Terminally Ill Adults (End of Life) Bill

Naz Shah Excerpts

Friday 16th May 2025 Commons Chamber

[Anneliese Dodds]

I am grateful to my hon. Friend for making that point. I believe the Bill has been substantially improved through the many amendments that she and others have tabled. I know that these issues were discussed in detail in Committee, but I have to be honest: sadly, the prospect of a prosecution has often not been sufficient to prevent abuse. I note that in the discussions in Committee, a number of medical professionals mentioned that they often have to assess whether coercion has taken place and that they are confident in that assessment, but there is a huge amount of contestation around whether that confidence is rightly placed or otherwise.

[Naz Shah (Bradford West) (Lab)]

Does my right hon. Friend share my concern that there will only be three hours for a panel, and that the first and second doctors might not actually know the patient or have met them? Their ability to spot coercion will be very limited.

[Anneliese Dodds]

Yes, I do share my hon. Friend’s concern in that regard. Sadly, we all know how perpetrators of coercion operate. They will often school the subject of their coercion in how to respond to questioning, to try to hide what they are doing from others. That is a concern.

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[Naz Shah]

Will my right hon. Friend give way?

[Anneliese Dodds]

I will not give way at the moment.

That is why it is important that that exclusion is put very clearly on the face of the Bill.

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[Siân Berry]

I am sorry, but I am on my last paragraph.

Those measures are effectively barriers to helping eligible people make their own choice for when and how to die at the end of all they have suffered.

I truly believe we must not make the process of gaining permission any harder or more traumatic than we need to. Although I am listening hard to the arguments made, quite a few of the amendments and new clauses cross that line. These momentous decisions about our deaths must be led by compassion, and must not be made to seem like yet another battle for people who have already given their all to staying alive.

[Naz Shah]

I thank Members for supporting amendments 14 and 38 in my name.

I acknowledge that the promoter of the Bill, my hon. Friend the Member for Spen Valley (Kim Leadbeater), has said that she is happy, as of this morning, to accept my amendment 14.

My hon. Friend has also indicated that there might be a need to change some of the wording, but until I see the wording of the new amendment and can scrutinise it, I cannot make an informed choice about accepting that. In addition, I was told this at only 9.30 am, on the Floor of the House. It was not discussed with me, and I am not sure whether the promoter has discussed it with Ministers. This very argument has been hashed out in Committee, where many of us spent weeks and weeks scrutinising line by line.

Indeed, the promoter tabled her own amendment 181 in Committee to strengthen clause 2. At that point, Ministers, outlining their neutrality, said that the amendments tabled, for which many colleagues had argued, were not, in the Government’s opinion, workable. In the Government’s opinion, what has now changed? Has an assessment been made by my hon. Friend or the Government that these amendments could now be accepted?

What this speaks to—I emphasise this to all Members listening and to the public at home—is a fundamentally flawed process. [Hon. Members: “Hear, hear.”] This is not how we make legislation. I take my responsibility extremely seriously, as I am sure everybody in this House does. This is literally a matter of life and death. If the Bill passes without these safeguards, there is no coming back from those decisions.

[Daniel Francis]

As my hon. Friend knows, having been on the Bill Committee with me, I had the same advice from Ministers: they disagreed with the wording of some of my amendments, yet they were accepted by the Bill’s promoter and the Committee and are now in the wording of the Bill. The position of the promoter and the position put to this House will now be that those amendments are not in line with the Government’s position. What is my hon. Friend’s view on the fact that we will be asked to support that?

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[Naz Shah]

My hon. Friend is absolutely right. That is the problem with this Bill, this process and what we are being told. We are being given things on the face of the Bill—

[Kim Leadbeater]

I thank my hon. Friend for her passionate contribution, but this is exactly how we make law. We take evidence and have discussions—[Interruption.]

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[Naz Shah]

Thank you very much, Madam Deputy Speaker.

My amendment 14 is very much about anorexia. It has been debated and hashed out time and again. I have come to the House today and been told, while sitting in my seat, that my hon. Friend the Member for Spen Valley is minded to accept the amendment without any discussion. I do not know what risk assessments or other assessments the Government have made, so how can I speak to that amendment when I do not have those details? I can say that Chelsea Roff, an expert on anorexia, gave evidence to the Committee. I can talk about how clinicians from every single major charity for eating disorders have made it clear that if this Bill goes through, it will not be fit for purpose and people will fall through that loophole. Without the information in front of me, however, I cannot speak to the amendment.

[Dr Tidball]

Will my hon. Friend give way?

[Naz Shah]

Sorry, I will make some progress.

[Kim Leadbeater]

Will my hon. Friend give way?

[Naz Shah]

I will make some progress. I sincerely appreciate the guidance from you, Madam Deputy Speaker, from Mr Speaker and from all across this House—the Clerks have been really helpful.

I come back to the amendments. In Oregon, in the States, 60 women were given assisted death. Every single one of them—100%—were told that they had the capacity. We have an issue in this country. Some 11 cases have gone to the Court of Protection, and my understanding is that nine of them have been told that they do not have the capacity, but doctors have been given permission not to continue to feed them. That is an issue for us; there is an issue of capacity.

There is a second issue in relation to amendment 38, which I will speak to. Even if my hon. Friend the Member for Spen Valley accepts my first amendment in its entirety, word for word, we do not close the loophole with amendment 38. What if we have somebody with diabetes? The hon. Member for South Northamptonshire (Sarah Bool) spoke very passionately about diabetes. I know the experience, because I was gestationally diabetic on three occasions and dependent on insulin, and I also appreciate the risk of being a pre-diabetic. If somebody decides not to take insulin and that they do not want to have dialysis, they would bring themselves within the scope of this Bill as it is written. That is a fact.

Contrary to the many people who have been on the radio and in other places saying, “The Bill excludes people’s mental health”, this Bill does not, as it is written, say that mental health is excluded. [Hon. Members: “It does!”] It does not.

[Dr Tidball]

Will my hon. Friend give way?

[Naz Shah]

No, I will make progress. I am very conscious that lots of colleagues are here. I remember that we were all sitting here in November the first time that we debated this Bill; more than 100 Members did not get to speak in that debate, and many people might not get to speak today.

I feel really disheartened. As other Members who were on the Committee have pointed out, we have spent so much time rehashing these arguments. There were opportunities to fix this Bill rather than me and others having to put down amendments, taking up time and not giving those who would otherwise have spoken the opportunity to speak.

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[Dr Mullan]

No, I need to make progress. They will be daunted not least because, although we have international examples, we are considering a novel practice in this country in our particular circumstances.

Members who are generally supportive or opposed in principle may choose to abstain on a number of amendments on which they feel that they are unable to give a definitive view and are content to vote on the final outcome on Third Reading. That would be understandable. I know that Members have considered how they will vote very carefully, and that they will continue to do so, by taking into account their views and experiences, as well as those of their constituents, other Members whom they respect, and experts and campaigning organisations. We will all be directly accountable to our constituents at the next election for all our votes throughout this Parliament.

That brings me to the remarks that I said I would like to finish with on the responsibilities of the public and campaigners towards MPs as they consider our votes. As we are first and foremost public servants, the focus is quite rightly usually almost entirely on the responsibility of MPs to the public, but as with all meaningful relationships, this is, and should always be, a two-way street. I accept the very strong feelings and deeply personal experiences that are brought to bear for those people contacting their MPs, and nothing I say should be taken as diminishing the rights of campaigners to make their cases strongly and consistently, but I and others have experienced lobbying by campaigners whose passion for securing the outcome they want has led them to question the integrity, sincerity or understanding of those MPs seeking a different outcome to them.

Some high-profile campaigners have made unhelpful remarks. Although I am not religious, I was concerned to see the clumsy criticism of those whose objections to the Bill are thought to be centred in their religious beliefs, as was mentioned by the hon. Members for Vauxhall and Camberwell Green (Florence Eshalomi) and for Lowestoft (Jess Asato).

[Naz Shah]

Will the hon. Gentleman give way?

[Dr Mullan]

I need to make progress.

I say that not least because I suspect that a very large number of supporters of the Bill might draw on their Christian or other religious compassion to explain why they want to see it pass. There was widespread reporting of how powerful the Second Reading debate was in showcasing the best of Parliament, with thoughtful debate and a consideration of nuanced and varied viewpoints. If Parliament demonstrates itself at its best, that creates a call for the public to do the same.