Terminally Ill Adults (End of Life) Bill Committee

In Meeting 5 (2025-10-30) of the Terminally Ill Adults (End of Life) Bill Committee, witnesses pressed for stronger safeguarding against coercion and discrimination in end-of-life decisions, with a focus on disabled people and victims of domestic abuse. Academics, mental-health advocates, and disability-rights representatives argued for a mandatory, multidisciplinary assessment framework; background checks; robust definitions of coercion; and independent advocates at every stage. They urged pre-implementation evaluation of health, social care, and palliative-care capacity before the Bill enters force; highlighted potential risks from online- and institution-driven pressure; and warned against relying on a fixed six-month prognosis as a safeguard. The EHRC and disability-rights voices called for the rights of disabled people to be central, alongside stronger data, accountability, and representation on decision-making panels. The discussion also covered international experience, the need for better palliative care funding, and how safeguards should be designed to prevent discrimination or coercion, while considering the political choices Parliament faces regarding passage of the Bill.

This session of the Terminally Ill Adults (End of Life) Bill inquiry scrutinised safeguards, equity of access, and the role of palliative and end-of-life care in the context of potential assisted dying. Witnesses from Hospice UK, Care England, the Association for Palliative Medicine, King’s College London, and the British Geriatrics Society articulated policy positions and concerns about implementation, funding, and inequities. Key themes included the need for a national policy to protect universal palliative-care access, the risk of widening inequalities if care is under-resourced, opposition or cautions about a fully medicalised model, and calls for robust safeguarding, training, and multi-disciplinary assessments. No explicit UK Government commitment was stated during this session; witnesses urged government action on funding, policy coherence, and clear delivery models ahead of any legislative change.

During the Ad-Hoc Meeting on 2025-10-29, Lords scrutinised the Government’s stance and the practicalities of the Terminally Ill Adults (End of Life) Bill. Key topics included government neutrality vs. sponsor/parliament policy choices, funding implications for the new voluntary assisted dying commissioner and legal panels, and how the panel will operate (not a court or tribunal but an administrative eligibility determination with inquisitorial steps). The witnesses stressed deliverability if enacted, highlighted the impact assessment’s findings (including recruitment and justice-system implications), and acknowledged safeguards around coercion and abuse, training requirements for panel members, and potential judicial-review avenues. Debates covered the default use of medical examiners versus coroners, potential NHS delivery versus mixed provision, cross-border learning from Australia, and safeguarding challenges in prisons. The ministers signalled ongoing technical support to sponsors, while repeatedly noting that funding, delegated powers, and delivery arrangements would be resolved through Parliament and associated departments. The session also touched on safeguarding to address violence against women and girls, and the possibility of a coroner investigation if concerns arise post-death. In sum, MPs and Lords pressed for clarity on funding, delivery models, legal definitions, and safeguarding, while MoJ witnesses asserted deliverability and stressed policy decisions rest with Parliament and sponsors plus the need for further legal advice where necessary.

The committee scrutinised the design and safeguards of the Terminally Ill Adults (End of Life) Bill through two expert panels. The first panel, comprising psychiatrists and social-work professionals, pressed for stronger safeguards, clearer panel functions, and a genuinely multidisciplinary assessment approach to capacity and unmet mental-health needs, arguing that the current panel model is not equivalent to a multidisciplinary clinical team. They called for expanded medical membership on panels, explicit safeguarding powers, early holistic assessments, and unanimous-panel decisions. They also urged opt-in professional involvement with training to address unconscious bias and recommended a series of 10 practical recommendations to improving the Bill. The second panel, focused on medico-legal oversight, warned that removing coroner oversight would be a retrograde step, emphasising the continuing need for coroner/medical examiner roles, robust training, and clear documentation to protect families and detect abuse or coercion. NHS England maintained a neutral stance on principle but signalled readiness to implement if Parliament passes the Bill, including workforce training and guidance for medical examiners. The witnesses highlighted the central tension between enabling patient autonomy and ensuring rigorous protection, with particular focus on safeguarding, mental-capacity assessment, family involvement, and the risk of coercion or abuse being missed under the proposed framework.