Terminally Ill Adults (End of Life) Bill

Sarah Olney Excerpts

Friday 16th May 2025 Commons Chamber

[Dr Opher]

Any restrictions around the doctor-patient relationship will harm patients, so I agree with my hon. Friend.

[Sarah Olney (Richmond Park) (LD)]

I rise to speak in support of amendment 87, which stands in my name, and in support of various amendments tabled by other Members and also signed by me.

Prior to this legislation being laid before the House, I had not held strong feelings about the issue of assisted dying. I listened carefully to the arguments on both sides, including those of the many constituents who wrote to me on the issue, before deciding to vote against the Bill on Second Reading. I made my mind up very late in the day. I continue to be appreciative and respectful of the reasons why people are in favour, but, for me, the fundamental question was whether we were putting vulnerable people at risk by passing this legislation. I resolved that, on balance, we were.

The lead Member, the hon. Member for Spen Valley (Kim Leadbeater), was keen to reflect the balance of opinion across the House, as well as within parties, in the make-up of the Bill Committee, and I was happy to volunteer as the sole Liberal Democrat “no” voter, as a service to my party and to the House. It was a privilege to serve on the Committee, and I wish to put on the record my admiration and respect to all Members, Ministers, Chairs and House staff who served alongside me, and my thanks to the many witnesses who gave oral and written evidence on which we came to rely.

I regret to say, however, that my experience in Committee has only hardened my opposition to the Bill. My opposition is not rooted in a fundamental objection to the principle of assisted dying, but in the approach taken to framing the legislation.

Amendment 87 seeks to tighten up the arrangement around the first declaration, to rule out the possibility of “doctor shopping”. In oral evidence we heard from the chief medical officer, Professor Sir Chris Whitty, that a diagnosis of terminal illness and a prognosis of life expectancy cannot always be made with a high degree of accuracy and that a degree of professional judgment is required on behalf of the co-ordinating doctor, which can result in differences of diagnosis and prognosis.

That was backed up by the Royal College of Physicians this week, whose spokesperson was quoted in The Times saying that it is “extremely hard to tell” if somebody has only six months left to live. My amendment seeks to establish whether the patient has already sought and been refused permission to seek an assisted death so that the co-ordinating doctor can consider the reasons for the first refusal and whether the patient’s circumstances have materially changed since that time.

[Neil O’Brien]

Will the hon. Member give way?

[Sarah Olney]

I will not; I am sorry.

The amendment would help to inform the clinical judgment that will need to be made in each individual case and discourage patients from applying to multiple doctors for an assessment.

I am proud to support amendment 24, tabled by the hon. Member for Bexleyheath and Crayford (Daniel Francis), which would disapply the presumption in the Mental Capacity Act 2005 that a person has capacity unless the opposite is established. There was a great deal of debate in Committee about the efficacy of the Mental Capacity Act and whether its provisions were sufficient to establish an individual’s capacity to make an informed decision about whether to seek an assisted death. The hon. Member for Bexleyheath and Crayford spoke compellingly in Committee about his experiences of how the Act is not always applied effectively. I am glad that the whole House has had an opportunity to hear him today.

The Royal College of Psychiatrists cited the insufficiency of the Mental Capacity Act as one of its nine reasons for opposing the Bill earlier in the week. It said:

“The Mental Capacity Act was created to safeguard and support people who do not have the capacity to make decisions about their care or treatment or matters like finances. Should the Bill become law in England and Wales, implications for both the Mental Capacity Act and Mental Health Act need to be considered.”

I also support new clauses 1 and 2, tabled by the hon. Member for Hackney South and Shoreditch (Dame Meg Hillier), which would prohibit health professionals from raising the subject of assisted dying with a patient. It is my personal belief that people’s rights to pain relief and palliative care towards a natural end should be prioritised above an assisted dying pathway, and that that should be made available only as the result of a specific request. It is particularly important that young people under the age of 18 should not be thinking about assisted dying as an alternative to continued treatment or palliative care.

I was disappointed that during Committee my proposed amendments to safeguard people suffering from eating disorders were rejected. Eating disorders are primarily a mental health condition but have an obvious physical impact, and there is a severe risk that the physical impact of an eating disorder can be diagnosed as a terminal illness, when in fact eating disorders are always treatable. We cannot allow vulnerable sufferers from eating disorders to elect for an assisted death when there remains the possibility of a full recovery and the chance of a happy and fulfilling future. That is why I support amendment 14, in the name of the hon. Member for Bradford West (Naz Shah), who was such an articulate member of the Bill Committee. I was glad to hear that the lead Member, the hon. Member for Spen Valley, will adopt that amendment; I look forward to seeing the further drafting.

I also support amendment 16, tabled by the hon. Member for Vauxhall and Camberwell Green (Florence Eshalomi). I welcome the lead Member’s new clause 10, which extends the right to refuse to participate in assisted dying to any person, but it is important also to extend that right to organisations such as hospices and care homes. Assisted dying undermines those institutions’ mission and purpose, and they should have the right to refuse to provide it on their premises if they do not wish to participate in it.

Finally, I will speak in favour of amendment 22, tabled by the name of the hon. Member for Shipley (Anna Dixon). There is insufficient provision in the legislation to identify and seek to ameliorate mental health conditions or other factors that may lead people to seek a premature end to their life, which they would not seek if those factors were addressed. Every time a person seeks to end their life prematurely is deeply regrettable, and we have a duty to explore whether preventable factors could be addressed before a request for assisted dying is granted.

[Dr Kieran Mullan (Bexhill and Battle) (Con)]

As has been the case throughout the Bill’s consideration, His Majesty’s Opposition have not taken a position on the principle of the Bill, and nor do we take a position on any of the amendments before the House. It is not for me to justify or argue against particular amendments. The arguments for and against have been well ventilated by hon. Members today.

As we might expect—I know this from my own email inbox—many constituents are considerably more interested in our proceedings than might ordinarily be the case for a Bill’s Report. It might also be the case that there is not a complete understanding of the nature of today’s proceedings, so I hope that I might usefully reiterate what we are and are not doing.

I then want to make some remarks focused on the public and campaigners, about how they should reflect carefully on their own obligations to respect the sincerity and freedom of choice of Members. I have come to consider that issue to be important, given some public interventions by high-profile campaigners, experiences with my own constituents and experiences that I know other hon. Members have had when they have been lobbied on the topic and on the way in which they will be voting today.