Terminally Ill Adults (End of Life) Bill

Baroness Goldie Excerpts

Friday 12th September 2025 Lords Chamber

[Baroness Goldie (Con)]

My Lords, I oppose assisted dying on principle; I voted against it in the Scottish Parliament and I want to be transparent. But the task before this House today is to scrutinise the Bill, and that is the process to which I wish to contribute. I reserve the right to vote against the Bill if—or, as seems more likely, when—such a vote arises, but I accept that the promoters of the Bill act with sincerity and with the best of intentions.

The genesis of this Bill is the profound distress which has attended many patients as they approach the end of their lives. Prominent in that distress is the management of pain. The answer to that problem is not assisted dying; it is how we care better for terminally ill patients and how we manage unbearable levels of suffering. That requires two things: a reversal of chronic underfunding over decades of palliative and terminal care, and a restoration to clinicians of their proper clinical discretion and professional obligation to always act in the best interests of their patients without fear of the consequences. If it takes legislation to provide that immunity and reassurance, that is a Bill I would support.

Within this Bill, which is literally dealing with life and death, we should find explicit detail, clarity and certainty. We should know as legislators what we are being asked to turn into law. We do not. Detail, clarity and certainty are missing. For example, the attempt to define terminal illness as

“an inevitably progressive illness or disease which cannot be reversed by treatment”,

with death reasonably expected “within six months”, is incapable of precision. Diagnosis is not an exact science and six months is an estimate—think of the convicted Libyan bomber, al-Megrahi. But the patient will certainly be influenced by that opinion, even if it is wrong.

There is an attempt to spell out the criteria which must apply to a patient requesting assisted dying, including

“a clear, settled and informed wish to end their own life”,

doing so voluntarily and not being

“coerced or pressured by any other person”.

But there is a crucial omission in the Bill: I can find no definition of a clear and informed wish. What constitutes that? Yes, a doctor has to refer to that in the report following the assessment, but what are the criteria? If the answer is to ask the patient the question and tick the box, that is grossly inadequate.

Equally troubling is the declaration to be repeated by the co-ordinating doctor—someone still to be defined by regulations—that the decision is made voluntarily and not under coercion or pressure. If the co-ordinating doctor has met the patient only once, how can that possibly be a basis on which to have formed an opinion about third-party coercion or pressure? As many noble Lords will know, such coercion and pressure is not trumpeted from the bedside; it is furtive and covert. It will take a skilful doctor visiting the patient on a regular basis to be able to make any informed judgment on such issues. On that, the Bill is silent.

This takes me to the most concerning omissions from this Bill. Where we should have explicit provisions in primary legislation, we have repeated reliance on delegated powers. That is what makes this Bill opaque and impossible to understand. On an issue of life and death, that is completely unacceptable. We should be indebted to the Delegated Powers and Regulatory Reform Committee of this House for its objective but deeply disturbing report laying bare these omissions and inconsistencies. This Bill should be rejected. It is not fit for purpose.