Terminally Ill Adults (End of Life) Bill

Lord Evans of Rainow Excerpts

Friday 12th September 2025 Lords Chamber

[Lord Evans of Rainow (Con)]

My Lords, it has been a great privilege to sit here all day and listen to noble, and noble and learned, Members of this House. The problem is that when you are the penultimate speaker, most of the good ideas and suggestions have already been made. I pay tribute to my noble friend Lady May, the noble Baronesses, Lady Falkner and Lady Hunt, and indeed the noble Lord, Lord Stevens, on his very good point regarding palliative care in England and Wales, which is highly relevant to this debate.

I am concerned about the fundamental shift that the Bill will cause for our relationship with the medical profession. As legislators, we owe it to the public who will be impacted by the Bill to think through all consequences carefully, whether intended or not, and to think about who we will empower to pass legislation.

If this Bill passes, we will be moving from an NHS where doctors are focused solely on healing to an NHS where, when the conditions of the Bill are met, any individual doctor with no specific training can raise ending a terminally ill patient’s life with the state’s endorsement, no matter how vulnerable the patient. We place a lot of trust in our doctors and healthcare professionals to seek what is best for us, and the Bill risks the implication, if not outright declaration, that ending your life early is a suitable course of NHS treatment.

The honourable Member for Sleaford and North Hykeham in the other place, who is an NHS consultant doctor, reflected on this issue of how patients interact with their doctors during the debate on Report:

“As a doctor, I am very aware of the trust that the public place in doctors and the seriousness with which they take what we say. If a doctor gives somebody information about assisted dying, it is quite reasonable for that person to think that the doctor is suggesting that they should take part in that process, or is hinting that their death will be dreadful and trying to be kind. If doctors are allowed to say, ‘This is a good process,’ more people will take it up than would otherwise have wanted to”.—[Official Report, Commons, 16/5/25; col. 646.]


I know when I go to the doctors, I assume that the doctor before me will be there to help my health and recovery and nothing else. That should be our experience. Any threat to this kind of relationship between the medical profession and its patients must be rejected. We cannot afford to fundamentally rewire the NHS to the effect that the public will no longer be sure that their recovery is occupying the totality of the doctor’s thoughts, or will worry that in a cash-strapped NHS trust, somebody is calculating, as set out in the impact assessment, that £13,000 could be saved per patient for every four months of unused healthcare for the cost of a £14 prescription.

As this Bill passes into law and establishes assisted dying as a regulated and approved treatment, something commonplace, we will have to be sure not just that systems and process are beyond reproach; many professionals at all stages on their career will have the opportunity and ability to put patients on the route to an assisted death. This means that we will have to have faith in the competence and professionalism of every individual. I have no problem, having closely interacted with three NHS trusts as a Member of Parliament, in saying that some of the most dedicated people in our country work in the NHS. However, I would be delusional to pretend that that is universally true. I have seen deeply worrying cases where one bad apple was simply shunted from job to job. As with all institutions, doctors are fallible human beings. Mistakes will be made through exhaustion, misunderstanding and, yes, in some cases, malice.

Yet advocates for this Bill would have us reject common experience. When the Member for Vauxhall and Camberwell Green raised the point on Report that many constituents

“have grave concerns about the way in which they are treated, because they feel that they do not have a level of equality within our NHS”,

the Member for Solihull West and Shirley rejected it as

“rhetoric that engenders a fear around the medical profession”.—[Official Report, Commons, 16/5/25; col. 651.]

We must not underestimate how much power this will put into the hands of, potentially, very junior medical professionals, and the scope of impact that a very small cohort can have. That is evident in the international jurisdictions with similar regimes. According to an official report in 2021, a single doctor in Oregon wrote one-eighth of all assisted dying prescriptions. In Victoria, according to the Voluntary Assisted Dying Review Board, during 2023-24 10 doctors handled 55% of all cases. This Bill should not pass in this current form.