Terminally Ill Adults (End of Life) Bill

Karen Bradley Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Dame Karen Bradley (Staffordshire Moorlands) (Con)]

This is a very difficult day. No one could fail to be moved by the grief of campaigners and by the deeply personal stories, whether born of their own experience or of those they have lost. Those voices deserve to be heard, and it is important in this place that we respect all views, whether we agree or disagree; but as we deliberate today, I go back to the words of the hon. Member for Bradford West (Naz Shah) in a past debate, asking us to remember

“the quiet ones, those who may be less organised or not as powerful but who are none the less equally, if not more, important—the voiceless”.—[Official Report, 13 May 2026; Vol. 786, c. 11.]

Those words resonated particularly strongly with me, because I had the privilege of serving 10 years ago as the Minister for Preventing Abuse, Exploitation and Crime—the first time that safeguarding brief had been brought under one Minister. It was so often the quiet voices that needed to be heard. It was the time I spent with victims that persuaded me that modern slavery was something we needed to legislate for. It was the time I spent with the victims of domestic violence, some of whom did not even want to admit that they were victims, that persuaded me we needed to do more and that we needed to legislate in this area.

When I took the coercive control offence through Parliament, it was incredibly important. That is a very difficult offence; coercive control is not easy to prove or to find the evidence for, but it was so important that we did that. I remember speaking at an event not long after the legislation had gone through, where I explained that coercive control offence and what we were trying to do in Parliament. Afterwards, a woman came up to me privately, in tears, and told me that what I described had been her life some 30 years earlier. She had recognised eventually that she was a victim; so often victims do not recognise that they are victims, but she did recognise it. She had gone to the police, but because the offences were not violent or physical, they said that there was nothing they could do. They even said, “Lock the door and hope that he beats the door down, because then we could arrest him on criminal violence.” That was all they had. There was nothing they could do to help this woman.

That encounter stayed with me, and it reminds me time and again that abuse is not always a single act. It can be the gradual erosion of somebody’s confidence, independence and sense of what choices are really theirs. Coercion to end one’s life may not come as an explicit threat. It may be the repeated suggestion that someone is becoming a burden.

[Catherine Fookes (Monmouthshire) (Lab)]

Will the right hon. Lady give way?

[Dame Karen Bradley]

I will not be giving way much, Madam Deputy Speaker, but I will give way to the hon. Lady.

[Catherine Fookes]

I thank the right hon. Lady very much for giving way and for sharing that really difficult story. Does she not agree that the current system has no safeguards at all against coercion, and that is exactly why we need this Bill?

[Dame Karen Bradley]

Coercion is something that we absolutely need to tackle and understand as a society, but I do not think that this Bill has the safeguards that are needed.

[Several hon. Members rose—]

[Dame Karen Bradley]

I will give way to the hon. Member for Strangford (Jim Shannon), and then to the previous sponsor of the Bill, the hon. Member for Spen Valley (Kim Leadbeater), and then I will make progress.

[Jim Shannon]

I quote the story of one of my constituents, a motor neurone disease sufferer. He said that, if he had had the option of assisted dying two years ago, he probably would have taken it. But, in his words, “I would have missed out on the most fulfilled two years of my life and the knowledge that I can have more moments like this ahead of me.” His words are, “Please don’t do this, life is worth living.” Does the right hon. Lady agree?

[Dame Karen Bradley]

The hon. Gentleman makes a very important point.

[Kim Leadbeater (Spen Valley) (Lab)]

The right hon. Lady is making a very important point, which I have considered at length during the last two years. Many amendments relating to coercive control were made to the Bill to ensure that all professionals involved have training, and there are multiple checks for coercion throughout the process, which do not currently exist. At present we check for coercion only when someone is dead.

[Dame Karen Bradley]

I accept what the hon. Lady says, and I know she speaks with great sincerity, but it is still the case that under this Bill, somebody could be seen remotely—without a face-to-face appointment—where they are not alone and the coercive perpetrator may be forcing them.

[Jess Phillips (Birmingham Yardley) (Lab)]

Suicide currently outstrips homicide as the main reason for the deaths of women in cases of domestic abuse and coercive control, so what the right hon. Gentleman outlines is currently happening. Arguing for the status quo is not something I feel comfortable with. I feel considerably stronger about the safeguards that I worked with my hon. Friend the Member for Spen Valley (Kim Leadbeater) to ensure that the Bill had.

[Dame Karen Bradley]

I have enormous respect for the previous Minister, who I have worked closely with, but the point she is making about suicide of women who were victims of domestic abuse is a separate matter. For women to feel that they have nowhere else to go other than to commit suicide, is the most outrageous and horrendous situation, and we absolutely have to tackle and work on that. But this Bill is not the solution to that problem.

[Naz Shah (Bradford West) (Lab)]

I speak as a survivor of domestic violence and as a survivor of an attempted suicide many years ago, while campaigning about domestic violence. Does the right hon. Lady agree that coercion is not always external? Coercion can also be internal—“Am I a burden on my family?”, “Can they afford to look after me?” That coercion is not picked up on in training, because it comes from deep inside when a person is vulnerable and at their lowest ebb.

--- Later in debate ---

[Dame Karen Bradley]

The hon. Lady makes the case so powerfully. I am going to disappoint Members now, because I will not take any further interventions for some time.

Like the hon. Lady, my fear is not principally for those who are confident, articulate and able to insist on what they want; it is for the person who does not want to make a fuss—the person accustomed to putting everybody else’s needs before their own, who internalises that coercion and feels guilty about the care they require, or has simply been deprived of it.

Recognising abuse is really difficult. Those who have the misfortune of watching daytime TV may notice that there are currently adverts for “no frills” cremation services. I am particularly struck by one, which features a woman of late middle age, who is slightly small and says in a quivering voice that she does not want to be a burden or cause any fuss and does not want her family to have an awful time at the point of her death. Therefore, she is investing in a “no frills” cremation to make things better for her family. That person exists. The advertising agency would not bother making that advertisement if that person did not exist.

We have to think about the most vulnerable. These are the people who Parliament—this House—has a particular duty to remember when we legislate and, today, when we decide whether this Bill, without further changes, is safe to become law.

The question before us is, what decision will this House make. I recognise that the sponsor, the hon. Member for Rochester and Strood (Lauren Edwards), is keen to focus on the other place. There is an appealing simplicity in saying, “Send it back there and let them do their work”, but this is not really about the other place anymore. That House has made itself irrelevant. It is about this House and this House alone.

If we seek to engage the Parliament Act, we are, in effect, taking a unicameral decision, and we should understand what that means. We would be declaring that the Bill before us is in a fit state to become law whether or not the other place completes its work. There is no separate process by which this House later authorises the Parliament Act. Our approval of the Bill is the decision.

[Dr Opher]

Will the right hon. Lady give way?

[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.

[Martin Wrigley (Newton Abbot) (LD)]

Will the right hon. Member give way?

[Dame Karen Bradley]

I am sorry; I really must make progress.

We could have thousands of people entering the system immediately. If the safeguards are not right on day one, vulnerable people will be exposed on day one.

We also have the updated equality impact assessment, to which the hon. Member for Bradford West referred, and its conclusions should give every Member pause. It recognises that

“disabled people may feel subtle pressure due to attitudinal barriers or a lack of alternative appropriate services and support…This could also include structural pressures such as neglect, poverty and difficult living conditions”.

It also recognises that we may see

“disproportionate numbers of ethnic minority people choosing to have an assisted death to avoid financial hardship or escape abuse.”

I believe that the Bill is not finished, but we are effectively voting today for a completed and finished Bill. That worries me enormously. Much has been said previously in the debate—I will not repeat the point—but we are giving powers to a future Government to implement this Bill. We are not giving those powers to the Ministers sitting on the Front Bench today, and we are not necessarily giving them to those on the Opposition Front Bench; we are giving them to a future Government of any political persuasion. When I was a Government Minister, I remember always asking myself, “Would I be happy if another Government took this forward—if they had the power to do this?”

I ask Members to apply a test that we too rarely apply when legislating: do not ask whether you trust the people who will administer these powers today; ask whether you would be content with the political party you trust least possessing them tomorrow. There is simply not enough detail in the Bill to constrain how many of these decisions would be made. The National Down Syndrome Policy Group put it best: this Bill hopes for the best rather than prepares for the worst.

[Lewis Atkinson (Sunderland Central) (Lab)]

Will the right hon. Member give way?

[Dame Karen Bradley]

I feel sorry for my hon. Friend from the Home Affairs Committee, but I really must make progress, because Madam Deputy Speaker has been clear to me that I must.

I say to colleagues who supported the Bill before and have wrestled sincerely with the issue since: you do not have to repudiate the vote you cast last time to vote differently today. You do not have to decide that assisted dying can never be right. You do not have to abandon the compassion that led you to support the principle. You need only ask whether this Bill, in this form, on the evidence before us today, is safe enough for Parliament to force it into law. That is today’s test. There is no shame whatsoever in concluding that the answer to a different question is different. Indeed, there would be something profoundly wrong with a Parliament in which Members felt bound by an earlier vote, regardless of everything they had learned since.

Success is rare for private Members’ Bills. It is an amazing route when legislation is simple and consensus is easily achieved, and the whole House came together last Friday to do something quite remarkable for babies, but it is a terrible route when the risks of getting it wrong are great and there is great complexity and such emotion.

Before a Government Bill is introduced, Departments will normally spend months or years developing the policy—sometimes that is too slow, but that is what they do. They consult experts and those affected, test the legal and practical implications, produce impact assessments, secure cross-Government agreement and have the legislation professionally drafted and scrutinised by parliamentary counsel. Finally, the legislation goes through the Parliamentary Business and Legislation Committee, where Ministers have to prove to the rest of Government that the Bill is fit for purpose. That is what we needed here, when dealing with one of the most profound changes that Parliament could make to the relationship between the citizen, medicine and the state.

Some say they want to amend the Bill. Have there been any reassurances that those amendments will be supported? The promoter controls the make-up of the Public Bill Committee and will have a majority. On Report, if we are fortunate Members may have the opportunity to vote on only a handful of issues, and those who support the Bill will be asked to reject each one. We are being asked to support the Bill as it stands, alongside a commitment to force it into law regardless of what safeguards are forgone or what gaps, through which vulnerable people may fall, remain.

There is no one else to whom we can pass responsibility. We cannot say that the other place will sort it out, or that we will fix it later. If the Bill becomes law, Parliament may not get another opportunity to reopen it and put right what we discover we got wrong. The consequences will instead be worked out in practice—in hospitals, homes and, ultimately, the courts, where judges will make decisions based on the law before us today. For the people affected by a mistake, “We will sort it out later,” is no safeguard at all.

My appeal today, particularly to those who voted for the Bill before, is this. Look at what we know now. Look at the people who will depend on our having got every safeguard right. Remember the quiet ones. Are you prepared today to say that this Bill, in this form, is safe to be forced into law?

[Several hon. Members rose—]