Commons Sense

House of Commons · Bill Debate

Terminally Ill Adults (End of Life) Bill

29 November 2024 · 84 other contributors

Opened by Kim Leadbeater Lab Spen Valley

Summarised by AI from the official record, so it can contain mistakes.

At a glance

Kim Leadbeater raised concerns about terminally ill adults (end of life) bill in the House of Commons. Other MPs contributed to the debate.

Key points

  • The Bill would allow terminally ill adults to choose to end their life under strict conditions.
  • Kim underscores the necessity for legal clarity and safeguards against coercion.
  • Current law is inadequate for people experiencing severe suffering at the end of life.

How the debate unfolded

MPs spoke in turn to share their views and ask questions. Here's what each person said.

Opened the debate

Kim Leadbeater Lab Spen Valley

The Bill would give terminally ill adults the choice to end their life under stringent criteria, which include two medical professionals and a High Court judge's approval. Kim highlights the need for legal clarity and protection against coercion, emphasising that current law is failing people who are suffering severely at the end of their lives.

Other contributors (84)
  • Kevin McKenna Lab Sittingbourne and Sheppey

    Argues that medical professionals, including himself as a nurse with over 25 years of experience, are well-trained to spot coercion. Believes the Bill's stringent criteria will provide additional safeguards.

  • Simon Hoare Con North Dorset

    Questions the ability of two clinicians to definitively rule out coercion without any doubt, suggesting that subsequent investigations remain possible after a person's death.

  • Alicia Kearns Con Rutland and Stamford

    Expresses concern about the risk of systemic coercion, questioning whether elderly people in care homes might feel compelled to end their lives early due to financial burdens.

  • Richard Burgon Lab Leeds East

    Supports the Bill but raises concerns about societal or systemic coercion, questioning if elderly people in care homes might feel pressured to end their lives early to save costs.

  • Wera Hobhouse Lib Dem Bath

    Argues that conversations with doctors will reveal whether patients have been coerced or are suffering intolerably, focusing on the criteria of suffering.

  • Jim Shannon DUP Strangford

    Raises concerns about Belgium's experience with similar legislation expanding to include minors and those with dementia, questioning guarantees against such expansion in this case.

  • Mark Pritchard Con The Wrekin

    Expresses concern that safeguards may become obsolete over time and questions if the current protections are permanent or temporary.

  • Rachel Taylor Lab North Warwickshire and Bedworth

    Supports the hon. Lady's arguments, citing personal experience with a constituent suffering from pancreatic cancer to argue for dignified end-of-life choices.

  • Blair McDougall Lab East Renfrewshire

    Raises concerns about judicial activism potentially expanding the Bill's scope and advocates for a precautionary approach to ensure legislative certainty before proceeding.

  • Lloyd Hatton Lab South Dorset

    Argues that nearly everyone in the House agrees that current end-of-life care is unsustainable and undignified, suggesting today's debate is about improving conditions.

  • Daisy Cooper Lib Dem St Albans

    Raises concerns for learning disabled individuals under Clause 9(3)(b), questioning whether further psychiatric assessments should be mandatory rather than optional.

  • Barry Gardiner Lab Brent West

    Argues that legislating for society as a whole requires considering broader impacts beyond individual suffering, such as family and financial considerations.

  • Toby Perkins Lab Chesterfield

    Reflects on previous voting against similar legislation 10 years ago but now supports reconsidering end-of-life choices due to lack of progress in addressing the issue.

  • Alistair Strathern Lab Hitchin

    He expressed doubt about voting for or against the bill, highlighting that people will suffer unnecessarily if they reject it.

  • Andrew George Lib Dem St Ives

    Contrary to media portrayal, today’s vote is not about bringing the Bill into law but allowing it to proceed to the next stage. There are opportunities for amendments at later stages.

  • Kevin McKenna Lab Sittingbourne and Sheppey

    Clarified that 'medical practitioner' is a synonym for doctor, not nurse or pharmacist. The bill's definition of proxy also requires substantial personal knowledge.

  • Lewis Atkinson Lab Sunderland Central

    Asked the hon. Member to give way and questioned the certainty in medical assessments, suggesting that current legal oversight provides protections against coercion.

  • Gavin Robinson DUP Belfast East

    Commended the hon. Member for engaging respectfully and pointed out that no court will second-guess medical opinion, only look at process.

  • Paula Barker Lab Liverpool Wavertree

    Urged the hon. Member to check the Bill wording which states that a proxy must have known the person for at least two years before signing on their behalf.

  • Jim Allister TUV North Antrim

    Quoted Clause 15(5) to argue that there is no real protection in the Bill's definition of a proxy.

  • Simon Hoare Con North Dorset

    Asked about the importance of the six-month period for exercising rights under the Bill and questioned why it could not be extended.

  • Melanie Ward Lab Cowdenbeath and Kirkcaldy

    Raised concerns about the assessment process, questioning if doctors making assessments need to have met or been involved in the patient's care.

  • Wera Hobhouse Lib Dem Bath

    Agreed that medical assessments are approximations, and argued for making a decision based on merit despite uncertainty.

  • Cat Eccles Lab Stourbridge

    Called out incorrect language used by an hon. Member regarding suicide as offensive and requested correction.

  • Richard Tice Reform Boston and Skegness

    Argued that the Bill requires detailed debate in Committee, implying that issues raised should be addressed during that stage.

  • John Hayes Con South Holland and The Deepings

    Stated that proper scrutiny of Bills takes place before Second Reading through cross-party scrutiny, not after.

  • Diane Abbott Ind Hackney North and Stoke Newington

    Raises concerns about insufficient safeguards in the Bill, questioning judicial intervention as a genuine safeguard. Emphasises the risk of coercion by family members and the potential for future amendments to extend eligibility criteria beyond terminal illness to include serious mental health conditions and disability.

  • Catherine Atkinson Lab Derby North

    Supports Diane Abbott's argument about insufficient safeguards, highlighting concerns over care proceedings for vulnerable children taking longer than six months to complete.

  • Jake Richards Lab Rother Valley

    Asks Diane Abbott about current safeguards for individuals contemplating suicide and expresses concern over lack of inquiry into such cases.

  • Shockat Adam Ind Leicester South

    Questions the ability to detect non-tangible issues like coercion, given the difficulty in detecting tangible medical signs and symptoms.

  • Mary Foy Lab City of Durham

    Shares personal experience with a daughter who lived for 27 years despite being told she might have only six months to live, expressing dread and fear about non-verbal individuals without advocates.

  • Graham Stuart Con Beverley and Holderness

    Supports Diane Abbott's call for rejecting the Bill today but suggests a commitment to revisit the issue in a considered manner.

  • Andrew Mitchell Con Sutton Coldfield

    Supports the Bill, arguing that it gives constituents a choice and provides necessary safeguards. Emphasises the current law's cruel nature and the need for transparency and regulation.

  • Andrew Slaughter Lab Hammersmith and Chiswick

    Stressed that there are no safeguards in current law, emphasising the role of High Court as part of the process. Argued against opponents' views on complexity and cost, highlighting the need for resources to implement proper safeguards. Emphasised human dignity and agency at the end of life.

  • Jonathan Davies Lab Mid Derbyshire

    Interjected with concerns about potential relaxation of safeguards in a future pandemic, suggesting people might feel compelled to sacrifice themselves for younger patients.

  • Kit Malthouse Con North West Hampshire

    Rejected arguments that other countries care less about their citizens and suggested learning from international experiences. Addressed concerns over NHS and judicial overload, arguing they are not valid reasons to oppose the Bill. Emphasised that a vote against the Bill would lead to continued violent suicides and more trips to Switzerland.

  • Sam Rushworth Lab Bishop Auckland

    Interjected, agreeing with the need for palliative care improvement alongside discussions on assisted dying. Suggested that voting against the Bill should lead to a cross-party consensus on fixing palliative care in the country.

  • Roger Gale Con Herne Bay and Sandwich

    Agrees that better palliative care should be the focus, highlighting a specific need for improved services for children.

  • Lewis Atkinson Lab Sunderland Central

    Asked to give way during Maskell's speech, indicating support or further elaboration on her points.

  • Layla Moran Lib Dem Oxford West and Abingdon

    Moran supports the Bill, advocating for better conversations about death and improved palliative care. She urges MPs to vote yes today but reserves the right to reconsider at Third Reading based on further details. She raises concerns over insufficient government commitments on palliative care and calls for tangible actions within a year or two. Moran highlights the case of her constituent Tracey, who fears a painful death due to incurable cancer.

  • Tonia Antoniazzi Lab Gower

    Antoniazzi acknowledges the emotional difficulty of the debate and supports the Bill despite its complexities. She expresses concern about the Bill's impact on Wales, particularly noting the need for legislative consent from the Welsh Government due to potential conflicts with devolved powers in healthcare. She highlights issues related to codes of practice and subordinate legislation.

  • Ben Spencer Con Runnymede and Weybridge

    Believes in respecting bodily autonomy for individuals with full decision-making capacity but raises concerns about implementation, resource implications, and safeguarding. Criticises lack of independent review, pre-legislative scrutiny, and impact assessments. Argues that limitations on assisted dying should be carefully defined and implemented to prevent coercion and abuse.

  • Meg Hillier Lab Co-op Hackney South and Shoreditch

    Raises concerns about fundamental changes in state-citizen relationship, emphasising the importance of protecting vulnerable individuals from coercion. Recounts personal experience with hospice care and highlights failures in palliative care systems as reasons not to support assisted dying legislation.

  • Caroline Nokes Con Romsey and Southampton North

    Ordering interventions to be short due to time constraints for other speakers. No position on the amendment was explicitly stated.

  • Edward Leigh Con Gainsborough

    Reads letters from constituents expressing concerns about end-of-life care and opposes legalizing assisted dying, emphasising that better funding for palliative care is necessary. Highlights the fear among patients of inadequate pain relief and lack of clarity in current law.

  • Peter Prinsley Lab Bury St Edmunds and Stowmarket

    Supports legalizing assisted dying, stating that he has seen the unbearable distress caused by terminal illnesses and poor quality of end-of-life care. Emphasises strict safeguards in the Bill to prevent coercion and manipulation.

  • Steve Witherden Lab Montgomeryshire and Glyndŵr

    Intervenes to support his colleague's argument, highlighting that unregulated assisted dying is already occurring with traumatic consequences. Supports the Bill for providing essential safeguards.

  • Melanie Ward Lab Cowdenbeath and Kirkcaldy

    Raises concerns about coercion, especially for vulnerable people, citing data from Washington state where 59% of individuals who chose assisted dying did so out of fear of being a burden to family and caregivers.

  • Tim Farron Lib Dem Westmorland and Lonsdale

    Opposes legalising assisted dying, citing concerns about coercion, inadequate palliative care, and potential for mental health issues leading to premature death. Highlights evidence from Canada showing one in three people opting for assisted dying felt they were a burden on others. Emphasises that legalised assisted dying would divert resources away from palliative care.

  • Naseem Shah Lab Bradford West

    [INTERVENTION] Urges caution on assuming uniform standards of palliative care across the UK, highlighting disparities and their impact on vulnerable populations.

  • Sorcha Eastwood Alliance Lagan Valley

    [INTERVENTION] Criticises assumption of uniform palliative care standards in the UK, emphasising that disparities would disproportionately affect vulnerable and marginalised individuals.

  • Marie Tidball Lab Penistone and Stocksbridge

    Supports moving the Bill to the next stage despite personal reservations, citing need for compassionate choice at end of life with strong safeguards. Highlights importance of defining key terms and improving regulations on training for medical practitioners.

  • Nusrat Ghani Con Sussex Weald

    Called for Members to face the Chair and requested that they be picked up on microphones.

  • David Davis Con Goole and Pocklington

    Expressed a change in his position due to the sanctity of life and opposition to torture and misery at the end of life. Emphasised that Second Reading is about principle rather than outcome, and criticised procedural comments. Raised concerns over Clause 4(2) regarding doctor-initiated process and supported the Bill but wanted it to be given more time in Committee.

  • Anna Dixon Lab Shipley

    Expressed concerns over moral and ethical dilemmas, legal and practical considerations. Highlighted inequalities in access to palliative care and the risk of coercion due to social care failures. Raised issues about the NHS capacity and costs of implementation.

  • Carla Lockhart DUP Upper Bann

    Opposes the Bill as it undermines the NHS foundation to preserve and protect life. Argues that terminally ill patients should have improved palliative care rather than a state-sanctioned service ending lives. Cites statistics showing one in four people do not get necessary end-of-life care, highlighting inadequate healthcare funding.

  • Rachel Hopkins Lab Luton South and South Bedfordshire

    Supports the Bill advocating for terminally ill adults to choose a peaceful death through assisted dying. Cites public opinion polls showing 75% support for legalising assisted dying, highlighting financial inequality in accessing such services abroad. Emphasises the importance of stringent safeguards and the need for compassionate choice at end-of-life.

  • Alicia Kearns Con Rutland and Stamford

    Supports the Bill as a matter of personal autonomy and compassion, arguing that it does not prevent improving palliative care. Uses her mother's experience to highlight the need for choice in cases where suffering cannot be alleviated by current medical means.

  • Paulette Hamilton Lab Birmingham Erdington

    Hamilton argues against the Bill, citing her experience as a district nurse and personal experience. She expresses concerns over ethical implementation, potential coercion of disabled and elderly individuals, lack of support for palliative care, and risks associated with medical professionals proposing assisted dying. She fears that the current law presents a clear boundary that cannot be crossed, while the Bill could lead to abuse or misunderstanding.

  • John Hayes Con South Holland and The Deepings

    Hayes shares his personal experience with suicide and argues against the Bill. He expresses concerns about changing the relationship between clinicians and patients, the potential for judicial interpretation to expand assisted dying provisions beyond the original intent, and societal implications of altering views on life and death. Hayes also highlights risks faced by vulnerable individuals when interacting with unkind or cruel people.

  • Jake Richards Lab Rother Valley

    Richards supports the Bill, emphasising moral imperatives to offer peace and empowerment at the end of life. He cites support from former Directors of Public Prosecutions for legal reform, highlighting the chaotic nature of current laws regarding assisted dying. Richards also argues against procedural objections, referencing successful private Members' Bills in similar contexts.

  • Julian Lewis Con New Forest East

    Concerned about the impracticality of effective safeguards against external coercion and internal pressures on terminally ill patients. Feels that palliative care can alleviate pain sufficiently but there are uncertainties in its availability and effectiveness across different regions. Emphasises the need for doctors to have the freedom to administer pain relief that may shorten a patient's life.

  • Jessica Asato Lab Lowestoft

    Concerned about potential abuse and coercion, especially among vulnerable groups like older people with disabilities. Highlights the issue of domestic abuse and coercive controlling behaviour that can lead victims to feel coerced into ending their lives. Worries that there is no adequate system in place to ensure proper investigation and protection.

  • Siân Berry Green Brighton Pavilion

    Acknowledges the emotional impact of debating assisted dying but believes it reflects public opinion. Argues that current law forces people to endure horrific deaths and seek unregulated alternatives. Supports better safeguards against coercion and improved palliative care alongside the Bill's provisions.

  • Lizzi Collinge Lab Morecambe and Lunesdale

    Emphasised that patients and doctors are already making life-and-death decisions under current law. Cited a personal example of a family member dying through withdrawal of treatment, highlighting the existing legal framework allows for such decisions. Argued that the Bill’s safeguards would provide a stronger protection than the current law by ensuring capacity, coercion and consent assessments by two doctors followed by judicial review.

  • Robert Jenrick Reform Newark

    Critiqued the Bill's safeguards as inadequate, particularly highlighting the low threshold for judicial decisions and lack of transparency. Raised concerns about potential changes to the law by activist judges in Strasbourg. Emphasised that passing the Bill could lead to societal changes that would disadvantage vulnerable groups.

  • Florence Eshalomi Lab Co-op Vauxhall and Camberwell Green

    Argued against the Bill due to health inequalities affecting black and minority ethnic disabled people. Cited personal experiences with her mother's sickle cell anaemia, advocating for better living conditions before considering death options. Worried about clause 15 on proxy signing potentially increasing risks of coercion for vulnerable groups.

  • Liz Saville-Roberts PC Dwyfor Meirionnydd

    Expresses concern over the potential for institutional pressures and lack of resources to lead to coercive practices in end-of-life care. Supports the Bill on Second Reading if there is sufficient scrutiny to ensure robustness, cross-party representation on the Committee, proper consideration for Wales, and a legislative consent motion in the Senedd.

  • Simon Opher Lab Stroud

    As a doctor with 30 years of experience, supports the Bill as it provides an additional tool for palliative care. Argues that good palliative care and assisted dying are not mutually exclusive, and that the Bill's safeguards are important to ensure safety.

  • Luke Evans Con Hinckley and Bosworth

    Argues for the importance of offering choice in death when palliative care cannot provide a solution. Emphasises the need to empower people, especially those facing intractable cases with no cure or respite.

  • James Frith Lab Bury North

    The Bill poses significant risks to societal norms, with potential for coercion and commercialisation. The strained state of the NHS means that patients may not have consistent relationships with named doctors, leading to inconsistencies in advice and care. This could lead to situations where assisted dying is suggested as an option due to doctor-patient dynamics rather than genuine patient choice.

  • Neil Shastri-Hurst Con Solihull West and Shirley

    Supports assisted dying as a means of providing autonomy to terminally ill patients. Despite concerns, it is not a binary choice between palliative care or assisted dying; rather, it offers an option for those seeking control over their end-of-life decisions. The debate should move forward and improve the Bill through Committee discussions.

  • Paula Barker Lab Liverpool Wavertree

    Supports assisted dying with appropriate safeguards, as it places human dignity at its heart. Palliative care can be improved alongside legalisation of assisted dying. Not expanding to include other groups despite long-term implementation in Oregon reassures against slippery slope concerns.

  • Peter Bedford Con Mid Leicestershire

    Argues for end-of-life choice based on personal experience with a terminally ill relative. Proposes legalisation as offering dignity and control in final days, complementing but not replacing palliative care. Emphasises robust safeguards against coercion.

  • Dawn Butler Lab Brent East

    Thanked her friend for conducting the debate. Highlighted the importance of having discussions on assisted dying and end-of-life care, but argued that they should be separate from assisted suicide debates. Emphasised the need for safeguards against coercion in medical decisions and supported the right to die with dignity and compassion. Cited a survey showing 80% of her constituents oppose this legislation.

  • Christine Jardine Lib Dem Edinburgh West

    Praised Dawn Butler for conducting the debate and expressed the responsibility to make decisions on behalf of those suffering. Believed in the need for palliative care improvement rather than opposition based on its inadequacies. Stressed that the safeguards included in the Bill are sufficient and that it provides choice safeguarded by medical professionals. Emphasised the importance of a national conversation about end-of-life choices.

  • Catherine Fookes Lab Monmouthshire

    Supported changes in the law based on personal experiences with her father’s terminal illness and her sister-in-law’s cancer in Australia. Stressed that palliative care, while important, is not always sufficient and people should have a choice at end of life. Cited numerous emails from constituents expressing similar concerns.

  • Jim Allister TUV North Antrim

    Expressed strong opposition to state-sanctioned suicide and the potential for coercion. Highlighted that terminally ill patients are among the most vulnerable in society and may be influenced by coercive forces. Questioned the adequacy of safeguards such as two doctors and a judge to protect against coercion.

  • Ruth Jones Lab Newport West and Islwyn

    Jones expresses concerns about presuming consent in assisted dying, citing examples from jurisdictions like the Netherlands and Canada where laws have been expanded after initial implementation. She highlights that more than 65 private Member's Bills passed without thorough scrutiny, suggesting potential risks with this legislation. Jones is worried about the Bill’s impact on vulnerable people and calls for more detailed safeguards.

  • Saqib Bhatti Con Meriden and Solihull East

    Bhatti acknowledges the importance of discussing assisted dying but ultimately opposes the Bill. He argues that it risks medicalising death, burdening healthcare professionals, and potentially endangering vulnerable individuals. Bhatti raises concerns about future changes to the law based on experiences from Canada, where mental illness could become a valid reason for assisted suicide in 2027.

  • Rosie Wrighting Lab Kettering

    Wrighting supports the Bill, emphasising the right to choose at the end of life. She stresses that terminally ill individuals should have a peaceful and pain-free death as an option, especially for those unable to travel abroad or afford alternative means. Wrighting highlights personal stories from constituents expressing their need for such legislation.

  • Vikki Slade Lib Dem Mid Dorset and North Poole

    Slade advocates for the Bill, arguing that palliative care and assisted dying are not mutually exclusive. She clarifies misconceptions about mental health conditions and coerced decisions under the legislation. Slade shares personal stories of constituents struggling with terminal illnesses, emphasising the need for compassionate and humane choices at end-of-life.

  • Kieran Mullan Con Bexhill and Battle

    Mr Mullan supports the bill, acknowledging the difficulty of the decision. He highlights the potential to reduce suffering for terminally ill patients who choose assisted dying without undue pressure. However, he also respects opponents' concerns about sanctity of life and moral implications. He advises voting with humility and respect.

  • Kit Malthouse Con North West Hampshire

    Mr Malthouse moved the closure (Standing Order No. 36), indicating his support for proceeding with the bill's second reading vote.

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