Terminally Ill Adults (End of Life) Bill

Baroness Fraser of Craigmaddie Excerpts

Friday 12th September 2025 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I have spent some years working to improve care and support for vulnerable people, specifically as chief executive of Cerebral Palsy Scotland, through my involvement in the Scottish Government’s framework for action for neurological conditions and as a previous trustee of the Neurological Alliance of Scotland. I believe that we all want to ensure that compassionate care and services are available for anyone when they need it; I also believe that everyone is entitled to be supported to make informed choices about their treatment, to access care that ensures they are able to live as pain free as possible and with dignity.

Sadly, however, as we have heard, for too many people that is not a reality. Lack of access to condition-specific support, to palliative care and to social care are all reasons why the status quo does not work for too many people. Set in the context of clinical backlogs and constrained funding in health and social care, people will not make all their choices in a context that is equal.

Here in this Chamber, we are all, in the main, healthy, competent, articulate and above all, privileged people. I have been asked whether I would not want an assisted death if I was unable to speak for myself, dress myself or eat by myself, but this is the reality every day for many disabled people. In seeking to ensure that the Bill leaves this place fit for purpose, we must consider assisted dying not through the lens of what we think we might want for ourselves, but rather through its impact on the most vulnerable in our society. We have been told that the Bill gives people choice, but which people and what choices?

As it stands, the Bill leaves me profoundly uncomfortable. The personal stories of people seeking choice and control over the manner of their death, or the heart-rending examples of poor care, seem not likely to be resolved by the provisions of the Bill. I am also concerned about the differences between this Bill and the Bill currently going through the Scottish Parliament, and the implications of those differences for service provision and regulation across the UK if both Bills pass. I gave evidence to the lead committee scrutinising the Bill on behalf of Cerebral Palsy Scotland in Holyrood, and both Bills leave too many details to be agreed later. Sweeping consequential powers, such as the process for the approval of drugs or other substances and the regulation of professions, will require co-operation and co-ordination between the two Administrations and should, I believe, require full and transparent scrutiny in both Parliaments. Where these Bills use words such as “terminal”, “progressive” or “treatment”, we need greater clarity on what exactly these terms mean, otherwise such broad terminology and the lack of detail around the process of assisted dying will result in unintended gaps that would be challenged.

I also want to seek provisions to ensure mandatory involvement of health professionals who actually know the person and are experts in the condition the person is presenting with. There is, however, a host of other issues that currently concern me, including greater clarity on how people will die, especially if they are unable to use their hands or ingest a substance; direction on what medical professionals are supposed to do or not do in case something goes wrong; stronger protections for conscientious objectors; and far greater clarity on training and reporting standards and requirements.

At the moment the Bill presents too many questions and not enough answers. I look forward to playing my part during its passage, as it is essential that these questions are not brushed aside or dismissed and that clear answers are provided.