Terminally Ill Adults (End of Life) Bill

Torcuil Crichton Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Dr Ahmed]

Not at the moment.

It is on the foundational principles of the Bill that I primarily want to concentrate today. The first is the idea of a “six months to live” label. “Terminal illness” is a fast-changing medical diagnosis in the modern medical world, and it is becoming an increasingly meaningless term. Only yesterday evening, I was in the company of a professor of respiratory medicine who, with rightful satisfaction, told me that many of his stage 4 lung cancer patients who were designated with six months to live in 2023 are being managed as having a chronic disease in 2026.

In my practice, if a patient comes to see me with stage 4 colon cancer that has spread to their liver, the advent of immunotherapy means that I have an equal chance of telling them they have six months to live or six years to live. Under this law, when I meet that kind of patient, it is unclear to me, with the Supreme Court precedents around consent, whether I should be offering them immunotherapy and an assisted death at the same sitting.

A six-month prognosis will take a new and unhealthy salience in every clinical conversation. It will be a label some will desire, and others will want at all costs to avoid being placed on their clinical record. It will fundamentally change and undermine the candidness and sanctity of the patient-doctor conversation and relationship.

[Torcuil Crichton (Na h-Eileanan an Iar) (Lab)]

My hon. Friend is making a very informed speech on how the medical landscape has changed, but while the arguments we make today are the same, the political landscape has changed as well. Would he agree with the Father of the House that we now have a Prime Minister committed to solving the problems with social care and palliative care, and that in Scotland, where the hon. Gentleman comes from, we saw the political landscape change in front of our eyes? MSPs initially voted for similar legislation, but ultimately voted against it. People can change their minds, and I hope that they do.

[Dr Ahmed]

I am grateful to my hon. Friend for mentioning the Scottish context. We voted down such legislation on Third Reading, when we understood the impacts and the wider societal ramifications.

I have to be honest. When I am asked to prognosticate on whether someone has six months to live, I am as often wrong as I am right. It is no longer a good enough marker for the DWP to use in discharging benefits for life-limiting conditions, and I do not see why it should be a good enough marker for prescribing death.

There is another paradox in this legislation: someone like me could write a prescription to induce death with less regulatory oversight than is on me when I have to remove a kidney to give life through transplantation. Of course, I sympathise with and endorse the desire of many colleagues who support this Bill to relieve suffering. To be clear, we have many tools to do this, and we must bust some myths today. Clinical discretion, for instance, means that there is no maximum dose of morphine, so I can give my patients whatever they need, in the setting in which they need it. But this Bill is less about relieving suffering and more about bypassing its possibility, and I understand that.

The Bill is in many ways advocating for death as prophylaxis. Under the definition in this Bill, death must be induced by medical prescription. It will be the only medical prescription that I will be able to write as a doctor but not administer, because the burden of administration falls to the patient, and the weight of expectation falls on the patient. We must discuss the mechanisms by which death will occur: muscle paralysis, slowing of the heart rate, sedation, and the possibility that paralysis will take hold before sedation does. Death will not be an event; it will still be a process. In 15% of cases, it will be subject to some form of complication, such as vomiting or seizures, and it will not always achieve its goal.

I wish I could give hon. Members more information about the complication profile, but despite this procedure being prevalent in other jurisdictions across the world, the data continues to be woefully lacking. Alongside that, the 14-day cooling off period means that the patient must remain lucid in that time. There have been cases elsewhere in the world where patients have denied themselves palliative care and pain relief to remain lucid in order to consent to their death. I am therefore of the opinion that the foundational elements of this Bill will create the allure of choice and control, but not the agency to pursue either.

Turning to safeguards, much is made of the provision requiring two doctors to assess eligibility, but the trouble is that neither has to know the patient well, or go to any great lengths to exclude the likelihood of coercion. Doctors are trained to do many things, but assessing and picking up on coercion is not one of them. In fact, consultant psychiatrists with PhDs in coercion, like the hon. Member for Runnymede and Weybridge (Dr Spencer), whom I hope we will hear from soon, have said in written testimony presented in court that they would find it difficult to exclude coercive controlling behaviour.

I came into medicine, and into Parliament, to act with compassion, and to provide dignity to those we serve. I believe that is why we are all here. Compassion and kindness is not the preserve of one those on one side of the argument or another, but for me, compassion and kindness also calls to courage—the courage to be honest with patient and constituent alike. We need the compassion and honesty to say that the Bill will not fulfil its aims; it will disappoint many who crave total agency and control, and it will expose and disenfranchise further the vulnerable in our society. We need the compassion and honesty to say that our NHS, while a great institution, is not, in its current form and state, ready. It is not safe for this conversation or for this Bill in this moment.

--- Later in debate ---

[Torcuil Crichton]

Will the right hon. Gentleman give way?

[Kit Malthouse]

I will not.

Some of those Members had just a few months before been specifically rejected by the electorate and replaced in this House by others, and I am afraid that they cannot be trusted not to do the same thing again. I grant my right hon. and learned Friend the Member for Kenilworth and Southam (Sir Jeremy Wright) that this is a less than ideal situation. However, I know that the sponsor in the House of Lords is willing to entertain amendments being tabled in the Lords, which will come back to the House for conclusion.

Before I conclude, I want to deal with a couple of other issues. The first point is about the notion of palliative care, which we discussed extensively on Second Reading. I am pleased that this legislation has stimulated a strong debate about palliative care. The Health and Social Care Committee of the House of Lords found that in territories that have assisted dying, palliative care generally improves, because people become less afraid of talking about death. But we must be careful not to say that perfection is a precondition for those who are dying; perfection has to be an objective for those of us who will carry on living. We cannot delay and indulge the dying in their agony because we are not satisfied with the state of palliative care. We have to deal with the choice that those people are facing at the point of their death, and give them the choice that so many of them seek.

The second point is about coercion. The Father of the House, my right hon. Friend the Member for Gainsborough (Sir Edward Leigh), talked about love. One of the most affecting people I have met over the last 11 years of campaigning on this issue is Warwick Jackson, who came to our party conference a couple of years ago. Warwick’s wife, Ann, was diagnosed with terminal peritoneal cancer. She basically knew that she was going to die a slow, suffocating death at the end. As Warwick watched her dying and heard her begging her palliative nurse to end it all for her, he contemplated smothering her with a pillow. The only thing that stopped him was that he did not want her dying thought to be that her loving husband had brought her life to an end. That is the conflict of love that we pose to people by perpetuating this appalling status quo. We have heard time and time again that the situation that thousands of our constituents live with every single day is so horrific and appalling that even the best palliative care cannot alleviate their pain.

I urge colleagues to consider what their vote may mean today. As we said on Second Reading previously, a vote against this Bill is not a passive act. It is not something neutral; it is a vote for a status quo of misery, degradation and cruelty for so many. We know that the British people support this measure. We know that there are lots of territories around the world that we respect and admire that have assisted dying and have operated it for many years successfully. It is not beyond us to get our democracy operating as it should and to design something that will work for the British people. We cannot give dying people more time, but we can give them mercy and love. I urge Members to vote for the Bill today.