Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

My Lords, as legislators, all sorts of laws pass through our hands—the good, the bad and the ugly. All are consequential for our fellow citizens, but rarely does a Bill weigh as heavily as this one. Wherever we stand, this law change could have a seismic impact on social attitudes to life, illness and death. Our task is formidable because of how many norms the Bill will overturn; I will mention a few.

The Bill unsettles centuries-old medical ethics. It rebrands assisting someone to die as a medical treatment, upending its understood meaning. The Bill rewrites the role of doctors. They will no longer be guided by the “Do no harm” ethos of preserving and protecting life; instead, the Bill mandates that they actively engage in taking a patient’s life by supplying lethal drugs that will kill them. The Bill especially shakes the foundations of society’s attitudes to suicide—and, yes, that is the accurate word; we know this because, at present, intentionally assisting someone to end their life is a criminal offence. So the Bill is forced to amend the Suicide Act 1961 to allow medical professionals to plan, prepare and assist in intentionally ending the lives of a particular group of citizens.

My greatest dread is that this state licensing of suicide could unleash a regressive culture change. For decades, we have made concerted efforts to deter people from taking their own life; this was brilliantly documented last week by the noble Baroness, Lady May, and the noble Lord, Lord Jackson.

Now, I pause. Any of us who have known family or friends who have committed suicide know that it is gut-wrenchingly tragic; it brings an especially visceral, raw grief. This is compounded by guilt as loved ones endlessly soul-search, totally unfairly blaming themselves: “What more could we have done?” This is why, if we see someone about to jump from a bridge, even if they give us 100 objective reasons why their life is not worth living or even if they have only a few months to live, we do not just shrug and walk on—we cling on to them and plead, “Don’t do it. Don’t jump”. All this reflects our deep humanistic intuition that, when a person acts to end their life, it should be resisted with all the energy society can muster. What happens culturally, though, when the state shouts, “Jump”, or agrees with those who say that ending their life is a compassionate choice?

I worry especially about what message this sends to the young, who are already often nihilistic and prone to anxiety, self-harm and mental health problems. When we debated the censorious Online Safety Bill, those of us who raised its negative impact on free speech were metaphorically slapped down and hectored. The one indisputable reason for that law was to close down suicide sites—something echoed by the Prime Minister only yesterday. We had to protect the young from malign online suicide influencers, but I worry that this Bill is the legislative embodiment of a suicide influencer. What do we think will happen when we tell newly franchised teens that, in some instances, taking your own life equates to dying in dignity? Saying that it will be restricted to those with a terminal illness just will not wash with a generation immersed in the language of rights and entitlements: “Why not assist me when I am suffering so much? Why am I being discriminated against?”

That brings me to my final point. We have heard some fine speeches from supporters of the Bill, stressing the importance of autonomy and giving people control of their life. I usually champion such sentiments in a political sense, but not when they are used to justify the state having a role in ending human life—forgive my squeamishness. For those who state passionately, “My body, my life, my choice”, why back a Bill that limits that choice to the terminally ill? Surely logically that right should apply to anyone who wants to kill themselves. No doubt this logic will lead to demands to expand the law—God help us once human rights lawyers get involved. As I say, we have a weighty responsibility to ensure that such nightmarish unintended consequences do not become a reality.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

I will deal first with the central issue in this debate, which is the amendment from the noble Baroness, Lady Finlay. The wording currently mentions:

“A terminally ill person in England or Wales who … has the capacity to make a decision”.


The noble Baroness proposes that “capacity” should be changed to “ability”. From what the noble Lord, Lord Wolfson, says, I understand that we should read that with Amendment 115, although there is another amendment that the noble Baroness proposes in relation to Clause 3. But I accept what the noble Lord says in relation to Amendment 2.

With the greatest respect to the noble Baroness, Lady Finlay, she is suggesting that we remove “capacity” and replace it with “ability”. The noble Lord, Lord Sandhurst, put his finger on it when he said that “capacity” is well known to the law. You could not possibly have a Bill that did not refer to capacity because what it means, in the eyes of the law and of people in practice, is the ability to make the decision. As the noble Lord, Lord Blencathra, said, if you do not have capacity, you cannot make the decision. That applies right across the doings of human beings, and the law recognises that. If, therefore, you replace “capacity”—

[Baroness Fox of Buckley (Non-Afl)]

On a point of clarification, I thought that the idea of adding both words was very helpful, but when the noble and learned Lord says that you cannot make the decision without capacity, it is not any decision but this particular decision in this Bill. Can he reflect on a point that was made very well by one of his noble friends on something that happened in my family as well? Somebody with dementia was said to have capacity for a particular decision, but I would not have wanted my mother to have been trusted as having the capacity to decide whether to ask for assisted death.

The Mental Capacity Act is fantastically important, but is it appropriate for this decision—not any old decision but this decision—which is a bit more challenging than some of the decisions that the Mental Capacity Act is used to decide on?

[Lord Falconer of Thoroton (Lab)]

That is very well put and is exactly the question. Is it appropriate to bring the Mental Capacity Act into this Bill? I understand that whether you have an assisted death is an incredibly important decision. You cannot remove the word “capacity”, so you have to reject the amendment from the noble Baroness, Lady Finlay.

Her Amendment 115 effectively draws on how the Mental Capacity Act 2005 is currently drafted, except it adds two things. It removes the presumption of capacity and, separately, it requires the person making the decision to be aware of a variety of things that are connected with their illness. To summarise, the way the Mental Capacity Act operates at the moment is that if you are unable to understand information relevant to the decision, to retain that information, to use and weigh that information or to communicate your decision, you do not have capacity under the current Mental Capacity Act. The extent to which the things that the noble Baroness, Lady Finlay, has referred to in her amendment would be relevant would have to be weighed in the context of the decision that has to be made.

I am more than happy to debate whether we need to make the changes to the Mental Capacity Act that she is suggesting. For my part, I do not think we do. One thing that is absolutely clear is that the amendment proposed, as the noble Lord, Lord Sandhurst, identified, is completely ridiculous. You cannot remove the question of capacity from this choice. Putting aside some detail hurdles, there are two hurdles that need to be overcome in how this Bill is constructed. You have to be capable of making the decision, as the noble Lord, Lord Wolfson, said, and—completely separately—you have to make that decision completely voluntarily. It has to be your own decision, not the product of pressure.

We have had—and I say this with warmth and respect—a rambling debate going over a whole range of issues, miles away from the question of whether one should remove the word “capacity” and put in the word “ability”. If this House wants to make the law completely confused in this area, either put in the word “ability” or put in “capacity and ability”. I echo the speech of the noble Baroness, Lady Hayman, when she says we have to approach this in a grown-up manner, and to remove the word “capacity” is not a sensible way to deal with this.

I also echo those who have said that the idea of running two systems at the same time—the Mental Capacity Act system and the separate system proposed by the noble Baroness, Lady Finlay—is wrong and confusing. I congratulate the noble Baroness, Lady Fox, for spotting what the right decision is. Of course, under the Mental Capacity Act some unimportant decisions are taken, but a decision such as whether to have the ventilation removed from you if you have motor neurone disease, that will almost certainly lead to your death, is without a shimmer of a shadow of doubt a life and death decision.

The Chief Medical Officer of England and Wales, in evidence to the Lords Select Committee, said:

“it is far better to use systems that people are used to and that are tested both in practice and, where necessary, in law”.

He went on to say:

“I have a concern that you could have a conversation in one bed in a hospital where someone is talking about, for example, an operation where they might well lose their life, because they are frail and there is the operative risk, done under the Mental Capacity Act, and, in the next-door bed, someone is trying to do the same process of having a difficult conversation about someone who might die, or could definitely die, as a result of that decision, but using a different legal framework. The risks that that could lead to confusion are not trivial”.


I also echo what the noble Baroness, Lady Browning, who sadly is not in her place, said. There are problems about practically every aspect of how various parts of the health service work, but she was part of a process that considered how the Mental Capacity Act worked. The broad conclusion was that it was a good, workable Act, and we should not stray from it in this particular case. I invite the noble Baroness to withdraw her amendment.

Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Farmer (Con)]

My Lords, I rise in support of Amendment 118 tabled by the noble Lord, Lord Hunt of Kings Heath, and I am introducing Amendments 118A and 118B which follow it. I also support Amendments 45, 46, 47, 49 and 58.

This is an atheist Bill that assumes there is nothing after death, which is not a neutral but an ideological position. To those without an active belief that there is something after death, I would say, “How can you be so sure?” What makes the point that it is an atheist Bill? It is that it desacralizes death and by so doing it opens the door to very many evils including coercion and pressure, the subject of this group. The Bill is coercive: it gives oxygen to dark thoughts which can loom especially large when our best days seem to lie behind us, and when we are no longer contributing to family and society in the way we once did. Culturally and societally, it encourages and influences them as much as any person referred to in Amendments 45 and 46. Two of my friends with terminal conditions both followed earlier stages of this Bill in the other place and told me the subject’s very airing made them feel that they were a burden. The message that legislation and policy should amplify is, “You will not walk the valley of the shadow of death on your own”. We should encourage people to make and keep those relationships that will carry them through life and through that dark valley.

Others might also have dug out the words of the Times columnist Matthew Parris, quoted in a debate on assisted suicide in the other place in April 2024. He said that although

“‘Your time is up’ will never be an order”

to the elderly, disabled, severely ill and the others to whom assisted suicide will, inevitably, be extended eventually, it

“may one day be the kind of unspoken hint that everybody understands. And that’s a good thing”.

As the right honourable Stephen Timms said in that debate:

“I cannot see that that would be a good thing. It seems to me that legalising assisted dying would impose a terrible dilemma on frail people, elderly people and others when they are at the most vulnerable point in their lives, especially on conscientious frail people who do not want to die but do not want to be a burden. I do not think that there is any way to avoid imposing that dilemma”.—[Official Report, Commons, 29/4/24; col. 18WH.]


We have heard from the noble Baroness, Lady Finlay, about the data from Oregon, where over half the people who have applied for assisted dying since 2017 did so not because they wanted to die but because they felt that they were a burden. Amendment 47 from the noble Baroness, Lady Coffey, would guard against this “internal coercion”, to use the Royal College of Psychiatrists’ phrase. Further, her Amendment 49 includes,

“body corporate, institution or organisation”,

alongside “person”, which would of course catch the Government themselves. Tragically, and I declare my interests as a Hampshire farmer, there are farmers who have committed suicide ahead of the imposition of the family farm tax, choosing to die early so their land is passed on intact. Law and policy starkly influence personal decisions, hence our responsibility as lawmakers to take these unforeseen consequences into account and not brush them aside.

In her Amendment 58, the noble Baroness, Lady Grey-Thompson, is right to focus on lack of care as a disadvantage that pressurises. If death looks as if it might be painful and protracted then going through it alone, unmissed and uncared for, is too terrible to contemplate, but surely we can do better than help someone act on that dread thought, “No one would miss me; no one cares”.

Amendments 118A and 118B, which are my amendments to Amendment 118 in my name and that of the noble Lord, Lord Hunt, would ensure that wills were scrutinised and the backgrounds of friends, as well as family, were not overlooked if sinister motives suggesting financial abuse were not assumed but at least considered. Legislating for motivation is notoriously difficult, because motives are private, subjective, and easy to disguise. Instead, assisted dying legislation must use clear, objective safeguards to remove the possibility of improper motives influencing the process.

As an aside, I am not sure the Bill prevents any doctors involved profiting from early death, but Dr Harold Shipman did of course inveigle himself into the wills of some of his victims, and that would also be a red flag if found in the commissioner’s checks on wills.

Therefore, I ask the noble and learned Lord, Lord Falconer, why the Bill does not do more to exclude anyone with a financial or personal interest, and by extension anyone who might have been under their influence. We cannot draft either for compassion or for malice, but we can protect applicants by making it clear from the outset that if anyone with suspect motives has any involvement, their application will fall.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I, by contrast, speak as an atheist and humanist, mainly to address my Amendment 45, which would add the word “encouraged” after “coerced”. I support the general theme of the other amendments in this group, which largely tackle the need to strengthen safeguards against patients being indirectly influenced into opting for assisted death—often coerced, in all but name. All these loopholes undermine any certainty that the “choice”, in inverted commas, is made autonomously.

My amendment, supported by the noble Lord, Lord Goodman of Wycombe, may appear to be a small change, as it would add just one word. But before anyone concludes that I am tabling trivial amendments to waste time, I note that, when dealing with a fundamental change in the state’s relationship with its citizens and the NHS’s relationship with patients, and life and death decisions, the specificity and appropriateness of the words in the changed law matter.

At present, the Bill requires doctors to ascertain only coercion or pressure. They are the only two words given in Clause 1; there is no duty even to probe or ask broader questions about more subtle, insidious influences that could affect a person’s decisions. I note that the concept of encouragement is not arbitrary; the encouragement of assistance in suicide is illegal under the Suicide Act but would not be in this Bill. Indeed, CPS policy guidance on prosecuting those who have assisted suicide acknowledges “encouraging”—it uses that word—the victim as a factor in favour of prosecution. It is also criminal to encourage a person to commit an offence under the Serious Crime Act. Therefore, the question is less about why I am bothering to table an amendment to add just one word; the question is why the sponsors of the Bill left out that word “encouragement”.

Adding the word “encouragement” would allow a shift in perception about what undue influence could look like. Even though there are real problems in spotting coercion or pressure—we have heard many examples of that—the concepts at least have a hard edge or overt sense, at least in everyday parlance, that you are talking about people doing something that they really did not want to do. You do not say, “I had a really lovely day today; my husband coerced and pressurised me into doing” something. There is a grey area of much more subtle intervention; an individual could motivate, lead on or nudge someone into opting for an assisted death, rather than making that person aware of all the ways that they might live out their limited time as comfortably as possible. This amendment is trying to get at that sort of encouragement.

As I explained at Second Reading, one of my big dreads is that, once assisted dying is normalised as a positive treatment option, that vibe shift will not be confined to medical scenarios. It can and will mean that it is popularised as a go-to option in broader society. Consider this scenario: you have just received the news that you have a terminal diagnosis and have about six months to live. You are frightened, shocked and seeking reassurance. It is a bleak time and you are depressed because you do not want to die.

But then a third party—a family, carer or friend to whom I ascribe no motivation—says, “Have you thought about asking your GP for an assisted death? I’ve been reading about it all over the place and you can do that now. At least that way you’d have dignity in dying. You know how much you hate hospitals and all those doctors fussing about you, and we all know that you are not good with pain. How would the kids cope with running around having to visit you when you’re in and out of hospital? Wouldn’t it be so lovely to choose when you go, then we could all be with you at the end?” All of this is said in soothing, kind tones. Therefore, you think, “Well, I really don’t want to die. My instincts are to

‘Rage, rage against the dying of the light’,


but I don’t want to be a nuisance either, and they know me so well. They know what I’m like and that I won’t cope. They have my best interests at heart, so I suppose so”. It does not sound exploitative or coercive, but it is an iron fist in a velvet glove.

We have some cultural reference points here. In discussions about how the Online Safety Act will tackle suicide sites, there is consensus about the problems of online influencers encouraging vulnerable people into believing that suicide is a positive way out of their suffering. There is widespread revulsion at those cajoling siren voices encouraging death as an attractive option. In that context, none of us concludes that this encouragement is not problematic because it is not explicitly coercive.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

The Bill makes it absolutely clear that it must be your own decision. Let us suppose that your views of the world are affected by the internet and that you are ill and an organisation is urging you to commit suicide, that organisation should be liable if that happens.

In Amendment 49, the noble Baroness, Lady Coffey, wants “person” to include a body corporate or an organisation in relation to pressure. If an organisation or a body corporate is putting pressure on a group of people or on individuals and that makes them do it—this is putting it crudely, but if an organisation says, “Do have an assisted death; it is the right thing for everybody or for you”—that should be covered by the Bill. The noble Baroness adverted to how “person” can generally include both corporate person and human person, but I can talk to her separately about that to make sure that it is covered.

[Baroness Fox of Buckley (Non-Afl)]

Some clarification is needed in relation to a number of points that you have made. How does anybody know, how does the doctor know, whether any of these scenarios have happened? Is there anything in the Bill that makes the doctor ask and explore? The word I proposed was “encouragement”—that you would ask not just “Were you coerced or pressurised?” but “Were you encouraged?”—because it would develop a richer conversation. Is there anywhere in the Bill where all the things that you have just said—apologies; I should not have said “you” but “the noble and learned Lord”—can be fleshed out, discussed and teased out?

Maybe I have got this wrong, but at the moment as I understand it, you fill your form in, somebody might even ask “Were you coerced?” and you say no, and that is that, out the window and then, Bob’s your uncle, you are eligible and off you go. It does not matter how often that process happens. The noble and learned Lord spoke about “first doctor, second doctor”, but if they do not all explore it, how will we know whether it was anything other than a yes/no? The noble and learned Lord has given a very rich explanation of what could have happened, but the Bill does not allow us to find out whether any of that will have occurred before the assisted death is enacted.

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.