Terminally Ill Adults (End of Life) Bill (Twenty-seventh sitting)

Rebecca Paul Excerpts

Committee stage
Wednesday 19th March 2025 Public Bill Committees

[Kim Leadbeater]

These amendments relate to criminal liability under the Bill. They get to the heart of why the legislation is needed. Amendment 504 seeks to clarify the language of clause 24 and provide reassurance that it will not be considered an offence to perform a function under the provisions of the Bill or to assist a person seeking to end their own life in connection with anything done under the Bill. It will ensure that those acting within the law, and with compassion, to assist terminally ill individuals who wish to end their suffering and take control at the end of their life are protected under the law.

Amendment 505 ensures that the provisions of the Terminally Ill Adults (End of Life) Act 2025 will supersede the Suicide Act 1961, providing clarity that actions taken under the new Act will not be subject to the outdated legal framework established under the 1961 Act. That is a crucial step in modernising our laws to reflect the values of compassion, dignity and personal autonomy. These amendments bring us closer to a legal framework that is clear and safe.

Our Prime Minister, my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), the former Director of Public Prosecutions, stated in relation to assisted dying, “The law must reflect the changing moral landscape of society, and in cases such as this, where the individual’s autonomy and suffering are at stake, our legal framework must offer clarity and compassion.” During his tenure as DPP, Sir Keir also emphasised the importance of not criminalising individuals who act out of compassion, particularly in difficult and morally complex situations. He said, “The law must be clear, and it must ensure that those who act with the intention to relieve suffering are not penalised, as long as their actions are in accordance with the law.” That sentiment is echoed in the amendments before us today, which ensure that those who assist individuals under the Bill are protected by law, offering clarity and reassurance to both the public and professionals who may be involved in such decisions.

Sir Max Hill, another former Director of Public Prosecutions, remarked in 2019, “The law around assisted dying is often unclear and creates a great deal of uncertainty for both individuals and healthcare professionals. What we need is a system that balances compassion with protection, ensuring that people who are at their most vulnerable are supported in a way that is both legal and ethical.” Sir Max Hill’s words emphasise the need for clear, compassionate guidance, which these amendments will provide. They will help to eliminate the legal uncertainty that can cause fear and hesitation in those who act in the best interests of individuals facing terminal illness.

The 2010 DPP policy clarified that assisting someone to end their life was not automatically criminal and that each case would be assessed on its individual facts. However, that has not changed the law and many people are still being failed by the law as it stands. These amendments create clarity and prevent ambiguity around what constitutes a criminal act versus an action legally protected by the new law.

I will finish with a very powerful testimony from Louise Shackleton from Scarborough. Louise accompanied her husband to Dignitas last December. I believe she was the first person to make that trip since Second Reading. Louise talks about the trip she made to Switzerland with her husband. She says:

“This is not an easy process as some against Assisted Dying might have you believe, might try and convince you. It is a robust and thorough almost an ordeal in itself. Then there is the cost, not just financially but mentally and physically as he had to be able to get to Zurich and someone had to assist him to do this…My husband did not deserve this to be his end nor did I deserve this to be his end, my last memory of him…I accompanied my husband to Switzerland, where we had 4 wonderful days together, my husband’s mood had lifted, he was at peace, it was as if the weight of the world had been lifted from his shoulders. He was not scared, no anxiety, his emotional suffering had ceased. You cannot imagine unless you see and feel this he was looking forward to his peaceful death, looking forward to leaving his pain, suffering…At the end, my husband was able to die on his own terms, pain-free and peaceful, held in my arms as his heart gently slowed and finally stopped, granting him the dignified and serene farewell that he had wished for. But where was I? alone in a strange country alone, scared, bereft, organising an Uber to take me away from the…Dignitas House, I was vulnerable and in utter shock, now having to leave my dead husband alone, leave his body to be cared for by people I had never met…Due to our draconian laws my husband had to be in a foreign country, had to be cremated to be brought back home. No funeral that he would have chosen, no mourners, no ceremony, cremated with no Reverend to pray for him, returned to me in a cardboard box. The pain is excruciating beyond any other loss I have experienced”.

She then says:

“I have been arrested and spent just under three hours being interviewed by two CID officers. Four days after my husband left my world there I was stuck in a Police station being cautioned, questioned, having to relive my trauma, for my crime, a crime made by love, a crime made by adoration, a crime of compassion and respect of my husband’s last wish.”

She now faces a prolonged police investigation. She tells us,

“My husband was the first British person to go to Dignitas after parliament debated on Friday 29^th Of November 2024. You have the power, the power is yours to be human, to follow Gods wish, to ‘suffer’ choices that other people may make even if its uncomfortable for you. Palliative care I hear you say, My Husband did not want palliative care…Please give others the gift of dignity and a good death in their homes…You have the power to do something amazing, give people the choice.”

I commend these amendments, which will help many people. Sadly, it is too late for Louise, but they will help many other families who will potentially go through what she has been through.

[Rebecca Paul (Reigate) (Con)]

I rise to speak briefly on clause stand part. As I noted a few weeks back—it feels a long time ago—when we debated amendment 82, the clause leaves the law in a strange position. I hope that we will now have the opportunity to explore that and make sure that we are comfortable with the position and have identified whether any changes are needed.

Section 2(1) of the Suicide Act 1961 criminalises both assisting and encouraging suicide:

“A person (‘D’) commits an offence if—

(a) D does an act capable of encouraging or assisting the suicide or attempted suicide of another person, and

(b) D’s act was intended to encourage or assist suicide or an attempt at suicide.”

It is a single offence, but can be committed in two ways: either through assistance or through encouragement.

Clause 24(3), both as drafted and as amended by amendment 505, would make an exception from criminal liability under the Suicide Act, but in respect only of assistance, not of encouragement. It would cover:

“(a) providing assistance to a person to end their own life in accordance with the Terminally Ill Adults (End of Life) Act 2025, or performing any other function under that Act in accordance with that Act, or

(b) assisting a person seeking to end their own life in accordance with that Act, in connection with the doing of anything under that Act.”

In other words, it is strictly limited to assisting suicide. It only covers the actions in the Bill around conducting the preliminary discussion, assessing the applicant, giving the applicant the approved substance and so on. What happens to the other half of section 2 of the Suicide Act: the offence of encouraging suicide? I will not rehash the debates that we had over amendment 82, but I must point out that as that amendment was rejected, the law does not dovetail. Encouragement would still be very much an offence under the Suicide Act, as it has not been excepted under the Bill.

Because my amendment was not agreed to, we will have the absurd situation in which somebody can commit the crime of actively encouraging someone to take their own life, yet that will not be looked for or taken into account when assessing someone’s eligibility for an assisted death. On the flipside, there is a very real risk for families and friends of loved ones who could inadvertently overstep the mark and move from support of a loved one to encouragement. It does not take much imagination to realise that that could lead to accusations and potentially even to prosecution if the law is not sorted and clarified at this stage.

We already know how difficult it has been for family members who want to accompany loved ones to Dignitas but fear that they could face prosecution; the hon. Member for Spen Valley has made that point so eloquently. No one wants that, so it is important that we ensure that the Bill does not create a similar situation in which someone could be unfairly prosecuted for encouragement, which is still very much a crime under the Suicide Act.

--- Later in debate ---

[Sarah Sackman]

Again, it would depend on the actual facts. However, if they were attempting to perform duties under the Bill, it is highly unlikely that, in circumstances where the facts establish and meet the threshold of gross negligence manslaughter, they could be said to have carried out those duties in accordance with the Bill. They might have been carrying out duties that they thought were what the Bill prescribed, but if they have done that in such a way that it amounts to gross negligence manslaughter, then clause 24(1) would not apply.

The hon. Gentleman makes the point about what the pharmacist in that scenario believes they are doing; that belief has to be reasonable, and that is a test that our courts are well used to applying. That is why the amendments introduce the belief that someone is acting in accordance with the Bill. It is not enough that they think they are doing it; it has to be a reasonable belief. That is an objective standard.

[Rebecca Paul]

I thank the Minister for those helpful clarifications. Was any consideration given to also exempting encouragement as an offence under the Suicide Act? I am interested in why it was not exempted in the same way as assistance, particularly given that if it did fall within coercion and pressure—based on what the Minister said—it would get picked up as a criminal offence anyway under the Bill. I appreciate that the Minister will write to me on some of this, but the issue comes back to what is encouragement. As the hon. Member for Spen Valley set out—

[The Chair]

Order. As I have said time after time, if it is a question of receiving clarification, Members should keep their comments short, rather than expanding on them.

[Rebecca Paul]

My apologies, Mr Dowd, but it is a technical point. I think the Minister understands what I am asking.

[Sarah Sackman]

Helpfully, the hon. Member has also set out her questions fully and precisely in a letter to me, so I think I know what she is asking and I will try and answer it as best I can. I reiterate, as I and the Minister for Care have said throughout, that the policy choices have been for the promoter—the Government remain neutral. The offence of encouraging or assisting suicide or attempted suicide in section 2 of the Suicide Act is well established. Encouraging someone to go through the assisted dying process under the Bill with the intention of encouraging suicide or an attempt at suicide would therefore remain a criminal offence under section 2 of the Suicide Act. That is what I made clear earlier.

What we are talking about will always depend on the particular circumstances of the case. It is the Government’s view that in a scenario—I think this is what the hon. Member for Reigate is getting at—where a family member or friend simply suggests to a person with a terminal condition that the option of assisted death under the Bill is something they may wish to consider, and nothing more, it is unlikely—dare I say, inconceivable—that that would amount to an offence under the 1961 Act.

However, if someone encourages a person in a more tangible way, such as encouraging or pressuring them to make the first declaration, that could well amount to an offence under the 1961 Act. Where that encouragement crosses the threshold into what, interpreted in line with their natural meaning, the courts would understand as pressure or coercion, that could amount to an offence under clause 26 of the Bill, which we will come to in due course. I hope that that addresses the hon. Lady’s question. I will set that out to her in writing, and she is welcome to write back if there is any ambiguity.

I hope that that assists the Committee. I am going to sit down before anybody else intervenes.

[The Chair]

May I make an observation? I understand where the hon. Member for Reigate is coming from, but if letters have gone back and forth to the Department and other Committee members are not privy to what they say, the debate gets a little abstract. That is all I am trying to get to—we should not get too abstract, so that everybody knows what is being said.

[Rebecca Paul]

I appreciate that, Mr Dowd, which is why I was elaborating—I wanted to make sure that everyone understood the nature of the question without having seen the letter. In order to summarise, following your instruction, I refer to the letter.

[Kim Leadbeater]

I have nothing further to add.

Amendment 504 agreed to.

Amendment made: 505, in clause 24, page 15, leave out lines 22 and 23 and insert

“—

(a) providing assistance to a person to end their own life in accordance with the Terminally Ill Adults (End of Life) Act 2025, or performing any other function under that Act in accordance with that Act, or

(b) assisting a person seeking to end their own life in accordance with that Act, in connection with the doing of anything under that Act.”.—(Kim Leadbeater.)

This amendment ensures that it is not an offence under the Suicide Act 1961 to perform a function under the Bill, or to assist a person seeking to end their own life, in connection with the doing of anything under the Bill.

Clause 24, as amended, ordered to stand part of the Bill.

Clause 25

Civil liability for providing assistance

--- Later in debate ---

Amendment 509 ensures that prosecution for any offence under this clause can only be initiated by, or with the consent of, the Director of Public Prosecutions. This is an important safeguard, ensuring that prosecutions are handled with the utmost care and consideration. By involving the Director of Public Prosecutions, we make sure that decisions to prosecute are made fairly, consistently and with proper oversight. This also aligns the approach to assisted dying with the principles of prosecutorial discretion seen in the Suicide Act. This will ensure that cases are reviewed for their individual circumstances before a decision to prosecute is made, ensuring that the individual circumstances of the case are assessed based on the case’s merits. The amendments refine and clarify the Bill’s provisions by ensuring that legal terminology is more precise, penalties are more aligned with the seriousness of offences, and stronger oversight mechanisms such as the DPP’s consent for prosecutions are in place. They aim to protect the integrity of the assisted dying system while offering greater accountability, punishment and deterrence against fraudulent or coercive practices.

[Rebecca Paul]

I will be fairly brief. I welcome amendment 508, which would ensure that conviction for the offence leads to a necessarily serious result. However, it is not just the strength of the sentence that we need to think about; there is also a question about how difficult it can be to detect and demonstrate coercion in the first place.

Domestic abuse prosecutions have followed an overall downward trend over the past decade, according to Women’s Aid. A report from the Domestic Abuse Commissioner in January found the criminal justice system unfit to hold abusers to account and safeguard domestic abuse victims. Domestic abuse victims are being failed by the criminal justice system at every stage, from police to probation. Victims seeking safety in justice routinely face a lack of specialist service referrals, poor enforcement of protective orders, court delays and early release of abusers. The commissioner also found that just 5% of police-recorded domestic abuse offences reached conviction and that less than a fifth of victims have the confidence to report to the police in the first place. Within the police workforce itself, only 4% of alleged domestic abuse perpetrators are dismissed.

Women’s Aid says that trust in the criminal justice system is at an all-time low, with domestic abuse survivors not feeling that they will be believed and supported when reporting abuse. That is even more challenging for black and minoritised survivors, who face additional barriers and poor responses when they seek help.

[Kim Leadbeater]

The hon. Lady is making a point that we have already covered several times in the debate. It is an important point, but I hope that she is reassured by the offences to be included in the Bill, which create sentences that do not currently exist.

[Rebecca Paul]

I am absolutely reassured by the hon. Lady’s amendment, and I welcome it, but it is worth drawing attention to the fact that the sentence is important but identifying coercion and pressure can be difficult too.

In written evidence, a social worker called Rose has cast doubt on the workability of the Bill. She was writing when the High Court safeguard was still part of the Bill, so we need to bear that in mind, but what she said applies to the panel too. She wrote that

“based on lived experience…there is no authentic provision mechanism or route that cheaply and swiftly would allow an approved palliative care professional…or social worker to act to protect a vulnerable person under the grounds of coercion….Place yourself in a position of being sick or older, coerced by family for financial gain or by a practitioner wanting to save public costs to pursue assisted suicide, the social worker senses it by body language, a squeezing of their wrist, a sharp silencing look. Can you see a judge saying: ‘the social worker sensed a tension in the air and a look’.

Do you think that would serve to reach the threshold to override a request for assisted suicide in a court of law?

In practice, what would happen would be, the social worker will record her concerns on the system, share them with her manager who will go to her manager who will say we do not have funds to consult legal and your evidence provided does not reach threshold anyway.”

[The Chair]

Order. I am genuinely trying to give as much latitude as possible, but the issue of coercion has come up before. In the context of the offence, I am not sure that this is necessarily pertinent or relevant. Will the hon. Lady bear that in mind during her speech, please?

[Rebecca Paul]

Thank you, Mr Dowd. In that case, I will stop there. I was just making the point that this is important.

Amendment 509 states:

“Proceedings for an offence under this section may be instituted only by or with the consent of the Director of Public Prosecutions.”

I would find it useful to have more clarity around how the offence is used currently, why it is used and why it is appropriate to use it in this instance. Those are all genuine questions. I simply do not know, so I would be grateful for some input. I will leave it there.

[Danny Kruger]

I will be grateful if the Minister or the hon. Member for Spen Valley can explain the situations in which behaviour criminalised by clause 26(2) would not also amount to an offence under section 2 of the Suicide Act, as amended, or indeed to murder. What behaviour would be criminalised here that is not already criminal? Can the hon. Lady think of any instance in which there would be no crime under section 2 of the Suicide Act, but there would be an offence under clause 26(2)? If there is no such instance—I cannot think of one—it strikes me that, at least in respect of coercion and pressure, the offence being created here is redundant and duplicative.

Ministers have rightly stressed the importance of their duty to the statute book. My understanding is that having redundant or duplicative legislation, or indeed duplicative offences, would be inconsistent with our duty to the statute book. One might ask, “What does it matter? Wouldn’t it be helpful to have additional belt-and-braces safeguards in the Bill?” I agree in principle, but I note that when other Members have deployed that argument in relation to adding terms such as “undue influence”, the neutral Ministers have rebuked them by appealing to the duty that we are supposed to have to the statute book. I think the point cuts both ways. Why are we embroidering the statute book with duplicative offences?