Terminally Ill Adults (End of Life) Bill

Lord Gold Excerpts

Friday 12th September 2025 Lords Chamber

[Lord Gold (Con)]

My Lords, when I spoke at Second Reading of the Assisted Dying Bill in 2021, I expressed grave concern about the “hidden persuasion” being used by family members, encouraging loved ones to take their own lives. This means that by words or conduct a patient is made to feel guilty that they continue to live, that they are a burden and expense on the family and that it would be better for everyone if they were no more. This new Bill fails effectively to address this issue. Yes, it outlaws coercion, but it does not deal at all with the issue of hidden persuasion.

In the earlier Bill, a High Court judge was required to confirm the patient’s eligibility for assisted dying. Those involved could be questioned and the process tested. The role of the judge is now to be taken by a panel comprising a “legal member”, a psychiatrist and a social worker, but the lawyer’s view could be ignored, as decisions are by majority vote. Removing proper judicial scrutiny is a most worrying development. There is no requirement in the Bill that the patient must be known to the two doctors who are required to be involved, and the patient will certainly not be known to the panel, so determining capacity and intention will be extremely difficult.

Inevitably, the patient will be in a vulnerable state. They may be distressed that their family is inconvenienced by having to visit, sometimes coming from afar. For those in a care home, there may be a concern about the substantial cost being incurred, eating into future inheritances. Nobody outside the visiting family will know what pressure has been put on patients. How can we ever be sure that there has not been abuse?

Further, the Bill expressly provides, in Clause 38, that a death by self-administration does not constitute an “unnatural death”, so there will be no inquest unless a senior coroner has reason to suspect that the deceased died an unnatural death. No guidance is offered as to what might persuade the coroner to undertake such an investigation.

I have a further major concern about the Bill: far from ending the debate about assisted dying, it is the beginning of a far bigger debate, as touched on by some noble Lords today. The replacement of judicial scrutiny by the proposed panel is a warning that safeguards risk being abandoned. We should have no doubt: if the Bill becomes law, this is the slippery slope to further change, with calls for us to introduce euthanasia, which has been the experience of other countries. Euthanasia is now accepted in Belgium, the Netherlands, Canada and the state of Oregon. In some places, patients have been euthanised for psychiatric conditions, including depression.

Indeed, the Netherlands has proposed extending the law to elderly people with completed lives. There is already pressure to extend this Bill, with some suggesting that doctors should be able to administer the drug, not simply assist, when the patient is too ill to take it themselves. Is this what we want? I certainly do not.

This Bill outlines a complicated process before a patient will be permitted to receive assistance in dying. The Bill is silent as to how this is to be done. I am concerned that none of this has been sufficiently thought through. I do not believe our present medical staff can cope with assisted death in addition to the very valuable work they now do, so something different is needed. The NHS is finding it hard enough coping with the patients who want to live, let alone those who want to die.

One possibility is that Ministers might create mobile assisted death units, making the option of choosing death far easier for vulnerable patients to accept because all the problems of the process will be managed by professionals who know the system, know what is required, provide the two doctors needed, liaise with the panel and assist patients with all the administration and form filling. Frankly, this risks a further means of subtle coercion.

I have only touched on some of the concerns I have about this Bill. It is a thoroughly bad measure and should be rejected. Nobody wants patients to suffer a painful death, but assisting an early death is not the answer. If this measure is approved and the Government have to make it work, the costs and administration involved will be colossal. It would be far better spending this money and putting our efforts into improving the palliative care we offer.