Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Friday 24th April 2026 Lords Chamber

[Baroness Andrews (Lab)]

My Lords, this is a very difficult day for this House. It is a profound day, and that has been reflected in extraordinary speeches, but it is a devastating day for people who invested hope that this House would follow the democratic lead of the other place and improve and vote for this Bill.

I am grateful to follow the noble Lord, Lord Moore of Etchingham, because there is one thing on which I want to take issue with him. On 27 March, he said there was “a big moral gulf” in this House between the two sides. I could not disagree more. We disagree on many aspects of the Bill—for example, I disagree with my dear friend, the noble Lord, Lord Deben, that it should have been a government Bill; I think there would have been an outcry if it had been a government Bill—but we are not divided on morality. We find different ways to approach grace. I am particularly glad that we have the most reverend Primate with us today and have listened to her words of reconciliation, because that is what this House has always been about.

Noble Lords will forgive me for a bit of history, but I was the responding Minister on the first Bill on assisted dying in this House in 2005. I remember very well what the noble Lord, Lord Baker, said—several people who are still in this House were there. It was the first time we had ever debated it. What marked that debate in 2005 was a generosity of spirit and a gentleness of approach that took every single view of this House into respectful consideration. That was true of the two other Bills we had in 2014 and 2016. We have never had a debate in this House that has been contested, where views have been challenged for the reasons that they have been held. This Bill has been different in so many ways. The tone of our debate has been pretty awful at times. We have not paid the respect we should have paid to what we have heard—and we have all learned a lot.

I also disagree with the noble Lord, Lord Deben, because I think this Bill is the best Bill we have ever had, not least because it has embedded legislation that has become tried and tested over the years—the Mental Capacity Act, for example. We have listened to the patient voice. We know more about patient safety than we did 20 years ago. We have the experience of many other countries.

When I stood at that Dispatch Box, hardly any of the medical colleges supported that Bill. They were sceptical and some were hostile. Public opinion was very ambivalent; it has moved. Medical opinion has moved to a position of more neutrality.

[Baroness Berger (Lab)]

My Lords—

[Baroness Andrews (Lab)]

I would prefer not to give way. I have hardly spoken in this debate and I would like to make a coherent case.

Public opinion has moved, medical opinion has moved, and I think the House has moved. Many countries have taken the decision, and millions of people now have the right to choose to die without fear and pain. That of course includes people near to home in Jersey and the Isle of Man. The major critical difference is that this House has listened to the other place make up its own mind—but we have come to the decision that we must not do that.

It is not a bad Bill. It was in the process of improvement. One of the first things that the noble and learned Lord, Lord Falconer, said was that he would have accepted many of the amendments that came out of the Delegated Powers Committee report, and it is hardly surprising that that committee found the emphasis on delegation something to comment on. Private Members’ legislation sometimes does not have government rigour, so there is always a sense that you have to put things into implementation. Let us have that debate. We have not had that debate and the House has not been able to vote on it.

I have not had the experience that others across the House have had, which we have heard in extraordinarily personal and powerful statements, not least this morning from the noble Lord, Lord Markham, which was so moving. But in the past few weeks, I have heard the testimonies of people who are living with the reality of what it means to know that they are dying. One of the things they have found so difficult, as has been so well said by many people this afternoon, is the disconnect with reality that they have heard as we have wrestled with arcane elements and bureaucratic and technocratic issues that they do not recognise in their experience of dealing with, say, a multiple team of medics rather than a single practitioner, or with residence qualifications. I will not rehearse any of those arguments.

We would have done better to listen more rather than, in some instances, pontificate. We should have listened to Chris Whitty, who said: do not overengineer a process that is already extremely complicated. I really wish more noble Lords had taken advantage of listening to the Australian practitioners who told us how they manage in the most humane and effective ways to implement the Act in Australia.

I am sorry that the noble Lord, Lord Moore, is not in his place. I want the House to listen for a moment to the words of a real expert, a terminally ill lady in a wheelchair who we heard on Wednesday:

“I am a lay preacher in the Church of England. I am deeply grateful for the excellent care and treatment I receive … I do not want to die. Not now. I want to live. But alongside that desire to live I carry something else, fear, a deep, persistent fear and how my life may end. And while palliative care is often excellent it is not all powerful. It has limits … I am not alone … too many terminally ill people are living not only with pain but with fear; fear of losing control … Fear of being forced to continue when all sense of dignity and meaning has gone. That fear shapes our days. For some that fear leads to impossible choices”.


She said that she may die

“sooner than I would choose … And yet instead of confronting reality we have seen repeated delay in the House of Lords … Delay is not neutral. It is a choice. A choice that risks overriding the will of the Commons and the wishes of the majority of the public”.

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[Lord Dobbs (Con)]

My Lords, this debate has become very personal at times, and perhaps I might indulge in that. First, I apologise to my noble friend Lord Sandhurst for trying to get in the way of his valedictory speech. He is a friend of mine and will remain so, and I shall miss him very much. There are many other opponents of the Bill, which I so fervently support, who are dear friends of mine, for whom I have and will continue to have great respect. That includes, for instance, a previous Chief Whip who I can see, and who am I to argue with the wiles of a Chief Whip?

Five years ago, when I was diagnosed with the cancer that had killed my father and my brother, one of the first people to come to me to say, “Michael, come and have a cup of tea”, and to give me a hug, support, sympathy and advice was the noble Baroness, Lady Finlay of Llandaff. I am very sad that she is not in her place today because I would have liked to express my affection for her and my gratitude to her in this House to her face.

This has been a Bill of passions and disagreements. I will continue to respect all those of my friends who disagree with me on this, but—there is always a “but” in life, is there not?—while this has not been a filibuster, I was silly and went and looked up how a filibuster is defined, and it is “to talk something to death”. There is a certain irony in that definition, is there not? Look, it is not a filibuster, but if something looks, sounds and smells like an elephant and it is standing on your bloody foot, you can be forgiven for believing that it is indeed an elephant—but, of course, it is not a filibuster, is it?

It is not the job of this House, as we have heard so many times, to bury a Bill in distractions, which is what so much of the last few weeks and months have been about. I believe that we as a House have let ourselves down by failing to come to a conclusion on this Bill. We have harmed our future by failing to do our duty. There are people out there, opponents of this House, who would bring this House down and use this debate and our failure to deal with this Bill properly as a reason for doing so.

No one wants a bad law, but we already have a bad law. It is a law which is cruel. It is a law which is callous. It is the law of Dignitas, whereby people are forced—only if they can afford it—to go off to a strange land and die there. We have a law of suffering and excruciating pain. It is the law of humiliation and degradation, which far too many people have to endure, totally unnecessarily. I fail to understand how anyone can suggest that the current law in this country is acceptable. We must find an alternative. We should not be made, as individuals, to go on that longest journey we will ever take, to our deaths, racked with pain and stumbling in fear.

To know that you can and may die in peace is to live in glory. This Bill will fail, but it will be resurrected. It will return and it will succeed—and I personally will rejoice.

[Baroness Berger (Lab)]

My Lords, I am dismayed at the decision to spend some time today on process instead of continuing to consider the raft of outstanding issues that we otherwise would have considered, so that the substantive challenges could be addressed in any future legislation. Today we would have considered how an assisted death would interact with the NHS constitution.

As we take note of the overall progress that has been made in this House, I will respond to a number of the claims that we have heard today, in some cases more or less from the moment the Bill arrived before us last summer. The claim today has been that the scrutiny that has taken place has been unnecessary or unusual and that in any event, the elected House had already undertaken sufficient scrutiny before we began. The Bill was first published in the way any Private Member’s Bill is. We have heard in this Chamber today some attempt to equate it with government Bills such as the Crime and Policing Bill and the welfare rights Bill, but there was no prior public consultation on this Bill. There was no pre-legislative scrutiny, no Green Paper, no White Paper, no international comparison. Even at the earliest stage, when the Bill was first presented, it was several times longer than any other Private Member’s Bill, weighing in at 43 clauses. It has now been expanded to 59 clauses and three schedules. The House of Lords Library tells us that this is the longest Private Member’s Bill ever.

This is in stark contrast to previous well-known Private Members’ legislation on issues of conscience that supporters have sought to use as precedents, such as the seven-clause-long Abortion Act and the four-clause-long Murder (Abolition of Death Penalty) Act. Both benefited from a commission which fulfilled the pre-legislative scrutiny role that this Bill has sorely lacked.

After Second Reading, the amending stages in the other place began in Committee with the overwhelming majority of amendments being rejected by a Committee made up of 14 Members who supported the sponsor, in contrast to nine MPs who raised concerns about the Bill. Two-thirds of the way through Committee in the Commons, about 62 hours in, the most significant safeguard in the original Bill—the High Court stage at the end of the process, involving a judge—was removed. It was replaced by the new untrialled process, involving non-judicial panels overseen by a new, tsar-like figure, the voluntary assisted dying commissioner.

This seismic change was made without any input from the 627 Members of the other place who were not on the Bill Committee. Significantly, no evidence was taken on that totally new process. On Report in the Commons, scrutiny was limited to just over two days, and of 77 amendments tabled—

[Lord Falconer of Thoroton (Lab)]

My understanding is that Sir Nicholas Mostyn and Sir Max Hill gave evidence to the Bill Committee about the role of the judges and the possibility of a panel. Am I wrong?

[Baroness Berger (Lab)]

My point is that the change to the Bill was introduced after 62 hours. No evidence was taken on the new process. On Report, of the 77 amendments tabled by Members other than the sponsor, only seven were selected for a separate decision.

[Lord Winston (Lab)]

The noble Baroness and I are relatively unique in that we were two of the 12 members of the Lords Select Committee panel that looked at the Bill. One issue that we found on our side was that the people against the Bill refused to take the evidence that we were trying to propose from other countries that had been successful with this type of Bill, including Australia, New Zealand and many other countries—some 30 sovereignties. We had great difficulty getting any chance of a proper hearing until the very end, by which time it was too late.

[Baroness Berger (Lab)]

Forgive me; I am unclear exactly what the noble Lord is referring to. I can tell the House, for clarity and for the record, that only one vote was taken at the Select Committee of this place: a vote not to accept written evidence. We all would have benefited from accepting the greatest number of representations. I voted in support of written evidence, and it is a shame that we did not have it. It meant that, because of the time limitations, we did not get to hear from more people. That was in large part determined by the clerks who supported us on the Bill.

It was therefore not surprising that the Bill cleared the Commons by just 23 votes—less than half of its already moderate majority at Second Reading. The assertion repeated today is that the Commons carried out thorough scrutiny and addressed the most important issues, but I attest that that does not mirror the facts. This is not a criticism of the efforts made by our colleagues in the other place; it is an acknowledgement that the process for Private Members’ Bills is completely inadequate for the task of scrutinising a Bill of this length, magnitude and complexity that has not been preceded by any consultation or other pre-legislative scrutiny.

It was therefore no surprise that, when the Bill arrived in this House, not one but two Select Committees in this place, the Constitution Committee and the Delegated Powers and Regulatory Reform Committee, were scathing about the state in which we received it—specifically about the 42 Henry VIII powers that the Bill now conferred. It was exactly for that reason that an agreement was reached with my noble and learned friend to hold a time-limited Select Committee, which did not delay the timetable for the Bill. It ensured that we maintained the four protected Friday Committee sessions before the Christmas break at the end of last year but allowed us to take evidence on the Bill as we received it in this place and to hear from the professional bodies whose members will be responsible for delivering on the Bill.

We heard evidence from organisations such as the Royal College of Psychiatrists, the Royal College of Physicians and the Royal College of Nursing, and from GPs and medical examiners—organisations and groups that are neutral on the principle of assisted dying but have legitimate and significant concerns about the efficacy, workability and safety of the Bill. I was seeking to make an intervention earlier on my noble friend Lady Andrews. Not a single royal college in this country will attest to the safety of the Bill. Why is it that noble Lords in this place believe that they know better than the people, organisations and professions that will have to deliver on the Bill? The Equality and Human Rights Commission, disability organisations, mental health organisations and domestic abuse experts talked about the Bill’s practical issues: its gaps and lack of safeguards or guardrails.

I have to express my significant disappointment that virtually none of that evidence presented to us has been taken on by my noble and learned friend the sponsor. What should have been an opportunity to strengthen and improve the Bill seems to have been treated instead as a mere hurdle to be jumped over to get this legislation over the finish line. That rich body of authoritative evidence, imparted over 13 panel sessions, has been largely ignored in the sponsor’s own amendments—the only amendments that have so far been accepted, save for one amendment to an amendment from my noble and learned friend Lady Scotland.

As for the comments that have been made about Committee, I attended every sitting and I do not believe that the depth and seriousness of this scrutiny can be captured in mere numbers and statistics. However, since supporters of the Bill have repeatedly referred to the number of amendments tabled, I will point out only that it is not clear what a normal number of amendments is for a Private Member’s Bill of this length and complexity that has not benefited from any pre-legislative scrutiny, because there has never been any attempt to pass a Bill like this before. It is a wholly spurious criticism.

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[Lord Falconer of Thoroton (Lab)]

The letter of 31 January 2026, which was sent to every Peer, said that.

[Baroness Berger (Lab)]

Forgive me, but I have seen that letter about amendments that would be forthcoming and looked at it very closely. There was a letter that said, for example, that my noble and learned friend would bring forward alternatives on the issue of 18 to 25 year-olds. We are still waiting for those alternative amendments.

[Lord Falconer of Thoroton (Lab)]

I am slightly surprised that the noble Baroness, Lady Berger, says that I did not indicate which of the coming amendments I would accept, because I indicated in detail which I would accept. I set out a whole number of amendments. The suggestion that the House did not know what I was willing to agree to is, if I may say so, not correct, and I am really surprised that she is saying it.

[Baroness Berger (Lab)]

I can reiterate only what I said in previous meetings about having specifics. I do not know which, if any, of the 1,000 amendments—some of which were tabled just the night before and we had to understand them in detail—my noble and learned friend was prepared to accept. I have looked very closely at the communications that I have received, and there have been some indications on two of the measures, but on everything else we have not received that.

I have taken a number of interventions. In conclusion, I will just address one issue that has been raised. The accusation has been repeatedly made, last weekend and this morning, that religion has been driving opposition to this legislation. There are Peers of all faiths and none who have participated in your Lordships’ House and raised concerns. The objections that I and many others have to the Bill are not doctrinal; they are rooted in the real-world consequences the Bill may have for those whom we have spent years striving to represent—in my case, drawn from my direct experience as a Member of Parliament for almost 10 years—including people who do not have the same amount of agency or resources that all in this place are fortunate to enjoy.

I conclude by saying that to insist that we should have glossed over this legislation that will hand the state the ability to end the lives of some of its most vulnerable citizens, ignoring the evidence that we have heard, and a Bill that no professional medical royal college in this country today says is safe, has been a misguided approach.

[Baroness Burt of Solihull (LD)]

My Lords, I cannot tell you how disappointed I am to see this important Bill come down to this. I feel very strongly for the sponsors, as well, over some of the accusations that have been made here. I am not a medical or a legal specialist, but I am going to take just two minutes to make one point.

Despite being given the extra time that we have had, we are faced with a Bill that has not now been properly considered. A great opportunity has been wasted for a very small number of noble Lords to go to the extreme point. I am no stranger to this: I have had several Private Member’s Bills on schools lost for the only reason that they ran out of time.

It is clear to me that the Private Members’ Bill is not suitable for purpose, and this is better highlighted nowhere than here today. The difference is that this started in and passed the House of Commons, so it already has the approval of the House, and not just this House but the proportion of the British public who support it. They can see that the tactic of delay and manipulation is wrong, so I suggest that the Member system should be revised; it is not allowed to play with a Bill that has the clear will of the House—and I believe the collective House, although we never had the opportunity to test that.

However, looking past the non-passage of this Bill, those who took part in its fall have taken away the opportunity, and surely the right, of a painless death if that is a patient’s wish. I hope that the elected House will involve the Parliament Act and stop making the perfect the enemy of the good.

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[Baroness Blackstone (Lab)]

My Lords, I am not going to give way because time is short.

[Baroness Berger (Lab)]

My Lords—

[Baroness Blackstone (Lab)]

I am sorry, but I am not giving way. I do not think it is appropriate for me to do so, and many others have not. I am happy to discuss it with the noble Baroness afterwards.

The largest survey of medical opinion in the UK by the BMA found doctors more likely to support than to oppose assisted dying. Organisations that represent them have worked closely with my noble and learned friend Lord Falconer and Kim Leadbeater MP, the sponsor of the Bill in the House of Commons. I had intended to turn to several examples of blatant misrepresentation that have taken place in Committee, but in the interests of giving other people an opportunity to express their views, I will leave them out. I am afraid to say that it was a failure—

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[Baroness Blackstone (Lab)]

My Lords, I will answer that briefly. I did not, in what I have just said, in any way imply that the medical colleges did not have some suggestions for improvements to the Bill. Many people have suggestions for improvements to the Bill, including my noble and learned friend Lord Falconer of Thoroton. What I am saying is that it is misleading to suggest that they are opposed to the Bill in principle as a profession—they are not; they have been neutral.

[Baroness Berger (Lab)]

Before my noble friend sits down, I say that I have been accused of dishonesty in my representations. I will just repeat what I said. I was very clear that, while the overwhelming majority—bar one, I think—of the royal medical colleges take a neutral position on the principle of assisted dying, there is not a single medical royal college in this country that will attest to the safety of the Bill. I reiterate that that should concern us all.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I acknowledge that those who have been campaigning for the Bill, inside and outside here, are well motivated. Many have watched a loved one die in great discomfort, even agony, and are informed by grief. Understandably, they do not want that for their loved ones or themselves. I also acknowledge that they are often driven by choice and autonomy, which are honourable virtues. Facing death, when illness threatens to remove bodily or cognitive control, can be daunting. As the noble and learned Baroness, Lady Prentis, so vividly and movingly described earlier, you can feel how people would therefore want to assert control at the end of their life.

I acknowledge that absolutely, but I want to refute something that keeps being thrown out regularly: the accusation that those of us who raise concerns about the Bill do not care about those campaigners and that we have never listened, or are not listening, to the terminally ill. To note, the terminally ill are not an undifferentiated identity group with a fixed view. Sadly, we will all know people who are terminally ill now. I can tell the House that those I know find that politicians’ enthusiasm for assisted dying—in preference to energy going into palliative care or hospices—makes them feel like a burden, and they are demoralised and dispirited.

It seems that some people are determined to undermine the motivations of those of us who tabled amendments, as though we are all part of some malign Machiavellian plot. Media reports this week—by the way, I must give credit to Dignity in Dying for its good comms and PR; its media work is second to none—have said that we in the Lords should hang our heads in shame. Actually, we should hold our heads up high. At the moment, it is fashionable in politics to look the other way—to see no evil, hear no evil, and so on—but we were charged with a huge task and a heavy responsibility. If there was to be a law that would mean that the state and doctors could help end the lives of the terminally ill, how could we pass that law without creating recklessly unsafe legislation?

This has not been some tactical coup, as the noble Baroness, Lady Hunter, implied. The task was to scrutinise the longest Private Member’s Bill on record—all without any guidance from Government Ministers beyond narrow, technical comments on legal and operational workability, not safety. Also, we were charged with the task of scrutiny not just because of our intrinsic role here but because MPs in the elected House told us that they were relying on our House to fix a flawed Bill.

Contrary to the point made earlier by the noble Baroness, Lady Gerada, what has become obvious is that the people who are not grounded in reality are those who support the abstract ideals of the sponsors. Once amendments try to pin down the practical, specific mechanisms of the Bill about how an assisted dying service would operate on the ground, worrying implications and unintended consequences are exposed. When the Health Minister, Stephen Kinnock, admits that the Government would need to reprioritise spending from NHS budgets to fund assisted dying, it is our duty not to stay shtum. We should not talk it out but we should be talking about it, because we should ask: which health services will be cut? Could palliative care get even less money? When the Royal College of Psychiatrists warns that the requirement for members to sit on AD panels would mean taking them away from overstretched, front-line mental health services, our job is not to ignore that but to ask: would that mean even longer waiting lists for those who are mentally distressed, or a reduction in people at the coalface of suicide prevention because they have been diverted into okaying the state assisting individuals in taking their own lives—that is, not suicide prevention? Such moral dilemmas hint at the fundamental shift in the—