Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

This is a really important group of amendments. We need a lot of honesty about what we are trying to do here. I appear to be quoting the noble Lord, Lord Harper, quite a lot today—that is not a scenario I thought would possibly ever happen—but I join him in very much welcoming my noble friend Lady Campbell back to the Chamber today. Her expertise in the Bill is paramount. I would not dream to count how many disabled people are in this Chamber, but there are two wheelchair users. I am very much looking forward to the contribution she will make on the Bill.

[Baroness Campbell of Surbiton (CB)]

My Lords, I hope the noble and learned Lord, Lord Falconer, will forgive me for intervening at this stage. I know we are all in a hurry, and I have not got my name on any of the amendments—yet. Noble Lords will know that I have been away for over six months because of an accident on the high seas, when I found myself hurled across the room by a wave. I broke my leg, I dislocated my shoulder, and I had all sorts of internal injuries. I spent the next six weeks in St Thomas’ Hospital, instead of here talking about the Bill. I do not know quite where I would have rather been, but I am here now. I hope noble Lords will forgive my late interventions having not been at Second Reading, but I am jolly pleased to be back, and thank noble Lords for their welcome, which has been very nice.

I want to say something very briefly about burden and motivation. We all know that burden is one of the primary reasons for people to seek an assisted death. That is not only in the conversations I have had here, but we know it is the primary reason throughout the world. Burden is real. It is why, in another life, I set up the organisation the National Centre for Independent Living, because I realised there were hundreds of disabled people living in institutions or in their mum and dad’s back room, basically just surviving, not living.

I also campaigned for a law called the direct payments Act, with which the noble Lord, Lord Harper, will be very familiar. That allowed severely disabled people to employ their own personal assistants, so that they would no longer be a burden on their families. No one wants to rely on their families or their spouses. I certainly do not want to have to rely on my husband to get me up in the morning or to put me to bed at night. I am his wife: he is not my carer; he is my husband. And that is a good relationship.

There is an answer to burden, and it is good social care support. Good infrastructure or technology allows you to be independent and not to be a burden on others, but to begin to plot your life as you want it to be. I know this because I have helped hundreds of disabled people to do it. Some of them had progressive conditions and would not live for long, but the lives they had for those years were good lives—good months and good weeks.

I am not saying that it is always the answer, but we surely must find out from anybody who is asking for their life to be ended, “What are your reasons? Is it because you do not have adequate social care? Is it because you cannot get out of your house, because nobody from the local authority has come to build you a ramp?” For disabled people, people with terminal illnesses and people with progressive conditions, these small things can make the difference between them wanting to die and them not wanting to die.

I know this, because they have told me. Many disabled people come up to me and say, “Jane, you know, I love my independent living and I love my direct payments. If that was taken away and I was forced to go into an institution against my will, I do not know what I would do. I would probably ask for an assisted death”. They were not joking. It is the truth. We should all think about motivation and that is why I support this suite of amendments. We have not really grasped that nettle.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I too warmly welcome the return of my noble friend Lady Campbell—the most extraordinary person and advocate for disabled people and so many more in our societies. I just remind the Committee that, in all these discussions about burdens and people who have had a stroke— I am terribly sorry that the husband of the noble Baroness, Lady Grey-Thompson, had a stroke—we are talking about six months for somebody who has been diagnosed with a terminal illness. We should reflect on and remember that in all our deliberations on the Bill.

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

My Lords, the noble Baroness, Lady Campbell of Surbiton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, before I speak to the amendments in this group, I say that I too have not received the letter sent by the noble and learned Lord, Lord Falconer, regarding amendments he proposes to return with, so I am somewhat in the dark today, should the content relate to remarks I am about to make now. Please would he check the distribution list, as such information is crucial to our deliberations, especially when one relies so heavily on remote participation for inclusion, as I do?

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 13th March 2026 Lords Chamber

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I have added my name to Amendment 149 in the name of my noble friend Lady Grey-Thompson. I also support the principle underpinning Amendments 150, 151 and 154, all of which aim to prevent a medical practitioner initiating discussions on assisted dying under Clause 5 of the Bill.

Like the noble Lord, Lord Shinkwin, I thoroughly agree that doctors must not be permitted to initiate conversations about assisted dying to patients. Let me tell your Lordships why. Doing so would breach their fundamental duty of care to their patients at the very point when the patient may well be at their most fragile—newly diagnosed and frightened about what the future holds. It would not be a neutral clinical act but an intervention laden with power, meaning and consequence. The very suggestion of assisted death from a doctor at such times risks being heard not as an option but as a judgment.

Not long ago, during the scariest time of the Covid-19 pandemic, disabled people were contacted by their GPs to ask them to allow permission for DNR notices to be placed on their medical records should they be hospitalised after contracting the virus. Disabled people were horrified; many contacted me and other parliamentarians to know why they were being treated differently from non-disabled people. They said that it felt as though catching Covid would be a death sentence. Thankfully, the Secretary of State for Health rectified the issue, reminding doctors that their actions were in contravention of the Equality Act and the Human Rights Act, but the damage was already done. Disabled people who relied on their doctors for their health and well-being felt betrayed and unworthy of life-saving treatment.

If a medical practitioner raises the possibility of an assisted death, the patient’s feeling of security and trust will be damaged in the same way as during the pandemic. Your Lordships have often heard me say that I count my blessings every day because my doctors support and celebrate my life, however ill I become. I feel secure knowing that they will do their absolute best, however grim my prognosis may be. Reliance on that assurance is critical to the well-being of patients, especially those with long-term disabilities.

If assisted dying is to become an option, it must be one that is strictly patient-initiated, tightly defined and clearly demarcated from ordinary clinical care. It must sit within a system that prioritises palliative care, practical support and the affirmation of life; otherwise, it will be seen as the simplest and most straightforward option for the patient, their family and friends, the NHS and society as a whole.

The doctor-patient relationship is inherently unequal, and never more so than after a terminal or life-limiting diagnosis. When a doctor introduces the possibility of assisted dying, however delicately phrased, it carries weight. For many patients, particularly those who already feel themselves to be burdensome, costly or devalued, the message risks being internalised as a subtle signal that their lives are no longer worth living.

We must also confront the reality of acute vulnerability. A diagnosis of serious illness often brings shock, despair and temporary suicidal thoughts—feelings that, with time, treatment and compassionate support, frequently pass. This is why I support my noble friend Lady Grey-Thompson in her Amendment 149, which seeks to address this. Depression, unmanaged pain, fear and loneliness are not unusual bedfellows for people with a terminal diagnosis. Medical practitioners are not specialists in disentangling these states.

If we are serious about safeguarding autonomy, our first duty is to ensure that people are offered care, hope and practical support, not an expedited exit at a time when they feel most afraid. I therefore hope the noble and learned Lord will recognise this and come back with his own amendments on Report, to ensure that the subject of assisted dying is raised only by the patient and never by a medical practitioner. I would be very pleased to meet him between now and Report to explain further why this is so essential for the legislation to be safe in practice.

[Baroness Blackstone (Lab)]

It is with some trepidation that I speak, since I realise how passionately the previous speakers think about what they have said. The first small point I want to make is that the noble Baroness, Lady Campbell, referred to Report—we are not going to have a Report stage, because we have taken so long in dealing with all the many, many amendments that have been tabled.

Leaving that on one side, we have to realise that doctors’ main objective is to try to alleviate suffering. This is what those of us backing the Bill believe it does: it will alleviate suffering—sometimes terrible suffering—and torment by allowing people to choose the time of their death when they are already dying. We must not forget this. If we accept that this is the role of doctors, that this is what they try to do in their professional work, we must allow them to discuss at an appropriate point, in their judgment, all the possible options that are available to the dying person. If the Bill were enacted, one of the options would be an assisted death if they had reached that point. So to say that a doctor in a close relationship with his or her patient would be unable to raise this as a possible option would be entirely wrong.

I advise everybody, if they have not done so already, to look at what the BMA says about this. It has specifically briefed against prohibiting doctors from initiating discussion about assisted dying under the Bill, warning that it will be detrimental to patient care. I accept this piece of advice from the BMA. It is a view that many doctors, and some in this Chamber, too, would actually adhere to and agree with.

I very much hope that this group of amendments will not be accepted. It does not mean that at the end the patient is not the one who makes the decision about whether to request an assisted death—of course he or she does. But it just becomes one of the options that is available to them, and that is an option I believe we should allow them to be aware of.

Terminally Ill Adults (End of Life) Bill

Baroness Campbell of Surbiton Excerpts

Committee stage
Friday 27th March 2026 Lords Chamber

Those of us who were following the debate in the Scottish Parliament last week will know that one of the reasons MSPs changed their minds was exactly the lack of clarity of the protections for conscientious objectors. Their ability to refuse to participate in assisted dying was not clear and that Bill has now fallen. Can the noble and learned Lord confirm his response to the royal colleges’ call for an opt-in system to be adopted, and how can he guarantee that no one will face legal or professional repercussions, including indirect ones, for refusing to participate in assisted dying? I beg to move.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I have added my name to my noble friend Lady Finlay’s Amendment 190, and support Amendments 268, 359, 383, 617 and 657 in this group. This basket of amendments, as the noble Baroness, Lady Fraser, has said, seeks to ensure that no doctor or associated healthcare professional is under any pressure to participate in the process of assisted dying unless actively opting in to the process.

Amendment 190 provides an important safeguard against pressure on doctors by making it clear that the obligation to refer a patient to relevant information and another doctor applies only when the patient has specifically requested a preliminary discussion on assisted dying. It also ensures that doctors who do not wish to be involved are not required to take part beyond that point.

Last summer, I spent six weeks in St Thomas’ critical care after an accident at sea in the Bay of Biscay. I came home broken, bruised and in terrible pain, but my salvation was the compassionate, dedicated team of health professionals whose combined efforts brought me back to life and back to this Chamber. This was what they were born to do. As ever, I took the opportunity to ask each person who came to my bedside what they thought of the Bill and whether they would participate in its application should it become law. Hand on heart, not one doctor, nurse or allied professional said yes. What they did say was, “It’s not what I trained for years to do. My job satisfaction is making patients as comfortable as possible and supporting life however long or short”. I must admit that it made me feel a great deal better, and, yes, safer, knowing they would go the extra mile to help me while in their care.

A number of the royal colleges have raised concerns about the pressures on healthcare professionals to clear hospital beds and meet treatment targets. This, in turn, may pressurise them to participate in the assisted dying process—a subtle yet deadly form of unconscious coercion, causing division within medical teams and undermining patient trust. This was clearly illustrated in the sobering BBC documentary “Better Off Dead?” last year.

Throughout our exchanges in this Committee, I have heard the term “treatment option” to describe assisted dying. It is not a treatment option. Assisted dying as a treatment does not accord with the fundamental principles of medical practice. Medical treatment is to alleviate symptoms and support life, however short, in the least distressing way possible. To do otherwise would fundamentally alter the nature of medical practice, shifting the focus from supporting life to suggesting its end, leaving patients feeling pressurised or fearful when seeking care.

Amendments 383 and 657 in this group address this issue. The evidence is clear that without these amendments, we are in danger of travelling the same road as the Canadian legislation, a law that began as tightly drafted legislation but soon gave way to systemic pressures on healthcare professionals, many of whom now see assisted dying as part of the end-of-life treatment. We must not allow the introduction of assisted dying to disrupt the fundamental principles of healthcare.

The opt-in system proposed by my noble friend Lady Finlay and others in this group is not about protecting the rights of healthcare professionals; it is about preserving the very essence of patient care. The amendments from the noble and learned Lord, Lord Falconer, fall short of addressing these concerns. By limiting the statutory opt-in solely to the bespoke training for co-ordinating doctors and independent doctors, he leaves significant gaps in protection for the wider medical workforce. They are seen as too narrow and procedural to meet the fundamental concerns raised by the Royal College of General Practitioners and the Royal College of Psychiatrists.

I urge your Lordships to support the amendments I refer to and to stand with the royal colleges in their call for a clear opt-in system that respects the rights and dignity of all healthcare professionals, providing them with a safe, ethical healthcare environment and protecting the integrity of their relationship with patients.