Terminally Ill Adults (End of Life) Bill

Baroness Murphy Excerpts

Friday 20th March 2026 Lords Chamber

[Lord Deben (Con)]

First, it is said on both sides that they want more money for palliative care, but we now know that palliative care includes assisted dying. I therefore do not accept that the demand for more money for palliative care from those in favour of this Bill is the same thing as those of us who are asking for more money for palliative care so there is a proper choice.

Secondly, the issue is not whether the people of Wales should make the decision on the issue of assisted suicide; the issue is whether decisions made on that subject—which have to be made, because the noble Lord is perfectly right that the legal issue is not devolved—should be made in circumstances in which the application and implementation of those decisions are excluded from the powers that the Welsh Government have. All we are saying here is that those are two different things. I accept entirely what the noble Lord said about the need to make a national decision because of criminal law. However, I am saying that the sponsors of this Bill have got to face that it will ask the Welsh to give up the important control they have in circumstances in which they are already impoverished by the way in which they are supported and where they have particular difficulties with what we call palliative care—not that which the noble Baroness, Lady Murphy, calls palliative care.

[Baroness Murphy (CB)]

My Lords—

[Lord Deben (Con)]

I knew I would do that. I am sorry. I will not refer to the noble Baroness, Lady Murphy.

[Baroness Murphy (CB)]

My Lords, could I make it clear to noble Lords that, in the best legislatures that have implemented similar legislation to this one—and I am thinking of Oregon, the State of Washington and so on—assisted dying is a small part, a very tiny part, of a good palliative care service, and it is best delivered when people who have been caring for somebody through the course of their terminal illness are enabled to make that final choice in their own time when they are ready. That is the point I was making then, and which holds today. I did not say that it was part of palliative care here. It certainly is not at the moment; I would like it to be, but it is not.

The only other point I would like to make is that we have been referring throughout this debate to the Scottish vote. Is it not lovely that the Scots could make a vote? We will not have the opportunity to make a vote in this House due to people going on and on about Wales and matters we have already discussed many times and have already had explained to us. It seems to me that we are just wasting time and we will never get to a vote. I realise that is what some in the House would like, but it is sadly the case that we will never get to the point where we can make a decision in this House about whether we support this legislation or not.

[Lord Deben (Con)]

I am pleased that I gave time for the noble Baroness to talk, given that she thinks all of this is nitpicking. I remind the House that is what she said about the work we are doing. The fact is—

--- Later in debate ---

[Baroness Murphy (CB)]

We have discussed this issue at some length before, but I wonder if the noble Lord, Lord Moylan, has considered that the Bill does not say anything about a definite diagnosis. The phrase is “can reasonably be expected”. It does not mean that anybody has to agree with a diagnosis that it will be four, five or six months, or any particular time; it is “can reasonably be expected”.

I would like to come back on the noble Lord’s issue about people with a positive attitude. Does he accept that it is not just people with a very positive attitude who have good expectations? There are now numerous studies of people with breast cancer showing that the alternative, to totally deny it, also has a slightly better prognosis. There are different ways of approaching these bad news prognoses and people can adapt their own way of dealing with issues from them. I hope he will note that.

[Lord Moylan (Con)]

I am now precluded from taking further interventions, because there is a limit on how long I can speak and that was a very excessive intervention. I will discuss with the noble Baroness outside the Chamber what a reasonable expectation is, if it is not based on a prognosis. I do not know what the functional difference is. As for being in denial, funnily enough, an oncologist said to me that being a bit in denial is quite a good thing. In my own case, I managed to combine a positive attitude and a certain sense of denial; I agree that these things can work. It is quite complicated. But none the less, I am going to continue with what I wanted to say.

Thirdly, the title of Professor Gould’s article was, quite subtly, The Median Isn’t the Message. Yet at the heart of the Bill is a six-month prognosis—we may call it a reasonable expectation—in which that is exactly the message. It is that flawed message which we are making the heart of the Bill.

Lastly, I think we are all agreed that a positive attitude can help, even if denial can help as well, but in using this Bill, we do not inculcate a positive attitude. What we actually say is: “You have six months to live and here is the pills option. That’s another option you can take”. We should be promoting a positive attitude, and the Bill does not do that.

My Amendments 175 and 384 simply require that in the three doctor encounters that are required—in the preliminary discussion, with the co-ordinating doctor and with the independent doctor—there is an explanation of the underlying mathematics or, if you like, the underlying data of the condition that the person has as part of the conversation. The amendments would make that mandatory, so that the idea that the six-month diagnosis is a prediction is not lodged in the mind of the patient.

Professor Gould died in 2002. That was 20 years after his original diagnosis, and he did not die of mesothelioma. In my own case, I took Professor Gould’s article to my oncologist—it was our second meeting—and I said that, in the light of his experience, I was not satisfied with 18 months, that my target was 20 years and that anything less I would consider failure. It seems to have worked because, within three months of the diagnosis, I was discovered to be in complete metabolic remission, a condition I have stayed in. If you have had stage 4 cancer, they will not use the word “cured”, but I am as close to cured as you can be, and I am in complete metabolic remission. I still have 18 years to go on the bargain I struck with my oncologist.

I occasionally hear rather rude remarks about Dame Esther Rantzen—that she was given so long to live and she is still alive years later. I never share those comments; I reject that attitude completely. There are lots of people, such as her and me, who live out there in the farther reaches of the third standard deviation, with our heads hard up against the roof of the bell curve. That is natural because, as Professor Gould says, variation is the reality and the prognosis—the median—is the abstraction.

We have put something false and misleading at the heart of this Bill. There are very few conditions for a person to embark on a course that leads them to an assisted death; one is residence, one is capacity and one is this six-month prognosis. We have put this right at the heart of the Bill, and it is, as I say, false and misleading. It is a fundamental flaw in the Bill, and I would like noble Lords to reflect on that and I hope, on that basis, at the very least, agree my amendments. I beg to move.