Terminally Ill Adults (End of Life) Bill

Simon Opher Excerpts

2nd reading
Friday 11th September 2026 Commons Chamber

[Lauren Edwards]

I will not give way. I am asking Members today to start the process of sending this Bill back to the House of Lords, so that they can continue their important function of fulfilling their constitutional role.

[Dr Simon Opher (Stroud) (Lab)]

I thank my hon. Friend for giving way, and for making an incredibly strong speech. I was part of the Bill Committee, and we gave about 200 hours of assessment to this Bill, which is much more than most Government Bills get. Indeed, the Lords had an enormous amount of time to consider it, too. Saying that there has not been enough scrutiny is simply wrong.

[Lauren Edwards]

Members should be in no doubt that the Bill we sent the Lords last year was robust.

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[Dame Karen Bradley]

The hon. Lady makes the case so powerfully. I am going to disappoint Members now, because I will not take any further interventions for some time.

Like the hon. Lady, my fear is not principally for those who are confident, articulate and able to insist on what they want; it is for the person who does not want to make a fuss—the person accustomed to putting everybody else’s needs before their own, who internalises that coercion and feels guilty about the care they require, or has simply been deprived of it.

Recognising abuse is really difficult. Those who have the misfortune of watching daytime TV may notice that there are currently adverts for “no frills” cremation services. I am particularly struck by one, which features a woman of late middle age, who is slightly small and says in a quivering voice that she does not want to be a burden or cause any fuss and does not want her family to have an awful time at the point of her death. Therefore, she is investing in a “no frills” cremation to make things better for her family. That person exists. The advertising agency would not bother making that advertisement if that person did not exist.

We have to think about the most vulnerable. These are the people who Parliament—this House—has a particular duty to remember when we legislate and, today, when we decide whether this Bill, without further changes, is safe to become law.

The question before us is, what decision will this House make. I recognise that the sponsor, the hon. Member for Rochester and Strood (Lauren Edwards), is keen to focus on the other place. There is an appealing simplicity in saying, “Send it back there and let them do their work”, but this is not really about the other place anymore. That House has made itself irrelevant. It is about this House and this House alone.

If we seek to engage the Parliament Act, we are, in effect, taking a unicameral decision, and we should understand what that means. We would be declaring that the Bill before us is in a fit state to become law whether or not the other place completes its work. There is no separate process by which this House later authorises the Parliament Act. Our approval of the Bill is the decision.

[Dr Opher]

Will the right hon. Lady give way?

[Dame Karen Bradley]

I will not; I really need to make progress.

The hon. Member for Rochester and Strood and co-sponsors of the Bill have been clear, including in the debate now, that there will not be amendments made in this place. A deliberate decision has been taken to introduce a near-identical Bill and not to incorporate the 77 amendments from the Lords sponsor, including changes that addressed issues that he himself accepted required attention.

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[Dr Ahmed]

I commend the hon. Member for her powerful testimony. I know that she has personal experience of this matter.

When you visit places like Govan and Pollok, you know what vulnerability looks like. Those people cannot send their voices down here via the mic, the TV studio or a billboard in Westminster tube station. We need to make sure that they do not feel the burden of making what some call an option, or a choice, their obligation or duty.

[Dr Opher]

Will the hon. Gentleman give way?

[Dr Ahmed]

Not at the moment.

It is on the foundational principles of the Bill that I primarily want to concentrate today. The first is the idea of a “six months to live” label. “Terminal illness” is a fast-changing medical diagnosis in the modern medical world, and it is becoming an increasingly meaningless term. Only yesterday evening, I was in the company of a professor of respiratory medicine who, with rightful satisfaction, told me that many of his stage 4 lung cancer patients who were designated with six months to live in 2023 are being managed as having a chronic disease in 2026.

In my practice, if a patient comes to see me with stage 4 colon cancer that has spread to their liver, the advent of immunotherapy means that I have an equal chance of telling them they have six months to live or six years to live. Under this law, when I meet that kind of patient, it is unclear to me, with the Supreme Court precedents around consent, whether I should be offering them immunotherapy and an assisted death at the same sitting.

A six-month prognosis will take a new and unhealthy salience in every clinical conversation. It will be a label some will desire, and others will want at all costs to avoid being placed on their clinical record. It will fundamentally change and undermine the candidness and sanctity of the patient-doctor conversation and relationship.

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[Josh Fenton-Glynn (Calder Valley) (Lab)]

I have struggled with this vote perhaps more than any other in Parliament. Had I been asked at any time in my life whether I was for or against assisted dying, I would have said that I am in favour of it. I believe that people have autonomy over their own bodies as a fundamental liberal principle. But we do not vote on principles here; we vote on legislation, and this Bill at this time is not one I can support. I do not believe that it is safe. I do not believe that it addresses the very legitimate concerns raised by disabled voices, and I do not believe that it has come at the right time. In my speech, I will cover the state of palliative care and fears of coercion, but first, I thank my constituents for the role that they have played in this, coming to meetings, speaking to me at surgeries, writing me emails in a respectful way—the way that we should conduct our politics in all things but particularly those that are so serious.

I bring professional and personal experience to this debate. I have been a council cabinet member for social care, sitting on a safeguarding board, I have worked for the General Medical Council and for the past two years I have sat on the Health and Social Care Committee. Like many people, I have also sat with a loved one as they died. Ultimately, my experience means that I do not for one minute believe that this is simple. I know that if we do not pass this Bill, some number of people will die in preventable pain and suffer a painful death. I also know that if we pass any Bill, there will be some number of people who are coerced into taking their own lives. If you have moral certainty—

[Dr Opher]

rose—

[Josh Fenton-Glynn]

I will not give way just now. If you have moral certainty on this question, I honestly envy you.

On the state of palliative care, we are told that this Bill is about giving our constituents more options—a choice between good palliative care or an assisted death. But in a world where there are such gaping holes in our health, social care and palliative care system, that is simply not the case.

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[Noah Law (St Austell and Newquay) (Lab)]

I have long said that my support for this private Member’s Bill is contingent on a commitment to improving, not sidelining, the palliative care system, and I pay tribute to the courageous and dedicated palliative care workers of our country, including those at Mount Edgcumbe hospice in my constituency. Despite being seen as charitable organisations that work alongside the NHS, hospices provide a vital line of support and reduce the cost of care in our NHS, which is something that should be considered.

[Dr Opher]

Does my hon. Friend acknowledge that, even with excellent palliative care, there are very similar rates of people demanding assisted dying? In fact, even in 2010, when we had probably the best palliative care in the world, people still went to Dignitas or took their own lives.

[Noah Law]

My hon. Friend makes a very important point.

Each year, independent hospices help around 20,000 people spend their final days outside hospital settings, and this saves the NHS an estimated 1.5 million bed days and more than £800 million annually. Our Prime Minister is right to say that we must fix palliative care, and I greatly welcome his commitment to work cross-party to end the decades of political drift on social care, too. Ballooning budgets have hit not just the NHS but local authorities, particularly those in Cornwall—they have hit us really hard. We need to fix the system so that it gives people dignity.

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[Mary Kelly Foy (City of Durham) (Lab)]

We have heard much today about the legal, medical and ethical questions being raised by this Bill. For me, the idea of ignoring the warnings of the medical professions is absolutely baffling, but my remarks today will focus on poverty, inequality and what dignity really means at the end of life.

My daughter Maria has been in my mind throughout my considerations. Maria lived with severe cerebral palsy. She was non-verbal and required round-the-clock care. From the day she was born, we were told that she might have just six months to live, but she defied that and lived for 27 years, bringing immense joy to our family. It is because of Maria that I approach this debate with concern; I fear for non-verbal or vulnerable people, and I worry about those who do not have a trusted person to protect them or speak out for them.

I am sure that we all want to see dignity for those at the end of life, but we must ask ourselves what dignity really is. In these circumstances, dignity means being well cared for and supported, receiving the best possible treatment, and knowing that your life is valued. It is not dignified to feel pressured towards death because of the burdens of cost, or the social and economic pressures that accompany serious and terminal illness. When we talk about coercion, we often think of pressure from individuals, but the greater risk may be social coercion driven by inequalities that exist in our society.

[Dr Opher]

Will my hon. Friend give way briefly?

[Mary Kelly Foy]

Briefly, because my hon. Friend has made a few interventions already.

[Dr Opher]

Can I just say that there has not been one confirmed case of coercion in any of these jurisdiction anywhere in the world?

[Mary Kelly Foy]

I thank my hon. Friend for that intervention, but he will find that there are statistics on that. In America, 8% of those who have been deemed to have chosen to end their life have faced huge financial difficulties.

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[Dr Simon Opher (Stroud) (Lab)]

May I praise the House for some fantastic speeches all round, including from my hon. Friends the Members for West Lancashire (Ashley Dalton) and for Filton and Bradley Stoke (Claire Hazelgrove), and indeed just now from my hon. Friend the Member for Penistone and Stocksbridge (Dr Tidball) and the hon. Member for Runnymede and Weybridge (Dr Spencer)? I am proud of our House and the way in which we have debated this matter.

I have been involved in delivering palliative care and end-of-life care—they are actually quite different—for over 34 years and I continue to do so as a GP. Given the time, I will cut my speech short, but I want to say that this is really about choice. Choice exists for people in France, in Spain, in the Netherlands, in Belgium, in Australia, in the US and in Canada, and indeed in Jersey and the Isle of Man. It also exists for people in this country if they have got 15 grand. However, we do not give access to it at the moment.

To all the doubters, I say that this is the safest assisted dying Bill in the world—full stop. That is a fact, because it has got so many safeguards: many more than the ones in Australia or any other place.

[Jonathan Davies]

Will my hon. Friend give way?

[Dr Opher]

No, I will carry on if that is okay.

It is a great thing to offer end-of-life care and palliative care. In 2010, the UK system for palliative care was at the level of the best in the world, yet still people went to Dignitas. Still, 600 people who were suffering from terminal diagnosis killed themselves. Indeed, in Oregon, 92% of patients who opted for assisted dying were receiving good palliative care. They are different things.

[Naz Shah]

Will my hon. Friend give way?

[Dr Opher]

I am going to carry on; I will be very brief.

There has been a lot of concern—quite rightly—about disabled people and people from black and Asian minorities and whether they will be harshly dealt with. In fact, the evidence from other jurisdictions is that these people do not go for assisted dying—it is actually a white, middle-class, able-bodied thing—so in a way we have the opposite problem to deal with.

Let me also say, to answer a point made earlier, that studies done in California showed that where people with terminal illness and depression were treated for their depression, it made no difference to their choice on assisted dying. Assisted dying is different because, as my hon. Friend the Member for Bury St Edmunds and Stowmarket (Dr Prinsley) said, it is a choice not between life and death, but between someone’s death from natural causes and death under their own control. I say to all hon. Members that we have a choice to make in five or ten minutes, but we must give other people that choice. Is it our right to deny those people that choice? I will end my remarks as Madam Deputy Speaker is giving me some black looks.

[Madam Deputy Speaker (Caroline Nokes)]

That brings us to the Front Bench contributions.