On 16th October 2024, Kim Leadbeater (Labour) presented the Terminally Ill Adults (End of Life) Bill 2024-25 to Parliament, having been drawn first in the Private Members’ Bill Ballot for the 2024-25 session. This Bill would legalise assisted dying for terminally ill people with less than six months left to live. The second reading debate took place on 29 November 2024, when the Bill was approved on a free vote by 330 votes to 275 and committed to a Public Bill Committee for further scrutiny. The bill was considered by a public bill committee over 29 sittings between 21 January 2025 and 25 March 2025. The Bill’s remaining stages (Report and Third Reading) were debated in the House of Commons on 16th May, 13th June and 20th June 2025 where it passed by 313 votes to 291. It will now be scrutinised by Peers in the House of Lords. You can track the Bill's progress online: https://bills.parliament.uk/bills/3774
Rebecca was in the House of Commons for all the stages of the legislation. The matter was a free vote for all MPs as it is a matter of conscience. Assisted dying is a subject on which it is entirely possible for people to hold widely different but defensible opinions. This is why the substance of the law in this area is not a matter of party politics but of personal conscience.
“I voted against this Bill and I am very disappointed it has gone through in its current form. While I do not have a religious objection to assisted dying, the actual Bill passed today is dangerous and there are absolutely nowhere near enough safeguards for vulnerable people. Now, everyone who receives a six-month diagnosis, but who would never have considered this as an option previously, may feel they should now end their life sooner than they wished. Very sadly, there will be cases of exploitation by unscrupulous relatives pressuring family members to end their life when they do not truly want to. It will soon become the expected norm to end your life earlier, not just in exceptional cases.” Rebecca voted against the Assisted Dying Bill
Impact Assessment
Having now had the chance to look at the Government’s Impact Assessment of the Bill, published on Friday 2nd May, I have noted it includes potential savings to the Exchequer in state pension and NHS care. I find it chilling that there would be a form of financial incentive for the state to offer somebody an assisted death. I am very worried if this Bill passes that people will be offered this as a “treatment” route when doctors are able to raise assisted dying multiple times and patients cannot stop doctors from raising this with them. No life should simply be seen through a view of a cost-benefit analysis.
The Impact Assessment also states that all NHS doctors and nurses would be able to carry out an assisted death. Yet, they would receive just two and a half hours of online training about this, far less than many other areas of healthcare and in this limited time they are also meant to learn how to identify vulnerabilities or concerns of patients – impossible given the scale of the issue.
Finally, I have issues with legislating for a “six-month terminal diagnosis”. Doctors do not have diagnoses like this down to an exact science and this point is best proved by prominent campaigner Dame Esther Rantzen, who was told two years ago she would only live for six months. People may decide to end their lives prematurely when in reality they may have lived for much longer.
I am deeply worried that for those who receive a six-month terminal diagnosis, but who would never have considered this as an option previously, may feel they should now end their life sooner than they wished - as a direct result of this change. This may be for financial reasons, so an individual does not feel they are a burden to their family, but also very sadly, cases of exploitation by unscrupulous relatives pressuring an individual to end their life when they do not want to in their heart of hearts.
The lives of the terminally ill, the disabled and those with incurable conditions are of equal value to anyone else’s. I completely sympathise with those who have been given a terminal diagnosis and patients should receive the highest quality palliative support, pain relief and end-of-life care. I would also like them to have the option of assisted suicide. However, we must get this legislation absolutely right or we could have no end of terrible consequences.
Terminally Ill Adults (End of Life) Bill Amendments: Explanation
The Report Stage debate is the first opportunity for all MPs who were not on the Bill Committee to speak about very specific elements of the changes that this legislation proposes to introduce and vote on amendments.
On Friday 16th May, there were only two votes. Firstly, for New Clause 10: Obligation to assist, which I supported. This broadens protections to people and professionals who would have no obligation to assist a death. This includes doctors, nurses, social care workers and other health professionals. They should not be discriminated against by their employer if they did not wish to participate in the process of assisted dying. This amendment passed.
Secondly, for New Clause 10a. This amendment sought to ensure that employees who work for an employer who had chosen not to provide assisted dying cannot offer it whilst working for that employer. Although I supported this as well, it did not pass.
On Friday 13th June, there were several more amendments that were voted on.
Firstly, for New Clause 14(b) which I supported. This amendment would limit the exceptions that can be created to the advertising ban which ensures that services relating to assisted dying are not promoted in any way. This amendment would limit the power of the Secretary of State to create new loopholes to the advertising ban, ensuring that conversations about carrying out an assisted death can only ever happen in person between a doctor and patient and not be promoted on television or seen on the side of a bus. Unfortunately, this did not pass.
I also voted for New Clause 1: No health professional shall raise assisted dying first. This would have removed one of the clearest issues in the Bill that means, as it is currently worded, that doctors are able to raise assisted dying multiple times and patients cannot stop doctors from raising this with them, no matter how vulnerable they are. This amendment would have ensured that the issue of assisted dying is entirely patient-led and a collaborative process about an individual’s healthcare plan. This was also rejected.
I also supported New Clause 2: No health professional shall raise assisted dying with a person under 18. This amendment ensures that only adults will be able to receive information regarding an assisted death, as is defined in the title of this Bill. I am pleased that this passed, providing an important safeguard for all children who are very sadly facing terminal diagnoses but who may not have the capacity to make such a decision regarding their care.
In the first two days of Report Stage, MPs had the opportunity to vote on just 12 of the 133 amendments tabled and only 14% of MPs were given the opportunity to speak in the Chamber during this process. Yet, amendments were being drafted and included by the Bill’s supporters at the 11th hour.
On Friday 20th June, at the conclusion of Report Stage, there was a further series of votes. Firstly, I voted for New Clause 16: Wish to end one’s own life. This amendment would ensure that a person seeking an assisted death is not motivated to do so simply because they do not want to be a burden on others or public services, have a mental disorder or a disability; motivated by financial considerations or a lack of access to treatment. However, this did not pass.
I also voted for Amendment 24. Under this Bill, as currently worded, the capacity that an individual has to take this decision is already presumed. Doctors and the panel involved in this would only have to be 51% sure that a person has the capacity to take the decision to seek an assisted death. This amendment would have reversed this and would require capacity to be actively assessed and only then approved, rather than just presumed. This is a key safeguard that would have protected vulnerable people who may be at risk of coercion or self-coercion. Sadly, this was voted down.
I also voted for Amendment 12. This Bill currently gives sweeping powers to future Health Ministers to change the principles and purpose of the NHS as they see fit, with no role for MPs or Parliament to even debate whatever is proposed. It means that no matter who they are or no matter their political persuasion, through this Bill the future Health Secretary would be able to change this to their full desire. I was not prepared to risk the very future of our NHS and the amendment I supported would have ensured that any changes that are made on this must happen through a full Act of Parliament. It would therefore have to be debated as a Bill before the House of Commons and Lords, ensuring it receives the greatest amount of scrutiny possible. Yet again, this was voted down.
There were also other amendments accepted into the Bill, that passed without a vote, which I was supportive of - such as Amendment 14. This was tabled by Naz Shah MP and seeks to clarify that a person cannot be considered terminally ill solely because they voluntarily stopped eating or drinking.
I also supported Amendment 21 - Marie Curie is a respected campaigner for palliative and end-of-life care across the UK. As you may know, Marie Curie supported Amendment 21 to the Terminally Ill Adults (End of Life) Bill at Report Stage in the House of Commons. The Amendment called for an assessment of the availability, quality and distribution of palliative care services within a year of the Bill gaining Royal Assent. This includes pain and symptom management, psychological support for those persons and their families and information about palliative care and how to access it.
This Bill must not detract from the need to provide high quality end-of-life care. These issues are not competing and I note Marie Curie has a neutral position on Kim Leadbeater's Bill. I was pleased that Kim Leadbeater supported Amendment 21 at Report Stage and that Clause has now been added to the Bill. More broadly, I am grateful that Marie Curie campaign has led to an increased awareness and public discourse about palliative and end-of-life care.
The limitations of carrying this through the Private Members Bill system has been obvious throughout this process. I was the Government Whip in charge of Private Members Bills for 7 years and I can categorically state this system is not designed to deal with legislation of this importance and magnitude. This Bill alters the foundations of our NHS, the relationships between doctors, their patients and their families and would leave much of the actual practical implementation to Ministers, codes of practice and regulations years in the future with little Parliamentary oversight.