Terminally Ill Adults (End of Life) Bill

Debate between Simon Opher and Blair McDougall

Report stage
Friday 13th June 2025 Commons Chamber

[Blair McDougall]

The hon. Member makes an important point that we have to consider. We must recognise that, as he says, people’s choices are limited by the unfair distribution of wealth, the injustices that disabled people face throughout their life, or the attitudes of the powerful in society towards those who are less fortunate.

[Dr Opher]

If my hon. Friend looks at the statistics, he will see that it is usually the better-off in society who choose assisted dying, not the less well-off.

[Blair McDougall]

I will come to that point shortly.

We have a duty to ask whether the poorest and most vulnerable will be coerced into choosing assisted dying over palliative care because of economic disadvantage. Will they be exploited by those with a financial interest in their choosing to end their life? Will their death become a commodity? If we are really going to pass legislation that allows someone’s death to become a matter of business, we must have full transparency on those financial motivations, and my amendment 15 would require that. If we are really going to pass legislation that allows someone’s death to become a matter of business, we must have full transparency on those financial motivations, and my amendment 15 would require that.

Carers in the private sector are not bad people any more than people working directly in the NHS, but private healthcare operates in a context. The evidence that profit influences the moral choices made in the care and treatment that is already provided in this country is overwhelming; this is not a hypothetical concern. For example, a systematic review published by The BMJ found that private equity ownership of healthcare is associated with lower standards of care. Around the wonderful miracle of IVF there is an industry profiting from people’s desperation as they start life rather than end it. Already, at the end of life—this relates to the point made by my hon. Friend the Member for Stroud (Dr Opher)—choice in palliative care is limited by economic status, with the wealthy more likely to die a good death than the poor. My amendment seeks to address the fundamental question of whether free choice really is free by bringing into daylight the financial motivations of those involved in individuals’ decisions.

--- Later in debate ---

[Blair McDougall]

My hon. Friend makes an important point. Amendment 15 seeks to recognise that there is a difference in where private providers’ income stream comes from and that that raises moral issues.

[Dr Opher]

Will my hon. Friend accept one more intervention?

[Blair McDougall]

I do not wish to exacerbate your bronchitis, Madam Deputy Speaker, so I will continue.

Amendment 15 touches on a fundamental point at the heart of the debate. Disabled people and the sick, in every aspect of their lives, have to fight every day for resources from a state, a market and a society that view them as a drain on finances. Do we honestly believe that at the moment when the most vulnerable are least able to argue for themselves, under the most intense societal and cultural pressure, and at their most expensive, those same public and private sector institutions will succeed in making choice real for them when they have failed to do so throughout the rest of their lives? Even if we stretch credulity and convince ourselves that that will be true in the state sector, can we say that it will be true in the market? I do not believe that the Bill should be passed, but if it is, let us not make it worse by allowing unscrutinised profit from the loss of human beings.