Terminally Ill Adults (End of Life) Bill

Patricia Ferguson Excerpts

Friday 13th June 2025 Commons Chamber

[Kim Leadbeater]

It is a privilege to open today’s debate and to present to the House the amendments tabled in my name, a number of which relate to issues that I promised to return to when they were raised in Committee. All amendments in my name have been drafted with technical advice and expertise from civil servants from the Department of Health and Social Care and the Ministry of Justice, along with the brilliant Government Legal Department and the Office of the Parliamentary Counsel, in order to make the Bill workable and to give coherence to the statute book, as confirmed by the Minister for Care, my hon. Friend the Member for Aberafan Maesteg (Stephen Kinnock), and the Minister for Courts and Legal Services, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman), in their recent letter to MPs. Some are technical and drafting amendments, and all are there to strengthen the Bill, so I hope that colleagues will be able to support them, wherever they stand on the principle of assisted dying.

I know that many colleagues wish to speak today, so I will endeavour to speak with brevity. I will speak first to the new clauses that stand in my name, starting with new clause 13. This important new clause and the related amendments would create a regulatory framework and safeguards around the approved substances referred to in the Bill by imposing a duty to make regulations about those substances and a power to make regulations about devices for use in connection with their self-administration.

Amendment 72 provides that the regulations relating to approved substances would be subject to the affirmative procedure, meaning that they must be laid before Parliament and approved by resolution of both Houses, providing important parliamentary oversight. These measures ensure that the substances used in assisted dying are subject to a specific and appropriate regulatory regime.

[Patricia Ferguson (Glasgow West) (Lab)]

I am genuinely looking for clarification. As a former Cabinet Minister in the Scottish Government, I jealously guard the devolution settlement. I wonder how the extension of some of these clauses to include Scotland will be interpreted. What conversations have taken place between my hon. Friend, Scotland’s Lord Advocate and the Scottish Government?

[Kim Leadbeater]

I have taken legal advice from Government officials to ensure that devolution is respected at every stage in proceedings. Where legislation that affects other jurisdictions needs to be amended, those conversations have already started and will continue.

--- Later in debate ---

[Ellie Chowns]

The evidence shows that it is dying people themselves, facing the end of life, who wish to have the choice. Only small numbers of them will take up that choice, but it is crucial, humane and compassionate for us to offer them the choice. Assisted dying is complementary to palliative care, not contradictory, and this Bill has been through a huge amount of scrutiny—far more than any other Bill in this Session. Therefore, I deeply hope that the House will pass this compassionate, humane, clearly drafted and tightly structured Bill, to offer a dignified death to those who are facing death.

[Patricia Ferguson]

I rise to speak to my amendment 13, which concerns the appointment of the voluntary assisted dying commissioner. In Committee, it was decided that the Prime Minister would appoint the voluntary assisted dying commissioner, and that the appointee would serve for five years and be responsible for appointing the assisted dying review panels. The commissioner would also oversee the training of panel members, give them guidance on the procedures to be used and, crucially, decide when a case that a panel has refused should be referred to another panel for reconsideration. According to the Bill, the commissioner will not be acting as a judge, but they must be a current or former senior judge of the Supreme Court, Court of Appeal or High Court. However, they are not required to have any expertise in medicine or healthcare.

Importantly, following our considerations in Committee, the Bill no longer requires that the chief medical officer be responsible for monitoring whether or not the assisted dying regime complies with the law. That responsibility has now been transferred to the voluntary assisted dying commissioner, so the person in charge of overseeing the process and setting up the panels will also be the person deciding whether the Act is being administered correctly.

[Jonathan Davies]

Given the scandals we have seen in healthcare over many years, from infected blood and medicines that should not have been prescribed to what happened at Mid Staffs hospital, it is clear that having that independent, robust oversight from the chief medical officer is a good way forward if people are going to be able to trust this legislation, if it comes into law.

[Patricia Ferguson]

My hon. Friend makes a valid point. The point of my amendment, as I will come on to, is that we need to ensure as much scrutiny as possible in this regard.

From what I have outlined, this is clearly an exceptionally important post, which carries great responsibility and significant power; indeed, it seems the postholder will require the judgment of Solomon to be able to fulfil their role. It is therefore surprising that, as the Bill stands, there is no requirement for pre-appointment scrutiny by the relevant Select Committee, despite the profile of the post and the controversy it will inevitably attract.

Considering that such pre-appointment scrutiny is required for the chair of the Competition and Markets Authority, the chair of the BBC, the chair of the Charity Commission, the Information Commissioner, the chair of the Care Quality Commission, the health service commissioner for England, the chair of the Judicial Appointments Commission and the chair of the UK Statistics Authority, the omission of such scrutiny in this case is clearly a serious oversight, which my amendment seeks to remedy by ensuring that the correct Select Committee has the power of scrutiny.

In my view, we need to guard the rights and privileges of Parliament jealously. We must ensure that Parliament is involved in the scrutiny of this legislation going forward as much as we possibly can. The Bill itself requires this to be as rigorous and transparent as is possible. No matter what side of the debate we are on, it is important to ensure that the Bill is as strong and as good as it possibly can be; we owe it to the people who send us here—the people who have been writing to us in such great numbers. My amendment seeks to strengthen the Bill in respect of the voluntary assisted dying commissioner.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

I refer right hon. and hon. Members to my entry on the Register of Members’ Financial Interests—I am an NHS consultant paediatrician.

The debate so far has focused primarily on ethical considerations, legal frameworks and who will be eligible—the who, the when and the why—but I want to focus my remarks on the how. As a doctor, I know that various drugs in different combinations can be fatal; in other words, there is more than one way to kill people. Which would be the best drug, if that is what we wished to do? Which would be the most comfortable, and how do we know?

Some forms of assisted dying use neuromuscular blockades, which, in common parlance, means that they paralyse the body. Imagine a situation where someone in a lot of pain is given such a drug; from the outside they would look relaxed and peaceful as their muscles relaxed, but inside they would be in a lot of pain, and unable to express that to anybody else. Do we want people to be comfortable and to know that they are comfortable, or only to appear comfortable to us? Clearly, we want them to be comfortable inside as well. We therefore need to have drugs that are properly understood and regulated for this purpose.

Assisted dying is often portrayed as safe, peaceful and controlled, but the reality in comparable countries where it has been legalised so far is more complicated. Technical difficulties frequently arise, leading to complications causing greater suffering, requiring intervention and potentially leading to a prolonged and painful death.

A report in The BMJ by Dr Suzy Lishman, former president of the Royal College of Pathologists—who, I should say, works at the same trust as me—showed that there is a lack of reliable data on the effectiveness and safety of the drugs used, largely due to inconsistent reporting in jurisdictions where such dying is legal. In Belgium it is estimated that only 52% of euthanasia cases are reported to the Federal Commission for the Control and Evaluation of Euthanasia.

During a Select Committee visit in the last Parliament to Oregon to discuss assisted dying, which I and two other hon. Members from the Labour Benches went on, we heard about the complications being unknown in 71% of cases. No healthcare professional was present when the drugs were given so we could not really know, and we did not even know if the drugs had been taken in some cases. Where we did, we found a history of seizures, vomiting and prolonged deaths. On having been given the drugs, patients in nine cases in Oregon in 2023 had reawakened later. How they felt in the intervening time is difficult for us to know.

In Washington, a 2018 report found that 31% of patients took more than 90 minutes to die. I also remind hon. Members that an absence of evidence that things are not going well is not evidence of an absence of things going wrong.