Terminally Ill Adults (End of Life) Bill

Debate between Lord Archbishop of Canterbury and Baroness Rafferty

Committee stage
Friday 24th April 2026 Lords Chamber

[Baroness Rafferty (Lab)]

My Lords, I speak for the first time in this debate as a nurse and former dean of the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care at King’s College London. Our patron saints include Florence Nightingale and Cicely Saunders. It would be hard to imagine two more rigorous and formidable expert witnesses to comment on the debates that we have been having these past few weeks. Both were deeply committed Christians, driven by the alleviation of human suffering and providing the practical means to do so through nursing and palliative care. Both were accomplished scientists, Nightingale being hugely influential in public health, epidemiology, statistics and social science, as Cicely Saunders was in physiology and the psychology of pain, coining the concept of total pain to convey the holistic sense of suffering.

But both had more speculative sides to their characters. In the case of Nightingale, it was a fascination with Thomas à Kempis, Teresa of Ávila and the medieval mystics. She committed some of her thoughts to paper, consulting Benjamin Jowett, regius professor of Greek and theology at Balliol College, Oxford, who became her spiritual confessor. Cicely Saunders’s library reveals a similar quest to understand Christian ethics and the existential nature of the human condition. Both were deeply interested in, as well as troubled and possibly tormented by, the challenge of squaring the existence of a benign God with the dark side of the soul and human suffering. Perhaps the ultimate question in their minds was an eschatological one. How will it all end? How will life end and what will death be like?

In a sense, that is what we have been wrestling with over the past months, struggling to reconcile very different perspectives on how it will end for ourselves, loved ones, patients and relatives. Some of us believe in enabling people to exercise autonomy over the end of life and the nature of their deaths—to have agency over the end. We have heard testimony from people who have chosen this path, as well as from relatives and loved ones. They have spoken powerfully of the sense of freedom and relief it has provided and the physical, emotional and spiritual sense of peace for all concerned.

There are those who do not agree that this should be possible. Such views are profoundly personal. I happen to have witnessed some very difficult deaths of patients and close family members. That has convinced me that assisted dying is a positive step in easing people through to a good ending. Denying that option to people who would like to avail themselves of it, when we can offer it and international evidence demonstrates that it is safe to do so, seems not only cruel but unethical. When seen in the context of a Bill that has passed in the elected Chamber and is supported by public opinion, it seems like a dereliction of duty. It is not our job to defy or block the democratic process. I implore noble Lords: it is time to dissolve our differences and do the right thing by finding a way to pass this Bill.

[The Archbishop of Canterbury]

My Lords, I shall briefly make some reflections. It is a great privilege to follow my friend, the noble Baroness, Lady Rafferty; I thank her for her contribution. I recognise the enormous amount of work that has gone into this Committee stage. I am grateful to the noble and learned Lord, Lord Falconer, for meeting me; I thank him for the time that he has given me.

Noble Lords will know that I oppose the Bill in principle, both as a priest and as a nurse, but it is clear that some things unify us. Whether we support the Bill or oppose it, we are unified by the fact that we want people to die in a dignified, pain-free and compassionate way, with the least possible fear. I also believe that we are unified in the belief that there needs to be investment in palliative care now. I welcome the new modern framework for palliative care that the Government have introduced, but recognise that financial investment still needs to occur.

We are also unified around the fact that if this Bill or topic comes back in some form, we need to do our work differently. There is no doubt in my mind that this is one of the biggest societal shifts that we are seeing or will see. Therefore, we need to take our role seriously, as we have done. There is something about our learning for this process and looking forward to how we do it differently when it comes back. I was very taken by the view of the noble and learned Baroness, Lady Butler-Sloss, of pre-legislative scrutiny, although I do not know the details. We should look seriously at that.

We are also united in knowing that this touches some of our deepest emotions. I am grateful to those who have shared their own experiences and stories; I have felt very humbled listening to them. For me, as a Christian, this is clearly an eschatological question, as my friend, the noble Baroness, Lady Rafferty, said. Of course, for me, as a Christian, death is not the end. There is hope in death and life everlasting. As we talk about these things that touch us deeply, we need to look after each other and ourselves and recognise that this process will have impacted us, as well as those listening.