Terminally Ill Adults (End of Life) Bill

Paul Kohler Excerpts

Friday 13th June 2025 Commons Chamber

In closing, even if we apply all the safeguarding amendments put forward, the Bill will still not be fit for purpose. The Renters’ Rights Bill contains 191 pages; this Bill consists of just 43. But should it pass, let us at least try to ensure that we have inserted some level of safeguarding and oversight. As such, no matter how they stand on principle, I urge hon. Members to support the new clauses and amendments I have addressed, and those I have not had time to address, in particular new clause 4 and amendments 12, 15, 27 and 42.

[Mr Paul Kohler (Wimbledon) (LD)]

Let me begin by laying my cards on the table. I am, of course, a liberal and have always supported the right of individuals to choose freely when they want to end their life. I have no religious or philosophical objection to assisted dying, and when the debate on the Bill began, I assumed I would vote in favour of it. However, as the debate in this Chamber on Second Reading progressed, and in particular as a result of the compelling speeches by the hon. Members for Vauxhall and Camberwell Green (Florence Eshalomi) and for City of Durham (Mary Kelly Foy), and in particular from the Mother of the House, the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), I came to the reluctant decision that the state of palliative care in this country and the safeguards against coercion in all its forms were not sufficient to vote in favour of the Bill. Despite the changes in Committee, my mind has not changed. I will again be voting against the Bill.

However, let me be equally clear that amendments 103 and 104, in my name and to which I will now speak, are not wrecking amendments, but critical to ensuring proper parliamentary scrutiny if the Bill becomes law.

[Iqbal Mohamed (Dewsbury and Batley) (Ind)]

The issue of palliative care has been raised across the House. We have been repeatedly told that this is not an either/or choice, but does the hon. Member agree that without world-class palliative care, that will force some patients down the assisted dying route, where otherwise they would have chosen better care?

--- Later in debate ---

[Mr Kohler]

I agree entirely with the hon. Member. It would not be a free choice if we make that choice now, given the standard of palliative care.

[Christine Jardine (Edinburgh West) (LD)]

Will my hon. Friend give way?

[Mr Kohler]

This is the last one; I will.

[Christine Jardine]

I thank my hon. Friend for giving way. I share with him concerns about the level and quality of palliative care in this country. However, I do not agree that giving people the choice to end their life, if they are terminally ill and have been diagnosed as dying shortly, in any way undermines our ability as a House to insist on an improvement in palliative care. What is more, statistics from other jurisdictions show that once given that choice, people often turn to palliative care.

[Mr Kohler]

I thank my hon. Friend for her intervention. Giving people a choice when they look on the internet and see how awful their death might be because of the shocking state of palliative care is not a free choice.

This is an extraordinary Bill. It has 55 clauses and 38 regulation-making powers, of which five are Henry VIII powers—in other words, powers to modify primary legislation. As Ruth Fox of the non-partisan Hansard Society, which is absolutely neutral on assisted dying, made clear, there are lots of powers in the Bill conferred on Ministers. Why is that a problem? Lord Hermer KC, the Attorney General, in his Bingham lecture last year, puts the point as follows:

“Henry VIII clauses…upsets the proper balance between Parliament and the executive. This not only strikes at the rule of law…but also at the cardinal principles of accessibility and legal certainty.”

I am afraid the Bill is an example of such excessive reliance. That is a major problem because in large part the safeguards are left to be decided by regulations. What level of qualification and training will doctors need to have? How will mental capacity be assessed? Who can be a proxy? What happens if the self-administration of drugs goes wrong and a person suffers complications but does not die? When pressed on the key safeguards and key issues, supporters of the Bill say that they are problems that can be approved later.

The same goes for how the Bill will actually be delivered. Will it be delivered by the NHS, and if so, how? Will private providers be commissioned, and if so, how, by who and on what terms? Will for-profit providers be allowed? All those questions go unanswered by the Bill. I had hoped that they would be answered in Committee, but they were not, and instead we got even more reliance on delegated powers.

First, that means that MPs cannot make a judgment about assisted dying and how it will work in practice. On training, for example, MPs might assume that the training provided will be a robust two-week course on assessing coercive control, but there is no such requirement in the Bill. Indeed, the impact assessment suggests that it would be a short course. Secondly, regulations cannot override statute and are ultimately bound by it. While it might be reassuring that a code of practice must be issued to take into account how depression can impair a person’s decision making, as the Royal College of Psychiatrists recently reminded us, that does not change the fact that impaired judgment does not mean that someone lacks capacity. Thirdly, leaving all those matters to be considered by guidance and regulations places them outside the democratic control of MPs. With limited exceptions, we will not get a vote on those regulations, and will have no input, directly or indirectly, in formulating them.

The case for the defence might be that reliance on such guidance and regulations is inevitable with a Bill of this complexity, but the experience of other common law jurisdictions suggests that that is not the case. In Victoria, the first Australian state to legalise assisted dying, there are only 20 pages of regulations and much more has been included in the Act, which is necessarily longer than the Bill before us. That is a good thing, as it means more parliamentary scrutiny.

I wholly understand why it was not possible for the hon. Member for Spen Valley (Kim Leadbeater) to draft a Bill as detailed as the Australian Act before Second Reading, but I had hoped that with the help of Government resources, those gaps would have been filled in Committee and on Report. Sadly, that is not the case. [Interruption.] I had much more to speak about, but heeding your cough, Madam Deputy Speaker, let me say clearly that I will vote against the Bill, but even if Members disagree with me, they should please vote for my amendments.

[Rachel Taylor]

I begin by thanking my hon. Friend the Member for Spen Valley (Kim Leadbeater) who has exemplified the integrity and transparency that we need in public service.

I will speak about amendments 82 to 86, which were introduced by the right hon. Member for Salisbury (John Glen) earlier, because as a former lawyer, they concern me. In Committee, the Minister of State, Ministry of Justice, my hon. and learned Friend the Member for Finchley and Golders Green (Sarah Sackman) was clear that the panel’s decisions will be subject to public law principles. That will include procedural propriety and an absence of bias, including the appearance of bias. My concern is that the panel is deliberately designed to be inquisitorial. It is intended to collect information; it is not meant to be adversarial like a court.