Terminally Ill Adults (End of Life) Bill

Baroness Finlay of Llandaff Excerpts

Friday 19th September 2025 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare my roles in palliative medicine, caring for thousands of dying patients over decades, and in Living and Dying Well.

The Bill as written does not improve patient choice or control. True choice would ensure patients can get the care they need. Control will rest with the doctors who can initiate the conversation and are the gatekeepers on eligibility for lethal drugs.

Supporting a patient who wants to stop treatment is not assisted suicide. Stopping unwanted treatment allows life to close in a timely way. The person dies of their underlying disease; it is good care.

Training in palliative care is lamentably poor across most of health care. Ignorance of pain and symptom control management is widespread across the globe. Morphine to control pain does not kill, although some mistakenly think it does; it provides comfort as life slips away.

Specialist palliative care can save millions a year to the NHS through care that meets need, substantially improves well-being and comfort, and avoids unnecessary interventions. It does not keep people alive who do not want to keep living.

The Bill’s impact assessment suggests that there will be up to 4,500 assisted deaths by year 10. The Bill does nothing for the over half a million people dying each year on whom it will have a profound impact, many with needs not addressed but wanting to live better right to the end of their lives. They are unheard, already often made to feel a burden; they fear being persuaded to take lethal drugs; and they face their local services being further eroded to fund the assisted death service. It is unethical for us to pass poor legislation for a state-provided NHS assisted death service while leaving the care of half a million dying people to be patchy, often inadequate, and, at best, subsidised ad hoc by struggling charities.

Throughout, we have heard horror stories of bad care and inadequate or appalling management, especially out of hours. The Bill does not require any attempt to relieve pain or suffering, even if they are present. It puts power in the hands of the two assessing doctors, who may know nothing about the condition of the person, who cannot detect undue influence or coercion and whose motivation may be opaque. Prognosis is a guess and diagnostic errors are common. These doctors do not need to be certain; only on the balance of probability do they need to believe that the criteria are met. With no oversight of their assessment, how can a panel approve the death with any certainty when there is no ability to appeal against a panel approval and no coroner oversight? How many wrongful deaths a year is acceptable? No system can be 100% safe.

Providing massive drug overdoses in an unlicensed way to end life is not a therapeutic act and has no place in health and social care provision. Evidence, not heard in the other place, from other jurisdictions reveals complications, slow deaths, complex grief in the bereaved and profound clinical distress. Whether or not you feel that some people should be able to have an assisted death or even euthanasia, this Bill, as written, is deeply flawed. It must have essential scrutiny.

Some noble Lords have suggested that a timetable has been agreed. That is not the case. It has been agreed to have a Select Committee that will complete its work in November, allowing the Committee of the whole House to get under way promptly to undertake that scrutiny, which is absolutely essential.