Terminally Ill Adults (End of Life) Bill

Tom Rutland Excerpts

Friday 16th May 2025 Commons Chamber

“be given the ability to exclude themselves from the act of an assisted death.”

[Tom Rutland (East Worthing and Shoreham) (Lab)]

I rise to speak in support of new clause 10, which is about choice. In fact, the Bill is about choice: choice at the end of life and choice to have a dignified death. It is about a choice that is currently being denied to many in untreatable, excruciating pain at the end of their lives—a choice that the majority in this country would want for themselves.

New clause 10 is in that same spirit. It would offer practitioners a choice, by ensuring that there was no obligation on any person to provide assistance to a terminally ill adult seeking an assisted death. That includes those such as my constituent Aimee’s grandmother, who repeatedly asked her, “When will it end?” from the bed in her hospice, where, despite the best efforts of staff, they were medically unable to treat her constant pain and legally unable to make good on her wish to, in her own words, be helped to go.

The Bill allows doctors to choose not to participate in the assisted dying process if they so wish. The new clause would improve it by extending that provision to all registered medical practitioners, health professionals, social care professionals, pharmacists and pharmacy technicians. It would also make it clear that no person is under any duty to act as a witness or a proxy in the process. It would further amend the Employment Rights Act 1996 to ensure that no one could be subjected to detriment by their employer for providing assistance to those seeking an assisted death or for choosing not to do so. That is a good thing: it respects people’s choices.

Some will not want to aid someone seeking an assisted death because of religious or other principled objections, but some, like my constituent Karen, will want to. Karen wrote to me setting out her father-in-law’s terminal diagnosis of a brain tumour, his fear of losing control of mental and bodily functions as his condition progressed and his hope that the Bill would pass in time for him to benefit from it.

Karen is not simply a relative of a terminally ill person; she spent years working in palliative care, watching people lose their independence and dignity as a result of their terminal illness, with patients asking her how they could end the suffering for both themselves and their families. She was heartbroken to witness their distress and pain over days, weeks or even months, knowing that nothing could be done for them. In their painful final stretches, some felt suicidal and some felt a burden. For that reason, I must oppose new clause 16, which would rule ineligible for assisted dying anyone who is substantially motivated by a number of factors, including feeling a burden, or suicidal ideation.

[Sir John Hayes]

I am surprised by the hon. Gentleman’s objections to new clause 16, given that we have been assured throughout that the Bill would apply only to people who were terminally ill with six months to live. Is he really saying, therefore, that he does not want a new clause that would rule out from assisted death people who feel that they would be a burden on others, people with a mental disorder and people with a disability? His argument for choice is exactly the argument that in other jurisdictions has led to the expansion of assisted death to just those kinds of people.

[Tom Rutland]

I am grateful to the right hon. Gentleman for that intervention, because it allows me to continue making an argument that will address those points. First, substantial motivation is vague, undefined and legally imprecise. This new clause is a blunt instrument and an attempt to shut the door on entire groups of people accessing an assisted death. How would one establish what a substantially motivating factor in any individual case is? No motivation exists in a vacuum, and feeling a burden can co-exist with physical deterioration and untreatable pain. Secondly, if suicidal ideation is to think about dying by taking one’s own life, would that not encompass everyone considering assisted dying?

[Dr Sandher]

I think today of Norman Ward, who in 2020 shot himself while terminally ill because of the terrible pain that he faced. Does my hon. Friend agree that under subsection (f) of new clause 16, Norman Ward would have been unable to access the choice that would have ended his suffering?

[Tom Rutland]

I agree with my hon. Friend.

Similarly, I cannot support amendment 102, which would require doctors to ensure that there were no “remediable suicide risk factors” before conducting a preliminary discussion with the patient. There is no clear legal or clinical definition of the term “remediable suicide risk factor”, and the Bill already includes multiple checks on mental capacity and mental illness, including by independent doctors and a specialist panel. The vagueness of this amendment risks wrecking this much-needed Bill.

I emailed Karen again yesterday to ask if I could refer to her in this speech. Her father-in-law had sadly died in the time that had passed between her initial email and our exchange yesterday. The Bill was not passed in time for him and he could not benefit from it. However, Karen hoped that his story could make some small contribution to changing the law. There do not need to be more people in Karen’s father-in-law’s position, or in Aimee’s grandmother’s position—they can have choice at the end of life, and our brilliant palliative care workforce, like Karen, can have choice on the kind of care they provide too.

[David Smith]

Will my hon. Friend give way?

[Tom Rutland]

I am afraid I must make progress.

I therefore hope that Members across the House will join me in supporting new clause 10, strengthening the Bill and reinforcing the fact that choice, for patients and practitioners, is at the heart of this legislation, and I hope they will oppose the amendments and new clauses that would wreck the Bill and put that choice at risk.

[Several hon. Members rose—]