Terminally Ill Adults (End of Life) Bill

Baroness Rafferty Excerpts

Friday 24th April 2026 Lords Chamber

[Lord Farmer (Con)]

I will continue. Almost 250 Members of this House have been involved in a massive and sustained effort to try to make the Bill safe and workable. The House staff, as we have heard, have been outstanding in their service to us all and I am sure we are extremely thankful and grateful to them for that. Much has been imputed, particularly in the press, about our motivation in closely scrutinising the Bill, including that we are cruel. At no time have we been unaware of the suffering that the Bill’s supporters have wanted to alleviate. However, it is not compassionate to pass a Bill without addressing the many concerns raised by royal colleges, three committees of this House, myriad disability groups and others: that would be cruel to the poor and the vulnerable. Yet we, and by extension they, have been shown not a little contempt at times when we have taken time to lay out how the Bill would affect them. We need to be wary of contempt when courtesy, as we were reminded at the beginning, is the currency of this House.

I continue to have a quiet concern about the language used. Orwell described political language as

“designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind”.

First, we talk about “assisted dying”, when we surely mean “assisted suicide”. Assisted dying is what Dame Cicely Saunders said hospices and palliative care would provide. She said:

“You matter to the last moment of your life, and we will do all we can to help you not only to die peacefully, but also to live until you die.”


I urge this Government to do what no previous Government have done and make high-quality palliative care sustainable and universally available.

Secondly, the legal qualifier for assistance is terminal illness within six months to live. As we have heard already, when that prognosis has at least a 20% to 30% unreliability, according to evidence given to the Select Committee, we should not pretend that legal solidity exists where actually there might be pure wind. Thirdly, any notion that noble Lords are filibustering rather than legitimately scrutinising the Bill is unsustainable, given both the length of the Bill and the proceedings in the Commons, and the fact that the mean length of speeches in this House has actually been under five minutes.

Finally, I detect an assumption that anyone who is religiously motivated should not be heard or impose their views on anyone else. We do not impose our views, but we do echo a very substantial number of people outside this Chamber whose faith is partly why the Bill evokes deep concern. In contrast, every day of our lives, secular humanism is imposed on us, with its assumptions about the primacy of individual autonomy and the irrationality of belief. Such assumptions deny that human existence is inherently relational, deny the loneliness of hyperindividualism and deny that it takes more faith to believe that this incredible world in which we live came from nothing than to believe that there is something or someone behind it:

“Does he who make the eye not see?”

Finally, there are very many ethical, medical and practical reasons why this Bill has needed robust and lengthy scrutiny from a very diverse group of Peers. The process in this House and evidence from other countries have profoundly challenged the assumption that the service that the Bill attempts to provide can be safe. Many here say that this is based not on faith, but on evidence. To return to what I said at the beginning, this House has a premier global reputation for its thoroughness of scrutiny. When I was in Brussels, I talked to an Italian lawyer working for the European Commission who said that the work received from this House was second to that from no other secondary Chamber in the world. I believe that we have lived up to that reputation over the course of this Bill.

[Baroness Rafferty (Lab)]

My Lords, I speak for the first time in this debate as a nurse and former dean of the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London. Our patron saints include Florence Nightingale and Cicely Saunders. It would be hard to imagine two more rigorous and formidable expert witnesses to comment on the debates that we have been having these past few weeks. Both were deeply committed Christians, driven by the alleviation of human suffering and providing the practical means to do so through nursing and palliative care. Both were accomplished scientists, Nightingale being hugely influential in public health, epidemiology, statistics and social science, as Cicely Saunders was in physiology and the psychology of pain, coining the concept of total pain to convey the holistic sense of suffering.

But both had more speculative sides to their characters. In the case of Nightingale, it was a fascination with Thomas à Kempis, Teresa of Ávila and the medieval mystics. She committed some of her thoughts to paper, consulting Benjamin Jowett, regius professor of Greek and theology at Balliol College, Oxford, who became her spiritual confessor. Cicely Saunders’s library reveals a similar quest to understand Christian ethics and the existential nature of the human condition. Both were deeply interested in, as well as troubled and possibly tormented by, the challenge of squaring the existence of a benign God with the dark side of the soul and human suffering. Perhaps the ultimate question in their minds was an eschatological one. How will it all end? How will life end and what will death be like?

In a sense, that is what we have been wrestling with over the past months, struggling to reconcile very different perspectives on how it will end for ourselves, loved ones, patients and relatives. Some of us believe in enabling people to exercise autonomy over the end of life and the nature of their deaths—to have agency over the end. We have heard testimony from people who have chosen this path, as well as from relatives and loved ones. They have spoken powerfully of the sense of freedom and relief it has provided and the physical, emotional and spiritual sense of peace for all concerned.

There are those who do not agree that this should be possible. Such views are profoundly personal. I happen to have witnessed some very difficult deaths of patients and close family members. That has convinced me that assisted dying is a positive step in easing people through to a good ending. Denying that option to people who would like to avail themselves of it, when we can offer it and international evidence demonstrates that it is safe to do so, seems not only cruel but unethical. When seen in the context of a Bill that has passed in the elected Chamber and is supported by public opinion, it seems like a dereliction of duty. It is not our job to defy or block the democratic process. I implore noble Lords: it is time to dissolve our differences and do the right thing by finding a way to pass this Bill.

[The Archbishop of Canterbury]

My Lords, I shall briefly make some reflections. It is a great privilege to follow my friend, the noble Baroness, Lady Rafferty; I thank her for her contribution. I recognise the enormous amount of work that has gone into this Committee stage. I am grateful to the noble and learned Lord, Lord Falconer, for meeting me; I thank him for the time that he has given me.

Noble Lords will know that I oppose the Bill in principle, both as a priest and as a nurse, but it is clear that some things unify us. Whether we support the Bill or oppose it, we are unified by the fact that we want people to die in a dignified, pain-free and compassionate way, with the least possible fear. I also believe that we are unified in the belief that there needs to be investment in palliative care now. I welcome the new modern framework for palliative care that the Government have introduced, but recognise that financial investment still needs to occur.

We are also unified around the fact that if this Bill or topic comes back in some form, we need to do our work differently. There is no doubt in my mind that this is one of the biggest societal shifts that we are seeing or will see. Therefore, we need to take our role seriously, as we have done. There is something about our learning for this process and looking forward to how we do it differently when it comes back. I was very taken by the view of the noble and learned Baroness, Lady Butler-Sloss, of pre-legislative scrutiny, although I do not know the details. We should look seriously at that.

We are also united in knowing that this touches some of our deepest emotions. I am grateful to those who have shared their own experiences and stories; I have felt very humbled listening to them. For me, as a Christian, this is clearly an eschatological question, as my friend, the noble Baroness, Lady Rafferty, said. Of course, for me, as a Christian, death is not the end. There is hope in death and life everlasting. As we talk about these things that touch us deeply, we need to look after each other and ourselves and recognise that this process will have impacted us, as well as those listening.