My vote on the Assisted Dying Bill

Today, I voted against the Terminally Ill Adults (End of Life) Bill. The purpose of this letter is to set out for you exactly why.

I know how deeply and personally people feel about this issue. I am truly grateful to everyone who has written to me; both those who supported the Bill and those who urged me to oppose it. I also recognise the compassion and sincerity of Lauren Edwards, who brought the Bill before the House, and Kim Leadbeater, whose earlier Bill began this parliamentary debate.

The previous Bill passed through the Commons but ran out of time during detailed consideration in the House of Lords. Today, Parliament was asked to begin the process again.

This was a moment for me to listen carefully to the debate, and to reconsider the arguments. But today’s debate and the scrutiny of the past two years which I have followed closely has reinforced rather than resolved my concerns.

I therefore voted against the Bill.

This is not an abstract question for me. I lost my mum to an agonising pancreatic cancer when she was just 52. I was deeply involved in her care. The pain of that experience profoundly shaped who I am, and I live with the memory every single day. But I then supported my dad through his struggle with an addiction to alcohol which profoundly deepened after losing the wife he loved with all his heart.

The tragedy of this double loss, this double agony, profoundly shape how I think about suffering, capacity, dependence and the responsibilities we owe to people at their most vulnerable.

My starting point remains a fundamental belief in the dignity and sanctity of human life. I understand completely the wish for autonomy and for the dignity of a good death.

But changing the law would also change the responsibilities of doctors, families and the state and perhaps most profoundly it would change the pressures experienced by people approaching the end of their lives, or struggling with the twists of fate life has thrown at us. Five concerns were decisive for me.

1. There is no meaningful choice about how to die if good end-of-life care is not available in the first place

Palliative care in Britain is not reliably available to everyone who needs it. Many people never receive high-quality pain relief, emotional support or specialist hospice care at the end of their lives.

These inequalities fall particularly heavily on Black, Asian and other minority ethnic communities, which already experience barriers to referrals and lower levels of trust in end-of- life services. Nor are the services available to those wrestling with addiction good enough. In my experience, with my dad and working with the homeless community in Birmingham, I found that addiction often begins with people effectively self-medicating the pain of trauma which is simply a twist of fate.

Introducing assisted dying before repairing these failures would risk presenting some people with an unfair choice: not between excellent palliative care and an assisted death, but between a bad death and an assisted death they might not otherwise have chosen.

A choice is only truly free when a meaningful alternative exists.

Before the state creates a pathway to an assisted death, it should guarantee every terminally ill person a pathway to a good death and it should transform the services available to those struggling with addiction. We are not yet close to providing that guarantee.

2. I do not believe the promise that we can build both systems equally can be kept on our present trajectory

Supporters of the Bill argue that assisted dying would sit alongside excellent palliative care and that nobody would choose it because proper care was unavailable.

That is the promise. But I do not believe our present health and care system can deliver it.

An assisted dying service would require money, clinical time, training, inspection, administration and ministerial attention. Those resources would come from the same health budgets and the same overstretched workforce that palliative care has been waiting years for.

Under severe financial pressure, there is a danger that the newer and less costly pathway will expand more quickly - not because anyone intends that outcome but because that is how stretched systems behave.

The risk Parliament must weigh is therefore not simply assisted dying alongside universal palliative care. It is assisted dying arriving before good palliative care ever reaches all the people who need it.

Investment in end-of-life care must come first.

3. The safeguards against coercion, depression and mistaken judgments are not strong enough

Assisted dying laws are only as safe as their safeguards. Once the option exists, some people particularly those who feel like a burden or are subject to pressure from others may come to believe that they ought to take it.

Coercion does not always take the form of an explicit threat. It may be a person being made to feel guilty about the cost of their care, the exhaustion of their relatives or the delay to their children’s inheritance. It may arise within an abusive relationship that doctors have not detected, even after knowing the patient for years.

These pressures can be extraordinarily difficult to identify in a clinical conversation.

The Bill does not require every applicant to undergo a personal psychiatric assessment. Nor does it require a panel to hear evidence from relatives or others who may hold vital information about the person’s mental state or family circumstances.

Indeed, family members may discover that their loved one has chosen an assisted death only after it has happened. They would therefore have no opportunity to present evidence of depression, abuse or coercion. Nor does the Bill provide a clear route for a concerned relative to appeal against a panel’s approval. The applicant can challenge a refusal, but there is no equivalent safeguard against a mistaken approval.

Family members should not have a veto over a competent adult’s decisions. But excluding them altogether could also exclude crucial evidence.

I am particularly concerned that the existing mental capacity test was not designed specifically for an irreversible decision to end life. Someone may have legal capacity in the narrow sense while still being influenced by depression, fear, addiction, abuse or a deeply internalised belief that their life has become a burden.

When the consequences of an error cannot be reversed, “probably safe” is not safe enough.

4. The Bill risks damaging trust between doctors and patients

Doctors and their professional bodies have raised serious practical and ethical concerns about the Bill.

These include the difficulty of predicting accurately whether someone has only six months to live. This was the diagnosis my mum received; it turned out to be completely inaccurate.

For an older patient, a disabled person or someone managing several chronic conditions, a doctor raising assisted dying could also be interpreted as a suggestion that their death would save the NHS money or relieve pressure on their family.

That may not be the doctor’s intention. But trust depends not only on what is intended; it depends on what a frightened and vulnerable patient hears.

The proposed law risks sending a wider message about lives involving illness, dependence or disability. Disabled people repeatedly describe having their quality of life underestimated by others. Many disabled people and disability rights organisations oppose this Bill, and their warnings deserve to be heard.

No one should feel that they ought to die because the care they need is unavailable, because their family is exhausted or because public services are overstretched.

5. The proposed route through Parliament creates a serious constitutional risk

The previous Bill ran out of time in the House of Lords. It has now been reintroduced largely unchanged, despite members of the House of Lords agreeing important amendments and despite further changes being proposed by hospices, medical professionals, legal bodies and others who would have to make the legislation work.

There is therefore a real concern that the Bill is being placed on a path towards enactment under the Parliament Acts.

Those Acts exist to uphold the ultimate authority of the elected House of Commons, but they have been used only a handful of times.

They have never been used to enact a Private Member’s Bill of this kind.

If the Parliament Acts were used, the Lords could be prevented from insisting upon amendments, even practical safeguards accepted as necessary by people on both sides of the argument. Parliament could effectively be presented with a “this or nothing” choice.

That would be a highly unusual and, in my judgment, dangerous way to make such profound and irreversible law.

This is not an argument that the House of Lords should be allowed to frustrate the elected Commons indefinitely. I do not question the good faith of those who brought the Bill forward. But the primacy of the elected House of Commons is more than a right to enforce our will. It is a responsibility to exercise our power with the greatest possible care.

A law governing life and death must command confidence not only in its intentions, but in every detail of its safeguards. It should emerge from the fullest possible scrutiny, not from a constitutional showdown.

What should happen now

Voting against this Bill does not mean defending the status quo. Too many people today endure avoidable pain. Too many families struggle without proper support. Hospices face financial insecurity, access to palliative care remains profoundly unequal, and the law can create terrible uncertainty for families confronting the most painful circumstances imaginable.

The Government should urgently establish an expert commission to examine end-of-life care, the operation of the existing law and the evidence from other countries. Above all, it should set out a properly funded plan to ensure that high-quality palliative and hospice care is available to everyone who needs it.

This has been a serious and compassionate debate. I respect colleagues and constituents who reached a different conclusion. But on a question of this gravity, I must exercise my own judgment.

My conclusion remains that genuine choice does not exist without universal palliative care; the safeguards are not strong enough; our health and care systems are not ready; and the proposed parliamentary process does not provide the careful scrutiny that legislation of this consequence demands. That is why I voted against the Bill today.