Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Friday 21st November 2025 Lords Chamber

[Lord Farmer (Con)]

My Lords, I rise in support of Amendment 118 tabled by the noble Lord, Lord Hunt of Kings Heath, and I am introducing Amendments 118A and 118B which follow it. I also support Amendments 45, 46, 47, 49 and 58.

This is an atheist Bill that assumes there is nothing after death, which is not a neutral but an ideological position. To those without an active belief that there is something after death, I would say, “How can you be so sure?” What makes the point that it is an atheist Bill? It is that it desacralizes death and by so doing it opens the door to very many evils including coercion and pressure, the subject of this group. The Bill is coercive: it gives oxygen to dark thoughts which can loom especially large when our best days seem to lie behind us, and when we are no longer contributing to family and society in the way we once did. Culturally and societally, it encourages and influences them as much as any person referred to in Amendments 45 and 46. Two of my friends with terminal conditions both followed earlier stages of this Bill in the other place and told me the subject’s very airing made them feel that they were a burden. The message that legislation and policy should amplify is, “You will not walk the valley of the shadow of death on your own”. We should encourage people to make and keep those relationships that will carry them through life and through that dark valley.

Others might also have dug out the words of the Times columnist Matthew Parris, quoted in a debate on assisted suicide in the other place in April 2024. He said that although

“‘Your time is up’ will never be an order”

to the elderly, disabled, severely ill and the others to whom assisted suicide will, inevitably, be extended eventually, it

“may one day be the kind of unspoken hint that everybody understands. And that’s a good thing”.

As the right honourable Stephen Timms said in that debate:

“I cannot see that that would be a good thing. It seems to me that legalising assisted dying would impose a terrible dilemma on frail people, elderly people and others when they are at the most vulnerable point in their lives, especially on conscientious frail people who do not want to die but do not want to be a burden. I do not think that there is any way to avoid imposing that dilemma”.—[Official Report, Commons, 29/4/24; col. 18WH.]


We have heard from the noble Baroness, Lady Finlay, about the data from Oregon, where over half the people who have applied for assisted dying since 2017 did so not because they wanted to die but because they felt that they were a burden. Amendment 47 from the noble Baroness, Lady Coffey, would guard against this “internal coercion”, to use the Royal College of Psychiatrists’ phrase. Further, her Amendment 49 includes,

“body corporate, institution or organisation”,

alongside “person”, which would of course catch the Government themselves. Tragically, and I declare my interests as a Hampshire farmer, there are farmers who have committed suicide ahead of the imposition of the family farm tax, choosing to die early so their land is passed on intact. Law and policy starkly influence personal decisions, hence our responsibility as lawmakers to take these unforeseen consequences into account and not brush them aside.

In her Amendment 58, the noble Baroness, Lady Grey-Thompson, is right to focus on lack of care as a disadvantage that pressurises. If death looks as if it might be painful and protracted then going through it alone, unmissed and uncared for, is too terrible to contemplate, but surely we can do better than help someone act on that dread thought, “No one would miss me; no one cares”.

Amendments 118A and 118B, which are my amendments to Amendment 118 in my name and that of the noble Lord, Lord Hunt, would ensure that wills were scrutinised and the backgrounds of friends, as well as family, were not overlooked if sinister motives suggesting financial abuse were not assumed but at least considered. Legislating for motivation is notoriously difficult, because motives are private, subjective, and easy to disguise. Instead, assisted dying legislation must use clear, objective safeguards to remove the possibility of improper motives influencing the process.

As an aside, I am not sure the Bill prevents any doctors involved profiting from early death, but Dr Harold Shipman did of course inveigle himself into the wills of some of his victims, and that would also be a red flag if found in the commissioner’s checks on wills.

Therefore, I ask the noble and learned Lord, Lord Falconer, why the Bill does not do more to exclude anyone with a financial or personal interest, and by extension anyone who might have been under their influence. We cannot draft either for compassion or for malice, but we can protect applicants by making it clear from the outset that if anyone with suspect motives has any involvement, their application will fall.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I, by contrast, speak as an atheist and humanist, mainly to address my Amendment 45, which would add the word “encouraged” after “coerced”. I support the general theme of the other amendments in this group, which largely tackle the need to strengthen safeguards against patients being indirectly influenced into opting for assisted death—often coerced, in all but name. All these loopholes undermine any certainty that the “choice”, in inverted commas, is made autonomously.

My amendment, supported by the noble Lord, Lord Goodman of Wycombe, may appear to be a small change, as it would add just one word. But before anyone concludes that I am tabling trivial amendments to waste time, I note that, when dealing with a fundamental change in the state’s relationship with its citizens and the NHS’s relationship with patients, and life and death decisions, the specificity and appropriateness of the words in the changed law matter.

At present, the Bill requires doctors to ascertain only coercion or pressure. They are the only two words given in Clause 1; there is no duty even to probe or ask broader questions about more subtle, insidious influences that could affect a person’s decisions. I note that the concept of encouragement is not arbitrary; the encouragement of assistance in suicide is illegal under the Suicide Act but would not be in this Bill. Indeed, CPS policy guidance on prosecuting those who have assisted suicide acknowledges “encouraging”—it uses that word—the victim as a factor in favour of prosecution. It is also criminal to encourage a person to commit an offence under the Serious Crime Act. Therefore, the question is less about why I am bothering to table an amendment to add just one word; the question is why the sponsors of the Bill left out that word “encouragement”.

Adding the word “encouragement” would allow a shift in perception about what undue influence could look like. Even though there are real problems in spotting coercion or pressure—we have heard many examples of that—the concepts at least have a hard edge or overt sense, at least in everyday parlance, that you are talking about people doing something that they really did not want to do. You do not say, “I had a really lovely day today; my husband coerced and pressurised me into doing” something. There is a grey area of much more subtle intervention; an individual could motivate, lead on or nudge someone into opting for an assisted death, rather than making that person aware of all the ways that they might live out their limited time as comfortably as possible. This amendment is trying to get at that sort of encouragement.

As I explained at Second Reading, one of my big dreads is that, once assisted dying is normalised as a positive treatment option, that vibe shift will not be confined to medical scenarios. It can and will mean that it is popularised as a go-to option in broader society. Consider this scenario: you have just received the news that you have a terminal diagnosis and have about six months to live. You are frightened, shocked and seeking reassurance. It is a bleak time and you are depressed because you do not want to die.

But then a third party—a family, carer or friend to whom I ascribe no motivation—says, “Have you thought about asking your GP for an assisted death? I’ve been reading about it all over the place and you can do that now. At least that way you’d have dignity in dying. You know how much you hate hospitals and all those doctors fussing about you, and we all know that you are not good with pain. How would the kids cope with running around having to visit you when you’re in and out of hospital? Wouldn’t it be so lovely to choose when you go, then we could all be with you at the end?” All of this is said in soothing, kind tones. Therefore, you think, “Well, I really don’t want to die. My instincts are to

‘Rage, rage against the dying of the light’,


but I don’t want to be a nuisance either, and they know me so well. They know what I’m like and that I won’t cope. They have my best interests at heart, so I suppose so”. It does not sound exploitative or coercive, but it is an iron fist in a velvet glove.

We have some cultural reference points here. In discussions about how the Online Safety Act will tackle suicide sites, there is consensus about the problems of online influencers encouraging vulnerable people into believing that suicide is a positive way out of their suffering. There is widespread revulsion at those cajoling siren voices encouraging death as an attractive option. In that context, none of us concludes that this encouragement is not problematic because it is not explicitly coercive.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

The Bill makes it absolutely clear that it must be your own decision. Let us suppose that your views of the world are affected by the internet and that you are ill and an organisation is urging you to commit suicide, that organisation should be liable if that happens.

In Amendment 49, the noble Baroness, Lady Coffey, wants “person” to include a body corporate or an organisation in relation to pressure. If an organisation or a body corporate is putting pressure on a group of people or on individuals and that makes them do it—this is putting it crudely, but if an organisation says, “Do have an assisted death; it is the right thing for everybody or for you”—that should be covered by the Bill. The noble Baroness adverted to how “person” can generally include both corporate person and human person, but I can talk to her separately about that to make sure that it is covered.

[Baroness Fox of Buckley (Non-Afl)]

Some clarification is needed in relation to a number of points that you have made. How does anybody know, how does the doctor know, whether any of these scenarios have happened? Is there anything in the Bill that makes the doctor ask and explore? The word I proposed was “encouragement”—that you would ask not just “Were you coerced or pressurised?” but “Were you encouraged?”—because it would develop a richer conversation. Is there anywhere in the Bill where all the things that you have just said—apologies; I should not have said “you” but “the noble and learned Lord”—can be fleshed out, discussed and teased out?

Maybe I have got this wrong, but at the moment as I understand it, you fill your form in, somebody might even ask “Were you coerced?” and you say no, and that is that, out the window and then, Bob’s your uncle, you are eligible and off you go. It does not matter how often that process happens. The noble and learned Lord spoke about “first doctor, second doctor”, but if they do not all explore it, how will we know whether it was anything other than a yes/no? The noble and learned Lord has given a very rich explanation of what could have happened, but the Bill does not allow us to find out whether any of that will have occurred before the assisted death is enacted.

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.