Terminally Ill Adults (End of Life) Bill

Kieran Mullan Excerpts

Friday 16th May 2025 Commons Chamber

[Sarah Olney]

I will not; I am sorry.

The amendment would help to inform the clinical judgment that will need to be made in each individual case and discourage patients from applying to multiple doctors for an assessment.

I am proud to support amendment 24, tabled by the hon. Member for Bexleyheath and Crayford (Daniel Francis), which would disapply the presumption in the Mental Capacity Act 2005 that a person has capacity unless the opposite is established. There was a great deal of debate in Committee about the efficacy of the Mental Capacity Act and whether its provisions were sufficient to establish an individual’s capacity to make an informed decision about whether to seek an assisted death. The hon. Member for Bexleyheath and Crayford spoke compellingly in Committee about his experiences of how the Act is not always applied effectively. I am glad that the whole House has had an opportunity to hear him today.

The Royal College of Psychiatrists cited the insufficiency of the Mental Capacity Act as one of its nine reasons for opposing the Bill earlier in the week. It said:

“The Mental Capacity Act was created to safeguard and support people who do not have the capacity to make decisions about their care or treatment or matters like finances. Should the Bill become law in England and Wales, implications for both the Mental Capacity Act and Mental Health Act need to be considered.”

I also support new clauses 1 and 2, tabled by the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier), which would prohibit health professionals from raising the subject of assisted dying with a patient. It is my personal belief that people’s rights to pain relief and palliative care towards a natural end should be prioritised above an assisted dying pathway, and that that should be made available only as the result of a specific request. It is particularly important that young people under the age of 18 should not be thinking about assisted dying as an alternative to continued treatment or palliative care.

I was disappointed that during Committee my proposed amendments to safeguard people suffering from eating disorders were rejected. Eating disorders are primarily a mental health condition but have an obvious physical impact, and there is a severe risk that the physical impact of an eating disorder can be diagnosed as a terminal illness, when in fact eating disorders are always treatable. We cannot allow vulnerable sufferers from eating disorders to elect for an assisted death when there remains the possibility of a full recovery and the chance of a happy and fulfilling future. That is why I support amendment 14, in the name of the hon. Member for Bradford West (Naz Shah), who was such an articulate member of the Bill Committee. I was glad to hear that the lead Member, the hon. Member for Spen Valley, will adopt that amendment; I look forward to seeing the further drafting.

I also support amendment 16, tabled by the hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi). I welcome the lead Member’s new clause 10, which extends the right to refuse to participate in assisted dying to any person, but it is important also to extend that right to organisations such as hospices and care homes. Assisted dying undermines those institutions’ mission and purpose, and they should have the right to refuse to provide it on their premises if they do not wish to participate in it.

Finally, I will speak in favour of amendment 22, tabled by the name of the hon. Member for Shipley (Anna Dixon). There is insufficient provision in the legislation to identify and seek to ameliorate mental health conditions or other factors that may lead people to seek a premature end to their life, which they would not seek if those factors were addressed. Every time a person seeks to end their life prematurely is deeply regrettable, and we have a duty to explore whether preventable factors could be addressed before a request for assisted dying is granted.

[Dr Kieran Mullan (Bexhill and Battle) (Con)]

As has been the case throughout the Bill’s consideration, His Majesty’s Opposition have not taken a position on the principle of the Bill, and nor do we take a position on any of the amendments before the House. It is not for me to justify or argue against particular amendments. The arguments for and against have been well ventilated by hon. Members today.

As we might expect—I know this from my own email inbox—many constituents are considerably more interested in our proceedings than might ordinarily be the case for a Bill’s Report. It might also be the case that there is not a complete understanding of the nature of today’s proceedings, so I hope that I might usefully reiterate what we are and are not doing.

I then want to make some remarks focused on the public and campaigners, about how they should reflect carefully on their own obligations to respect the sincerity and freedom of choice of Members. I have come to consider that issue to be important, given some public interventions by high-profile campaigners, experiences with my own constituents and experiences that I know other hon. Members have had when they have been lobbied on the topic and on the way in which they will be voting today.

--- Later in debate ---

[Jess Asato]

The shadow Minister says that we are debating those amendments today, but we have not actually been able to hear from all those who have tabled those amendments. Nine Members who have tabled amendments have not been called to speak, so how can we call this a debate when we have not even heard why they are proposing their amendments in the first place?

[Dr Mullan]

I will make some remarks about the process. The time allocated today is a matter for the Chair and it would not be appropriate for me to comment, but I accept and understand the concerns raised by the hon. Lady and other hon. Members.

Today we have also looked at the procedure for receiving assistance, including safeguards and protections, and issues related to eligibility and mental capacity. As in Committee, some of the proposed amendments would make significant changes. I want to comment on the correspondence from the relevant Ministers regarding the amendments. Their letter to Members quite properly explained that those amendments laid by the Bill’s promoter, the hon. Member for Spen Valley (Kim Leadbeater), were considered workable by the Government, but the same could not be said about other amendments. It is important that the Minister emphasises, in his closing remarks, that that should not be read to mean that those amendments are not workable, which a superficial reading of the letter might imply; it just means that the Government have not given a view.

I have sympathy with the concerns raised by the hon. Members for Hackney South and Shoreditch (Dame Meg Hillier) and for Bradford West (Naz Shah) about the challenges for Members seeking to lay amendments without Government support. While all the normal conventions may have been followed, this is not a normal Bill, because of its significance and potential impact.

[Several hon. Members rose—]

[Tom Tugendhat (Tonbridge) (Con)]

My hon. Friend will remember that in the last Parliament we brought in the National Security Act 2023, which introduced huge controls on the nature of an individual’s liberty. The legislation passed through the House over a period of two years and required an entire Department to prepare it. There were considerations with the judiciary, foreign Governments and other services, including the police. The Bill before us allows the state to kill someone. Does he feel that this legislation is therefore somewhat more constrained than other legislation that would normally have been allowed to pass? And yes, it is correct to say that it allows the state—an actor on behalf of the state, at the request of an individual—to take a life. In the English language, that is called killing.

[Dr Mullan]

As I said, I recognise that the Bill is of greater significance than a typical private Member’s Bill, but it has been delivered through the normal procedures of the House, and it is for the House as a whole to make those changes.

[Neil O'Brien]

Will my hon. Friend give way?

[Sir John Hayes]

rose—

[Dr Mullan]

Not on that point.

We may wish to reflect on how we might change our approach to Bills like this one in the future, given the significant dissatisfaction that has been expressed with the manner in which it has been considered, even though it has been done in the ordinary way. But we are where we are.

As on Second Reading, this debate has been a balancing exercise. The promoter of the Bill and others have appropriately reminded us all of the very difficult and tragic experiences faced by the terminally ill and their families, but I respectfully say to the hon. Member for Spen Valley that we should be cautious in saying that opponents of the Bill are happy with the status quo, and I know that she would not have meant to suggest that.

[Neil O'Brien]

I am one of those people who is against the Bill, not in principle but for the reasons set out brilliantly by many articulate Labour Members. When my constituents ask what I think about this, I have no way of telling them; there is no way for me to get into the nuance of my position on it, because there has been no time to have a proper debate, and so many Members will now be unable to say a single thing about this totally transformative Bill.

[Dr Mullan]

My hon. Friend has added his concerns to those of others about the manner in which the debate has been conducted, but I reiterate that this has been done in the ordinary manner in terms of the Speaker’s discretion and the Standing Orders of the House.

Opponents of the Bill are concerned that it will lead to a different set of unacceptable circumstances for different people; it is not that they are happy with how things are at the moment. All MPs have talked about people they care deeply about and how to help them. Whether they referred to disabled people, young people or the terminally ill, MPs have been speaking out in support of or against amendments, out of concern and compassion.

I may be tempting fate in saying that we might find consensus on advertising restrictions, but outside of that, Members have undoubtedly expressed a variety of strong views on others’ amendments. It may be that Members vote consistently in line with whether they were originally for or against assisted dying, but other Members who are supportive of the Bill in principle are voting for restrictive amendments because they think that they are necessary. That is because this is a complex moral, legal and societal matter. I understand that Members are considering their votes with a degree of uncertainty.

There should be no shame at all in Members’ admitting that they will be daunted by the sheer number of potential changes to the Bill, not to mention the decisions from the Speaker on those we are going to vote on or the challenge of deciding how to vote on each of them, either today or on a future day.

[Sir John Hayes]

Will my hon. Friend give way?

[Dr Mullan]

No, I need to make progress. They will be daunted not least because, although we have international examples, we are considering a novel practice in this country in our particular circumstances.

Members who are generally supportive or opposed in principle may choose to abstain on a number of amendments on which they feel that they are unable to give a definitive view and are content to vote on the final outcome on Third Reading. That would be understandable. I know that Members have considered how they will vote very carefully, and that they will continue to do so, by taking into account their views and experiences, as well as those of their constituents, other Members whom they respect, and experts and campaigning organisations. We will all be directly accountable to our constituents at the next election for all our votes throughout this Parliament.

That brings me to the remarks that I said I would like to finish with on the responsibilities of the public and campaigners towards MPs as they consider our votes. As we are first and foremost public servants, the focus is quite rightly usually almost entirely on the responsibility of MPs to the public, but as with all meaningful relationships, this is, and should always be, a two-way street. I accept the very strong feelings and deeply personal experiences that are brought to bear for those people contacting their MPs, and nothing I say should be taken as diminishing the rights of campaigners to make their cases strongly and consistently, but I and others have experienced lobbying by campaigners whose passion for securing the outcome they want has led them to question the integrity, sincerity or understanding of those MPs seeking a different outcome to them.

Some high-profile campaigners have made unhelpful remarks. Although I am not religious, I was concerned to see the clumsy criticism of those whose objections to the Bill are thought to be centred in their religious beliefs, as was mentioned by the hon. Members for Vauxhall and Camberwell Green (Florence Eshalomi) and for Lowestoft (Jess Asato).

[Naz Shah]

Will the hon. Gentleman give way?

[Dr Mullan]

I need to make progress.

I say that not least because I suspect that a very large number of supporters of the Bill might draw on their Christian or other religious compassion to explain why they want to see it pass. There was widespread reporting of how powerful the Second Reading debate was in showcasing the best of Parliament, with thoughtful debate and a consideration of nuanced and varied viewpoints. If Parliament demonstrates itself at its best, that creates a call for the public to do the same.

[Gregory Stafford]

I agree with the shadow Minister that the Second Reading debate was Parliament at its best. Would he say that the length of time that we have had to debate the Bill today, given the number of amendments and the number of people who wanted to speak, showed Parliament at its best?

[Dr Mullan]

I have expressed my views on that matter. I understand why Members are concerned, but it has been in order, and at your discretion, Mr Speaker.

MPs who disagree with campaigners’ views for or against assisted dying are not uncaring or lacking in compassion. They have not failed to understand the arguments; they have just inevitably disagreed with at least some of their constituents. I urge campaigners to use their passion and commitment to the cause to fuel their campaigning, as is their right, but to pause and reach understanding before criticising an MP simply because they have reached a different view on a very challenging matter.

In a democracy, the public are as important as politicians in determining the quality of our discourse. I hope that my remarks remind people of that, and encourage them to aspire to be the best example of the behaviour that they want to see from their elected representatives, just as we have seen again in the Chamber today.