Terminally Ill Adults (End of Life) Bill

Debate between Lord Moylan and Baroness Murphy

Committee stage
Friday 20th March 2026 Lords Chamber

[Baroness Murphy (CB)]

We have discussed this issue at some length before, but I wonder if the noble Lord, Lord Moylan, has considered that the Bill does not say anything about a definite diagnosis. The phrase is “can reasonably be expected”. It does not mean that anybody has to agree with a diagnosis that it will be four, five or six months, or any particular time; it is “can reasonably be expected”.

I would like to come back on the noble Lord’s issue about people with a positive attitude. Does he accept that it is not just people with a very positive attitude who have good expectations? There are now numerous studies of people with breast cancer showing that the alternative, to totally deny it, also has a slightly better prognosis. There are different ways of approaching these bad news prognoses and people can adapt their own way of dealing with issues from them. I hope he will note that.

[Lord Moylan (Con)]

I am now precluded from taking further interventions, because there is a limit on how long I can speak and that was a very excessive intervention. I will discuss with the noble Baroness outside the Chamber what a reasonable expectation is, if it is not based on a prognosis. I do not know what the functional difference is. As for being in denial, funnily enough, an oncologist said to me that being a bit in denial is quite a good thing. In my own case, I managed to combine a positive attitude and a certain sense of denial; I agree that these things can work. It is quite complicated. But none the less, I am going to continue with what I wanted to say.

Thirdly, the title of Professor Gould’s article was, quite subtly, The Median Isn’t the Message. Yet at the heart of the Bill is a six-month prognosis—we may call it a reasonable expectation—in which that is exactly the message. It is that flawed message which we are making the heart of the Bill.

Lastly, I think we are all agreed that a positive attitude can help, even if denial can help as well, but in using this Bill, we do not inculcate a positive attitude. What we actually say is: “You have six months to live and here is the pills option. That’s another option you can take”. We should be promoting a positive attitude, and the Bill does not do that.

My Amendments 175 and 384 simply require that in the three doctor encounters that are required—in the preliminary discussion, with the co-ordinating doctor and with the independent doctor—there is an explanation of the underlying mathematics or, if you like, the underlying data of the condition that the person has as part of the conversation. The amendments would make that mandatory, so that the idea that the six-month diagnosis is a prediction is not lodged in the mind of the patient.

Professor Gould died in 2002. That was 20 years after his original diagnosis, and he did not die of mesothelioma. In my own case, I took Professor Gould’s article to my oncologist—it was our second meeting—and I said that, in the light of his experience, I was not satisfied with 18 months, that my target was 20 years and that anything less I would consider failure. It seems to have worked because, within three months of the diagnosis, I was discovered to be in complete metabolic remission, a condition I have stayed in. If you have had stage 4 cancer, they will not use the word “cured”, but I am as close to cured as you can be, and I am in complete metabolic remission. I still have 18 years to go on the bargain I struck with my oncologist.

I occasionally hear rather rude remarks about Dame Esther Rantzen—that she was given so long to live and she is still alive years later. I never share those comments; I reject that attitude completely. There are lots of people, such as her and me, who live out there in the farther reaches of the third standard deviation, with our heads hard up against the roof of the bell curve. That is natural because, as Professor Gould says, variation is the reality and the prognosis—the median—is the abstraction.

We have put something false and misleading at the heart of this Bill. There are very few conditions for a person to embark on a course that leads them to an assisted death; one is residence, one is capacity and one is this six-month prognosis. We have put this right at the heart of the Bill, and it is, as I say, false and misleading. It is a fundamental flaw in the Bill, and I would like noble Lords to reflect on that and I hope, on that basis, at the very least, agree my amendments. I beg to move.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Moylan and Baroness Murphy

Committee stage
Friday 13th March 2026 Lords Chamber

[Lord Moylan (Con)]

There is, indeed, a spectrum, and the doctor should be able to speak. As I say, there have been 3,000 years of thought given to this. What has resulted from that is a firm conviction that, while some medications that do you good may also do harm—and the doctor has to make careful judgments about that—the active killing of a patient, the actual administration of substances with a view solely to bringing about death, is morally abhorrent.

It may not be morally abhorrent to the noble Baroness, but she has to understand the novelty of this and the violence that she is doing to our inherited moral framework when she—

[Baroness Murphy (CB)]

My Lords—

[Lord Moylan (Con)]

Let me finish. The noble Baroness puts that forward and says that, to her, it is simply one option. It is not one option; it crosses a line.

[Baroness Murphy (CB)]

My Lords, “morally abhorrent” is quite distressing. I am a doctor; I have been a doctor for 50 years and have worked with dying people quite regularly in hospital, particularly in general hospitals. I find the notion that doctors all find this abhorrent is utterly wrong. We know that at least half support the principles of the Bill and can recognise that it is something that they would like to support. I am not talking about the medical royal colleges; they take one line—in fact, most of them are neutral about the principle. The reality is not as the noble Lord, Lord Moylan, describes. Certainly, I do not feel the way he does. I find it very offensive when somebody says that it is morally abhorrent. It is not morally abhorrent to help people when they are desperately suffering and to respond during a conversation to what they are talking about and what they are asking for.