Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Hollins (CB)]

My Lords, it has been an extraordinary two days. After last Friday’s debate, I went to a Beatles tribute band with my learning-disabled son, and we sang “All You Need Is Love”. Compassion is love, and it means journeying alongside someone, even at the end of life, as I did when my husband died from motor neurone disease earlier this year.

I nursed him with the help of fast-track NHS continuing healthcare funding, alongside hospice and district nurses and the brilliant Epsom rapid response team, which aims to keep frail and dying people at home. MND is often called the most feared disease. Martin just smiled and told his grandchildren and his friends that he was fading away as his paralysis increased. Some want the Bill to pass because they are afraid of dying, even though most of us will die peacefully, as my husband did.

During my 40-year career as a doctor in the NHS, I worked on the front line as both a general practitioner and a psychiatrist, two of the specialties most affected by the Bill as it stands today. As a medical student, I was taught by Dame Cicely Saunders, the founder of the hospice movement. Hospices should be our pride and joy; we are world leaders in palliative care. However, the evidence from the Association of Palliative Medicine is that growth in palliative care slows in countries with assisted dying services. Can the noble and learned Lord give us details of the anticipated impact on the availability of palliative care services of introducing assisted dying in this country? What measures would need to be put in place to prevent that happening?

In highly centralised healthcare systems such as the NHS, the integration of assisted dying would risk subtle systemic coercion. Institutional endorsement would normalise its practice and implicitly shape patient decisions. The existence of statutory powers can, over time, drive their own use beyond original policy intentions. Just look at what has happened in psychiatry, where an increase in coercive measures cannot just be explained by clinical demand. It must also be understood in terms of the institutional and cultural momentum generated by the availability of the powers in the Mental Health Act.

Can the noble and learned Lord explain what safeguards will prevent coercion by doctors? Does he support the contention by doctors that assisted dying is not a treatment? Alternatively, if he thinks that it is a treatment, why are there no plans to license and regulate the experimental lethal substances that will be used, rather than leaving it to the Secretary of State?

I will correct an earlier assertion about suicide rates. There is substantial evidence in 10 US states that legalisation is associated with a significant increase in suicide.

I support the Select Committee proposed by the noble Baroness, Lady Berger, and we must listen carefully to the evidence and not rush it. The evidence taken in the other place was partial—at first attempting to exclude even the Royal College of Psychiatrists, despite psychiatrists being given a key role in the Bill.

The lawyers and campaigners have left their mark on the Bill, but there is considerable and more relevant expertise in your Lordships’ House: Members who could competently question witnesses on areas such as capacity assessments, coercion, psychological issues at the end of life, the role of doctors, the licensing and monitoring of lethal substances, and more. There is expertise that could be harvested to see how and if the Bill can be amended to make it fit for purpose.

The other place has left us a lot of work to do. The Bill is neither safe nor workable as it stands today.