Thank you to everyone who has written to me sharing their personal accounts and views on this Bill as it makes its way through the Parliamentary process. For many, these are painful and heartful and I am immensely grateful to everyone – from those on both sides of the debate and from those who feel conflicted – for sharing their deeply personal experiences with me.
Some of you may be aware that back on 25 November, I published an open letter setting out my views on the Terminally Ill Adults (End of Life) Bill as the Bill has its “Second Reading”. This stage is when MPs tend to debate and vote on the principles rather than the details of the Bill. At that stage, I set out my views on the Bill so far, explained that I had voted for the Bill at Second Reading to enable further scrutiny and debate and also outlined my own reservations and concerns about some of the provisions in the Bill as they related to mental capacity, coercion, and monitoring. You can read that open letter here (Link here).
Parliamentary process
In my last letter, I confirmed that as the Bill had passed it’s Second Reading, it would move to Committee Stage where appointed Members of Parliament would review the Bill line by line, take evidence from stakeholders and experts, and have the opportunity to amend the Bill to improve it.
The Bill concluded its Committee Stage and has now moved to Report Stage. This is where the Committee reports back to the House of Commons as a whole and specific amendments can be considered, debated and voted upon. Friday 16 May was the first day of that Report Stage. We expect that Parliament may well sit for a number of other days as part of this Report Stage, but all of these dates are yet to be confirmed.
Conscience issue
As a reminder, this Bill is a conscience issue. There is no party whip, and each MP will make up their own mind having considered all the evidence and debate, personal accounts and their own conscience too.
Scope
A number of constituents have raised concerns about the scope of this Bill again or for the first time. As set out in my initial open letter and to clarify: the scope of this Bill is determined by its title, and so it can only ever be applicable to adults who are terminally ill. Unlike other jurisdictions, this Bill could never be amended in the future to go beyond that scope. For the avoidance of doubt, neither children, nor those who are not suffering from a terminal illness with less than six months to live, could use the provisions in this Bill to seek assistance to end their lives.
Scrutiny
Some of the messages I have received in recent weeks and months have suggested that this Bill should not proceed because it hasn’t been subject to enough scrutiny in Parliament. Many of those who raised these concerns told me in their emails, letters and postcards that this perceived lack of scrutiny was because this proposed law is making it’s way through Parliament as a Private Members Bill, and not a government one.
In my opinion and personal experience as an MP for almost 6 years, I have found the opposite to be the case.
First, I believe it’s important to note that many of the greatest social changes in the twentieth century came about using the private members bill process. The first law to abolish the death penalty, the legalisation of abortion care for women and the decriminalisation of homosexuality all came to pass as a result of private members bills. More recently, the legalisation of civil partnerships for opposite sex couples was passed using a private members bill in 2019. The United Kingdom has a strong tradition of navigating these sometimes contentious, but almost always non-partisan, issues in a collegiate and respectful way. Indeed, the Private Members Bill process actually lends itself to encouraging cross-party cooperation.
Second, the level of scrutiny this Bill has received so far in both Committee and Report stages – and the plans for further scrutiny as it continues its Report Stage in the coming weeks – has been unmatched during my time as an MP. In fact, I can’t recall any other Bill which has received more than one sitting day of Commons scrutiny at Report Stage during my time as your representative in Westminster.
It can sometimes be unhelpful to compare different pieces of legislation as they deal with vastly different issues, with varying levels of complexity, contention and ethical dimensions. Notwithstanding, it may be of interest to some to know that the Terminally Ill Adults (End of Life) Bill was just 38 pages long when introduced, and the Committee Stage discussion transcripts take up 852 pages. Having looked at some of the larger pieces of legislation in the last Parliament, other Bills were often far longer (running into hundreds of pages) whilst the discussion transcripts were noticeably shorter.
Report Stage on the Terminally Ill Adults (End of Life) Bill has already had more than five hours of Report Stage debate, with at least another five expected; and a likely separate debate for Third Reading. Government Bills rarely get so much time for debate and scrutiny, and in my experience having substantially separate debates on Report and Third reading on government Bills is incredibly rare.
Given the magnitude of the issues at stake, I believe that this Bill deserves and requires this level of scrutiny. I believe that it should continue to be closely scrutinised – more so than any other Bill – and I am personally committed to engaging fully at every stage of this scrutiny. I continue to respect the fact that people are of course entitled to object to this Bill – either on principle or on its own merits – but I for one, am not persuaded by the argument that the Bill has suffered from a lack of scrutiny.
My amendments to the Bill
I was not a member of the Bill Committee, but I was in regular contact with MPs who were selected to serve in this important role and received updates from them. The committee membership reflected a broad range of views, and you can see from their debate transcripts that the Bill received robust challenges, debate, and many changes to address real and legitimate concerns about its provisions, workability, and protections for the most vulnerable in our society. In all, there was around 90 hours of Committee Stage debate between 28 January, and 25 March over 29 sessions. The Committee considered almost 600 amendments, with around a quarter of them being accepted. This included more than 30 amendments tabled by MPs who had voted against the Bill during its Second Reading debate.
There is no suggestion that the Committee members agreed on every point, but I am content that the process was thorough and collaborative, and that they took time to hear evidence from all sides of the wider public debate.
As some of you may know, I had some concerns about the Bill as it was introduced last year, and wanted to update you on the steps I have taken to address those.
I tabled six separate amendments in early February, and met with a number of the Committee members to discuss and explain them. You can find all of my amendments as originally tabled, online here in my name.
I’m grateful to the Bill’s sponsor for taking the time to meet with me, understand the need for the changes, and for her work with the government and parliamentary clerks to ensure that the protections I sought to introduce were incorporated into the Bill during Committee Stage. They included strengthening the safeguards around assessing capacity and preventing coercion, ensuring appropriate training is provided to healthcare professionals, giving parliament the ability to properly scrutinise regulations brought forward by government should the Bill pass and be implemented, and that there is adequate independent monitoring of how the Bill works in practice should it become law.
The Bill remains subject to further amendment during the continuing Report Stage, and I continue to follow any changes closely, to ensure I am satisfied that my concerns remain adequately addressed as the Bill evolves.
Report stage: Friday 16 May votes on amendments
In addition to the formal parliamentary scrutiny I’ve described here, I spent a considerable amount of time ahead of the first Report Stage debate on 16 May to read and absorb a number of reports, briefings and documents. These include: the Bill itself as amended by Committee, the Equality Impact Assessment, Human Rights Memorandum and Impact Assessment, all published jointly by the Department for Health and Social Care and Ministry of Justice. As you may know, the government is taking a neutral stance on the Bill, and so importantly these assessments are impartial, objective and non-partisan.
I’ve also attended a number of meetings in Parliament and in the constituency with those with relevant lived experience, the medical profession (including those for and against the Bill, and with those who have a neutral stance but are keen to engage in the details of the Bill to ensure it is workable), and those with a long-standing interest in the principle of assisted dying.
Many people contacted me ahead of the first Report Stage debate on Friday 16 May.
Unlike most government legislation, the enhanced scrutiny of this Bill means that it is progressing much more slowly, and the Report and Third Reading stages aren’t being bundled up into one day, or even just an afternoon.
To explain, MPs have two opportunities to vote on the overall principles of any Bill. The first opportunity is at Second Reading when it’s first debated (which in this case was back in November 2024), and the second opportunity is at Third Reading when it’s completed Committee and Report stages. The date of the Third Reading is yet to be scheduled.
Friday 16 May was the first of a number of Report Stage debates. At Report Stage, MPs are only permitted to speak to specific clauses that are selected for debate. They cannot speak to the broader principles of the Bill, or are likely to be reprimanded by the Speaker.
On 16 May, the amendments that were scheduled for debate and vote were provisions and amendments around the protections and duties for medical practitioners, hospices and care homes, the detail around procedure for receiving assistance to end ones life, and the safeguards, eligibility and mental capacity requirements surrounding that. You can find the debate transcript for Friday in full online here. I was present in the chamber to hear all but thirty minutes of the debate first hand, and had the opportunity to make a short intervention on the incredibly important matter of mental capacity.
Only one amendment was put to a vote on Friday 16 May. This was Amendment 10a, which would have allowed whole organisations to prevent their staff from providing the service. This would have created a battle within organisations for controlling the board and would have been unworkable given that many staff work in a number of different organisations. As such I voted against this amendment, which was ultimately defeated. You can find the full detail of that division here.
The only other vote was on what is known as a closure motion: if MPs vote for this, it allows the debate to be closed so that the house can take a decision on a motion, rather than letting the decision lapse. I supported this motion, which was successful, and so the Bill will continue to receive further scrutiny at a further Report Stage debate. Other amendments which were debated on Friday 16 May, may be selected by the Speaker for a separate division at future Report Stage sessions, but won’t be subject to further debate.
Next steps
The next Report Stage debate will be on 13 June, and will likely examine provisions related to approved substances and devices for an assisted death, restrictions around advertising and promotion of assistance, inquests, death certification, codes of practice and details such as the use of the Welsh language.
There are up to three or four days remaining in this parliamentary session to accommodate further Commons scrutiny of this Bill, one of which will be the Third Reading debate. After that debate, any vote will be on the Bill as a whole, including all the amendments made to it during Report Stage.
I will write to you again then, to update you on the further Report Stage debates, and set out how I decide to vote on the Bill as a whole.
As I have said on the parliamentary record, and confirmed in my last open letter on this Bill, my own personal values mean I believe in freedom, the freedom to choose and bodily autonomy. At the same time, I am however personally committed to supporting and protecting the most vulnerable in our society, especially those who do or may lack mental capacity, or may be vulnerable to coercion. My instinct is to support measures to allow assisted dying in limited and defined circumstances, so long as there are robust safeguards to ensure choice is genuinely free, and to prevent abuse.
I recognise that many constituents will be fiercely opposed to this Bill in principle, and I respect that point of view entirely. I do however hope that all constituents will recognise that I am taking my role as a legislator seriously and am working actively to ensure that the safeguards are as strong as they can be.
Thank you again to you, and all the hundreds of constituents who have contacted me about this Bill. I remain grateful for your patience as I work through my own thinking – and emotions – on this legislation, which would, if it passes, bring about a very profound change in our society. I continue to feel the weight of this process and this legislation very acutely and am aware of the great responsibility entrusted to me: I will continue to do all I can to scrutinise and vote on this legislation to the best of my ability and in line with my conscience.
Yours sincerely,
Daisy
Daisy Cooper MP
Member of Parliament for St Albans