Terminally Ill Adults (End of Life) Bill

Lord McCrea of Magherafelt and Cookstown Excerpts

Friday 13th March 2026 Lords Chamber

[Lord Moylan (Con)]

My Lords, if I may briefly answer that, I am saying that we have 3,000 years of a moral framework in which it is morally abhorrent. I am not here primarily to protect the sensitivities and feelings of doctors. I am saying what a violent novelty this is that we are embarking upon if we go down this route.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, there are a number of key objectives outlined in the amendments that we have been discussing for some time now, which are worthy of our most serious consideration. I suppose that the burden of the amendment is that doctors should be prohibited from initiating discussions about assisted dying because, if they were permitted to do so, it would fundamentally undermine the long-established patient-doctor contract and could expose vulnerable patients to undue pressure or influence at a time when they are fragile—at a fragile moment in their lives.

The raising of the issue of assisted dying surely must be strictly initiated by a patient and any discussion of the issue must be embedded in a manner that prioritises palliative or other support care over death. If doctors were permitted to initiate the issue of assisted dying, patients could rightly interpret this as an implicit recommendation on behalf of the medical profession and it could be seen as a choice influenced by authority, or even fear, and not a free choice. It must be acknowledged that, within society, doctors have an exceptional moral and social authority. A person who feels vulnerable, marginalised or devalued can easily be susceptible to pressure and influence if the recommendation or initiation of the issue of assisted dying comes from their doctor.

The moment of diagnosis of a terminal or life-limiting illness is an earth-shattering moment for most people within society. As a minister of religion for over 50 years, I have been with thousands of such people, who, when they have received the diagnosis that they have a terminal illness, feel shattered and absolutely broken. I can tell noble Lords that that leads to a multiplicity of emotions. I have also had many loved ones and friends who have faced that moment. The immediate shock of hearing those words can turn into depression and, even for a period, it can turn into suicidal thoughts and a feeling of “It’s all over anyhow; therefore, let me get out”.

However, we all know from personal experience—or many of us certainly know—that these thoughts at that earth-shattering moment can dissolve over time, whenever people are surrounded with love, aided by a loving conversation or their personal faith, or supported within the family or the community context. Indeed, the initial devastation I have seen turns dramatically into a quiet confidence: into a determination to fight for life and to live a fulfilling life, even though the person is in the midst of adversity. That is something to be cherished and praised. At the moment of despair, when a terminal diagnosis is given, how improper it would be for any doctor to raise or to suggest assisted dying as a more sympathetic way out of their pain or a free exit from life.

Sadly, the personal and deep doctor-patient relationship is no longer the reality that it used to be, and in multi-doctor practices, you may never see the same doctor again for months or even years. They do not really know you as they used to know you. To pretend that somehow it is the old way is not reality—it is living in a different world. Therefore, often no personal knowledge of that patient is held by a particular doctor. Any deep understanding of their mental health, their family life context, or societal or financial pressures that that person may be experiencing is negligible, yet it is the moment of crisis in a life.

During previous debates, some noble Lords and Baronesses have been rebuked for using the term “assisted suicide” instead of “assisted dying”. But does “assisted dying” terminology not mask the reality of what we are discussing? Normalising discussions about ending life before the natural-appointed, or God-appointed, time surely risks reframing suicide as a legitimate medical response to pain or distress, which is outside the scope of the Bill—at least, that is what we are told.

Allowing but not requiring doctors to raise assisted dying with their patient gives me no comfort, as I feel that it would lead to medical professionals being open to criticism or challenge. It will no doubt lead to inconsistency among professionals. Will patients seek to move from one general practice to another because the doctor they are moving to supports them in assisted dying? Will they have to move because their GP has a sincerely held conviction about the sanctity of life and will not participate in the practice of assisting a person to die?

A doctor permitted to discuss assisted dying with a patient surely cannot be just any registered medical practitioner. For clarification, I ask the noble and learned Lord, Lord Falconer, to confirm that the provision in Clause 5 is not limited to the patient’s GP, and that treating consultants, specialists or doctors who have a minimal relationship with the patient or none are not restricted from giving this advice. Can he also confirm that there are no restrictions on the setting in which a doctor might give this advice—a hospital ward, an out-patient clinic or elsewhere?

--- Later in debate ---

[Lord in Waiting/Government Whip (Lord Leong) (Lab)]

Order.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

I am finishing with this quotation, and it is just a couple of sentences:

“We also know that when you acquire disability, which most people do … it is absolutely frightening … If doctors are not on our side because they are thinking, ‘Should we mention the fact that they could have an assisted death?’, that poses a big cultural issue for the NHS, but also for us having confidence in the NHS”.

[Baroness Stedman-Scott (Con)]

My Lords, I will speak to the probing Amendment 161 in my name. It asks the simple but profoundly important question of whether registered medical practitioners should be granted a blanket legal protection to raise the possibility of ending any person’s life or whether that protection should be carefully and responsibly limited to patients already in their care.

At the heart of this debate lies the issue of safety and trust. The relationship between a patient and their doctor is not a casual exchange. I hope it is a deeply personal, often vulnerable, bond built on confidence, continuity and professional responsibility. When someone receives a terminal diagnosis, they are not merely confronting medical facts; they are confronting fear, uncertainty and the fragility of their remaining time. In that moment, words matter immensely. To grant blanket legal protection to any registered medical practitioner, regardless of whether they have an established clinical relationship with the individual, risks undermining that trust. It risks introducing the possibility that a suggestion about ending life could come from a professional who does not know the patient’s history, values, mental state, family circumstances or vulnerabilities.

Amendment 161 does not seek to obstruct lawful medical practice or to deny terminally ill adults the autonomy that the Bill intends to provide. Rather, it seeks to ensure that conversations about assisted dying occur in the right context, within a relationship in which the doctor knows the patient, understands their condition and is responsible for their ongoing care.

We must consider the subtle power imbalance inherent in clinical settings. A doctor’s words carry authority. Look at the effect they have on the noble Baroness, Lady Fox, at times. For a patient who is elderly, disabled, isolated or feeling like a burden, even a carefully phrased suggestion can carry unintended weight. If such a conversation is initiated by a practitioner with no established duty of care, we risk normalising a culture in which ending life becomes a broadly available option rather than a carefully safeguarded patient-led request.

Limiting legal protection to practitioners involved in a patient’s care and case strengthens safeguards. It ensures that any discussion arises from clinical knowledge, not abstract eligibility; it reinforces accountability; it reduces the risk of inappropriate suggestion; and it protects vulnerable people feeling steered towards a decision at a moment of profound weakness.

Autonomy is meaningful only when it is protected from subtle coercion, even unintentional coercion. By supporting Amendment 161, we are not diminishing choice: we are strengthening the ethical framework in which that choice is exercised. In matters of life and death, precision, boundaries and safeguards matter. Amendment 161 offers a proportionate, reasonable and ethically sound safeguard. It preserves trust in the medical profession, protects vulnerable patients and ensures that, if such conversations occur, they do so within the context of established clinical responsibility. For those reasons, I urge the Committee seriously to consider the intent and spirit behind Amendment 161.