The House of Lords: Where the assisted dying bill goes to die?

By Kate O'Mahony

Issues of life have dominated Parliament recently. Three days after MPs voted to fully decriminalise abortion, they returned to vote on the third reading of an even more contentious issue – the Terminally Ill Adults (End of Life) Bill. Passing by just 23 votes, Kim Leadbeater’s ambitious crusade to create one of the most significant social changes in a generation will now go to the House of Lords, where it will face its toughest challenge yet.

Many are now questioning what power the Lords have to alter or even block legislation? Without delving into intricacies of the UK’s constitutional system, multiple roadblocks have emerged. This bill is particularly vulnerable on three fronts – its slim majority, the inapplicability of the Salisbury Convention and its status as a Private Members Bill, meaning the Parliament Act cannot be invoked to override the Lords. Lord Jackson and Baroness Grey-Thompson have indicated that they "will table hundreds" of amendments, a move designed to exhaust the passage of the bill, making it incompletable in the available parliamentary time.

The bill passed the Commons by just 23 votes and reports suggest that many MPs who supported it were hesitant but chose to back the bill in principle, in the hope that the Lords will amend it appropriately. A stance that, opponents of the bill claim, grants the Lords greater licence to amend or even reject the bill. There is, however, a broader picture here. The bill passed its second reading in November with 55 votes and has garnered cross party support throughout the process. Most importantly, it reflects the will of the public. Polls consistently show overwhelming support for assisted dying, with the most recent results of 73% for and only 13% against.

By legalising assisted dying, we can regulate it and help people make informed decisions.

Opponents must ask themselves what they’re really achieving by urging the blocking of this bill and emboldening the unelected chamber. Yes, the bill has faced scrutiny, all meaningful legislation does. Particularly those as emotionally charged and morally complex as this. In doing so forcing us all to confront a deeply uncomfortable question – if we were to meet a distressing end, would we like the choice to die on our own terms?

As established, the principle of assisted dying is vastly popular. Few politicians on the opposing side have claimed a moral objection to the bill. The contention lies widely in the implementation and particularly the absence of safeguards. But the reality is that the UK’s Assisted Dying Bill would introduce the most tightly controlled framework worldwide. Countries like Canada and Belgium allow access for chronic or psychiatric conditions and permit advance requests. In contrast, the UK bill limits eligibility to terminally ill adults with under six months to live, mandates approval from multiple doctors and a multidisciplinary panel. The reality is that if the bill was any more restrictive, assisted dying would be essentially inaccessible.

There are still concerns of a slippery slope, fears that access will inevitably widen. But the UK’s political culture has resisted the world’s strictest criteria, with attitudes vastly more conservative than like countries with assisted dying, deeming the likelihood of us following course exceptionally minimal. Not to mention, history has not been kind to slippery slope arguments when it comes to social change. When contraception and divorce were legalised, many warned of the breakdown of the family unit and moral collapse. Or that gay marriage would lay the groundwork for polygamous unions. All of which clearly failed to materialise.

Some fear that legalising assisted dying will pressure people into ending their lives to avoid burden. It is a valid concern, but despite its illegality, people have resorted to assisted dying for decades. By keeping it illegal, we turn a blind eye to why people make that choice, including those who do so due to feeling burdenous. This bill would change that. By introducing assessment by two independent doctors followed by a multidisciplinary panel including a psychiatrist, a social worker, and legal expert, intent can actually be assessed, ensuring the choice is uncoerced and voluntary. No process is flawless, but this model offers far greater oversight and protection than the current approach. By legalising assisted dying, we can regulate it and help people make informed decisions.

This bill offers freedom to those dying in pain, ignored by the system, left to take desperate measures to relieve themselves of suffering.

Those who highlight the poor state of palliative care are not incorrect – it is overstretched and underfunded and the management of terminal illness under the NHS should be better. But while we wait for all of the UK’s faltering institutions to reach perfection, every year 300-650 terminally ill people will commit suicide, 3,000-6,500 will attempt to do so and 50-60 will travel to Switzerland for an assisted death, not including the thousands more who suffer in pain, fearing the consequences. What opposition groups like ‘Care not Killing’ ignore is a fundamental truth: some people at the end of life do not want pain management, they want choice. Even with better care, they do not wish to prolong dying. Death on one’s own terms, surrounded by loved ones and not at the mercy of illness is a legitimate desire. This bill offers freedom to those dying in pain, ignored by the system, left to take desperate measures to relieve themselves of suffering.

Opponents who cite inadequate safeguards rarely engage with the bill’s rigorous

global-standard framework. While those who point to the necessity to improve palliative care first have yet to define a standard that would justify offering assisted dying. For many, it is easier perhaps to stall rather than take responsibility for a reform that carries such emotional and political weight. This change in the law is bold. But consequential policymaking is rarely tame. If this bill fails, we miss another opportunity to recognise the suffering of the terminally ill. The opportunity to offer safe, compassionate options. To end silence and stigma. Some still perceive death as the ultimate failure, something to protest at all costs. But anyone who has seen a loved one suffering at the end of life knows that sometimes, the kindest thing we can offer people, is a choice.

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