Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

Friday 21st November 2025 Lords Chamber

[Lord Evans of Rainow (Con)]

My Lords, I rise to speak to Amendment 50 in my name and that of my noble friend Lord Goodman. It is a pleasure to follow the noble Lord, Lord Carlile. I would not describe him as a nasty lawyer at all. The noble Lord is a Burnley fan. I do not know any nasty Burnley fans, but I do know a lot of Arsenal fans. There is one thing I would say about some phraseology the noble Lord used early in his speech. He used the words “final solution”. I encourage the noble Lord to think of other phraseology to describe that.

I agree with a lot of what the noble Lord, Lord Carlile, said. I am grateful to my noble friend Lord Deben for following the noble Lord, Lord Pannick, because I, too, am not a lawyer, but like my noble friend, as a former Member of Parliament, I experienced lots of constituents who were under coercive control. Lots of MPs do surgeries for their communities and take on these cases. Not being a lawyer, as a layperson trying to fathom out coercive behaviour is notoriously difficult, and that is why I have come up with Amendment 50.

The existing language limits the coercion pressure bar to cases where it causes the person to make a decision, which creates evidential difficulties. This amendment excludes all cases of coercion and pressure without requiring finding out whether in fact it causes the person to make the decision to end their life. It is easier to see whether someone is being coerced or pressured than to know whether the coercion or pressure is the operable cause that leads a person into making the decision. A doctor should exclude all cases where a person is being coerced or pressured to make a declaration rather than engage in causation analysis. Similarly, offences ought to be focused on the wrongful act of coercing or pressurising regardless of the outcome.

At trial, the Crown, with plenty of resources, would have trouble proving that the coercion or pressure resulted in someone making the decision. How is a doctor on their own supposed to find out? Asking a patient is no help given that the frail or vulnerable person may not even know that they are pressurised or may have been intimidated by coercion. Doctors can see pressure from, say, the person accompanying the patient but cannot read the patient’s mind. This amendment would stop doctors being required to be detectives.

The closest analogy in existing law to this rule against coercion or pressure to do a potentially fatal action is Section 2 of the Suicide Act 1961, “Criminal liability for complicity in another’s suicide”. It does not require any attempt at suicide or even a decision to commit suicide and provides that

“D may commit an offence under this section whether or not a suicide, or an attempt at suicide, occurs”.

Section 184 of the Online Safety Act 2023 titled, “Offence of encouraging or assisting serious self-harm”, provides in subsection (5) that

“D may commit an offence under this section whether or not serious self-harm occurs”.

Compare also Section 65 of the Serious Crime Act 2007, which refers to pressurising someone to commit an offence and does not require the outcome be causative.

In recent years, the Crown Prosecution Service has pursued manslaughter charges against men who subject women to domestic abuse that is believed to have driven their suicide. These are criminal offences where there is a much higher bar to action, given that a person’s liberty is at stake. However, Clause 1 is addressing when civil authorities and doctors should draw the line at a patient’s autonomy. Why does the Bill have a higher standard? There is no statutory precedent for “pressured into making it”. The Government have claimed that the Online Safety Act 2023 and the Serious Crime Act 2007 are analogous, but the distinction is making the pressure all that is needed for an offence. Meanwhile the threshold for excluding a person in Clause 1 requires more than is necessary for a criminal offence under these Acts.

Without this amendment it would be lawful to progress a person towards an assisted death even though the person is living in a household where family members are actively making it difficult to live. All that is needed is to see that the person is not pressured or coerced into making the decision. The leading cause of death in domestic abuse victims is now suicide. We work to stop this, but this Bill is opening a door to help perpetrators. It is estimated that three women a week take their own lives. The Government view addressing this as a priority, and the CPS will now prosecute for manslaughter men whose abuse is seen to have contributed to the suicide of a woman. Those men have not had directly to coerce their partners into death, the facts of the abuse are sufficient pressure, but with assisted deaths there will be no coroner’s inquest to address foul play.

The UK leads the world in now recognising coercive control in law, but a regime of total control is poorly understood and insidious. As Cherryl Henry-Leach of Standing Together Against Domestic Abuse told the Lords Committee:

“Coercion is an incredibly complex phenomenon and by its very nature it is difficult to identify and respond to. A perpetrator of coercion will ensure that a person is dependent on them by isolating them from support, exploiting them and depriving them of their independence and autonomy to make decisions freely. As a result of this, we are extremely concerned ... When I think about pressure, I also am mindful of a pattern of coercive control that can be insidious and subversive. Pressure can be a tactic by a perpetrator to enforce a regime of coercive control. That is very complex and I get that, but it is important to be mindful that pressure can be a tool that indicates a pattern of coercive control”.


Studied neglect and coercion are naturally notoriously difficult to detect, and as it stands now, this Bill is a suicide charter. My amendment is intended to improve the Bill.

[Baroness Hollins (CB)]

My Lords, I have amendments in this group, and I have added my name to other amendments. I start by adding my support to Amendment 460, tabled by my noble friend Lady Finlay. Safeguarding measures are not optional; they are essential. To ensure that each individual requesting assisted dying is properly safeguarded, it is essential that all relevant information is gathered so that a full and thorough picture of their circumstances can be formed. We know that poor mental health, inadequate care support or unaddressed social vulnerabilities can profoundly affect a person’s decision-making and ultimately their capacity and understanding of an assisted death. When safeguarding is insufficient or overlooked, the risks of coercion, subtle pressure or abuse increase, and these are risks that may be difficult to detect or are deliberately concealed. This amendment seeks to ensure that such dangers are neither under-estimated nor ignored.

--- Later in debate ---

[Baroness Coffey (Con)]

I think the noble Baroness’s amendment about videoing affects Clause 25, which is considerably later, when the Act is about to happen. I wonder whether she would consider whether it should be done earlier in order to reduce that because, by the point of her amendment, the certificate of eligibility has already been issued. I would be interested to hear her thoughts on that and on whether video recording, as proposed in Amendment 612, should be considered at a much earlier stage.

[Baroness Hollins (CB)]

I thank the noble Baroness. I thought about that, and it could indeed be brought back in a different way later in the debate, but I feel that the prevention of coercion is really important, so thinking about it at this stage is really helpful.

[Lord Winston (Lab)]

My Lords, I want to ask this question of the noble Baroness, Lady Hollins, but it applies also to the noble Baroness, Lady Berridge: she mentioned various things that are cited as causing pressure, but does she not agree that being in palliative care also causes pressure?

[Baroness Hollins (CB)]

There is no suggestion in anything that I have said of imposing palliative care—none at all. I have listened to the debate, and I was not going to speak personally but I will now, since the noble Lord has challenged me on that. My husband was dying with motor neurone disease last year. He felt under immense pressure from this debate in the House of Commons, the other place. He found it very difficult. It made him ask questions, such as, “Am I still entitled to palliative care? Am I really entitled at a time when the NHS is so short of staff and short of time?” He worried about that, and I had to offer him a lot of reassurance so that he could make his own decision. He was not ready to die. The idea that offering palliative care applies pressure is really not to understand the whole nature of the dying process and the way in which, as we come to realise that our life is coming to an end, we need time to understand, reflect, heal and make sense. The pressure not to be a burden is huge, and the pressure of not having access to services that are in short supply is much worse.

[Lord Winston (Lab)]

I do not wish to extend this conversation but, given what the noble Baroness has said, can she explain why in Australia—I am sorry, in New Zealand—where there is very good palliative care, three-quarters of the people requesting assisted dying, something like 2,000 patients, had been in palliative care at the time of the request?

--- Later in debate ---

[Baroness Hollins (CB)]

My Lords, we are going to address palliative care in detail in a later group. We are going to make a distinction between palliative care of a general kind and specialist palliative care, and we are going to think about specialist palliative care at its best. Again, we hear day in, day out about how hospices are closing or having to make staff redundant— I think there is a hospice in Hertfordshire that is just starting its redundancy programme this week because it does not have the money to provide for people’s needs—yet we are relying on our hospices to provide that care, which is not sufficiently available.

When I asked my husband’s GP who was going to co-ordinate his care, because there were several different teams involved, said, “Oh, the hospice nurse will do that”. I thought: the hospice nurse or the community nurse who does not have access to all his notes and records? I was surprised that hospice nurses would take precedence over the GP and the district nurses. They did and they were brilliant but, golly, were they short-staffed.

[Lord Griffiths of Burry Port (Lab)]

My Lords, this has been an extraordinary and wide-ranging debate. I will limit myself, in a very short speech, to Amendment 3, which would take out the indefinite article and replace it with “an independent”. We have heard two poles of the considerations that are facing us. One is the need for autonomy for the person concerned—the person whose life is in danger and whose future we are considering—to make a choice with dignity and independence. Then there are the wide-ranging ways in which we have discussed coercion and pressure, which suggest that autonomy is not an easy thing to concentrate on. If there is this range of possible ways of expressing coercion, applying pressure or whatever it is, autonomy must be considered quite a difficult thing to achieve. I honestly believe that.

As I said at Second Reading, since the Enlighten-ment we have concentrated so heavily on the individual, but we need to rescue from that discussion of the individual the fact that we are individuals in community. From my experience as a Methodist minister—we are surrounded by people with all kinds of disciplines and experience—all I can say is that being with people, those who are clustered around the person who is to die, continuously from the time the news of an impending death is broken until the funeral, and indeed beyond the funeral, has made me aware of all kinds of pressures, subtle and otherwise.

I was taken by the list of possible pressures given by the noble Baroness, Lady Finlay, and the indirect or unthought-of ones: the groan, the body language and so on. What is more, the noble Baroness, Lady Thornton, asked whether witnesses were brought who were themselves facing an imminent death. I have sat with people facing an imminent death again and again, and I have heard them spell out both their hopes and their fears about their legacy, about someone who is whispering in their ear and about how it will play out among their children, who have quite different views between them. It is all indirect; it is real and contextual. Autonomy is a difficult thing to conceive of, and all these other indirect things need to be thought of very carefully indeed.

How many times have I counselled families for whom there was a rogue element who has fled the family home—for doing something or other years ago that was considered to be very nasty—on whether they should be brought into the picture about this imminent death, or invited to the funeral or beyond the funeral? They say, “Did we do the right thing?”, “How can we live with our conscience?” or “You shouldn’t have pushed me to say what I said”—all those things are said all the time.

Finally—I promised a short speech—just 16 years ago, I was diagnosed with a serious bowel cancer. After having very low blood levels and a total lack of energy, I was immediately rushed into hospital for a serious piece of surgery. It was a large tumour, and I had to face all kinds of things myself. As it happens, the letter that spelled out the seriousness and urgency of the case arrived when my wife, bless her, was with her mother, who was dying up in the Midlands, so I received it on my own. I cannot tell noble Lords what range of things my mind ranged over as I coped with that news: “How shall I tell?”, “Who will want to know?”, “Can I keep it secret?”, “What will the options be for me if I have this serious surgery?”, “Will I have to wear a colostomy bag?”, “Will I have to have invasive and extensive chemotherapy?”, and so on. It was surgery in the end and, mercifully, when we had the tests done and I went back later, they traced not an element of cancer in the rest of my body—and here I am to bore your Lordships with a five-minute speech all these years later. This is simply to say that the indirect subtlety—the stuff beyond the stuff you can be categorical about or put on a statutory basis—is what really comes into play when you are talking about the end of a life.

John Donne, long before the Enlightenment, reminded us that no man is an island—

“send not to know

For whom the bell tolls,

It tolls for thee”.

We are all caught up in this together. Somebody in the Times picked up a remark I had made casually to describe me. It was that I am now a semicolon on his way to his full stop.

--- Later in debate ---

[Baroness Hayter of Kentish Town (Lab)]

I do not have to give way. I have been speaking for three minutes, and I have listened for some hours. I am sure the noble Lord can come back; it is Committee stage, so he can speak again.

People have talked personally. Both my parents died when I was a child. People know that one of them died tragically and very suddenly; the other did so in enormous pain at the end. As a child, I went through that, so I understand about bereavement and grief, and seeing someone die in great pain. We have all been through that, and some of us come to a different conclusion. We come to a conclusion that no matter how we define pressure or coercion—the discussions we are having—what we want is the ability to move forward and help those who want help to bring things forward a few days earlier. I do not know whether the noble Lord, Lord Deben, has been through probate when trying to sell a house, but for someone who is already dying and may be a month off, bringing it forward a month or a couple of weeks would not make that much difference. We are finding excuses.

I am sorry not to have given way, but I have listened for some hours, and it is only appropriate that someone who supports the Bill also gets the chance to speak today.

[Baroness Hollins (CB)]

Before the noble Baroness sits down, can I just ask which amendments she was speaking to, because this is Committee and not Second Reading? Every amendment that I have tabled is designed to make the Bill better and I feel quite concerned to be accused of time-wasting.

[Baroness Hayter of Kentish Town (Lab)]

I was talking to the debate on coercion, because there is no check on it for the existing way of ending one’s life early, which is to go to Dignitas. I was asking whether, if the Bill is changed in the way that, for example, the noble Lady, Lady Hollins, would like, she would then support it.