Terminally Ill Adults (End of Life) Bill

Debate between Rebecca Smith and Alicia Kearns

2nd reading
Friday 11th September 2026 Commons Chamber

[Alicia Kearns (Rutland and Stamford) (Con)]

Palliative and social care need fixing, and that is a concern that unites the House. It is a scandal that how well people die depends on where they live, but to suggest that this Bill should wait until palliative care has been improved is a fallacy for two reasons. First, the Bill gives us an opportunity to improve palliative care. It places a statutory duty on the Secretary of State to tell this House what the state of palliative care in this country is, and whether people can even access it. No Government have ever been required to answer that question, and under this Bill, they would be. I would go further and say that this assessment should be in place before the Bill comes into force and should be an annual update to Parliament, but that amendment cannot be made to a Bill that does not exist. If we vote down this Bill today, we will delay and deny the possibility of mandating a genuine assessment of the state of palliative care in this country.

The second reason it is a fallacy is that Hospice UK has told us repeatedly that it would be inappropriate to even imply that hospice and palliative care can address pain in all circumstances; we know that it does not, and honestly cannot. When we say that we will fix palliative care first, we are promising something that no palliative care system has ever delivered or will ever be able to deliver, and we are asking people to die in pain waiting for something that cannot be given. If we vote this Bill down, we will be no closer to understanding the state of palliative care.

I would also add that in this country, we already have “do not resuscitate” orders. Doctors suggest them, families agree, and a person who could have been revived dies, often without their voice featuring in any way. I have experienced this in my own personal circumstances—I had to run across to Guy’s and St Thomas’ hospital and tell them to lift a “do not resuscitate” order that they had put in place without consulting me—so let us not pretend that this line is sacred, because no one in this place seems to be saying, “While we’re at it, let’s scrap ‘do not resuscitate’ orders.” Those are on the same continuum.

Let me turn to the other place and the question of procedure. A great many peers were doing precisely their job; others were laying siege to the Bill. If anyone does not want to accept that both those things are true, I ask them to look at their own bias. On some issues—treatable depression, eating disorders and whether a hospice can decline to take part—the Lords were right. When this House passed the Bill, we expected it to be debated and that amendments would come back to us in the ordinary way. “Erskine May” provides that where a Bill proceeds under the Parliament Acts, this House may suggest amendments to the other House without inserting them into the Bill. That power does not sit with the Bill’s promoter; it sits with anyone sat in this Chamber. If the Lords agree to those amendments, they are treated as Lords amendments already accepted by the Commons—they do not even need to come back to us. There is precedent in the Hunting Act 2004 and the Trade Union and Labour Relations (Amendment) Act 1976, so the choice before us is not between an unamended Bill and no Bill. I am not asking the House to accept the Bill as it stands, and I myself will press amendments through that process, particularly regarding the audit of palliative care and treatable depression. The process can be improved.

As a Conservative, individual freedom, choice and personal responsibility shape my decision making until those freedoms cause harm to others. For years, I have listened to debates on this issue, waiting for the harm in the principle of giving us autonomy over our own bodies and our own deaths to materialise. There is no harm in the principle of assisted dying, and I am yet to hear an argument that exposes it. This Bill applies to those who have six months left to live—no one else—and I am arguing for a freedom that harms no third party, but will relieve a great deal of suffering.

During our last debate, I told the House that my mother’s last words were, “I cannot go on like this.” She died a few days later, and that was a great kindness to her, even if it was a great cruelty to me and my children. However, too many in this country—this great, compassionate country—go to sleep at night desperate for the pain to end. They wake the next morning knowing that they must endure another day of it—a body that betrays them or wracks them, and that no medication will soothe—and another day in which this House has denied them the option of bringing it to an end, with their families and on their own terms.

[Rebecca Smith]

Will my hon. Friend give way?

[Alicia Kearns]

I am going to keep going. Members have often spoken of unexpected recoveries that have led them to oppose the legislation. That is the news we wish for every person we love and for every loved person we have. Last year, I was told twice that I would die—most likely or potentially—given complications I had that I will not speak about at the moment. I know what it is to want to survive. I know what it is to fight. But for many, that day is not coming—there will be no reprieve of that kind—and we cannot write laws about the dying in the hope of a miracle that will not come for most. As such, I will vote for the Bill, because living in a perpetual state of torture cannot be right, and we cannot allow people to wait longer. I urge hon. Members who are undecided to vote for the Bill. I urge them not to end the argument, but to continue it; I will stand with them in tabling amendments in the other place.