Terminally Ill Adults (End of Life) Bill

Neil Shastri-Hurst Excerpts

Friday 16th May 2025 Commons Chamber

[Dr Neil Shastri-Hurst (Solihull West and Shirley) (Con)]

This House is now faced with a responsibility as profound as it is complex: to ensure that this Bill remains clear in its purpose, cautious in its application and compassionate in its impact. That purpose is simple, yet solemn: to grant adults of sound mind with a terminal diagnosis the legal right to seek assistance to end their lives in carefully regulated circumstances through a legal framework in which compassion and control co-exist. With that in mind, I rise to speak against new clauses 1, 2 and 9, which, while no doubt well intentioned, threaten to confuse, dilute or duplicate what is already a well-constructed piece of legislation.

I begin with new clauses 1 and 2. New clause 1 would prohibit healthcare professionals from raising the topic of assisted dying unless it is first broached by the patient. While that may be appealing superficially as a safeguard, it represents a fundamental misunderstanding of the doctor-patient relationship. We trust our clinicians every day to raise subjects of great complexity and moral weight.

[Florence Eshalomi (Vauxhall and Camberwell Green) (Lab/Co-op)]

Does the hon. Member agree that, unfortunately, some of our constituents up and down the country do not trust our clinicians? They 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, which is sadly the case. That was explained and shown during covid.

[Dr Shastri-Hurst]

I am grateful to the hon. Member for that intervention. I fear there is some rhetoric that engenders a fear around the medical profession, which is misplaced.

[Daniel Francis (Bexleyheath and Crayford) (Lab)]

Will the hon. Gentleman give way?

[Dr Shastri-Hurst]

I will give way in a moment, if I may.

Those are not my experiences in clinical practice, nor are they those of family members who have worked in it. We must trust our medical professionals, who are highly trained and capable individuals, to have these difficult and complex conversations, which they do every day on issues such as aggressive chemotherapy or the withdrawal of ventilation.

[Daniel Francis]

The hon. Gentleman, like me, sat on the Bill Committee. He heard, as I did, that if somebody had a learning disability, they were five times more likely to have a “do not resuscitate” order placed on them during the pandemic. Did he hear that evidence? Why does he not agree with it?

[Dr Shastri-Hurst]

I am grateful to the hon. Gentleman for his intervention. These are complex conversations that take place up and down the country every day; we know that they are taking place in St Thomas’ hospital at this moment. We are treating our medical professionals as though they do not take their professional obligations seriously. We must recognise the expertise that they bring and the sensitivities in which they have these conversations.

[Melanie Ward (Cowdenbeath and Kirkcaldy) (Lab)]

I wonder if the hon. Gentleman has the experience, as I and the relatives of many disabled people up and down this country have, of having to fight the medical profession to get the attention and the worth that a loved one deserves when the medical profession is not listening to us or to what that loved one needs. That is the experience of many people up and down this country.

[Dr Shastri-Hurst]

I am grateful to the hon. Lady for her intervention. I commend those family members who are really powerful advocates for their children, parents and relatives in their engagement with the medical profession. We are at real danger of treating our clinicians as though they have no care for their patients—

[David Smith (North Northumberland) (Lab)]

I am sure that all of us in this place respect and value our medical professionals. The simple point to make is that not everyone who goes before the medical profession has the same experience or confidence as some of us in this place.

[Dr Shastri-Hurst]

I am grateful to the hon. Gentleman for his intervention. That is why it is so important that we have the rigorous training and safeguards that are a fundamental part of this Bill.

[Several hon. Members rose—]

[Dr Shastri-Hurst]

I will make some progress, if I may. The point is that people cannot have a fully informed discussion and weigh up the balance of the decision if they do not know the full options available to them. That is a part of informed consent.

[Shockat Adam]

Will the hon. Member give way?

[Dr Shastri-Hurst]

I will make a little progress, if I may.

In respect of new clause 2, those who have had the privilege of meeting a young person living with a terminal illness will know that they often display a maturity and a depth of understanding far beyond their years. To deny them the opportunity of a considered conversation about their future upon reaching adulthood is not an act of compassion, in my view; it is to abandon them. It is to leave them isolated, navigating a complex and deeply personal journey through the filter of online forums, rather than in dialogue with trusted, qualified professionals. We owe them better than that.

[Catherine Fookes]

My constituent Noah was diagnosed at 16 with an inoperable brain tumour, and he has said he would like the right to choose:

“The thought of being locked in unable to communicate is not how I want to spend the last months of my life. To end my life on my terms when the time comes would give me comfort.”

Noah does not want to be infantilised; he wants to be treated like the adult that he is. Does the hon. Gentleman not agree that the Bill will give him that protection?

[Dr Shastri-Hurst]

I am grateful to the hon. Lady for her intervention. That is a very powerful personal story from Noah, who I think reflects the maturity of many young people when dealing with these challenging issues.

By imposing, in effect, a statutory gag in this one area, new clauses 1 and 2 risk infantilising terminally ill patients, creating a chilling effect on communication at the very moment when clarity and compassion are most needed. If anything, new clauses 1 and 2 may result in harm to patients, forcing them to suffer in silence, unaware of lawful options simply because they do not know how to ask.

Finally, I turn to new clause 9, which presents a number of issues. In the first instance, subsection (1) would permit there to be, in effect, two different standards of proof. That must be legal nonsense. The boundaries of any legal test or hurdle must be clear. A failure to do so creates a great deal of uncertainty. Furthermore, the proposal to shift the standard of proof from the civil to the criminal, requiring panels to operate on the standard of beyond reasonable doubt, is deeply inappropriate. The balance of probabilities is the cornerstone of medical and civil decision making. To adopt a criminal threshold risks freezing the entire process, creating a very risk-averse system.

[Jim Allister (North Antrim) (TUV)]

With new clause 9, we are talking about the occasion when the final potion is delivered to the patient to kill them. We do not deprive people of their liberty without proving something beyond all reasonable doubt. Why should we deprive someone of their life if we are not going to prove beyond all reasonable doubt that that is their will?

[Dr Shastri-Hurst]

I am grateful to the hon. and learned Gentleman for his intervention. These are individuals who are making this ultimate choice for themselves. My fear is that this well-intentioned new clause would make the Bill so unusable as to become ineffective. We are not prosecuting a crime here; we are enabling a choice under tightly prescribed circumstances.

While I accept that each of these new clauses in their own way seeks to improve the Bill, we must be cautious about layering protections to the point of paralysis. The Bill as drafted is not a blank cheque—it contains safeguards, panel oversight and rigorous eligibility criteria. Let us not bury its moral clarity under legal clutter. In defending this legislation, we are not abandoning care; we are affirming dignity. Let us do so with confidence and reject these amendments.

[Gregory Stafford]

On a point of order, Madam Deputy Speaker. I would like your advice. Mr Speaker said that more than 90 people wish to speak in the debate. We have been debating the amendments for an hour and a half and four speeches have been made. If we go to 2 o’clock, that will mean fewer than 20 speakers. I understand that whether a closure motion can be moved is at the discretion of the Chair. If we have not got past, let us say, 20 or 30 Members speaking in the debate, can you give us any indication of whether, if you are still in the Chair, you would accept a closure motion at that point?