Terminally Ill Adults (End of Life) Bill

Debate between Baroness Campbell of Surbiton and Baroness Blackstone

Friday 13th March 2026 Lords Chamber

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I have added my name to Amendment 149 in the name of my noble friend Lady Grey-Thompson. I also support the principle underpinning Amendments 150, 151 and 154, all of which aim to prevent a medical practitioner initiating discussions on assisted dying under Clause 5 of the Bill.

Like the noble Lord, Lord Shinkwin, I thoroughly agree that doctors must not be permitted to initiate conversations about assisted dying to patients. Let me tell your Lordships why. Doing so would breach their fundamental duty of care to their patients at the very point when the patient may well be at their most fragile—newly diagnosed and frightened about what the future holds. It would not be a neutral clinical act but an intervention laden with power, meaning and consequence. The very suggestion of assisted death from a doctor at such times risks being heard not as an option but as a judgment.

Not long ago, during the scariest time of the Covid-19 pandemic, disabled people were contacted by their GPs to ask them to allow permission for DNR notices to be placed on their medical records should they be hospitalised after contracting the virus. Disabled people were horrified; many contacted me and other parliamentarians to know why they were being treated differently from non-disabled people. They said that it felt as though catching Covid would be a death sentence. Thankfully, the Secretary of State for Health rectified the issue, reminding doctors that their actions were in contravention of the Equality Act and the Human Rights Act, but the damage was already done. Disabled people who relied on their doctors for their health and well-being felt betrayed and unworthy of life-saving treatment.

If a medical practitioner raises the possibility of an assisted death, the patient’s feeling of security and trust will be damaged in the same way as during the pandemic. Your Lordships have often heard me say that I count my blessings every day because my doctors support and celebrate my life, however ill I become. I feel secure knowing that they will do their absolute best, however grim my prognosis may be. Reliance on that assurance is critical to the well-being of patients, especially those with long-term disabilities.

If assisted dying is to become an option, it must be one that is strictly patient-initiated, tightly defined and clearly demarcated from ordinary clinical care. It must sit within a system that prioritises palliative care, practical support and the affirmation of life; otherwise, it will be seen as the simplest and most straightforward option for the patient, their family and friends, the NHS and society as a whole.

The doctor-patient relationship is inherently unequal, and never more so than after a terminal or life-limiting diagnosis. When a doctor introduces the possibility of assisted dying, however delicately phrased, it carries weight. For many patients, particularly those who already feel themselves to be burdensome, costly or devalued, the message risks being internalised as a subtle signal that their lives are no longer worth living.

We must also confront the reality of acute vulnerability. A diagnosis of serious illness often brings shock, despair and temporary suicidal thoughts—feelings that, with time, treatment and compassionate support, frequently pass. This is why I support my noble friend Lady Grey-Thompson in her Amendment 149, which seeks to address this. Depression, unmanaged pain, fear and loneliness are not unusual bedfellows for people with a terminal diagnosis. Medical practitioners are not specialists in disentangling these states.

If we are serious about safeguarding autonomy, our first duty is to ensure that people are offered care, hope and practical support, not an expedited exit at a time when they feel most afraid. I therefore hope the noble and learned Lord will recognise this and come back with his own amendments on Report, to ensure that the subject of assisted dying is raised only by the patient and never by a medical practitioner. I would be very pleased to meet him between now and Report to explain further why this is so essential for the legislation to be safe in practice.

[Baroness Blackstone (Lab)]

It is with some trepidation that I speak, since I realise how passionately the previous speakers think about what they have said. The first small point I want to make is that the noble Baroness, Lady Campbell, referred to Report—we are not going to have a Report stage, because we have taken so long in dealing with all the many, many amendments that have been tabled.

Leaving that on one side, we have to realise that doctors’ main objective is to try to alleviate suffering. This is what those of us backing the Bill believe it does: it will alleviate suffering—sometimes terrible suffering—and torment by allowing people to choose the time of their death when they are already dying. We must not forget this. If we accept that this is the role of doctors, that this is what they try to do in their professional work, we must allow them to discuss at an appropriate point, in their judgment, all the possible options that are available to the dying person. If the Bill were enacted, one of the options would be an assisted death if they had reached that point. So to say that a doctor in a close relationship with his or her patient would be unable to raise this as a possible option would be entirely wrong.

I advise everybody, if they have not done so already, to look at what the BMA says about this. It has specifically briefed against prohibiting doctors from initiating discussion about assisted dying under the Bill, warning that it will be detrimental to patient care. I accept this piece of advice from the BMA. It is a view that many doctors, and some in this Chamber, too, would actually adhere to and agree with.

I very much hope that this group of amendments will not be accepted. It does not mean that at the end the patient is not the one who makes the decision about whether to request an assisted death—of course he or she does. But it just becomes one of the options that is available to them, and that is an option I believe we should allow them to be aware of.