Terminally Ill Adults (End of Life) Bill

Lord Moylan Excerpts

Friday 13th March 2026 Lords Chamber

[Lord Moore of Etchingham (Non-Afl)]

I am perhaps imagining the noble Baroness, Lady Fox, as a quivering wreck. If that is how she feels, you can imagine what it is like for most of us when we face our doctors, so the point was made very strongly.

There are so many good amendments here and I cannot possibly refer to all of them, but I want to drive home, by force of comparison, a point that arises from two things that were said—one by the noble Lord, Lord Rook, and one by the noble Baroness, Lady Hollins, who is no longer in her place. The noble Lord, Lord Rook, said that there is no duty under the Bill to raise assisted dying, which is obviously true. It is very important to pursue what that implies.

The noble Baroness, Lady Hollins, said that by raising assisted dying a doctor is not performing a neutral act, so the question we have to ask is what is going on when a doctor proposes assisted dying. I am saying that if it is not a neutral act it is an ideological act, and that is not something appropriate for a professional.

I shall draw a comparison that will illustrate that point. The Government keep promising to introduce a Bill to ban conversion therapy—and I think that they will do so. The objection to conversion therapy is that it is a form of coercion of the weak and of exploitation, forcing an ideology on people that is considered to be wrong and exploiting their feeling of weakness. That is the danger we face here. Many noble Lords will object, of course—and they will be right—that conversion therapists are quacks whereas doctors are real doctors. In my view, that makes it even more important that the doctors stick to their professional obligations and do not start advocating things they happen to believe are right. If we think about it that way, we will see just how important these amendments are.

[Lord Moylan (Con)]

My Lords, I rise to speak to a couple of amendments that I have in this group. I start by responding to what the noble Lord, Lord Moore of Etchingham, has just said. I think that he misconceives his opponents—indeed, if I may say so, our opponents. They do not regard the offer of assisted suicide as an ideological act but simply as the offer of a different medical treatment, and this is one of the great divides between us. There are those of us who will not accept that offering to kill somebody or assist them in killing themselves can constitute a medical treatment. I say that purely as a preliminary and without relevance to what I am coming to, which is Amendment 166, which I shall speak to briefly.

This is a minor and technical amendment. It arises from the fact that the Bill, because it has this elaborate bureaucratic process, creates lots of decision points; if you made a decision map, it would be very complicated as you passed down through it. There is one here in Clause 5 that needs correcting or improving. It says in subsection (3):

“Where a person in England or Wales indicates to a registered medical practitioner their wish to seek assistance to end their own life in accordance with this Act, the registered medical practitioner may (but is not required to) conduct a preliminary discussion”.


Now a “preliminary discussion” is a technical term in the Bill. It is a key that opens up the path to assisted suicide—it is not just any old discussion that happens to come early, but a technical term. The registered medical practitioner may at that point have the preliminary discussion, but they do not have to; but subsection (6) makes clear what they do have to do, which is to refer somebody to a place where they can get information about how they can have a preliminary discussion.

My point is that the person making the inquiry about assisted suicide does not actually have to be ill. They might be asking—and quite wrongly asking—about ending their life, without coming within the scope of the Bill at all. I suggest that to avoid the poor doctor being driven off on these two impossible and irrelevant courses, we add to subsection (3), after the words “in England or Wales”,

“who has been diagnosed with a terminal illness”.

I should have thought that the noble and learned Lord would be willing to add that in the interests of clarity, to try to straighten out some of the complexities that the Bill, through its complications, has created.

Amendment 152 would do something that many other amendments in this group seek to do: it would prohibit a doctor or another health professional from initiating a discussion about assisted suicide. So many speeches have been made already about why this is a valuable thing to do that I am not going to attempt to repeat them. Indeed, even the story about my late father that I was going to tell noble Lords has been trumped by the very moving stories from my noble friend Lord Evans of Rainow about his mother and grandmother. Everything that I wanted to say has been said.

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[Baroness Hayman (CB)]

I am grateful to the noble Lord. I was trying particularly to get to the point of the doctor’s role. I understand what he says, and he is quite right. I was trying to advocate that doctors should be able to have conversations with their patients about care, not just medical treatment—which is the phrase he was using before—to look holistically at what that dying person wants and needs, and be able to respond to their desire not to have any more pain, drugs or treatment. The doctor should be able to talk freely about all those options. In my view of the world, that would include assisted dying, but there is a spectrum.

[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.

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[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?

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[Baroness Blake of Leeds (Lab)]

My Lords, I thank all noble Lords who have contributed to this very important debate. As usual, I will limit my comments to amendments on which the Government have major legal, technical or operational workability concerns.

To begin, key concepts in Amendment 149, moved by the noble Baroness, Lady Grey-Thompson, are unclear. It will therefore be difficult to assess whether the duties have been discharged. For example, it is not clear who must co-ordinate and undertake the suggested multiagency assessment of support needs and who is responsible for ensuring that those needs are fully funded, so it may be impossible to demonstrate that these criteria have been met.

Amendment 152, tabled by the noble Lord, Lord Moylan, seeks to prohibit registered medical practitioners or any other health professionals from raising the subject of provision of assistance under the Bill. If passed, this would be inconsistent with the discretion currently afforded to the registered medical practitioner in Clause 5(2), which makes it clear that a registered medical practitioner may exercise

“their professional judgement to decide if, and when, it is appropriate to discuss the matter”.

This amendment would therefore create conflicting duties and may lead to confusion about whether a registered medical practitioner can raise the issue of assisted dying.

[Lord Moylan (Con)]

Briefly, as it is of no interest to other Members of the Committee, but it is surprising that, with all the legal advice offered to her, the noble Baroness has not noticed that there is a consequential amendment in my name in the same group—which I referred to—which deletes subsection (2), since I too have spotted that there is an inconsistency and I have dealt with it.

[Baroness Blake of Leeds (Lab)]

I thank the noble Lord for his comments. It is still worth raising these matters in this context to avoid any confusion.

Amendment 162, tabled by the noble Lord, Lord Shinkwin, would mean that a registered medical practitioner could not raise assisted dying with any person with a learning disability, including people with Down syndrome, unless they raise the subject themselves. This restriction would apply to all persons with a learning disability, including where the person has the capacity to make a decision to end their own life.

The purpose of Amendments 205, 207 and 207A, tabled by the noble Baronesses, Lady Monckton and Lady Grey-Thompson, appears to be to prevent a healthcare professional raising the subject of the provision of assistance with a person who has a learning disability or autism, unless that person has a family member, independent person or guardian present. Under Amendment 207A, both a family member and an independent person would need to be present. These amendments do not draw any distinction between varying levels of individual need. As drafted, a registered medical practitioner would be required to establish in all cases that the person does not have autism or a learning disability before raising the subject of an assisted death, unless a family member or independent person is present.

Amendment 200C, tabled by the noble Baroness, Lady Berridge, would mean that no person could raise the provision of assistance with those under the age of 18, whether online or otherwise. Amendment 209, tabled by my noble friend Lady Goudie, prohibits any adult with a duty of care or responsibility for a person under 18, including but not limited to guardians, social workers, educators or carers, from raising the subject of assisted dying “with such a person”. These amendments would be extremely difficult to enforce, due to their breadth and ambiguity. They may, for example, prohibit parents or guardians from discussing the broad issue of assisted dying with their children.

Finally, I bring to noble Lords’ attention that amendments discussed here, including Amendments 149, 162, 200C, 205, 207, 207A and 209, could give rise to legal challenge on ECHR grounds, in particular challenges brought under Articles 8, 10 and 14. These amendments would require reasonable and objective justification to comply with ECHR obligations.

I make no comment on the other amendments in this group. However, as noble Lords will be aware, the amendments have not had technical drafting support from officials. Therefore, further revision and corresponding amendments may be needed to provide consistent and coherent terminology throughout the Bill.