Terminally Ill Adults (End of Life) Bill

Cat Eccles Excerpts

Friday 16th May 2025 Commons Chamber

[Damian Hinds]

My right hon. Friend is right, of course. When we in this House are told that there will be secondary legislation, guidance or a code of practice, we can only ever take that on trust, and this subject is of such moment that what is on the face of the Bill is that much more important. Given the scale of the decisions that people could make as a result of this legislation, it is right that an additional layer of caution should be applied by legislators.

Obviously, it is important not to generalise—every single person is an individual—but it is the case that people with Down syndrome often exhibit distinct social characteristics, including great sociability, empathy, and a strong desire to please others and seek positive social feedback, while also being particularly sensitive to criticism or perceived failure, which can compound issues around communication and comprehension. We do not need to define what can result as coercion to worry about what might happen in that context.

Amendment 101 and new clause 1 are about initiating a conversation and ensuring that there are additional safeguards, and I urge the House to apply caution that is commensurate with the gravity of the path that could be embarked upon.

[Cat Eccles (Stourbridge) (Lab)]

I rise to speak against amendments 102, 80, 5 and 38, and new clauses 16 and 9. In my varied NHS career, I have seen all aspects of death and disease. As healthcare professionals, we commit first to do no harm. As medicine advances at breakneck speed, we are able to preserve life far beyond what could have been thought possible in the past. However, there have been many times when I have felt that preserving life can be harmful.

Life-prolonging treatments do not always improve quality of life, and patients suffer pain and discomfort, as well as mental distress. Friends and family have to watch their loved ones go through these difficult experiences, and I believe that patients should have a choice to end their life with dignity when faced with a terminal illness. The safeguards in the Bill have been significantly strengthened in Committee, so amendments seeking further to delay the process are simply unnecessary. In the oral evidence given by multiple experts, including Professor Chris Whitty, it was argued that we must be mindful not to overcomplicate the process to the point that no one can access an assisted death.

Amendment 80 seeks to impose an unnecessary restriction by requiring the terminal illness to cause

“severe pain and discomfort that cannot be reasonably relieved”

by palliative treatment. However, the Bill already requires that symptoms cannot be reasonably relieved, and it is important to remember that terminal illness is more than just pain alone.

Amendment 102 states that “remediable suicide risk factors” must be addressed before any preliminary discussion. Again, that is already covered in the Bill, with multiple checks on mental capacity and mental illness. Suicide risk is complex and fluid, and as I know from my own struggles, it is possible to feel suicidal but not want to die. This is another vague and unnecessary barrier without clear legal or clinical definition.

New clauses 9 and 16 and amendment 5 all seek to undermine multiple layers of assessment, independent oversight and professional accountability, where safeguards are already strong and multifaceted.

Amendment 38 calls for patients to qualify only if they have not refused further treatment or taken life-shortening steps. It is morally wrong to force anyone to accept medical treatment that they do not wish to have. The Bill is about choice and autonomy, and the amendment would undermine the freedom to make deeply personal decisions about one’s care. This is not a one-size-fits-all pathway, and there must always be a patient-centred approach.

--- Later in debate ---

[Luke Taylor (Sutton and Cheam) (LD)]

Will the hon. Lady give way?

[Cat Eccles]

I will keep going, because of time.

Other countries that have implemented an assisted dying law have in turn increased funding and access to palliative care significantly, ensuring a fairer and more equitable range of options for patients. I believe that the safeguards in the Bill are more than adequate, and it is important to remember that doctors and healthcare professionals are constantly looking out for consent, competence and possible coercion in medical and social care settings.

[Several hon. Members rose—]

[Cat Eccles]

I am almost done, so I am going to keep going.

Around 20 people per day die in excruciating pain and discomfort in spite of the very best palliative care, and we as lawmakers owe it to those people and their families, and to the thousands more who will die in the meantime, to continue the debate towards reform.

[Siân Berry (Brighton Pavilion) (Green)]

I will speak only briefly, as I spoke in favour of the Bill on Second Reading in November, my name is on it, and I have long supported the campaigns to change the law, including those of Dignity in Dying and Humanists UK, of which I declare I am a member and patron.

Since the vote on Second Reading, I have met and listened to a range of groups, professionals and individuals, mainly those who have concerns and those who want to see further changes made. In Brighton that has regularly included constituents at my surgery, as well as a group of leaders of local faith groups and charities who provide support to different vulnerable groups, including disabled people.

Today we are debating about half of the more than 100 proposed amendments, led by several tabled by the hon. Member for Spen Valley (Kim Leadbeater), who has set out so well how she put them together based on her own very detailed work with civil servants and her listening, including to opponents. I cannot commend her work and that of the Committee more.

The new amendments from the promoter of the Bill include welcome changes to transparency rules and how the processes and decisions made are reported and scrutinised. Other MPs have also tabled many carefully drafted and clear proposals. On eligibility, I continue to support people with slowly progressive neurological diseases, such as motor neurone disease, as reflected by my support for amendment 4, which I have signed and which was argued for so well by the hon. Member for Harrogate and Knaresborough (Tom Gordon).

I intend not to list lots of amendments, but to set out briefly the approach that I will take to those amendments being debated, before listening to the rest of the debate and then deciding how to vote, because I believe we must end up with the strongest, clearest and fairest process for making decisions, safeguarding against abuse, scrutinising the use of the policy after it becomes law, and providing the very best and most appropriate help to people who want this choice at the end of their lives.

I aim to back strongly the amendments that demand greater reporting and recording of decisions made and that demand transparency, including financial transparency, demographic data and other statistics from those who are supervising decisions and providing the new service, including the new supervising commissioner. The ability to monitor the implementation of this policy, ensure it is working as intended and detect any problems immediately is really important to me. I will also back changes in the process that ask for more training for those taking part in decisions and to ensure fair and effective communication throughout, including new language requirements

However, I am not currently aiming to support amendments that I think place undue, compulsory, additional burdens, hurdles, intrusions or demands on the people applying for permission to make this choice beyond what is in the Bill currently. On the basis of what I have heard, the experiences of many of my constituents and the statistics, the people asking for this choice will, by definition, be at the end of a horrible disease—often terminal cancer—which they will have fought, and fought with their doctors, for a long time. They will now be facing their final months in a situation of potentially huge suffering over which they have no control and that they fear greatly.

We must all remember that only dying people are eligible. In the vast majority of these cases, the person’s eligibility, capacity and reasons will be more than clear to the decision makers. I believe we must enable those cases to be approved in a respectful, caring and compassionate way, and as swiftly as the current Bill process allows.

In other cases, where things are less clear, I agree: many more questions may need to be asked. I believe that the professionals currently tasked in this rigorous process under the Bill will be very well placed to judge when more information, consultation and investigation will be necessary. Under the current rules, along with the amendments and new clauses I support, they will also have to account very clearly for what they ask and what they decide under effective scrutiny.

I cannot, therefore, support proposed changes that would make every applicant subject to additional intrusive steps and interrogation, with somebody appointed to argue against them, extra processes or compulsory psychological investigation.