Terminally Ill Adults (End of Life) Bill

Anneliese Dodds Excerpts

Friday 16th May 2025 Commons Chamber

[Madam Deputy Speaker (Judith Cummins)]

I thank the hon. Gentleman for his point of order. We will cross that bridge when we come to it. We are currently asking Members to keep their contributions to 15 minutes and that, of course, will be reassessed very shortly—I can give him assurances about that.

[Anneliese Dodds (Oxford East) (Lab/Co-op)]

Madam Deputy Speaker, since I have been in the Chamber, I have received the truly awful news that three people died last night in a fire in Bicester, including two members of the Oxfordshire Fire and Rescue Service. The hon. Member for Bicester and Woodstock (Calum Miller) has had to leave the Chamber to liaise with those on the ground and we both want to take this opportunity, if we may, to convey our deep sorrow for and solidarity with the families of those who have died, and our fervent and heartfelt best wishes to the two firefighters who remain in a serious condition. We are grateful for their heroism and that of their colleagues when, as ever, they ran towards danger to serve us all. [Hon. Members: “Hear, hear.”]

I rise to speak in favour of new clause 16 and amendment 14, and I am very grateful for the opportunity to speak. When the Bill first came before the House, I was a Minister attending Cabinet and therefore unable to speak on the subject. I genuinely thank my hon. Friend the Member for Spen Valley (Kim Leadbeater) and every single Member who served for so many hours on the Bill Committee for this incredibly important Bill. I also thank the hundreds of my constituents who have contacted me with their views. I genuinely believe that every single one of them was motivated by compassion and a determination to reduce suffering, and in many cases their views were shaped by their experience of death and of suffering in life. I know that that is the case for many of us in the Chamber as well, so I hope that the same spirit of respect that we saw previously will continue throughout the passage of the Bill, whatever our views may be.

New clause 16(1)(a) would exclude from the scope of the Bill those who do not want to be a burden on others or on public services, and paragraph (b) would exclude those experiencing a mental disorder, including depression. On the former, we have discussed this morning whether it is appropriate to mention international analogies. They will, of course, be instrumentalised by those who have different views about this important subject. I have personally found survey evidence from the Oregon example of people expressing that they felt they were a burden to be highly compelling. I do not believe that it indicates that that was the primary reason why they sought assisted dying, but I believe that it is an important piece of evidence that we need to take into account.

I also believe that we need to look at situations where people who are potentially subject to coercion have been evaluated by professionals in our society, and where we might be concerned about the outcomes. I ask for Members’ understanding here.

[Tim Farron]

On the point that the right hon. Lady has just raised, the Oregon example suggests that in 2023, 47 people who opted for assisted dying gave as one of their primary motivations that they felt they were a burden to others. Is that not a great concern for everybody in the Chamber? Does it not undermine the argument about passing the Bill on the grounds of autonomy? That argument is not accurate, because the provisions affect the autonomy of people who will self-coerce.

[Anneliese Dodds]

I personally believe that it does. I have heard countless times the phrase, “I do not want to be a burden.” I know Members will come to different conclusions about whether it is sufficiently excluded by the Bill. I believe it needs to be on the face of the Bill, so that we can ensure that it is out of scope.

[Sir James Cleverly (Braintree) (Con)]

I tabled an amendment to ensure that the self-defined responsibility to go for assisted dying did not become a rationale. What is the right hon. Lady’s view on the impact of intersectionality on this issue? We know that, in practical terms, a number of people do not have full control over their lives. The Mother of the House, the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), made the point that people who are often pushed around by their families and their wider society—particularly women from ethnic minorities—will be at particular risk from the gentle advice or suggestions from authority figures to whom they will be overly deferential, which could lead them into a very dangerous position.

[Anneliese Dodds]

I agree with the right hon. Gentleman. I believe it is exactly those individuals who would be more likely to be subject to coercion by others, and I am afraid the evidence does indicate that. Sadly, we can see it in the experience of our courts, which have dealt with so-called mercy killings. I appreciate that many Members in this Chamber would not want that example to be used in the context of this discussion—of course, we are talking about something very different from those court cases. None the less, I believe it is instructive that in those cases, highly trained legal professionals have often described the actions, particularly those of former partners, as motivated by compassion, but when the circumstances have been investigated in detail, there has been substantial evidence of coercion and abuse. It is important that we consider that now.

[Kim Leadbeater]

Is my right hon. Friend reassured by the fact that the Bill creates a criminal offence of coercion and pressure, which does not exist at the moment? No one is checking for coercion when victims of domestic abuse or others take their own lives under desperate circumstances.

[Anneliese Dodds]

I am grateful to my hon. Friend for making that point. I believe the Bill has been substantially improved through the many amendments that she and others have tabled. I know that these issues were discussed in detail in Committee, but I have to be honest: sadly, the prospect of a prosecution has often not been sufficient to prevent abuse. I note that in the discussions in Committee, a number of medical professionals mentioned that they often have to assess whether coercion has taken place and that they are confident in that assessment, but there is a huge amount of contestation around whether that confidence is rightly placed or otherwise.

[Naz Shah (Bradford West) (Lab)]

Does my right hon. Friend share my concern that there will only be three hours for a panel, and that the first and second doctors might not actually know the patient or have met them? Their ability to spot coercion will be very limited.

[Anneliese Dodds]

Yes, I do share my hon. Friend’s concern in that regard. Sadly, we all know how perpetrators of coercion operate. They will often school the subject of their coercion in how to respond to questioning, to try to hide what they are doing from others. That is a concern.

[Dr Opher]

Does my right hon. Friend not see that, in Committee, we were very aware of coercion? That is one of the reasons why we have a social worker on the panel of experts. Additionally, clause 1(2)(b) says it will be necessary to establish that a person

“has made the decision that they wish to end their own life voluntarily and has not been coerced or pressured by any other person”.

It is very clear in the Bill.

[Anneliese Dodds]

I very much appreciate my hon. Friend’s efforts, and those of my hon. Friend the Member for Spen Valley, to ensure that these matters were covered in Committee. Sadly, because of the patterns of behaviour that we see time and again with those who have been subject to coercion, I do not believe that the safeguards go far enough. That is my assessment, and I know that other Members will come to a different view.

[Ellie Chowns]

Will the right hon. Lady give way?

[Anneliese Dodds]

I will make some progress, because I know others wish to speak.

I want to speak briefly about subsection (1)(b) of new clause 16, which relates to mental disorder. Colleagues will dispute whether analogies are appropriate, but it is important that the House is aware—this was covered in Committee—that in the Netherlands, which of course has a different regime from the one proposed in the Bill, two cases involving psychiatric suffering were subject to assisted dying in 2010; in 2023, that figure was 138. That is a very substantial increase. I understand that, as was said earlier, it is a completely different set of circumstances in the Dutch case, but I am concerned that there is some confusion about the scope of the mental capacity provisions in the Bill.

[Daisy Cooper]

I supported the Bill on Second Reading on condition that it would be strengthened to tackle the issue of capacity. Does the right hon. Lady accept that the Bill that we see today is very different from the one that we saw on Second Reading? There is a requirement for capacity. If there is any doubt at all, a doctor is compelled to report that person for additional assessment, and independent advocates have been introduced for people with learning disabilities, autism or mental disorders. Social workers are now included in the panel of experts, specific training on mental capacity is required, and there is a disability advisory board too. Does the right hon. Lady—

[Madam Deputy Speaker (Judith Cummins)]

Order.

[Anneliese Dodds]

I agree that the Bill has been improved, but there is a difference between mental capacity, at least as assessed by medical professionals, and the presence of mental disorder. I know the Committee examined that subject at length. It was very clear from the discussion in Committee that it anticipated that elements such as being able to assess information and make judgments between alternatives would be covered by the mental capacity provisions—but the evaluation of those alternatives, which can be impacted by mental disorder, is not part of that process. The reality is that those subject to a number of mental disorders—including, sadly, eating disorders—may be highly intelligent and may well be able to carry out many logical procedures to assess information, but their evaluation of the value of their future life and their assessment of the value of bodily control, in relation to other factors, are different from those of someone who is not ill. I believe that issue has not been fully understood.

[Naz Shah]

Will my right hon. Friend give way?

[Anneliese Dodds]

I will not give way at the moment.

That is why it is important that that exclusion is put very clearly on the face of the Bill.

[Dr Marie Tidball (Penistone and Stocksbridge) (Lab)]

Does my right hon. Friend agree that clause 2(3) makes it very clear that no one can qualify for assistance under the Bill by reason only of either disability or mental disorder unless they also have six months’ terminality and capacity?

[Anneliese Dodds]

I am aware of what my hon. Friend quite rightly refers to. Of course, any such condition would have to be coterminous with a terminal illness, but we know—the Committee thrashed this out for a long period—that depression is often present at the same time as a diagnosis of terminal illness. We also know that concepts such as “terminal anorexia” have started to be used in certain contexts. That unfortunately suggests that, despite the many protestations of those who understandably support the Bill, there is the possibility that those subject to eating disorders will be pulled within its scope. I am very pleased that amendment 14 would rule that out—it is important that it does so. It is critical that this Chamber sends that message too, given the potential confusion about scope.

I am very grateful for the opportunity to speak to new clause 16 and amendment 14. Above all, I hope we can continue this important discussion, which is critical for so many of our constituents.

[Madam Deputy Speaker (Judith Cummins)]

I call the Father of the House.