Terminally Ill Adults (End of Life) Bill

Alicia Kearns Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Lauren Edwards]

No, I will make some progress.

Taking the approach I have outlined respects both the will of this House, as expressed in June 2025, and allows the usual parliamentary processes to continue.

[Alicia Kearns (Rutland and Stamford) (Con)]

“Erskine May” gives this House a way to send what are called “suggested amendments” to the Lords as a separate motion alongside the Bill, when it goes to the other place. It has not been used since 2004, but does she recognise that if some Members of this House think certain amendments are crucial to the Bill, they can do so?

[Lauren Edwards]

That is a part of our usual parliamentary process and the hon. Lady is right to raise that point.

By sending the Bill back to the Lords as it stands, we will prevent that same small group of peers who talked it out last time from doing the same thing again. It is my fervent wish that all the peers—

--- Later in debate ---

[Dame Karen Bradley]

I will not; I really need to make progress.

The hon. Member for Rochester and Strood and co-sponsors of the Bill have been clear, including in the debate now, that there will not be amendments made in this place. A deliberate decision has been taken to introduce a near-identical Bill and not to incorporate the 77 amendments from the Lords sponsor, including changes that addressed issues that he himself accepted required attention.

[Alicia Kearns]

Will my right hon. Friend give way?

[Dame Karen Bradley]

I really cannot; I am so sorry to my hon. Friend.

We could have dealt with this over the summer; we had time to work on it. We could have included, for example, a clause that would have given an equal right to palliative care or a simple assessment of unmet need—something, anything, to allow there to be a genuine choice. But that opportunity is now gone.

Let me be absolutely clear about what today’s vote is and what it is not. It is not another vote on the principle of assisted dying as on an ordinary Second Reading debate, and the hon. Member for Rochester and Strood said that herself. It is not a vote to allow this House to improve the Bill. It is not even a vote to allow the other place to improve it, because that is not in this House’s hands. If this Bill is sent to the other place and falls for whatever reason—even if that is because Parliament prorogues early and it receives not a single further hour of debate—it could be forced into law as it is. The Hansard Society put it plainly in saying

“bills proceeding under the Parliament Act have been subject to only minimal amendment.”

The House needs to understand that the proposed approach requires

“preserving an unchanged bill with…defects”.

That is a very different decision.

I know that there will be Members in the House saying to themselves, “Nothing has changed since I voted for this before—why should I change my vote now?” My answer is simple. A great deal has changed, though not, unfortunately, in the Bill itself. We know more now than we did then, and changing one’s conclusion when the evidence changes is what Parliament is supposed to do.

We now have revised estimates from the Government showing that many more people may seek an assisted death than Members previously understood: up to 4,610 may apply in the first year, and up to 10,428 in year 10. That is more than 1,000 times the number going to Dignitas each year. That is not a slow run-up during which we can watch the system develop, identify mistakes and quietly correct them.

--- Later in debate ---

[Alicia Kearns (Rutland and Stamford) (Con)]

Palliative and social care need fixing, and that is a concern that unites the House. It is a scandal that how well people die depends on where they live, but to suggest that this Bill should wait until palliative care has been improved is a fallacy for two reasons. First, the Bill gives us an opportunity to improve palliative care. It places a statutory duty on the Secretary of State to tell this House what the state of palliative care in this country is, and whether people can even access it. No Government have ever been required to answer that question, and under this Bill, they would be. I would go further and say that this assessment should be in place before the Bill comes into force and should be an annual update to Parliament, but that amendment cannot be made to a Bill that does not exist. If we vote down this Bill today, we will delay and deny the possibility of mandating a genuine assessment of the state of palliative care in this country.

The second reason it is a fallacy is that Hospice UK has told us repeatedly that it would be inappropriate to even imply that hospice and palliative care can address pain in all circumstances; we know that it does not, and honestly cannot. When we say that we will fix palliative care first, we are promising something that no palliative care system has ever delivered or will ever be able to deliver, and we are asking people to die in pain waiting for something that cannot be given. If we vote this Bill down, we will be no closer to understanding the state of palliative care.

I would also add that in this country, we already have “do not resuscitate” orders. Doctors suggest them, families agree, and a person who could have been revived dies, often without their voice featuring in any way. I have experienced this in my own personal circumstances—I had to run across to Guy’s and St Thomas’ hospital and tell them to lift a “do not resuscitate” order that they had put in place without consulting me—so let us not pretend that this line is sacred, because no one in this place seems to be saying, “While we’re at it, let’s scrap ‘do not resuscitate’ orders.” Those are on the same continuum.

Let me turn to the other place and the question of procedure. A great many peers were doing precisely their job; others were laying siege to the Bill. If anyone does not want to accept that both those things are true, I ask them to look at their own bias. On some issues—treatable depression, eating disorders and whether a hospice can decline to take part—the Lords were right. When this House passed the Bill, we expected it to be debated and that amendments would come back to us in the ordinary way. “Erskine May” provides that where a Bill proceeds under the Parliament Acts, this House may suggest amendments to the other House without inserting them into the Bill. That power does not sit with the Bill’s promoter; it sits with anyone sat in this Chamber. If the Lords agree to those amendments, they are treated as Lords amendments already accepted by the Commons—they do not even need to come back to us. There is precedent in the Hunting Act 2004 and the Trade Union and Labour Relations (Amendment) Act 1976, so the choice before us is not between an unamended Bill and no Bill. I am not asking the House to accept the Bill as it stands, and I myself will press amendments through that process, particularly regarding the audit of palliative care and treatable depression. The process can be improved.

As a Conservative, individual freedom, choice and personal responsibility shape my decision making until those freedoms cause harm to others. For years, I have listened to debates on this issue, waiting for the harm in the principle of giving us autonomy over our own bodies and our own deaths to materialise. There is no harm in the principle of assisted dying, and I am yet to hear an argument that exposes it. This Bill applies to those who have six months left to live—no one else—and I am arguing for a freedom that harms no third party, but will relieve a great deal of suffering.

During our last debate, I told the House that my mother’s last words were, “I cannot go on like this.” She died a few days later, and that was a great kindness to her, even if it was a great cruelty to me and my children. However, too many in this country—this great, compassionate country—go to sleep at night desperate for the pain to end. They wake the next morning knowing that they must endure another day of it—a body that betrays them or wracks them, and that no medication will soothe—and another day in which this House has denied them the option of bringing it to an end, with their families and on their own terms.

[Rebecca Smith]

Will my hon. Friend give way?

[Alicia Kearns]

I am going to keep going. Members have often spoken of unexpected recoveries that have led them to oppose the legislation. That is the news we wish for every person we love and for every loved person we have. Last year, I was told twice that I would die—most likely or potentially—given complications I had that I will not speak about at the moment. I know what it is to want to survive. I know what it is to fight. But for many, that day is not coming—there will be no reprieve of that kind—and we cannot write laws about the dying in the hope of a miracle that will not come for most. As such, I will vote for the Bill, because living in a perpetual state of torture cannot be right, and we cannot allow people to wait longer. I urge hon. Members who are undecided to vote for the Bill. I urge them not to end the argument, but to continue it; I will stand with them in tabling amendments in the other place.