Terminally Ill Adults (End of Life) Bill

Lord Empey Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Baroness Grey-Thompson (CB)]

My Lords, I shall speak to three amendments in this group—Amendment 38, in the name of my noble friend Lady O’Loan, to which my name is attached, and Amendments 39 and 68. Amendment 38 seeks to address the challenges of those who have bipolar disorder, borderline personality disorder or other conditions associated with episodic suicide ideation, who face a higher baseline risk of self-harm and suicide. Research indicates that suicidal thoughts and behaviours are significantly more prevalent among people with these diagnoses, even without terminal illness, as reported by NICE in 2022 and Public Health England in 2021. Critically, evidence also shows that suicidal ideation tends to increase following a terminal diagnosis, so without the safeguard of this amendment, the Bill risks enabling assisted dying decisions to be influenced by pre-existing mental health vulnerabilities exacerbated by the receipt of a terminal diagnosis.

I support calls in the Chamber today to look at the benefits system. It is a really complicated process, whether you have a terminal diagnosis or not. It is important to learn from other jurisdictions. The 2024 Oregon official report cited that 9% of those who requested to end their lives did so for financial reasons and 42% requested it because they were felt a burden. I think it has already been quoted that in 2011, the noble and learned Lord, Lord Falconer, with the Demos report, said that no remedial mental health condition should be eligible for assisted suicide. I do not expect an answer in the Chamber on this question this afternoon because it might take a long time—I am very happy to meet outside—but I am interested to understand what has changed from his view in 2011 to thinking that this would work in the Bill now.

Many of the amendments talk about a settled wish. I could almost see how somebody could try to justify that, for someone with a terminal condition and suicide ideation, requesting assisted dying might be a form of suicide prevention. I feel like I am tying myself in knots with this argument, but I think when we hear the argument that people are already dying, we need protection for those groups of individuals. The noble Baroness, Lady Jay, who I do not think is in her place—I am sorry, I do not have my glasses on—raised evidence given in the Select Committee and talked about paternalism. My personal experience is that I do not see much paternalism in the health service. What I do see is an awful lot of ableism, and I think that if we are talking about paternalism, we should be talking about ableism as well. From a disabled person’s perspective, this recognises the intersection between disability, chronic illness and mental health vulnerability.

The panel has already been raised in the Chamber this afternoon. The panel is a really important part of the eligibility determination and deciding whether somebody can go forward. I think that one of the only things that the noble Lord, Lord Winston, and I could agree on today is that words are important. This relates to the place of the panel. I draw your Lordships’ attention to the clarification statement that was issued by the Association for Palliative Medicine this week. Because words are important, I am going to read it. It states:

“In Friday’s … debate (9/1/26), Lord Falconer cited, and misrepresented, expert evidence presented to the Terminals Ill Adults committee last year by the Association for Palliative Medicine … Crucially, panel members would not be required to meet the patient. They would, therefore, have no individual clinical perspective to bring to bear on the person applying for an assisted death. This renders the panel a mere administrative review, stripping it of the very nuance and human understanding that defines robust, compassionate decision-making at the end of life”.


This is why these amendments are even more important in terms of what we are trying to do.

I have previously discussed suicide among unpaid carers and the pressure on them. In Canada, there is a case of a man who had carer burnout and arranged for an urgent assessment for his wife. She died that day. That is listed in the Ontario coroner’s report. There is also written evidence to show that two men who had caring responsibilities for their partners ended up doing a mercy killing, which is often, strangely, very sympathetically portrayed in the media.

Amendment 39, in my name, is about recognising where an assisted death could take place and who will be most directly affected. The settings that could be affected include care homes or nursing homes—communities that care for those living with dementia, frailty, disability or advanced illness, where dependency is a condition of daily life rather than an exception.

It is important to recognise that a significant proportion of people living with dementia or cognitive impairment remain undiagnosed until the later stages of the disease. On average, people with dementia live with symptoms for three and a half years before receiving a diagnosis. Current NHS England and Alzheimer’s Society data show that only about two-thirds of those with dementia receive a formal diagnosis. The diagnosis rate in Wales is even lower. This further underscores the need for a specialist clinical assessment before any conclusion about capacity is reached. If one in three people with dementia are never diagnosed, one in three potential applicants under the Bill may have an unrecognised impairment in capacity. This is not a margin of error that any legislator can reasonably accept.

A recent report by the whistleblower charity Compassion in Care further illustrates the heightened vulnerability of care home residents. Based on evidence submitted by over 1,000 care workers who called the charity’s helpline to express their concerns about the Terminally Ill Adults (End of Life) Bill, the most predominant issue raised in 97% of cases was that of fluctuating capacity, which is common among those residing in care homes. The British Geriatrics Society, which gave evidence during the Select Committee, estimates the prevalence of delirium among care and nursing home residents to be as high as 60%.

Amendment 68 is about protecting autonomy. It would ensure that the right to request assistance to end one’s life remains solely with the individual who is terminally ill. It would prevent any surrogate, family member or medical professional making that decision on their behalf. By explicitly prohibiting third-party decisions, we safeguard vulnerable individuals from coercion or misinterpretation of their wishes.

Finally, I would like to ask the noble and learned Lord a few questions. How will he specifically seek to protect those who are in care homes or who may be vulnerable? How will the Bill protect those individuals who have had previous suicide ideation? Where does the Bill seek to understand the intersection of those with suicide ideation who then receive a terminal diagnosis and whether this is a genuine, settled wish? How, through the Bill, will we be able to offer protection to those who have a previous history of self-harm?

[Lord Empey (UUP)]

My Lords, following on from the proposal in Amendment 39, from the noble Baroness, Lady Grey-Thompson, one of the issues that perhaps is not fully appreciated or understood—it is only if you have actually witnessed it that you get the full implications—is delirium brought about by a combination of medications that are applied. One particular medication can clash with another and can produce a situation which appears almost like dementia, but the patient is not suffering from dementia but delirium. The noble Baroness, Lady Grey-Thompson, expressed that very well.

The noble Baroness, Lady Berger, spoke to Amendment 31. Again, it seems an elementary thing but, whether a person is sufficiently capable at the relevant point in time and is not suffering from delirium and/or dementia is best judged by the clinician who knows and works with the patient, rather than somebody with a white coat who is dashing in and out of a ward room and trying to assess the person on the hoof.

Like the noble Lord, Lord Deben, and others who spoke earlier, I do not like this Bill. However, as I said at Second Reading, like everybody else in this room I am a legislator. We have a role above and beyond our personal prejudices and beliefs.

I must say to the noble and learned Lord, Lord Falconer of Thoroton, that, as the noble Lord, Lord Deben, mentioned, a lot of issues have come up in the past few weeks. Last week, we had the series of amendments that were ably put forward by the noble Lord, Lord Carlile, which dealt with a very serious issue. The week before, we had five separate issues dealing with prisoners, pregnant women, et cetera, and we have had other issues. I know we are only part way through Committee, but if the noble and learned Lord wants the House to compress the process, rather than have to reiterate all this on Report, then I think it would make a difference to how people approach the rest of this legislation if he brought forward coherent amendments that address the issues that have been raised.

I do not mean to be unkind, but there is no point in him getting up every Friday like Stonewall Jackson and saying, basically, “I’m right and you’re wrong”. There is a difference of opinion—a chasm, in many respects—over a lot of these issues. To be brutal about it, we need to see the colour of his money. I hope that would allow us to go forward, but unless we deal with these fundamental, basic issues then we will have a very long slog indeed.

--- Later in debate ---

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I thank the noble Baroness, Lady Monckton of Dallington Forest, for that excellently clear way of expressing some of the discomfort and what we would like to see. I would be much happier and feel that I did not have to speak too much if I was getting reassurance and seeing on paper what exactly will address our concerns. At the moment, we are not getting that. We wish the noble Lord, Lord Shinkwin, were here. The fact that he is not is a real shame for the quality of this debate.

Inside and outside this House, I know plenty of people who support assisted dying and this Bill, inasmuch as they know the broad sense of what it is about. I try to avoid living in echo chambers. Whenever we discuss why they support the Bill, and potentially have a bit of an argument, they invariably say, in a very humane and compassionate way, that they think it will help people who are suffering, and that anyone who says they are suffering should have access to assisted dying. It is assumed, therefore, that the motivation of illness-induced suffering is at the heart of the Bill. That is what most people think. It has come up a lot in this Chamber but, ironically, suffering is not mentioned in the Bill, and neither is there any reference to motivations in the way that one would imagine. That bothers me, because the Bill checks on capacity, prognosis and residence, but it does not enforce a check on motivation. It seems to me that we should ask somebody who says that they want assisted dying, “Why?” It is a crucial absence in the Bill, and I hope that the noble and learned Lord, Lord Falconer, might rectify that or explain exactly why the Bill does not think that doctors should ask, “Why do you want assisted dying?” I think it would throw up a whole range of red flags in relation to coercion.

I have added my name to two amendments in this group, Amendment 30 in the name of the noble Baroness, Lady Foster, so ably moved by the noble Lord, Lord Weir of Ballyholme, and Amendment 56 in the name of the noble Baroness, Lady Coffey. To save time,I will concentrate on Amendment 30, which seeks to ensure that those who seek assisted dying are not substantially motivated by a number of factors. I will focus on two of those—not wanting to be a burden on others or public services, and not being motivated by mental disorder, including depression.

This week was the 29th anniversary of the death of my father, John Fox. He was only 66. He was diagnosed with cancer and given three months to live, although he actually made it for four and a half months. When he was told, the whole family was devastated, as anyone would be. The one thing that really shocked me to the core, and stays with me, was that when I had that initial, very emotional father to eldest daughter conversation, my father kept apologising. Believe me, that was not usual. In our relationship, he did not say, “Sorry, Claire” lots of times. He was so distraught. He was convinced that he would be a burden on us, and that his daughters and my mother, in looking after him, would all have to miss work and all the rest of it. He kept saying, “I’m really, really sorry”. He was worried about how we would cope. He did not want to distress others—a point that the noble Baroness, Lady Lawlor, was making on her amendment to this amendment.

I also noticed that he kept saying sorry to the nurses and the doctors. To everybody, he kept saying, “I’m really sorry for taking up your time. I’m really sorry that you’re having to give me so much attention”. There were stories in the media at the time about bed blocking. He was a vociferous reader of newspapers, and I was hiding the newspapers because I thought he would say sorry even more, convinced that he was taking up NHS resources. It took some time and determination for the family to reassure him, but I kept thinking afterwards how sad it would have been if he had been on his own or in a care home or whatever. To be honest, if a GP had suggested that assisted death was a medical option, in today’s circumstances, I think my father would have said yes—not because he wanted it but because he felt he was a burden on the family. It would not be the GP’s fault, as it is an internal feeling of being a burden. That is not the same as choice.

I was struck by a letter from Lord Sumption in the Times that is worth reflecting on. He says:

“The current bill contains a number of provisions designed to ensure that patients are not ‘pressured by any other person’ into taking their own lives”—

that was in relation to something else. He continues:

“The real problem, however, is not the pressure applied by ‘other persons’. It is assumptions which many old and ill people spontaneously make about the attitudes of the society around them. They are afraid of being an emotional or financial burden”.

That is very important.

By the way, I had better say that, in the four and a half months following his diagnosis that my father lived, we had some of the most meaningful time of our lives with him. It was through a veil of tears, but there was love, joy and reconciliation, there were conversations that would never have otherwise happened, and so on and so forth. It was a time that was important to him and to us as a family in a way that I cannot really describe.

Another motivation that I feel strongly we need to explore is on the part of those with a mental disorder. As many noble Lords have noted, a number of mental health conditions have suicidality as a feature. Again, I am sorry to do the personal stuff, but the first time I encountered that was as a young mental health community worker. I met a young man who was bipolar. I and others—psychiatric medics and social workers—worked hard not just to prevent his suicide but, using all our skills in pharmacological and psychological interventions, to alleviate the terrible “black dog” of depression and the horror of the obsessive suicide ideation that that young man had. I have to ask, then, whether the Bill would allow such a suicidal person’s depression-induced desire for death, and whether all those who had worked with him would suddenly be expected not just to welcome it if this young man made the choice of an assisted suicide but to say, “Oh, look, a perfect exemplar of autonomy and choice”.

I was therefore a little taken aback that the noble and learned Lord, in his summation of the last group on eligibility, said in relation to those with a mental disorder that it is their choice, and that if they want it and they have capacity then that is all right. I point out that, for anyone who wants to commit suicide, it is their choice and they want it, but some of us spend a lot of time asking them please not to do it, not saying, “Yippee!” I cannot think that, in that situation, if that young man had said, “I’ve got a terrible story. I’ve got a terminal illness in addition to my bipolar depression, and I want your support and help in assisted dying”, I would say that it is all perfectly fine and he should get on with it, and be delighted for him being able to show that he is a free, autonomous individual. I would say, “Please don’t”. The four and a half months that we had with my father was the kind of quality time that I would want to ensure that young man had, every day of his life, even if he was terminally ill and dying. I would want to make sure that he was not depressed or suicidal during the time he lived.

[Lord Empey (UUP)]

My Lords, I am associated with some of these amendments. I do not think we want to get completely hung up on the minutiae of each particular line, because there are variations that one could make. I guess that when one is drafting a Bill there are choices to be made and language can be better if one gets professional assistance.

The fundamental point, as has been outlined by the noble Lord, Lord Weir, and the noble Baroness, Lady Fox, is that anyone here who has represented an inner-city, working-class constituency will know that the approach that a lot of people have towards doctors and the medical profession is perhaps different from the approach that we have. If we want medical assistance, I guess most people in this room can pay for it if they so wish. That is not an option that other people have.

Terminally Ill Adults (End of Life) Bill

Lord Empey Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Lord Empey (UUP)]

My Lords, in my opinion, these amendments are really about safety, but we have turned the debate into a generalised whinge-fest about the shortcomings of the National Health Service, and we are all aware that there are many.

However, from recent personal experience, I accept what the noble Baroness, Lady Gerada, said. I am fortunate that we have a local health centre; it has four floors and four practices—a separate practice on each floor—each with multiple members within them, who come and go. In general, if somebody is seriously ill, we are fortunate in that we would be able to have established contact with more than one team member.

However, the noble and learned Lord, Lord Falconer, said that he wanted the GPs mentioned to be a central point for the records. Here we come to an entirely different issue. I have seen records that include what the GP practice puts in, as well as discharge letters from the various hospitals people have been in. Those discharge letters are written by F1 doctors—which is the most junior doctor grade—who have just come out of university. Sitting there late at night, writing these discharge letters is regarded as one of the worst things a doctor has to do. I have seen serious mistakes in those letters, even regarding one of the problems the patient had. Getting those records changed is very difficult. The making of decisions on the future of an individual on the basis of a record that might be totally wrong or misleading is the reason why we need additional protections. It is only common sense, because we humans are all frail and we make mistakes. We write and say mistakes. We overlook things.

Terminally Ill Adults (End of Life) Bill

Lord Empey Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

In conclusion, the proposed amendments—adding “influenced or encouraged”, clarifying “pressured” as “externally or internally”, and broadening “person” to encompass corporate and institutional actors—would significantly enhance the safeguards in the Bill. Also, broader structural disadvantages which may persuade a person to end their life, such as poverty, need to be taken into account. These changes would help ensure that decisions to end life are made with the highest standards of voluntariness and autonomy, free from all forms of undue influence, pressure or encouragement, whether from individuals, organisations or internalised feelings. I support all these amendments.

[Lord Empey (UUP)]

My Lords, there is one aspect of coercion that we have not so far discussed. It was mentioned tangentially by the noble Baroness, Lady Hollins. It is institutional coercion. As somebody who has unfortunately had to bring a loved one into hospital to be treated and discharged on a large number of occasions in recent years, I have become familiar with the process called “clerking”, where an individual is brought into the hospital, the paperwork obviously has to be brought to bear, the healthcare staff have to fill it in and so on.

If this legislation gets on to the statute book, in whatever form, it has to be translated into paper that the health service will have to deliver when a patient is brought into a hospital. We already have the “Do not resuscitate” aspect of an induction, and we will now have to have another set of paperwork. I have seen how it works frequently: the pressure that the staff are under from time to time, and the fact that the people coming and going and dealing with a patient are frequently different and they change at 8 am in the morning and 8 pm in the evening. That paperwork has to be done by an individual, sometimes a relatively junior member of staff, and all these things have to be translated into a box that has to be ticked.

How is that to be done? The actual process that one has to go through, particularly dealing with somebody who is seriously ill, is challenging in itself, and when you have to ask the person, “Do you want me to tick the box that says, ‘Do not resuscitate’?”, that is a big thing to do, and the person needs to be coherent, informed et cetera. We are moving things to a stage well beyond that.

I had the experience of being in a hospice and, while it was not an issue with pain that was the problem, when the consultant comes along and says to your loved one, “Have you considered the D-word?”, that sobers you up. Somebody who was perfect intellectually, who had the ability and the capability, shut down completely and could not cope with, “Have you considered the D-word?”. So, I say to noble Lords, these are emotional things, coercion is a very hard thing to define, but I have to say to the noble Lord, Lord Pannick, that the difference between his scenario and what we are facing is that the state is co-operating, providing the mechanism and delivering the mechanism for a person to end their life. That is the antithesis of what the medical profession and the National Health Service have stood for since its inception.

With regard to how we treat things in this House, when Bills come to us, of course we have a view on whether we are for them or against them. I remember when the Brexit legislation came before this House and I gently remind the noble Baroness, Lady Hayter, that she was not running to try to improve it so that she could get into the Content Lobby. It is the way things are. On an issue such as this, we have to be driven by our conscience, not by our parties or anything else, but let us remember that this will have to be translated into the room where the patient is sitting. What box is a junior nurse or a junior auxiliary going to be asked to tick? What is the question? Who is going to fill it out?

As the noble Lord, Lord Hunt of Kings Heath, said, if we had had a royal commission and a proper government Bill, we could have answered these questions, instead of having to sit here and go through the whole process again. I just ask the noble and learned Lord, Lord Falconer, to bear these things in mind. These are gaps in the system which the staff are going to have to face. There will be shifts coming on and there will be some members of those shifts who will refuse to participate. What kind of chaos is that going to create? These things need to be thought through and they are not thought through.

[Baroness Hayter of Kentish Town (Lab)]

I just remind the noble Lord, Lord Empey, that of course I did vote for the Brexit legislation and in fact led the Labour Party into the Lobby to support the final agreement on Brexit.

Terminally Ill Adults (End of Life) Bill

Lord Empey Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

As I said at the beginning of my remarks, I am not yet convinced that the amendment in the name of the noble Baroness, Lady Coffey, is the right way to address this gap, but gap there is. Unless the Government come forward with a clear proposal that addresses the concerns expressed by the First Minister of Wales, the Senedd, both the Senedd Select Committees, the leader of Plaid Cymru and in Committee in the other place, we risk doing real damage to the devolution settlement and to confidence in the capacity of Westminster to legislate in this area, and doing real injustice to those in Wales, who deserve better palliative care and better mental health care than would be the case if this legislation were to pass as it stands.

[Lord Empey (UUP)]

My Lords, the noble and learned Lord, Lord Thomas, said that some people were suffering from insomnia. I think this House is suffering from collective amnesia. All of a sudden there is a great hurrah about the Sewel convention and respecting devolution. I gently remind this House that it had no hesitation whatever in legislating over the heads of the Northern Ireland Assembly against the expressed wishes of that Assembly on abortion, for instance, and on other matters. So, if we have suddenly decided that we are going to respect these settlements, it is a Damascene conversion, and I hope that it is perfectly obvious that there are huge holes in where this legislation is taking us, as has just been ably pointed out by the noble Lord, Lord Gove. Like him, I leave it open as to whether this is the right amendment, but I just gently remind everybody that we in this House are not scoring very high on consistency.

[Lord Tyrie (Non-Afl)]

I will be brief—everybody will be delighted to hear that. I should say that I am a supporter of the intentions of the Bill, and I agree with what the noble and learned Lord, Lord Thomas, said, particularly when he suggested that the Government will need to be involved in sorting out some of these problems.

What concerns me is that we are now going to try to improve a Bill, which is demonstrably flawed, with 900 amendments—many of which seem to make sense to me—on the Floor of the House between now and Christmas. Surely the Government should now be listening, and grasping that they need to take the Bill in themselves. They need to consult nationally and widely, to try to find as much consensus as possible, and then in a considered way they need to come back to the House. To attempt to deal with these 900 amendments in this way will end up with the Bill being talked out, with us being in a place we do not want to be—at least those of us who want to see progress on the Bill—and we will end up in a worse place than we would have been had the Government done the sensible thing at the beginning and taken the Bill in, as they did with Private Members’ Bills such as the Suicide Act.

--- Later in debate ---

[Lord Gove (Con)]

My Lords, I speak briefly in support of the point made by the noble Baroness. I entirely understand why many Members of the Committee regard the suggestion to replace “capacity” with “ability” as wholly inadequate. The challenge that has been made by my noble friend Lord Markham and others is entirely fair enough, but the definition of “capacity” in the Bill itself is inadequate.

It is the case that the Mental Capacity Act was not designed for this purpose and that this legislation has been retrofitted to use the Mental Capacity Act because inadequate effort was put into defining the ability of an individual to make this decision in an appropriate way. It is the case that the Office of the Parliamentary Counsel has made it clear that the effort to put this Bill together was “done on a shoestring”. It is also clear, as the noble Baroness pointed out, that the Royal College of Psychiatrists—the people who are responsible for addressing mental capacity—said that assessing a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding than assessing capacity for treatment decisions, which is the purpose of the MCA.

We have been told by those responsible for the mental health of vulnerable people that the safeguard that we are about to legislate for is inadequate. More people will be placed at risk by its inadequacy. We may feel that the noble Baroness, Lady Finlay, in putting forward “ability”, is failing to meet the needs of the legislation. However, it is not her responsibility, but our collective responsibility, the promoter of the Bill’s responsibility and the Government’s responsibility to ensure that psychiatrists and this House can be satisfied that the threshold is sufficiently high.

We all recognise that, while this Bill may be about respecting personal autonomy, personal autonomy is not sovereign. We recognise that there may be circumstances in which that right cannot and should not be exercised. The promoters of the Bill have been very clear that they want to draw the lines narrowly to ensure that this is available only to people who are consciously capable at a time when their life will automatically end within a certain period.

[Lord Empey (UUP)]

Does the noble Lord agree with me that one of the issues, which has been sporadically mentioned, is the inconsistency of capacity or ability brought about by the interaction of certain drugs on an individual? They may be lucid at a particular point in time, but not lucid at another. Under our current proposals, the people who would be making that judgment do not even have to know or to have treated that person. Surely that has to be dealt with in any definition.

[Lord Gove (Con)]

The noble Lord is absolutely right. Again, there has been some debate about the evidence from psychiatrists and the reasons why they expressed doubts, but that evidence is plentifully available to Members of this House.

As a number of Members have made clear, the work of Alex Ruck Keene KC and the Complex Life and Death Decisions group of King’s College, which is available to this House and was examined in the Select Committee, makes it clear that the Mental Capacity Act is inadequate. It is inadequate to deal with the concept of suicidal ideation that occurs. It is inadequate to deal with the fact that capacity fluctuates, and that fluctuation can be affected by mental health and well-being in its broadest sense, as well as by other syndromes and conditions.

The psychiatrists would not have intervened as they did if they had felt that this was a matter that could be left to one side, a matter that was entirely, as it were, within the scope of parliamentarians or legislators to shrug their shoulders and to accept. They have sent a message to us that the Bill as framed endangers those who are most vulnerable. Can we really proceed on the basis of the MCA, a piece of legislation conceived at a different time for a different purpose and rendered in the eyes of the professionals as not the correct way to go forward?

Terminally Ill Adults (End of Life) Bill

Lord Empey Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Empey (UUP)]

My Lords, I have been shocked at the inaccuracy of the parliamentary process applied to the Bill. It has lacked the detailed scrutiny that such a major piece of legislation requires, as confirmed in recent devastating reports by committees of this House. Despite all the hype in the Commons, it failed to gain the support of a majority of MPs.

Let us be clear what the Bill does. It authorises medical professionals in the employ of the state to introduce and ultimately provide the means by which an individual in the care of the NHS can be assisted to commit suicide, and to observe and supervise that process. The Bill also gives unprecedented powers to the Secretary of State. The Bill is not fit for purpose, and I am not convinced that it can be adequately reformed. As a member of the Presbyterian Church in Ireland, I accept my Church’s teaching on the principle of the Bill, but I am also a legislator, and that confers its own distinct obligations and responsibilities.

In my family’s case, we were faced with the illness of my late wife, Stella. She suffered from complicated medical conditions. In January 2023, she was very unwell—to the extent that the consultant called the family together and said that she was not going to pull out of it this time. Had he been asked whether she was terminally ill and would die within six months, he would have said yes. Would he have signed off as expecting her death in six days? I believe so, as that is what we were told. Nine months later, I was still taking her out most days, and she was able to enjoy that time with our children and grandchildren. I am also aware that she felt she was impacting on the ability of our children to get on with their careers. I could sense the anxiety she felt at impacting on our lives. This is the pressure point that is glossed over in the Bill and the discourse around it.

Doctors do not get it right all the time, and this arbitrary six-month timescale is a dangerous nonsense. The Bill would fundamentally change the relationship between the medical profession and patients at all levels. Gone would be the days of “do no harm”. Doctors could be seen not only as healers but as instruments to end the life of a patient in hospital, maybe spurred on for financial reasons. Families are not always welcoming environments. They can be toxic with competing pressures, especially over money. It is in these circumstances where subtle pressures to end a life can be generated.

Some of the basic practicalities have not yet been investigated because of this mad dash to get the Bill through. I know that all of us in this Chamber want the same thing: to reduce and minimise suffering. None of us knows how our days will end, but I believe that we are adding to suffering by introducing massive anxiety to patients at the most vulnerable time of their lives.

Our mailbags have been characterised by messages from disabled people, the elderly and others who feel a sense that they are no longer valued by society, surplus to requirements and mere cost centres. I know this is not the intention of the sponsors, but that is the inevitable outworking. To involve the entire NHS and turn its ethos upside-down is a serious mistake. People may also be afraid to present themselves to doctors for fear of getting a one-way ticket. Those of us with the financial means to get the best advice can do so, but for those without the resources it is the NHS or nothing.

It is time to think again. We have underinvested in palliative care for years, thus reducing rather than enhancing choice. Surely it makes sense to follow that route, as emphasised by former Prime Minister Gordon Brown, rather than risking the nearly 80 years of the embedding of a life-saving NHS in our nation’s DNA.