Terminally Ill Adults (End of Life) Bill

Lord Falconer of Thoroton Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

Moved by

[Lord Falconer of Thoroton]

That the Bill be now read a second time.

Relevant documents: 32nd Report from the Delegated Powers Committee and 12th Report from the Constitution Committee.

[Lord Falconer of Thoroton (Lab)]

My Lords, this issue has been debated for years, particularly in this House. The House is full this morning; that reflects the seriousness with which your Lordships take this issue. For the first time, we have before us a Bill on assisted dying, which has come from the other place. I know that we will do what we do so well, which is scrutinise. This is a historic occasion.

The current law is confused, causes terrible suffering, and lacks compassion and safeguards. People must be at the heart of this debate. The Government’s own estimate is that, if the law was changed to introduce assisted dying, less than 1% of deaths would be assisted after 10 years. However, it is right that we allow assisted dying as an option for those who, despite the best palliative care, still want an assisted death.

Palliative care cannot alleviate the pain of everyone. Lucy Davenport’s husband, Tom, had an agonising death from bile duct cancer, despite receiving excellent care in a hospice. He died by choking on faecal vomit:

“The look on Tom’s face of terror and horror, that’s going to be with us forever. He would be horrified to think that was our last memory of him”.


For many others, it is not about pain; it is about alleviating fear or bringing to an end the terrible and continuing loss of dignity and control, which has no end, except in death.

If the patient wants to take control of the time of their own death, they are, under the current law, legally entitled to take their own life, but they must do so without any assistance, often horribly. Many of your Lordships were with me in the Archbishops’ Room in Millbank House when the widow of a man who had a lethal brain tumour described how she found her husband’s body in their garden, having stabbed himself in the heart.

Others go to Dignitas, often alone, because those who accompany them from England fear the consequences of the criminal law. Catie Fenner’s mother, Alison, had motor neurone disease and died at Dignitas in Switzerland. Catie could not join her for fear of a police investigation. She found out about the moment her mum had died by text. Catie says:

“We didn’t see her go, we didn’t hold her hand”.


The DPP’s guidelines make it clear that anyone with medical qualifications who provides assistance will certainly be prosecuted. Where the authorities learn that somebody has provided assistance or they suspect that they have, they investigate that person, invariably with compassion. But no matter how kind the process of investigation, it is an agony for the person investigated. It can go on for months, and sometimes for over a year. They fear prosecution as they grieve for the person they love.

It is right and possible to pass a law which allows those who are terminally ill to die with dignity and at a time of their own choosing, without the fear and the horror I have described and with appropriate safeguards in law, not as currently, where people, in order to have a death at their own choosing, seek to evade the law and therefore evade the protections. Some 300 million people in the world live in jurisdictions where there is such a law. There must be safeguards. The Bill we are debating today has benefited from those other jurisdictions. It is the most safeguarded assisted dying measure in the world, particularly in the light of the safeguards inserted in the Commons.

Key provisions in the Bill are as follows. The criteria for requesting assistance is that the person is terminally ill, has the mental capacity to make the decision, is 18 or over, is resident in England and Wales for the last 12 months, and is registered with a GP in England or Wales. The safeguards are designed to ensure that the patient has a clear, settled and informed wish to end their life and has made their decision voluntarily and without coercion. “Terminally ill” is defined as having

“an inevitably progressive … disease which cannot be reversed by treatment”,

with a reasonable expectation of death “within six months”.

The Bill is for the terminally ill only. It is about how you die when you are dying already. It is not for those with unbearable suffering, irrespective of their life expectancy, as in some countries, such as Canada. The Bill is clear that a person is not to be considered a person who is terminally ill if they are a person with only a disability or a mental disorder, or both.

Safeguards are layered throughout the process as set out in the Bill. First, a doctor in a preliminary conversation has to lay out all the care options, including the palliative care available in the context of the likely progress of the illness. Then two doctors, independent of each other, have to be satisfied that the illness is terminal within six months, that the patient has the mental capacity to make the decision, and finally, that it is their firm and settled wish arrived at without coercion. After that, a panel comprising a senior judge or King’s Counsel, a psychiatrist and a social worker has to be satisfied of the same things as the two doctors. If they are, then and only then can medical assistance be given.

I acknowledge that some think the process is too complicated and excludes too many people. On complicatedness, I am very conscious of the words of the Chief Medical Officer, Chris Whitty, who gave evidence in the other place that we should not create a “bureaucratic thicket”, and I very much hope we have avoided that. But it is vital that we should have a Bill that is robust in its safeguards in a matter of this gravity.

Disabled groups express fears that they may be vulnerable to being overpersuaded into an assisted death. I well understand the fears of the disabled in their dealing with healthcare providers, but the evidence strongly suggests that the disabled want the same rights as the rest of us when they become terminally ill. The Bill gives them excellent protection. There may be risks for them in other interactions with healthcare, but not in relation to this issue.

The multidisciplinary panel, which I have referred to, was added by amendment in Committee in the Commons, replacing the High Court judge alone. The panel provides a better safeguard than a judge alone because of the wider experience of the panel psychiatrist and social worker, but accompanied by the retention of the senior judge.

Beyond the current safeguards, some people have sought a compulsory psychiatric assessment for everybody. I do not believe that that is necessary or appropriate. The Bill provides that if either of the doctors have a doubt on capacity, they must refer the patient to a qualified psychiatrist. The panel includes a psychiatrist, and the panel can, if it wishes, require more psychiatric assessment.

No doctor or other person is required to participate in the provision of assistance under the Bill. Only those who opt in to participate in the work of the Bill need play any part. The Bill is explicit and wide in making that clear and provides extensive employment protections for those who do not wish to participate.

There are those who argue that it may be a terminal illness Bill now but its provisions will be expanded. Any such change would require primary legislation, and the experience of all other jurisdictions is that where they start with a terminal illness Bill such as this one, that is where they end. The Health and Social Care Select Committee in the Commons conducted an inquiry into assisted dying, ending in March 2024. Its conclusion on this issue was as follows:

“We … conclude that jurisdictions which have introduced”


assisted dying

“on the basis of terminal illness have not changed the law to include eligibility on the basis of ‘unbearable suffering’”.

It said that none of the jurisdictions which have introduced a terminal illness Bill has revoked it—and they have been there for as long as almost 30 years.

The Bill provides that for England:

“The Secretary of State must by regulations make provision securing that arrangements are made for the provision of voluntary assisted dying services”,


and that in Wales, Welsh Ministers “may” make such regulations. The difference between “must” and “may” is that we respect the devolution settlement. It is for Ministers in Wales to make their own decision in relation to that.

Concern is sometimes expressed about the cost of an assisted dying service and its effect on NHS provision. I draw your Lordships’ attention—please read the 151-page impact assessment that the Department of Health has produced—to the fact that the current budget of the National Health Service is £188 billion. On the central estimate as to what the service will cost once it is up and running, the impact assessment says it will be approximately £25 million a year. The figure does not take account of the annual savings calculated in the impact assessment, which exceed the figure of £25 million.

The NHS should have all the time it needs to introduce the service properly. It has said that it may need up to four years. The Bill has a backstop of being brought into effect after four years. We reflect what we have been told in relation to that.

The provision of assisted dying is not an alternative to palliative care. The Commons Select Committee report did not suggest that the availability of assisted dying compromised or reduced the availability of palliative care: rather, the reverse. Its conclusion was that

“we did not see any indications of palliative and end-of-life care deteriorating in quality or provision following the introduction of”

assisted dying, and

“indeed, the introduction of”

assisted dying

“has been linked with an improvement in palliative care in several jurisdictions.

The next stage is for this Bill to be scrutinised by your Lordships’ House in the normal way. I have been intimately involved with the Bill since it started its journey. This is a Private Member’s Bill, invariably and inevitably, because it is a matter of conscience. Once the Bill passed its Second Reading in the Commons, the sponsor of the Bill in the Commons, the honourable Member for Spen Valley and I, as the sponsor of the Bill in your Lordships’ House, have been provided with very substantial support from the Civil Service machine to ensure that the Bill is workable. The Government, in providing that support, did not forgo their neutrality. Rather, they provided comprehensive policy and drafting support.

I have long experience of shepherding Government Bills through Parliament. The support that I have had in relation to this Bill is second to none. The Bill passed its Third Reading in the Commons in June after more than 100 hours of debate, including 29 sittings in Bill Committee, two full days of debate on Report on the Floor of the House and a full day’s debate at both Second Reading and Third Reading.

I have to say that that compares very favourably. It is almost double the time given to scrutiny in the other place of the Children’s Wellbeing and Schools Bill, which we are dealing with now. Altogether, the Bill Committee considered and debated over 600 amendments, accepting around a quarter of them. Over 100 amendments were made in the sponsor’s name, and more than 30 amendments that had been tabled by MPs who voted against the Bill were passed.

I very briefly turn to the Motion in the name of the noble Lords, Lord Forsyth and Lord Bridges, and the amendment in the name of my noble friend Lady Berger. The noble Lords, Lord Forsyth and Lord Bridges, refer to the Delegated Powers Committee report, which I have considered along with that from the Constitution Committee. I will be tabling amendments to deal with many of the points that both committees raise. They always help us in our deliberations.

There are some amendments which I will not be able to accept: for example, that your Lordships specify the drugs to be used in the process. Medical advances come thick and fast. This legislation is designed to last for the ages. Civil Service support is mentioned in the amendment from the noble Lords, Lord Forsyth and Lord Bridges: I have already dealt with that. With regard to the availability of government time, which is also raised, I am confident, after conversations with the Government, that your Lordships will have more than enough time to scrutinise this Bill thoroughly—as long as, of course, we start our process of scrutiny in the ordinary course of business after we have given it a Second Reading.

I turn to the amendment from my noble friend Lady Berger. Unfortunately, I only got notice of this last night. I did not have the opportunity after that of talking to my noble friend, and she had not discussed it with me previously. I make no criticism of her, but these are my initial thoughts in relation to it. It is proposed that a Select Committee precede the Committee of the Whole House. It has been clear for some time that at least seven days will be required to complete the passage of the Bill: four days in Committee, two days on Report and a day for Third Reading. There will then need to be ping-pong between the two Houses. If the process cannot start until January, which is what my noble friend’s amendment suggests, and must complete by the spring—the spring is when the Government say this Session will end—we will have to fit seven Fridays in between 9 January and 31 March. Having regard to recesses, the need for the normal intervals and the fact that other business will be conducted on some of those Fridays, so it cannot be every Friday, I am afraid that it is not possible to do that. I will therefore be opposing that amendment on the basis that it is not a workable timetable. That does not rule out a Select Committee running in parallel to the Committee stage, and I would be more than happy to discuss such a proposal with my noble friend, or anybody else who has such a proposal to make. But we must do our job in this House, and our job is not to frustrate, it is to scrutinise.

The Bill has been passed by the Commons. The decision on whether to change the law in our democracy should be for the elected representatives. We should improve where we can, but we should respect the primacy of the Commons. There are so many people who have been following the debate who recall the agonising death of a loved one or, like the people I mentioned at the beginning of this speech, fear what their own death might be like. The public want this and the elected House has expressed its will. I am confident that your Lordships will now do what you have done so well in the past. Whatever view we might take on the decision that the Commons arrived at, the way the debate was conducted there enhanced the reputation of Parliament. I hope and believe that we can embark on our scrutiny in a manner that will reflect just as well on our House.

The Bill before us has already given hope to those with personal experience of the injustice of the current law. They will be looking to us to play our proper role. If we can improve it further, we should and we will have done our duty. I commend this Bill to the House and I beg to move.

Terminally Ill Adults (End of Life) Bill

Lord Falconer of Thoroton Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

Moved on Friday 12 September by

[Lord Falconer of Thoroton]

That the Bill be now read a second time.

Debate on the amendment to the amendment to the Motion resumed.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

My Lords, I draw attention to my entry in the Register of Lords’ Interests, which refers to the facts that I have an assistant funded by Bernard Lewis to assist me in the conduct of this Bill and that Dignity in Dying funded the printing of the literature that I sent to your Lordships in connection with the Bill. I apologise for not mentioning this in my opening speech.

This has been a debate of the highest quality, probably the highest quality I have heard in 28 years in this House. Your Lordships brought passion, expertise and wisdom to the issue. I thought that every single speech that was made rose to the gravity of the occasion. I would wish to refer to every speech, but I cannot.

I pay particular tribute, however, to those of your Lordships on both sides—some people have mentioned them—who have identified their own personal suffering in relation to this. I pay tribute to all of those speeches and will mention just two of them. First, the speech of the noble Baroness, Lady Prentis of Banbury, was very striking. She will know that she has the wishes of the whole House with her. I also mention the speech of the noble Baroness, Lady Falkner of Margravine. She, too, has the wishes of the whole House with her.

The debate shows beyond doubt that this House will bring both expertise and human understanding to the important task of scrutiny that we must now undertake. I express genuinely my gratitude to your Lordships’ Constitution Committee and the Delegated Powers and Regulatory Reform Committee respectively. As I indicated in my opening speech, I will be bringing forward amendments to deal with many of the recommendations that they raise. I have to say that my experience as a Minister was that both those committees frequently made recommendations of the sort that have been made here requiring changes. I very much hope that, in consultation with the Government, I will be able to make those changes.

I also mention the status of this Bill. This is a Private Member’s Bill because it is a matter of conscience. No major political party agrees on whether or not it supports assisted dying, and I do not find that surprising. It has to remain a Private Member’s Bill for that reason. I should say, as my noble friend Lady Merron referred to, I have had assistance, as has my friend in the other place, the Member for Spen Valley, from the Government—civil servants and lawyers—seeking to ensure that the Bill is workable. That explains very many of the changes that have taken place. But, ultimately, this is a Private Member’s Bill and must be treated as such.

I believe that the Commons was very capable and proved able to properly scrutinise this Bill. It gave the Bill 100 hours of scrutiny. At the same time in this House, we are looking at the Children’s Wellbeing and Schools Bill, which, as it happens, is longer, and it got 40 hours of scrutiny. We are looking at a Bill for which, in the Commons, there were no guillotines, so every clause was debated, not just those that were reached before the guillotine fell. We are looking at a Bill that has had a very large number of Select Committees look at it. The last one reported in the Commons in March 2024. We have a job of work to do, but I earnestly ask your Lordships not to approach this Bill on the basis that it has not been properly scrutinised in the other place.

[Baroness O'Loan (CB)]

I thank the noble and learned Lord for yielding. I simply wanted to say that a number of Members of the other place have said that the Bill did not receive proper scrutiny in the other place. They have also said that they expected that it would receive scrutiny in this place because that is what we do. That is profoundly important, and I do not think that what the noble and learned Lord just said is actually correct. I would also say that there were a number of amendments tabled and a number of MPs who wanted to speak who were not permitted to do so. That is reflective of the fact that the Bill did not receive proper scrutiny in the other place.

[Lord Falconer of Thoroton (Lab)]

I am grateful to the noble Baroness for her intervention. I have laid before the House the facts. I recognise that some Members of Parliament say that the Bill was not given proper scrutiny. I wonder if those were Members of Parliament who did not agree with the conclusion—I do not know. I have laid before your Lordships the time that was spent and the fact that it got more scrutiny than government Bills.

The essence of this Bill is that those who are terminally ill—and that means that they have a diagnosis that they will die within the next six months—should have the option, subject to safeguards, to be assisted to take their own life. One of the features of this debate was the personal experience that so many people have had of how, had that option been available, it would have ended terrible suffering. That suffering is not often about the pain but about the lack of dignity and the profound desire to keep control, because that is what people want.

I believe, from my own experience and from talking to so many people, that having that option is important. The points that have been made against it, which I have listened to incredibly carefully, are, in essence, not that people should not have that choice but that it brings dangers with it. The dangers are, first, that people will be overpersuaded and, secondly, that it will affect society in other ways.

On the idea that people will be overpersuaded, the Bill provides for the following: first, a conversation with the doctor in which all the options, including the palliative care options, are laid out; secondly, that a doctor decides that it is a free choice; thirdly, that a second doctor decides that it is a free choice; and, fourthly, that a panel, consisting of a senior judge or a King’s Counsel, a psychiatrist and a social worker, concludes that the person is not being coerced, that they are capable of making the decision and that it is their free choice. As it happens, that is probably the most safeguarded procedure in the whole of our healthcare system. It is certainly the most safeguarded process when compared with terminal illness Acts in other countries in the world.

I profoundly believe that people should have this choice—a profound belief that is based not on either my spirituality or my lack of spirituality, but on looking at the evidence from other countries that this will not lead to people being overpersuaded. I have in mind those countries that already have a terminal illness Act. The one that has been in force for longest is the one in Oregon, but there are many other states in the United States of America that have terminal illness Acts that have been in force for 20 years and more. They do not have those safeguards. They do have annual reports and record-keeping of the highest sort about assisted death. They show no evidence of the coercion that some noble Lords referred to in this debate.

I would have expected that, if there were real evidence of that, somebody in the course of the debate would have referred to a case from one of those countries where there is a terminal illness Act showing that there was coercion. There was none. I am convinced, first, that the Bill has had proper scrutiny in the other place and, secondly, that there is no real danger in relation to coercion. Thirdly, I completely accept the point made by noble Lords who said in this debate that they wanted more palliative care—I want more palliative care, and we should do everything we can to promote it. However, as so many people said, it is not either/or—it is both.

Some 75% of people in Victoria, Australia, who have had an assisted death came from palliative care, and 92% in Oregon came from palliative care. The Select Committee in the Commons to which I referred, which reported in 2024, said that palliative care in many jurisdictions went up in terms of its resources. In answer to the question that was raised about what the effect will be on palliative care: on the basis of other jurisdictions, it will get better. In fact, the debate here has provoked the Government to spend more money on palliative care.

Many noble Lords have talked about language. I take no point about language. I simply say this. For over 10 years of having been engaged in this debate, I have found that, for people who are terminally ill and want an assisted death, nothing upsets them more than saying that that is suicide. They hate that because of the impact it has on those they leave behind. What they feel is that they are dying anyway, and what they want is some degree of control over when and how it will happen.

I turn briefly to what happens next. I very much welcome my noble friend Lady Berger’s Motion to set up a Select Committee that can hear evidence. I very much welcome that it is time-limited, because, as my noble friend and I indicated in the letter we sent to every Peer, it allows for the Bill to go through all its phases after 7 November. I will therefore support my noble friend’s Motion to set up a Select Committee.

We have a job of work to do. I agree with everybody that, plainly, this House must give the Bill a Second Reading. We must listen to the evidence that my noble friend Lady Berger’s Select Committee will supply, and then we must do what we do so well, which is scrutinise and amend the Bill as necessary, and then send it back to the other place for a decision.

I have heard some noble Lords say, “Oh well, we can say no to this Bill”. Ultimately, on an issue such as this in our system, somebody has to decide. It is not the electorate because it is never in anybody’s manifesto, with the exception of the Greens. Therefore, Parliament has to decide. Ultimately, in our system, that means it will have to be those who are elected—not those who are unelected—who make that decision.

I end by expressing my profound gratitude to the House for the attention and quality of the debate it gave to the Bill. I commend this Bill to the House.

--- Later in debate ---

Moved by

[Lord Falconer of Thoroton]

That the bill be committed to a Committee of the Whole House.

[Lord Falconer of Thoroton (Lab)]

I beg to move.

Amendment to the Motion

Moved by