Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, there are passionately held views on the subject before us, and the informed and respectful deliberation so far shows your Lordships’ House at its best. We are being asked to legislate for autonomy, but we also have a duty to set out that principle within the reality of our unequal society. I am deeply concerned that the Bill as it stands would not only ignore but deepen those inequalities.

My views are shaped in part from learning about my mother’s work as a counsellor in a palliative care unit and the hours I spent at the bedside of three of my grandparents as they neared the end, including as they took their last breaths. While I am one of the younger Members of this place, and I hope I have at least another 50 years ahead of me, I have thought about the end of my life. Ideally, I would like to die naturally at home, with, if needed, access to the high-quality palliative care that everyone deserves.

While I would not want an assisted death, I recognise that some noble Lords do, as expressed during this debate. We are fortunate: as noble Lords, we have a voice, above-average resources, and agency—the ability to make our own choices, free from interference, prejudice, coercion or undue influence. But assisted dying, if introduced, would exist as a choice not only for us and other comparatively fortunate people; it would enter the lives of those most at risk—people already overlooked, unprotected and vulnerable at the end of life.

It was a privilege to be a Member of Parliament for almost a decade, and I have so many fond memories of my former constituents. But some of the most searing moments I experienced as a Member of the other place came at my weekly surgeries. The first time I heard someone speak openly, in the most unsavoury terms, about wanting a family member dead, I shook. I was appalled, and I could not believe what I was hearing. I was naive to think that this would be an isolated case. I have also not forgotten the words and realities of too many former constituents: people isolated and abused in their own homes, sometimes for decades, in fear for their own lives; people who felt like a burden because of long-term illness or serious mental health conditions, especially the elderly; and people treated as though their lives were worth less because they had a disability. Many were from low-income backgrounds, facing not only poor health but the crushing stress of unaffordable care costs.

These voices still ring in my ears and motivate me profoundly as I consider this Bill, alongside the many powerful representations we have heard in recent weeks, including, as we have heard from other Members, that there is no organisation of or for disabled people in this country that supports the Bill. In considering who the Bill might benefit by giving them more autonomy, we must equally consider who it may harm by taking their autonomy away.

We have a duty in this House to test the Bill’s safeguards when they meet reality, and I think we must also consider the role of family members and carers. The Bill does not require their involvement. It does not even guarantee they will be informed. Yet these are exactly the people who know a patient best, and who may spot signs of coercion, confusion or fear that professionals might miss. Their exclusion is not just a procedural oversight; it is a moral failing.

In conclusion, if the Bill passes, the relationship between vulnerable people and their doctors and the state would change for ever. There would be no going back. This Bill touches the deepest and most exposed moments of human life. It demands our utmost scrutiny, not just in principle but in practice—and, in practice, it currently falls short. We cannot legislate for irreversible decisions on the basis of incomplete protections. We have important work to do.

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Moved by

[Baroness Berger]

At end insert “but that the Committee of the Whole House shall not commence before a report has been received from a select committee appointed by the House to consider certain aspects of the bill.”

[Baroness Berger (Lab)]

My Lords, I have spoken already about how my experience as a Member in the other place has made me very concerned about this Bill, and more determined that it must not be a cause of further harm to vulnerable people. Many unanswered questions about the Bill before us have been raised during the course of this important debate. This is why I have tabled the amendment and the following Motion to hold a Select Committee before Committee of the whole House begins.

This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight, but it is clear that there are serious shortcomings, as both the Constitution Committee and the Delegated Powers and Regulatory Reform Committee noted in their reports last week. Indeed, I am concerned that the legislative process is being asked to compensate for the absence of robust policy-making before the Bill was published: no comprehensive review; no public consultation or prior engagement with professionals and other stakeholders; no Green Paper or White Paper, which we would have seen had it been a government Bill—I understand the case made for why it is not a government Bill, but that has diminished what is before us today; and no published analysis of international experiences. Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without this groundwork, which we would usually turn to for a law change of this magnitude.

Back in March, Jill Rutter of the Institute for Government—which is neutral on the principle of assisted dying—said:

“We’re expecting Commons scrutiny to do far too much—things it simply can’t do … Commons scrutiny is being left to solve a whole range of problems it isn’t equipped to deal with”.


We have seen the dropping of key but expensive safeguards, such as the review by a High Court judge, and whole new clauses and schedules introduced to replace them with very little opportunity for thorough scrutiny.

It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated power. There are now, as we know, 42 delegated powers contained within the Bill: 42 areas where government will work out the detail later, with Parliament largely excluded from the conversation. The result is a Bill that is today substantially different from when the Bill Committee in the other place took evidence in January this year, but now with less clarity.

I do not wish to detain the House any longer than is necessary, but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the Bill before us today. We need this information before we commence line-by-line scrutiny.

Noble Lords will have received a letter setting out a condensed list of witnesses that I and other supporters believe this House must hear from, including my noble and learned friend Lord Falconer of Thoroton and those who will bear the responsibility for delivering the Bill, should it pass, and setting out how they would use their delegated powers. These witnesses are to include the Secretary of State for Health and Social Care, the chief executive of NHS England, the Secretary of State for Justice and the Chief Secretary to the Treasury.

We must also take evidence from the professional bodies whose members will be asked to carry out the functions that the Bill sets out: the Royal College of Psychiatrists, the Royal College of Physicians, the Royal College of General Practitioners, the British Association of Social Workers and the Law Society.

We are, of course, not able to hear from serving members of the judiciary, but may hear from the former Chief Coroner of England, Thomas Teague KC, and Sir James Munby, President of the Family Division of the High Court. We must also ensure that we understand the impact of the Bill on our hospices and care homes, through Hospice UK, the Association for Palliative Medicine and Care England.

A previous suggestion of a Select Committee in parallel, alongside a Committee of the whole House, would not achieve—

[Lord Kamall (Con)]

I apologise, I do not want to detain the House any longer than is necessary. Just to clarify, will all the evidence before the Select Committee be published?

[Baroness Berger (Lab)]

I am very grateful for the intervention, and I was just about to come on to that, but I will answer that now. The answer is yes, absolutely. The intention is that all the evidence accumulated and amassed during that time will be published for everyone in the House to interrogate and consider in advance of us going into Committee of the whole House. To confirm, this Select Committee cannot take place in parallel in order that we can receive evidence on vital parts of the Bill before we go into debate, so that we are not in the unenviable position of knowing what is wrong with the Bill but being unable to amend it.

My Motion provides that a Select Committee would be intended as a focused piece of work, hearing vital expert oral evidence, as I have just set out, rather than it being a more time-intensive open exercise. It may report by simply publishing that evidence before we go into Committee of the whole House, in order to inform our detailed consideration of the Bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks, with two panels of witnesses on each of the days, to begin the week commencing 20 October and allowing it to conclude by 7 November. The revised timetable ensures that the Bill can progress to its next stage and maintain the opportunity for four sitting Fridays before Christmas.

We have, over the past two Fridays, shown the determination of your Lordships’ House to discuss the Bill in a considered and constructive way, and it is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the Motion that will follow, which contains the detail that I have just set out. I am grateful to my noble and learned friend Lord Falconer of Thoroton—

[Baroness Watkins of Tavistock (CB)]

Is the list to give evidence that the noble Baroness has detailed finally determined or would it be possible for us to add the Royal College of Nursing with its 500,000 nurses?

[Baroness Berger (Lab)]

I thank the noble Baroness for her intervention. As I understand it, it is within the gift of the Select Committee to determine who will be called for evidence. I have sought to set out the key people, but of course there will be many other suggestions. Obviously, conscious of the tight timetable, we will not be able to have an extensive list, but I am sure that the chair, when appointed, will consider the suggestion that has been made.

I return to expressing my gratitude to my noble and learned friend Lord Falconer of Thoroton for being prepared to work with me to reach an agreement that would allow the House to engage carefully with the substance of what is being proposed and the powers we are being asked to bestow on Ministers. I am grateful to the many noble Lords who have already indicated in their speeches their support for my amendment and my Motion. I beg to move.

Amendment to the Motion agreed.

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Moved by

[Baroness Berger]

That it is desirable that a select committee be appointed to consider the safeguards and procedures contained in the Terminally Ill Adults (End of Life) Bill; that the Committee shall hear evidence from professional bodies, those with professional experience of coronial services, and Ministers; that the Committee, notwithstanding the usual practice of the House, may report by drawing the attention of the House to the evidence received without making recommendations; and that the Committee do report by Friday 7 November.

[Baroness Berger (Lab)]

I beg to move.

Motion agreed.