Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, there are passionately held views on the subject before us, and the informed and respectful deliberation so far shows your Lordships’ House at its best. We are being asked to legislate for autonomy, but we also have a duty to set out that principle within the reality of our unequal society. I am deeply concerned that the Bill as it stands would not only ignore but deepen those inequalities.

My views are shaped in part from learning about my mother’s work as a counsellor in a palliative care unit and the hours I spent at the bedside of three of my grandparents as they neared the end, including as they took their last breaths. While I am one of the younger Members of this place, and I hope I have at least another 50 years ahead of me, I have thought about the end of my life. Ideally, I would like to die naturally at home, with, if needed, access to the high-quality palliative care that everyone deserves.

While I would not want an assisted death, I recognise that some noble Lords do, as expressed during this debate. We are fortunate: as noble Lords, we have a voice, above-average resources, and agency—the ability to make our own choices, free from interference, prejudice, coercion or undue influence. But assisted dying, if introduced, would exist as a choice not only for us and other comparatively fortunate people; it would enter the lives of those most at risk—people already overlooked, unprotected and vulnerable at the end of life.

It was a privilege to be a Member of Parliament for almost a decade, and I have so many fond memories of my former constituents. But some of the most searing moments I experienced as a Member of the other place came at my weekly surgeries. The first time I heard someone speak openly, in the most unsavoury terms, about wanting a family member dead, I shook. I was appalled, and I could not believe what I was hearing. I was naive to think that this would be an isolated case. I have also not forgotten the words and realities of too many former constituents: people isolated and abused in their own homes, sometimes for decades, in fear for their own lives; people who felt like a burden because of long-term illness or serious mental health conditions, especially the elderly; and people treated as though their lives were worth less because they had a disability. Many were from low-income backgrounds, facing not only poor health but the crushing stress of unaffordable care costs.

These voices still ring in my ears and motivate me profoundly as I consider this Bill, alongside the many powerful representations we have heard in recent weeks, including, as we have heard from other Members, that there is no organisation of or for disabled people in this country that supports the Bill. In considering who the Bill might benefit by giving them more autonomy, we must equally consider who it may harm by taking their autonomy away.

We have a duty in this House to test the Bill’s safeguards when they meet reality, and I think we must also consider the role of family members and carers. The Bill does not require their involvement. It does not even guarantee they will be informed. Yet these are exactly the people who know a patient best, and who may spot signs of coercion, confusion or fear that professionals might miss. Their exclusion is not just a procedural oversight; it is a moral failing.

In conclusion, if the Bill passes, the relationship between vulnerable people and their doctors and the state would change for ever. There would be no going back. This Bill touches the deepest and most exposed moments of human life. It demands our utmost scrutiny, not just in principle but in practice—and, in practice, it currently falls short. We cannot legislate for irreversible decisions on the basis of incomplete protections. We have important work to do.

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Moved by

[Baroness Berger]

At end insert “but that the Committee of the Whole House shall not commence before a report has been received from a select committee appointed by the House to consider certain aspects of the bill.”

[Baroness Berger (Lab)]

My Lords, I have spoken already about how my experience as a Member in the other place has made me very concerned about this Bill, and more determined that it must not be a cause of further harm to vulnerable people. Many unanswered questions about the Bill before us have been raised during the course of this important debate. This is why I have tabled the amendment and the following Motion to hold a Select Committee before Committee of the whole House begins.

This is a significant and complex piece of legislation by any definition. It demands a process that can withstand the weight, but it is clear that there are serious shortcomings, as both the Constitution Committee and the Delegated Powers and Regulatory Reform Committee noted in their reports last week. Indeed, I am concerned that the legislative process is being asked to compensate for the absence of robust policy-making before the Bill was published: no comprehensive review; no public consultation or prior engagement with professionals and other stakeholders; no Green Paper or White Paper, which we would have seen had it been a government Bill—I understand the case made for why it is not a government Bill, but that has diminished what is before us today; and no published analysis of international experiences. Instead, Parliament has been asked to grapple with questions about implementation, safeguards and NHS implications without this groundwork, which we would usually turn to for a law change of this magnitude.

Back in March, Jill Rutter of the Institute for Government—which is neutral on the principle of assisted dying—said:

“We’re expecting Commons scrutiny to do far too much—things it simply can’t do … Commons scrutiny is being left to solve a whole range of problems it isn’t equipped to deal with”.


We have seen the dropping of key but expensive safeguards, such as the review by a High Court judge, and whole new clauses and schedules introduced to replace them with very little opportunity for thorough scrutiny.

It was a clear pattern in the other place that when significant concerns were raised that had not been anticipated, the response was often to add another delegated power. There are now, as we know, 42 delegated powers contained within the Bill: 42 areas where government will work out the detail later, with Parliament largely excluded from the conversation. The result is a Bill that is today substantially different from when the Bill Committee in the other place took evidence in January this year, but now with less clarity.

I do not wish to detain the House any longer than is necessary, but I have been asked many questions on the process about what is before us, which I will seek to address. My amendment ensures that we can have some evidence, expertise and insight on the Bill before us today. We need this information before we commence line-by-line scrutiny.

Noble Lords will have received a letter setting out a condensed list of witnesses that I and other supporters believe this House must hear from, including my noble and learned friend Lord Falconer of Thoroton and those who will bear the responsibility for delivering the Bill, should it pass, and setting out how they would use their delegated powers. These witnesses are to include the Secretary of State for Health and Social Care, the chief executive of NHS England, the Secretary of State for Justice and the Chief Secretary to the Treasury.

We must also take evidence from the professional bodies whose members will be asked to carry out the functions that the Bill sets out: the Royal College of Psychiatrists, the Royal College of Physicians, the Royal College of General Practitioners, the British Association of Social Workers and the Law Society.

We are, of course, not able to hear from serving members of the judiciary, but may hear from the former Chief Coroner of England, Thomas Teague KC, and Sir James Munby, President of the Family Division of the High Court. We must also ensure that we understand the impact of the Bill on our hospices and care homes, through Hospice UK, the Association for Palliative Medicine and Care England.

A previous suggestion of a Select Committee in parallel, alongside a Committee of the whole House, would not achieve—

[Lord Kamall (Con)]

I apologise, I do not want to detain the House any longer than is necessary. Just to clarify, will all the evidence before the Select Committee be published?

[Baroness Berger (Lab)]

I am very grateful for the intervention, and I was just about to come on to that, but I will answer that now. The answer is yes, absolutely. The intention is that all the evidence accumulated and amassed during that time will be published for everyone in the House to interrogate and consider in advance of us going into Committee of the whole House. To confirm, this Select Committee cannot take place in parallel in order that we can receive evidence on vital parts of the Bill before we go into debate, so that we are not in the unenviable position of knowing what is wrong with the Bill but being unable to amend it.

My Motion provides that a Select Committee would be intended as a focused piece of work, hearing vital expert oral evidence, as I have just set out, rather than it being a more time-intensive open exercise. It may report by simply publishing that evidence before we go into Committee of the whole House, in order to inform our detailed consideration of the Bill. As I understand it from the clerks, the revised timetable allows the committee to hold six meetings over three weeks, with two panels of witnesses on each of the days, to begin the week commencing 20 October and allowing it to conclude by 7 November. The revised timetable ensures that the Bill can progress to its next stage and maintain the opportunity for four sitting Fridays before Christmas.

We have, over the past two Fridays, shown the determination of your Lordships’ House to discuss the Bill in a considered and constructive way, and it is my strongest hope that we can continue to do that. If my amendment is accepted, I do not intend to speak on the Motion that will follow, which contains the detail that I have just set out. I am grateful to my noble and learned friend Lord Falconer of Thoroton—

[Baroness Watkins of Tavistock (CB)]

Is the list to give evidence that the noble Baroness has detailed finally determined or would it be possible for us to add the Royal College of Nursing with its 500,000 nurses?

[Baroness Berger (Lab)]

I thank the noble Baroness for her intervention. As I understand it, it is within the gift of the Select Committee to determine who will be called for evidence. I have sought to set out the key people, but of course there will be many other suggestions. Obviously, conscious of the tight timetable, we will not be able to have an extensive list, but I am sure that the chair, when appointed, will consider the suggestion that has been made.

I return to expressing my gratitude to my noble and learned friend Lord Falconer of Thoroton for being prepared to work with me to reach an agreement that would allow the House to engage carefully with the substance of what is being proposed and the powers we are being asked to bestow on Ministers. I am grateful to the many noble Lords who have already indicated in their speeches their support for my amendment and my Motion. I beg to move.

Amendment to the Motion agreed.

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Moved by

[Baroness Berger]

That it is desirable that a select committee be appointed to consider the safeguards and procedures contained in the Terminally Ill Adults (End of Life) Bill; that the Committee shall hear evidence from professional bodies, those with professional experience of coronial services, and Ministers; that the Committee, notwithstanding the usual practice of the House, may report by drawing the attention of the House to the evidence received without making recommendations; and that the Committee do report by Friday 7 November.

[Baroness Berger (Lab)]

I beg to move.

Motion agreed.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, I shall be very brief. The definition at the beginning is a most important matter. I am quite clear, having heard noble Lords make a number of very sound observations, that “capacity” is an essential term. That is the first thing. However, it is not sufficient, and it has to be added to. I say that because the Mental Capacity Act states explicitly that a person is not treated as lacking capacity merely because they make an unwise decision. That is a very different situation from what we will be dealing with in many cases going forward. I urge the House, when this comes back on Report and preferably beforehand, and the promoters, to consider adding simply “and ability” so that it reads “capacity and ability” because they are different concepts, and they are necessary if this is to work properly in future.

[Baroness Berger (Lab)]

I wish to respond briefly to two points. I have every admiration for the noble Baroness, Lady Hayman, and I definitely concur that we have a responsibility in this House. I also gently remind this House that there were a number of Members of the other place who said, both in writing to their constituents and in their spoken contributions in the House, that they were essentially outsourcing the job to this place for us to ensure legislation that is fit for purpose. I regret that that is the case. I think there are many of us on all sides of the debate, on both sides of this House, who would wish to see a government Bill, which has been the case with previous Private Members’ Bills that have been adopted by the Government. We would have more time and opportunity to ensure that we have robust legislation.

In the absence of that, in the process that we find before us, I want to share with the Committee—I was going to bring it up in the next group but in light of the comments and the contributions that we have heard so far I think it is important to share on record—the comments that we heard in the Select Committee from the Royal College of Psychiatrists. It is a professional body that was called to give evidence on behalf of its members as one of the pillars of the process, as one of the pillars of the panel.

We heard from Dr Annabel Price, who is the lead for the Royal College of Psychiatrists on the Bill. She is an eminent expert in this space. She shared with us that the college had very carefully thought through its position and its views and that it had asked for a review of the Mental Capacity Act’s suitability because it believes that the Bill currently states that a person is eligible if they have the capacity to make a decision to end their own life, but this framework has not been tested for this particular decision. There are principles within the Mental Capacity Act that the college is not certain are compatible with this decision and need to be thought through more carefully.

I think we should heed that warning and listen very carefully to that college whose members will be responsible should this legislation go through. Therefore, in the context of the amendment moved by the noble Baroness, Lady Finlay, I think it is important for us to consider this in terms of how we inform our debate going forward, which is relevant to this group and to the group that follows.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Goddard of Stockport (LD)]

I respectfully accept that position. The problem is that the more I speak, the more I will be intervened on, which is the opposite of what I am trying to do; I am trying to speed the process up.

All I am trying to say is that we all want the best Bill possible. I get that. If that cannot be managed, something else will have to happen. I was only trying to bring in the evidence of three former Directors of Public Prosecutions. One of them, because people had said, “We’ve had no real-life experience”, actually advanced to us, “I’ve got Parkinson’s disease and I’m going to die. I have a terminal illness”. He actually said that to the committee, and added that if the Bill passed he hoped to avail himself of it. That is just one little anecdote from probably the only person who gave evidence who actually has a condition, which he confirmed to us freely. He was not asked to do that.

All I am trying to do is balance the evidence, because a lot of people are quoting evidence. I want to try to redress that a bit and to gently move this on a bit quicker. I have completely failed, because I have been standing up for nine minutes. I apologise to the Committee for taking up too much time.

[Baroness Berger (Lab)]

I am very grateful to the noble Lord for giving way. I will make a point that has been raised on a number of occasions, about what happened in the other place and the number of hours that were dedicated to the Bill there. It is important to put on record that this House received a Bill that is very different from the Bill as it was first presented to the House of Commons. Many hours were taken up in the other place on a Bill that was completely altered. I will point to one particular issue. The process massively changed from a judge-led process to a panel. In fact, of the 91.5 hours of debate in Committee in the other place, 62 were on a Bill that still had the High Court process in it. So we have to reflect in our deliberations that many hours were rightly taken scrutinising the Bill in the other place, but we have now received it in a very different form.

[Lord Goddard of Stockport (LD)]

I accept the noble Baroness’s position. Perhaps a High Court judge might resolve the issue, then.