Terminally Ill Adults (End of Life) Bill

Lord Oates Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Oates (LD)]

My Lords, I shall focus today on the group of people to whom the Bill actually relates—those terminally ill patients with capacity whose death in consequence of that illness or disease can reasonably be expected within six months. We can argue about whether the Bill should be wider or narrower in scope, or not at all, but our key focus should be on scrutinising the Bill, not speculating about legislation which may or may not come to us in future. Some time ago, I sat with a very dear friend in an oncologist’s office in Pietermaritzburg in South Africa as he learned that his prostate cancer had spread and was no longer treatable. Just over a year ago, he told me that the pain was becoming unendurable. Shortly afterwards, his daughter contacted me to say that he had died. She also sent me his death certificate. I thought that strange, but then I read it and I understood why. Under the cause of death, it states “cancer, prostate”, but above it, another cause is listed: organophosphate poisoning.

My friend would not have benefited from this Bill because he lived in another country. I share his experience only because several noble Lords have sought to restyle this Bill the assisted suicide Bill and, like the noble Baronesses, Lady Thornton and Lady Royall, I think that is quite wrong. My friend’s death cannot in any meaningful way be described as suicide. He did not choose death over life. He wanted more than anything to live, but that was not an option open to him. His choice was between the kind of death he was to have: an immediate and tragically painful one, or the prolonged and agonising death he had decided was unendurable. We should be clear. We are discussing an assisted dying Bill, not an assisted suicide Bill.

Although I believe strongly in the right of individuals to take decisions about their own lives, particularly when denying such rights may make them suffer intolerable pain in the way that my friend did, I do not discount the concerns of those who oppose the Bill. Alongside my belief in individual autonomy, I have an informed scepticism about the state and its institutions. I take seriously the concerns raised by the noble Lord, Lord Rees of Easton, and others last Friday about inequities of NHS treatment, particularly impacting black and minority ethnic groups and people on lower incomes, and the dangers of introducing assisted dying in such a system. I was struck by the compelling speech of my noble friend Lady Parminter, which alerts us to the risk to people suffering eating disorders, and I worry about the lack of value often put on the lives of older people and the serious concerns expressed by disabled groups.

Clause 5(2), which allows a medical practitioner to initiate a conversation with a patient about assisted dying, is particularly problematic to me, not because I believe that the medical profession is full of people who want to end the lives of their patients, but simply because I know that it is full of human beings. As such, it will have its share of bad actors but, more pertinently, it will have far more than its share of tired and overstretched professionals juggling competing priorities and resources.

Finally, there is the issue of coercion. Of course most families act in the best interests of their relatives, and many make huge sacrifices to do so, but there will always be some that do not. We must make sure that the safeguards in the Bill are workable and effective.

I thank all those who have written or spoken to me with great conviction on either side of the debate. In many ways I envy their certainty, not because I lack clarity on where I stand on the principle of the Bill, but because I find it harder to discount the flaws both in the existing state of the law and in the Bill before us. I therefore welcome the proposal to hold a Select Committee to take evidence, and I look forward to detailed deliberations on the Bill.