treatment they need including, of course, excellent palliative care. I reject the assumption that the sanctity of life requires terminally ill people to undergo a distressing and painful death against their will.
I am asking for you to support this Bill. It would be tragic if the Bill were to fail now, having passed through the Commons with a clear majority. It would be personally devastating for me and for countless others. The majority of the UK population supports the Bill, and there is also a majority among Church of England congregations, despite the Church leadership’s energetic lobbying against the Bill.
Please remember, this is not about shortening life; it is about shortening painful and distressing ways of dying. Despite the best palliative care, around 20 people die in agony and/or awful distress every day”.
This is Pamela’s plea for compassion, and mine too.
I am sorry that that is the case, and it is the case in a society that has far too many people about whom it has been suggested, because they do not work, are not worth anything. We must recreate the worth of all of us and the place that we all have in society. I am an individualist and a Tory, but I have to say that I see individuals as living in a society, and that means that we have responsibilities. It may be—I say this with due humility—that the contribution to society that someone in great pain may make is to protect vulnerable people by bearing that, in order that they will not be destroyed.
It became apparent last Friday that some supporters of the Bill believe that amendments in the Commons might prove the Bill to be “unwieldy if not unworkable”, to quote the noble Baroness, Lady Murphy, who said there is already
“too much bureaucracy and oversight”.—[Official Report, 12/9/25; col. 1797.]
in the Bill. Others—I agree with them—consider that the Bill needs lots of additional safeguards, including to protect those with mental illness, eating disorders, disabilities, communication difficulties and so on. Not only is the Bill currently not fit for purpose; it will become completely unworkable when amended even further.
If we continue down the road enshrined in the Bill, we will not only devalue the precious gift of God-given life; we will see people who could live for years dying early for want of compassion, depriving them, their families and society of their valuable contribution. This is not an exact science. Freedom of information data from the DWP shows that one in five people who qualify for end-of-life benefits are still alive three years later.
The noble Lord, Lord Forsyth, referred to his father in his contribution. As I recall, he also did so the previous time we debated this topic, and I referred to our daughter, who died aged 42 in 2013. I would get very emotional if I explored that further. I mention it because we all have personal stories and family experiences that have shaped our views, for or against the Bill, but we have to stick with principles. If we support it, we risk diluting our sympathy and concern for the elderly, the frail, the disabled and the depressed, seeing them as a drain on resources when they opt to live at society’s expense rather than conform to the new norm and opt to die. The Bill is dangerous and a retrograde step.
Our scrutiny of the Bill must also assess its disproportionate effect on many people, which the noble Lord, Lord Deben, referred to, who already doubt whether they are valued and understood—people, for example, in the outer estates of coastal towns and the shadowlands of rural villages where I minister in Sussex. The Bill takes from them the law’s protection of their right to life. It is a fundamental assault on their dignity.
When Pope Benedict XVI addressed Parliament in 2010, he asked where the ethical foundation for political choices was to be found and whether social consensus was a sufficient basis for addressing the moral dilemmas, considerable as they are, of the present age. Beyond a limited degree of social consensus, I do not see a solid ethical foundation for what is presented in the Bill. Human dignity demands of us better treatment.
Some speeches have referred rightly to the inadequacies of the status quo. Prosecutions of people who admit to helping a close relative die usually end in juries refusing to convict. Laws should not remain on the statute books where this is the case. Currently, there is no safeguarding when people end their lives at Dignitas, nor when unregulated and drastic ways of ending life, such as starvation, take place. Those who oppose the Bill need to address the problems of the status quo. We need more palliative care, yes, but it cannot always end the horrors of agonising deaths.
I end with two pleas. First, allow our fellow human beings greater autonomy over how they die; it is for them to decide and not for others, whether for faith or other reasons, to impose their views. Secondly, be truly compassionate in sparing terrible suffering as death approaches, allowing those who choose to die sooner to do so.
Lastly, I do not pretend that we can make death lose its sting; of course, we cannot. As Mother Teresa, who has prayed here in our Chapel of St Mary Undercroft, once so wisely said, the real freedom is to value all people exactly the same and to value them all, not to think of them as trouble or a nuisance. We need more palliative care, which is woefully underfunded in this country, and it has long been so; it is a shame on us all. Its provision remains a patchy postcode lottery, with current estimates of around 100,000 people per year who should be getting it not getting it.
From my own entirely personal point of view, worst of all, if from now on death becomes the default solution to perceived suffering—if it becomes the new normal—I believe this will have implications which will be more than significant just for the way we live now.