Terminally Ill Adults (End of Life) Bill

Lord McDonald of Salford Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord McDonald of Salford (CB)]

The last time your Lordships’ House debated assisted dying was in October 2021. More than 130 noble Lords signed up for the debate. I did not. I was a relatively new Member of the House and I thought that, with so many speakers, someone was bound to say what I thought—but that was not the case. Everyone I heard spoke eloquently, passionately and persuasively, but everyone had made up their mind for or against. I felt that I was torn in two directions.

In the past four years, though, I have settled. I am in favour of the Bill because it addresses one of my chief hesitations on that day, when it felt as though the Bill of the noble Baroness, Lady Meacher, was a foot in the door and would inevitably get wider. This Bill is framed very precisely. It is for the terminally ill with capacity in the last six months of their life. It excludes a large number of people; I know that that distresses my noble friend Lady Murphy, but I think it is right that mentally ill or depressed people and people with dementia will not be part of the Bill. It serves as a reminder to us and to the people of this country that we should have an advance care plan, which helps our relatives and doctors know what to do when we do lose capacity.

My second point is about safeguards. The safeguards in the Bill are elaborate; I fear that they may be too elaborate. Last week, the noble Lord, Lord Meston, reminded us that the first attempt at such a Bill foundered because it was felt that the safeguards were too cumbersome. I wonder what the panel would do. It feels to me that the key things here are that the patient is in control, and that there need to be two expert, senior and independent from each other doctors. One of them should probably be a consultant in the disease from which the terminally ill patient suffers, while the other should be a consultant in palliative care. With that amount of assurance, people at the end of their life should be able to proceed rather more quickly than all this bureaucracy would suggest. I was a bureaucrat; the idea that bureaucracy makes things safer is, I think, sadly wrong.

One bit of safeguarding that I would like to be included covers what happens to the unused doses. Last week, the noble Baroness, Lady Hayman, reminded us that up to 40% of doses in Oregon are not used. Could there be a line about whether they are destroyed or kept by the doctor for future use? It feels to me that that point needs to be addressed.

My last point is that this Bill is so important that we need to get cracking. A lot of people hesitate because it is a Private Member’s Bill, but I remind your Lordships’ House that these societal issues usually start as such a Bill. Sydney Silverman has already been mentioned; his efforts were a Private Member’s Bill. This is the same, but, clearly, it needs greater government help and attention if it is to become law. I hope that it does become law, and I hope that we can improve it, but, even if it is not changed, I would vote in favour.