Terminally Ill Adults (End of Life) Bill

Calum Miller Excerpts

Friday 20th June 2025 Commons Chamber

[Kim Leadbeater]

I am just going to make some progress.

Patients must have

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

and a person is not considered to be terminally ill only because they have a disability or a mental disorder. These clear, strict criteria, plus the multiple capacity assessments, exclude possible serious mental health disorders such as anorexia.

I was also very pleased to support the change advocated for by Marie Curie and Hospice UK, which would ensure an assessment of palliative and end-of-life care as part of the first report on the Act. We know from other countries, in no small part due to the 14-month inquiry by the Health and Social Care Committee, that palliative care and assisted dying can and do work side by side to give terminally ill patients the care and choice they deserve in their final days. It should not be an either/or for dying people, and we need to channel our energies into supporting all options for terminally ill people.

[Calum Miller (Bicester and Woodstock) (LD)]

I am very grateful to the hon. Lady for giving way. As she knows, the leading experts in palliative care have come out to oppose the Bill, and they point to the fact that hospices are underfunded and do not have the same ability to serve patients. I therefore gently question whether we are in a position today to make a judgment that patients truly would have a choice at the end of life.

[Kim Leadbeater]

I thank him for his intervention, but I would say, as I have said previously, that people working in palliative care have a mixed range of views on this subject. I have met with palliative care doctors, and some are very supportive of a change in the law because of the suffering they have seen.

--- Later in debate ---

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I thank everyone who has contributed to this debate, both inside and outside the House. There has been a great deal of passion, and sometimes that passion flares up while we debate this really intense and personal subject, and obscures the deep and profound compassion that we all feel. How each of us faces death is deeply personal, and the decisions surrounding it must honour every individual’s dignity and choice. Our goal must be to ensure that all patients are protected, while we empower people at their end of their life with greater autonomy and agency to make the choices that are right for them.

Having spent many years as an intensive care nurse in the NHS, I have witnessed the realities of end-of-life care countless times. I have seen patients find peace in their final days, but also patients who have been unconscious or unaware that their death was coming. I have seen others endure pain and anxiety that no palliative intervention—none—would alleviate for them. Those experiences have deeply influenced my perspective on assisted dying. They have reinforced my belief that individuals should have the autonomy to make decisions about such a personal and profound part of their life—the end of their life. That is fundamental to dignity at the end of life.

Consent must always be freely given, fully informed and revocable at any time, as it is right now for anyone who agrees to, or decides not to, undertake onerous, painful treatment that medical and clinical staff say might save or extend their life. Every one of us can refuse treatment. It is so important to understand that, because we have had lots of discussion about coercion. I have to lay it out for the House: there is a lot of coercion in the system currently. Well-meaning families and clinicians provide a degree of coercion. Clinicians, clinical teams and multidisciplinary teams are set up to try to detect that, and to have conversations with patients to get to the nub of their real wishes. I have a lot of faith in my clinical colleagues, and I have faith that this happens, as a result of collective action by multidisciplinary teams—that is how healthcare works today. I am really pleased that after extensive debate on this Bill, particularly in Committee, we have gone from a judge making the decision to having a panel, because that reflects best practice in clinical work. We now have a multidisciplinary team and a multidisciplinary approach to assessing what the patients wants.

[Calum Miller]

Will the hon. Member give way?

[Kevin McKenna]

No, I will not.

Many colleagues have talked about whether this debate has been too short, too long, too complicated or not complicated enough. I have heard questions about whether the Bill is ready to for us to hand on to the House of Lords. To be clear, I believe that it is. It is really important to remember that we have been debating this issue not just during this Parliament; the debate has gone on for decades. I remember being taught by a really strong advocate for palliative care when I was a student nurse; he was dead set against assisted dying. His argument was that if we bring in assisted dying, it will mean that palliative care will never get the funding and resources that it needs—something that so many people have said. That was nearly 30 years ago, and we have not grasped that nettle as a country.

At the end of this debate, I really hope that we can finally bring to fruition the ambition of almost every Member of this House: the ambition to ensure that palliative care works and is accessible to everyone in this country. However, if we do, that is not a reason not to have assisted dying. Assisted dying is the choice of many people in this country, and I want it to be a choice for me. If I get to that point in my life, I want that choice available to me, and that will be true for some other Members. Still others do not want to ever have that choice, but it needs to be there. I want people to think about themselves as well.