Terminally Ill Adults (End of Life) Bill

Baroness Murphy Excerpts

Friday 13th March 2026 Lords Chamber

[Baroness Cass (CB)]

To clarify, whether we take the system proposed by my noble friend or the original system with the series of doctors, it is very unlikely under any circumstance that the clinician who is providing primary care for the patient will also be in one of those formal roles specified by the Bill. The reason is that, as we have discussed, people will need to opt in to that kind of role and have very specific training for it. Given the number of people who are predicted to be required to grant an assisted death, that will be quite a small cadre of clinicians. Therefore, although I understand the aspiration of the sponsor in the other place, and certain Members here, for there to be close integration between the team providing normal care and those involved in the dying process, in practice I do not see how that would be feasible in either system.

[Baroness Murphy (CB)]

My Lords, I oppose the view of the noble Baroness, Lady Finlay, that we should have a completely separate service. That would target and isolate people who are dying. They will wish to be supported by the people who they have known through the course of their illness, so it is crucial that they be seen and examined by those people and not moved to another place. Yes, there will perhaps be separate people who take on this role, and they should be properly qualified and discuss it with the panel, but it is utterly crucial that, when patients are in the process of dying, we do not separate and reject their carers, who should be part of the palliative care provided to them.

In other countries, assisted dying usually happens as part of a palliative care service. That is how it is done, very successfully, in Oregon and Washington. We should not separate carers who are there to support patients during this process. These little nitpicking changes to the Bill will just make it worse.

[Lord Deben (Con)]

My Lords, I was not going to speak on this, but the last speaker has led me to do so. To describe the care with which this proposal has been put forward as “nitpicking” is frankly unacceptable. The noble Baroness should not have said that. The reason why this has been brought forward is that many of us feel that we should take seriously the pressures on the people who will have to carry out these arrangements, all of whom, either in principle or because of the nature of the Bill, have objections to the Bill, so one tries to find answers.

One of my sadnesses is that the sponsor of the Bill has so far not met the questions put forward by the Royal Colleges or—I say this to the noble Baroness—the committees of this House, which have suggested that the fact that this Bill is so unclear on so many things makes it unacceptable legislation, and that we need to be much more precise and much less vague.

[Baroness Murphy (CB)]

The fact of the matter is that many of the things we are discussing would, in normal medical and social legislation, be contained in codes of practice. They will certainly need to be worked up in great detail for some of these issues to be covered, but it is not necessary to put them in primary legislation. For example, the carting of medication around between a pharmacy and a doctor is in a code of practice that is quite straightforward. I agree that that needs to be done in detail so that it can be monitored and practitioners who are implementing the legislation can do it with confidence. There is no good in putting it in primary legislation that will inevitably change when processes and habits change.

[Lord Deben (Con)]

That may well be the view of the noble Baroness, but it is not the view of the Royal Colleges, and it is not the view of the Select Committees of this House that have looked at this. It is perfectly reasonable for me to suggest that there is an alternative, and I am suggesting an alternative to the noble Baroness. I am still sorry that she should think the word “nitpicking” a suitable phrase to describe people who have spent their lives working on these issues and are trying to find answers to the problems that have clearly been raised by this Bill. Most of us who have views on this subject have been extremely careful in the language that we have used. We have respected the views of those with whom we fundamentally disagree, and we have done so with great care.

I will explain why I think we should consider these amendments very carefully. I am not expert enough to say that this or that bit is the right answer to this, but this is precisely the kind of information that ought to be in the Bill, but which is not. These are the answers that most people who are expert in this matter, and have given evidence to the various Select Committees, have asked for. This should not have been needed as an amendment; it should have been presented by the noble and learned Lord and those who are putting forward this Bill, because we need to know this before we vote on it, not afterwards. That is the problem that the noble Baroness is avoiding. We are being asked to pass a Bill and leave so much to things that will be done in a way we have absolutely no knowledge of.

There is a second reason why it is important to take very seriously these amendments: the relationship between patient and doctor. My one expertise is from having spent nearly 40 years as a Member of Parliament, representing a constituency. It is all very well for those who are perhaps removed from the generality of the population, but one thing you learn in your weekly surgery, and from going around your constituency, is the degree of fear that people have of doctors and hospitals. Anyone who is concerned about this from a pastoral point of view—here is a non-religious element for bishops and ministers of all sorts—knows very well that this is a fundamental fact that you find everywhere. One problem, even for those who are in favour of the principle of the Bill, is that it increases that fear among many people. Therefore, it is hugely important to ensure that there is a service that is clearly separate from and unconnected in any way—except that necessary connection to which the noble Baroness pointed—with the care that has taken place.

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I thank the noble Baroness for what she said, because she revealed what we have always feared: that this would become a cheap alternative to looking after people—

[Baroness Murphy (CB)]

My Lords—

[Lord Deben (Con)]

I will give way in a moment but I wish to finish my sentence—and to being a society that cares for people right to the end of their lives. I know what sort of society I want to live in: one that looks after the most vulnerable at their most vulnerable time. If they are to be given that alternative, it is clearly unconnected with the fundamental moral duty of a society: to look after those who cannot look after themselves.

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[Baroness Lawlor (Con)]

My Lords, I will add a word to follow my noble friend Lord Goodman’s Amendment 151, in proposing my Amendment 153A. This goes further to stipulate that a medical practitioner may not raise the subject with the patient

“unless the person has raised it first during an in-person appointment requested specifically for that purpose”.

We have spoken today about the position of trust that the doctor enjoys. He or she is trusted by the patient and by our society, and is paid for by the taxpayer who trusts him or her. That trust is breached if the position is used not for the treatment of a patient’s symptoms, to help manage them or to benefit the patient, but to suggest that the patient should instead consider killing themselves.

A doctor who is trusted to find the best medical treatment for, say, pneumonia, blood pressure or heart disease becomes an agent who leads to the medicalised death for the patient with a poison that is self-administered, as if it were just an ordinary curative medicine. Moreover, as the Bill stands, the requirement to discuss possible side-effects and complications, which we know happens in other jurisdictions, is not there. Perhaps we might also consider why doctors are in this position of trust. It is because they have special knowledge, not only of medicine and its treatment, but of access to medications. They are especially trusted when the patient is very ill, very frail or terminally ill and perhaps already feeling a burden to those who are looking after them. If we permit the doctor to raise the subject of assisted dying to those who are so suffering, we leave the door wide open to the abuse of power. It need not be deliberate abuse. The doctor may only be raising a possibility—

[Baroness Murphy (CB)]

Is the noble Baroness, Lady Lawlor, aware that, of all the countries in Europe, it is the Netherlands where doctors are most trusted? We should consider what their legislation is and how close, often, the relationship is between the doctor and the patient who is in receipt of assisted death. I am not advocating their legislation, but I note that, of all the countries that have assisted dying, the doctors are most trusted in the Netherlands.

[Baroness Lawlor (Con)]

I thank the noble Baroness for that, but I point out that the Netherlands has many significant problems to do with various aspects of its legalisation of certain medical actions and operations. I will not go into them, but other countries are suffering from a fallout of what is happening, especially those on a rail service from Amsterdam.

If we leave the door wide open, it can happen. A doctor may only be raising the possibility, but a patient may be more swayed by a doctor’s opinion than their own. Indeed, where no pressure is intended, the pressure may be there none the less. The position of trust can therefore survive only if the doctor recognises that their normal role is limited to supporting the health of the living, helping the patient to live life as fully as possible by managing an illness or its symptoms or coping through the ups and downs of treatment. Participating in assisting suicide, for those doctors who agree to do so, is an extraordinary non-doctorly role that they should enter into only at the self-initiated request of the patient.

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[Lord Moylan (Con)]

There is, indeed, a spectrum, and the doctor should be able to speak. As I say, there have been 3,000 years of thought given to this. What has resulted from that is a firm conviction that, while some medications that do you good may also do harm—and the doctor has to make careful judgments about that—the active killing of a patient, the actual administration of substances with a view solely to bringing about death, is morally abhorrent.

It may not be morally abhorrent to the noble Baroness, but she has to understand the novelty of this and the violence that she is doing to our inherited moral framework when she—

[Baroness Murphy (CB)]

My Lords—

[Lord Moylan (Con)]

Let me finish. The noble Baroness puts that forward and says that, to her, it is simply one option. It is not one option; it crosses a line.

[Baroness Murphy (CB)]

My Lords, “morally abhorrent” is quite distressing. I am a doctor; I have been a doctor for 50 years and have worked with dying people quite regularly in hospital, particularly in general hospitals. I find the notion that doctors all find this abhorrent is utterly wrong. We know that at least half support the principles of the Bill and can recognise that it is something that they would like to support. I am not talking about the medical royal colleges; they take one line—in fact, most of them are neutral about the principle. The reality is not as the noble Lord, Lord Moylan, describes. Certainly, I do not feel the way he does. I find it very offensive when somebody says that it is morally abhorrent. It is not morally abhorrent to help people when they are desperately suffering and to respond during a conversation to what they are talking about and what they are asking for.