Terminally Ill Adults (End of Life) Bill

Simon Opher Excerpts

Friday 13th June 2025 Commons Chamber

[Rebecca Smith]

I thank the hon. Member and I will come to that point very soon. I will now make some progress; I will not take any further interventions.

I struggle to see how removing automatic oversight of assisted deaths squares with a commitment to enact legislation with the “strongest safeguards in the world”. By doing so, the Bill sets a lower bar for scrutiny and review, and creates an information deficit. Put another way, we simply do not know what we do not know. Implementing a novel piece of legislation such as this without ensuring the most robust possible scrutiny of deaths taking place under the Act is astonishing. Under the Bill, assisted deaths would be the outlier, as any other intentionally procured death would automatically be reviewed by a coroner. Why should deaths under this legislation be any different?

Requiring automatic scrutiny from a coroner for assisted deaths should not be viewed as an add-on at the end of the process or perhaps just a safety net, although it is that.

[Dr Simon Opher (Stroud) (Lab)]

Will the hon. Lady give way?

[Rebecca Smith]

No, I have already said that I am not going take any further interventions. I have been very generous with my time.

It is imperative to consider the whole picture, particularly regarding malpractice or coercion—whether that be on the part of medical professionals, families or third parties. In written evidence to the Committee, Dr Rees Johnson, a legal expert from Essex Law School, highlights that, in some cultures,

“decision-making is a collective process involving family and community members.”

--- Later in debate ---

in such culturally sensitive situations. Investigation of assisted deaths by coroners is not a luxury; it is a vital safeguard, without which people will fall through the cracks.

[Dr Opher]

Will the hon. Lady give way?

[Rebecca Smith]

No.

Beyond coercion, automatic inquests provide vital opportunities to identify other critical issues that may not otherwise be picked up. Without a coroner’s inquest, there would be no post-mortem examination. This is not merely an academic point; studies have shown that autopsy reveals that one in four cases have been misdiagnosed. Without this oversight, as His Honour Judge Thomas Teague KC, the former chief coroner, notes, there is

“no certain means of knowing whether the approved substance has led to a quick and painless death, or a lingering and distressing one, or even whether it had failed to cause death altogether and the deceased had been dispatched by manual asphyxiation or some other unlawful means.”

I am not sure whether that could be more clear. The view of experts in this area—both the Royal College of Pathologists and the former chief coroner of England and Wales—is that this Bill’s proposals, as drafted, are not fit for purpose. I strongly urge hon. Members to support my amendment (a) to new clause 15.

--- Later in debate ---

[Alison Hume]

New clause 15 particularly addresses the role of coroners. Coroners investigate deaths in which there is a reasonable suspicion that the deceased has died a violent or unnatural death, where the cause of death is unknown, or if the deceased died while in custody or state detention. This is not the case with an assisted death, and there would already be strong safeguards in place, including multiple layers of oversight and assessment. The process is cautious, thorough, and heavily safeguarded. There is no need to investigate an assisted death, as it is not unnatural. In this country, it is still a crime to help someone die peacefully and with dignity, even when they are suffering unbearably from a terminal illness.

[Dr Opher]

Will my hon. Friend give way?

[Alison Hume]

I will make some progress, thank you.

It is still a crime, even when the person is of sound mind and even when it is their deeply considered wish. Anthony wanted a good death—he wanted to die peacefully and with grace, without pain and without profound suffering. He got that in a foreign country, far from home and far from family, because our laws force people like him to make that desperate journey abroad. That is why I support this Bill and, in particular, new clause 15, as there is no need for coroners to investigate an assisted death.

[Alison Hume]

My hon. Friend makes a powerful case on behalf of her constituent. New clause 15 is a compassionate and practical clause, ensuring that the Bill works not only for the individual making the choice, but for the families they leave behind. Let us not turn our backs on people like Anthony and Louise; let us not make criminals out of the compassionate. The death of a loved one is always difficult. When someone has gone through the legal and safeguarded process of assisted dying, it is not right that their family should face an unnecessary, potentially lengthy and distressing coroner’s investigation.

[Dr Opher]

Will my hon. Friend give way?

[Alison Hume]

I am coming to my conclusion. New clause 15 will protect bereaved families such as that of my constituent Anthony, and therefore I urge hon. Members to support it.

--- Later in debate ---

[Ellie Chowns]

I am very short of time, so I think I had better continue.

Turning to new clause 15, which relates to the role of coroners, if the Bill is passed, assisted dying would be a very strictly regulated process—the choice of an individual; not a death caused by others, but by the individual themselves. As Aneez Esmail has pointed out, this would be the most scrutinised type of death in the country, and it therefore makes no sense to require another legal process at the end when there have already been multiple layers of scrutiny before the death.

[Dr Opher]

Will the hon. Lady give way?

[Ellie Chowns]

I am so sorry, but we are very short of time.

New clause 15 is a compassionate and practical clause. There are strong safeguards already in place, and requiring a coroner’s inquest would go against the spirit of compassion that should be driving us all.

I will briefly turn to amendment 42, tabled by the hon. Member for Newcastle-under-Lyme (Adam Jogee), which would remove the backstop commencement. Essentially, the amendment would leave it in the hands of the Secretary of State to decide when, or if, the Bill comes into effect. That would go against the will of the House. If the House passes this Bill, it is perfectly reasonable and workable for the detail of it to be worked out within the next four years. We have already doubled the length of time allowed for that to happen. Amendment 42 is effectively a wrecking amendment that seeks to kick the Bill into the long grass. [Interruption.] That would be its effect.

To conclude, I will briefly address the misconception that seems to have informed some of the comments I have heard in today’s debate, which is the assumption that families would want to pressure family members to die quicker. My mum is a specialist palliative care social worker, and she has told me that in all her years of practice she has never experienced that happening. It is the other way around.

--- Later in debate ---

[Blair McDougall]

The hon. Member makes an important point that we have to consider. We must recognise that, as he says, people’s choices are limited by the unfair distribution of wealth, the injustices that disabled people face throughout their life, or the attitudes of the powerful in society towards those who are less fortunate.

[Dr Opher]

If my hon. Friend looks at the statistics, he will see that it is usually the better-off in society who choose assisted dying, not the less well-off.

[Blair McDougall]

I will come to that point shortly.

We have a duty to ask whether the poorest and most vulnerable will be coerced into choosing assisted dying over palliative care because of economic disadvantage. Will they be exploited by those with a financial interest in their choosing to end their life? Will their death become a commodity? If we are really going to pass legislation that allows someone’s death to become a matter of business, we must have full transparency on those financial motivations, and my amendment 15 would require that. If we are really going to pass legislation that allows someone’s death to become a matter of business, we must have full transparency on those financial motivations, and my amendment 15 would require that.

Carers in the private sector are not bad people any more than people working directly in the NHS, but private healthcare operates in a context. The evidence that profit influences the moral choices made in the care and treatment that is already provided in this country is overwhelming; this is not a hypothetical concern. For example, a systematic review published by The BMJ found that private equity ownership of healthcare is associated with lower standards of care. Around the wonderful miracle of IVF there is an industry profiting from people’s desperation as they start life rather than end it. Already, at the end of life—this relates to the point made by my hon. Friend the Member for Stroud (Dr Opher)—choice in palliative care is limited by economic status, with the wealthy more likely to die a good death than the poor. My amendment seeks to address the fundamental question of whether free choice really is free by bringing into daylight the financial motivations of those involved in individuals’ decisions.

--- Later in debate ---

[Blair McDougall]

My hon. Friend makes an important point. Amendment 15 seeks to recognise that there is a difference in where private providers’ income stream comes from and that that raises moral issues.

[Dr Opher]

Will my hon. Friend accept one more intervention?

[Blair McDougall]

I do not wish to exacerbate your bronchitis, Madam Deputy Speaker, so I will continue.

Amendment 15 touches on a fundamental point at the heart of the debate. Disabled people and the sick, in every aspect of their lives, have to fight every day for resources from a state, a market and a society that view them as a drain on finances. Do we honestly believe that at the moment when the most vulnerable are least able to argue for themselves, under the most intense societal and cultural pressure, and at their most expensive, those same public and private sector institutions will succeed in making choice real for them when they have failed to do so throughout the rest of their lives? Even if we stretch credulity and convince ourselves that that will be true in the state sector, can we say that it will be true in the market? I do not believe that the Bill should be passed, but if it is, let us not make it worse by allowing unscrutinised profit from the loss of human beings.

--- Later in debate ---

[Lloyd Hatton (South Dorset) (Lab)]

I rise to speak in support of new clause 15 and amendment 54, and against new clause 5. As right hon. and hon. Members will be aware, new clause 15 would not classify a death under the Bill as suspicious or unexpected, so a full coroner’s inquest would not be needed.

If the Bill becomes law, assisted dying would be a legal, strictly regulated and well monitored choice made freely by the individual concerned. To be absolutely clear to hon. Members, it is not assisted suicide. The Bill concerns people who want to live but who, faced with an inevitable, irreversible and terminal diagnosis, want choice over the manner of their death. That is an important choice that removes some of the trauma and anxiety for not only the patients but their family and loved ones. New clause 15 and its consequential amendment 54 will ensure that families who are naturally grieving the loss of their loved one are not needlessly subjected to an invasive coroner’s investigation.

[Dr Opher]

It is important to realise that if there are any suspicions around an assisted death, a coroner can still be involved. The new clause does not exclude that, but it stops the automatic referral to a coroner.

[Lloyd Hatton]

I share my hon. Friend’s sentiment. I firmly believe that we should protect bereaved families against such a distressing ordeal happening automatically, particularly when the process, as set out in the Bill, will already be legal and transparent.

With that in mind, it makes practical sense to support new clause 15. If we pass legislation to permit assisted dying with the full weight of the law behind it, we must also respect that choice in the way that we classify and record such deaths. Those deaths would not be in any way unexpected or suspicious, so to classify them as such would simply be inaccurate.

As has already been touched on in great detail today, if the Bill is passed, it would implement the most robust assisted dying framework anywhere in the world. It already includes multiple layers of oversight. In my view, the process is cautious, thorough and robustly safeguarded. A retrospective investigation would be to duplicate the process, and risks suggesting wrongdoing when none has occurred.