Terminally Ill Adults (End of Life) Bill

Baroness O'Loan Excerpts

Friday 24th April 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

I apologise for intervening but I completely agree with what the noble Baroness has just said. The way in which that would happen is that the Bill would come back from the Commons and we would agree here to put in the amendments that I put in as a result of the power of the noble Baroness’s speeches. We would then send it back to the Commons, where it would be agreed, so as to not let it be caught again in a procedural thicket.

[Baroness O’Loan (CB)]

My Lords, as we all know, this is a Private Member’s Bill. There was no manifesto commitment to it, nor was it in the King’s Speech.

[Lord Falconer of Thoroton (Lab)]

My Lords—

[Baroness O’Loan (CB)]

The noble and learned Lord is interrupting me but I am not going to give way.

As the Constitution Committee of your Lordships’ House said, it is our duty to scrutinise, approve, amend or reject any Bill. Constitutionally, we are under no duty to pass a Bill simply because the other place did so. No constitutional crisis will ensue when this Bill fails, as it probably will do today. A majority of MPs now agree that that is the case.

Government Ministers have told the House that the Government are not responsible for ensuring that safety is considered and provided for in legislation —that it is a matter for the noble and learned Lord, Lord Falconer, and, ultimately, a duty of this House to scrutinise draft legislation in order to ensure that what we pass is safe. Yet what has happened is that, although the noble and learned Lord has made multiple commitments to table amendments to remedy problems, he has not done so. Indeed, some of the amendments that he has tabled have reduced the safeguards contained in the Bill, such as those inserted by Daniel Francis MP and Jess Asato MP, which relate to people with learning disabilities and domestic abuse. We know that it has been said that MPs expected this House to scrutinise the Bill and improve it, but, as The Parliament Politics reports:

“New data has emerged suggesting that the initial support for the bill was not an endorsement of its specific mechanics, but rather a tentative nod toward a concept that many MPs now believe is fundamentally unsafe”.


Now, only 40% of them would vote for the Bill, while 45% would not.

As has been said, there was no pre-legislative scrutiny, consultation or proper impact assessment before the Bill was introduced. The result was widespread concern, not least among the professional organisations. The short Lords Select Committee that took evidence received very specific, detailed criticisms and concerns from stakeholders. Most of those concerns have not been addressed by the Bill’s sponsor, including concerns articulated by the Royal College of Psychiatrists, the Royal College of General Practitioners, the Royal College of Pathologists, the Royal College of Nursing, the Royal College of Physicians, the British Geriatrics Society, the Law Society, the Royal Pharmaceutical Society and the organisation Standing Together Against Domestic Abuse. These are very real concerns about the safety of the Bill, its impact and its effect on professionals and ordinary people.

The debates at Second Reading and in Committee have enabled very extensive and necessary discussion on much of the Bill—but because it was so deficient when it came to your Lordships’ House, much remains to be considered. At least 244 Peers have been directly involved in scrutiny of the Bill in Committee. The average speech has lasted less than seven minutes. It has been said that only a handful of Peers tabled amendments. In fact, 92 Peers tabled or supported amendments. The noble and learned Lord, Lord Falconer, tabled 76 amendments. The noble Lords, Lord Birt and Lord Pannick, tabled 35 amendments jointly. Apart from that, the supporters of the Bill did not table any amendments and nor, for the most part, was there any constructive contribution to improving the Bill.

We have now debated more than 800 amendments. In the course of that debate, we have considered not just seven clauses, as has been asserted. Rather, we have considered Clauses 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 34, 35, 36, 37, 39, 41, 42, 43, 47, 49, 50, 51, 56, 57, 58 and 59, and Schedules 1, 2 and 3, in whole or in part.

[Lord Falconer of Thoroton (Lab)]

Is the noble Baroness’s position that we have completed our scrutiny in Committee of all clauses beyond the seven that she has mentioned? If not, I am not quite sure what point she is making. We certainly mentioned those clauses, but the idea that we completed our scrutiny is nonsense.

[Baroness O'Loan (CB)]

My Lords, to be accused of nonsense is slightly unsettling. I do not accept the accusation. The reality is that we have considered in depth a number of issues—

[Lord Falconer of Thoroton (Lab)]

I apologise for saying “nonsense”.

[Baroness O'Loan (CB)]

This Bill seeks to provide for individuals to be provided by doctors with fatal drugs to kill themselves. Where those patients cannot self-administer, Clause 25(8) says that

“the coordinating doctor may … assist that person to ingest or otherwise self-administer”

the drug. We have not yet debated this clause at length, but it does raise the spectre of Dr Shipman. What protection is there against a Dr Shipman in these circumstances? What protection exists for those who may be subject to coercion, which will not be identified because of virtual assessments—for example, where the assessing doctor is not in the room with the patient or has no way of knowing who else is there or what is going on? These things had to be identified and discussed and amendments tabled to address them.

In the course of our debates and through the submission of evidence to the Committee, we have identified multiple other serious problems. On many of them there was no engagement by the sponsor, as the noble Baroness, Lady Hollins, said. Following clearly argued criticisms, the noble and learned Lord has accepted a long number of problems with the Bill. However, there are virtually no amendments to address those issues. The legal definition of persons exerting pressure must expressly include bodies corporate, to uncover institutional or organisational abuse. Think of the pressures of bed-blocking and budgets in the NHS.

Regrettably, many of the amendments that the noble and learned Lord tabled weaken safeguards for which the MPs voted—such as explicit domestic abuse training or the mandatory independent advocate presence—under the guise of tidying up the Bill. Often these would save the Government money. The Government’s impact assessment reveals that it almost halves the cost of the assisted dying process if independent advocates or translators do not have to be present. There was provision for independent advocates to assist those who have substantial difficulty in understanding the process. Under the noble and learned Lord’s amendments, the advocate does not have to be physically present during medical assessments—and a person is allowed to entirely waive their right to an advocate.

It is perhaps paradoxical and dangerous to expect someone who qualifies for an advocate, precisely because they struggle to understand information, to independently decide to waive that very protection at the outset. The advocate is introduced only after key clinical and eligibility assessments have been completed, rendering them a box-ticking process. Think of the more than 100 languages spoken in England and Wales and of the problems of people with hearing difficulties, articulated by the noble Baroness, Lady Nicholson, and other communication difficulties.

Doctor-shopping possibilities have expanded as a consequence of the noble and learned Lord’s amendments. Let us be very clear. As is appropriate, our debates have ranged over a large number of issues. We have considered the effect on the NHS, the necessity to revise the NHS constitution, and the effect on practitioners who did not join their professions to kill people and who need protection against involvement. We have yet to debate the existing conscience protection provisions, but we know that they are inadequate. The BMA and the royal colleges asked for an explicit opt-in model, which was rebuffed multiple times in the Commons. The noble and learned Lord finally acknowledged the concern, but his Amendment 669A introduces an opt-in requirement only for training, not for assisted dying as a whole.

The Bill provides some protection for professionals but not for all the other people who enable our NHS to work—the administrators, the porters, the cleaners. The current option of going to an employment tribunal if facing disciplinary action in the context of an unwillingness to engage in any way in assisted dying is just not satisfactory. People need their jobs to pay their rent or mortgage, to feed their children. A system-wide opt-in model is the only way to protect staff from institutional pressure, yet the noble and learned Lord drew the line at protecting administrative staff, to ensure that the NHS runs properly.

Too many issues that should be debated fully in this House are to be left to secondary legislation, which Parliament can only accept or reject but not amend—for example, the approval of lethal drugs and the provision of assisted suicide services in England and Wales, which the DPRRC has said should be removed.

We talk of democracy, yet there is nothing democratic about handing sweeping powers to Ministers rather than to Parliament. There are those who, like me, believe that all life is sacred and to be protected, from conception to natural death. That has not been the subject of our debates over these months. As legislators, some with a religious faith and some with humanist beliefs or maybe no beliefs, we have been through this Bill word by word and clause by clause to see whether it can be improved. We have identified the massive inadequacy in the provision of specialist palliative care and the consequences of that inadequacy; the disparity of access to hospice care; the unique identity of hospices in providing a safe place to live and die without pain and at peace; the huge trust that is fundamental to the doctor-patient relationship in places in which people live and die; and the potential consequences if the Bill is passed for private and public funding arrangements for hospitals and the NHS.

[Lord in Waiting/Government Whip (Lord Wilson of Sedgefield) (Lab)]

The noble Baroness has spoken for over 11 minutes and it is supposed to be 10 minutes. Can she bring her comments to an end?

[Baroness O'Loan (CB)]

I am bringing my comments to an end.

We have tabled amendments to provide some protection for the vulnerable, the weak, the poor, the disabled, the sick, those with suicidal ideation, those with mental health problems and all those whom we have identified. Many of us have concluded that this Bill is not safe and have worked to try to make it safer. As I conclude, I pay tribute to those living with serious illness and disabilities; people such as Pete and George, who have attended every day of our debates and who sit behind me; and all those—

[Lord Wilson of Sedgefield (Lab)]

Can the noble Baroness please bring her remarks to an end now? It is nearly 12 minutes and other noble Lords want to speak.

[Baroness O'Loan (CB)]

The 12 minutes include the interruptions I have suffered.

I pay tribute to all those who have written to encourage us as we fulfil our duties as legislators in your Lordships’ House in scrutinising this flawed and very dangerous Bill.

--- Later in debate ---

[Baroness Mattinson (Lab)]

My Lords, it is important that we, as an unelected Chamber, focus on what the public think. Over the last few months, we have heard opponents of the Bill suggest that it lacks public support; I want to correct the record on that. The most recent British Social Attitudes survey—which is, by the way, the highly-regarded bible that tracks longitudinal public attitudes—was published in March, and it shows that an overwhelming eight out of 10 of us support changing the law to enable assisted dying. This powerful evidence is consistent across respected public polling and across age, gender, region and political attitudes. It is also consistent among those with disabilities, those who profess a religion and those who work in the medical professions.

Data modelling by the polling organisation More in Common reveals that support far outweighs opposition in every constituency in Britain. But do not take my word for this. Polling guru Professor Sir John Curtice observed recently that the picture of public support for assisted dying was

“one of remarkable stability and near consensus in public attitudes”,

while another senior and highly respected pollster, Peter Kellner, says:

“Having reported, commissioned and conducted polls for more than half a century, I cannot think of another major social controversy where the public mood has been so settled and so emphatic”.


Both pollsters, in my experience, place the very highest value on presenting an objective and truthful representation of people’s views. Those views are not just widespread and consistently held in favour of assisted dying; they are also heartfelt. They are not theoretical but drawn from painful personal experience, and many of those stories—

[Baroness O’Loan (CB)]

My Lords—

[Baroness Mattinson (Lab)]

I am speaking very briefly so, if the noble Baroness does not mind, I will continue. Many of those stories have been told very movingly here today.

The point is that 52% of us have cared for or witnessed a family member who was terminally ill and suffering at the end of their life. Unsurprisingly, experience of this rises with age, up to 66% in the 50 to 64 year-old age group, and higher as you get beyond that. Research—for example, England’s first ever citizens’ jury, so more qualitative and deliberative research—tells us that support for law change grows the more that people understand the issue and hear about it.

Meanwhile, the backdrop to this debate is that trust in our democracy has never been lower. Too often, the public do not feel listened to. Confidence in this unelected Chamber is at its lowest ever: a desultory one in five has confidence in the House of Lords to do its job. At the end of last year, YouGov found that just 2% had a lot of confidence in the House of Lords and only 17% had some confidence. Some noble Lords have quoted a poll that suggests that the public would like to see us doing better scrutiny. Yes, in abstract, they absolutely would, but, with reference to this particular Bill, a YouGov poll recently found that 58% disagreed with the way the Lords has dismissed the Bill while only 17% found it acceptable. Again, public opposition rises, as you would expect, with greater experience by age, consistent with the lived experience of the impact and pain of the alternative.

As this debate draws to its close, we should all be aware that the way the Bill has been treated by this Chamber risks having profound implications for the Chamber itself and its reputation, as well as the absolute tragedy of ignoring the passionately held public view for assisted dying.