February 8, 2026
BMJ Reports on UK Bill
Many lords are focused on optimising patient choice, safety, and control at the end of life, but as lords ourselves we are concerned that numerous amendments from ideological opponents risk undermining the bill entirely, write Dianne Hayter and colleagues
Last summer, the Terminally Ill Adults (End of Life) Bill to regulate medically assisted dying in England and Wales was backed by elected MPs.
Since then, the bill’s progress has faltered with more than 1200 amendments proposed in the House of Lords—vastly more than any other equivalent bill.
Over half were tabled by just seven peers. Because all amendments will be debated, many commentators inside and outside of parliament, including opponents of the bill, consider this to be calculated obstruction.
Scrutiny of the bill is vital, but the burden of amendments is obscuring constructive work to shape the best possible assisted dying service. The crux of the bill is that it offers choice to people enduring extreme suffering despite the availability of palliative care.
Amendments worth debating
Among the most important amendments are those clarifying eligibility, protecting vulnerable groups, and strengthening safeguards while preserving access for terminally ill patients. P
articular care would be needed to assess the competence of people requesting assisted dying if they have a history of mental illness or could be susceptible to persuasion or coercion from others.
Charlie Falconer, steering the bill through the House of Lords, supports tightening protections for people with eating disorders to ensure that the bill cannot be misused.
He also supports a new requirement for early involvement of the full multidisciplinary team caring for the patient, instead of relying solely on doctors, an amendment supported by other professionals.
Ensuring that health professionals who know the patient best are involved from the outset strengthens continuity of care and supports careful, well informed decision making.
Other constructive amendments include strengthening the role of independent advocates, requiring clinicians at each stage of the process to consider whether a patient would benefit from additional representation and support, and further protections for people aged 18-25 without undermining the principle that terminal illness—and not age—determines eligibility.
Explicitly stating that clinicians must opt in to participate will ensure that no professional is compelled to act against their conscience.
Each of these amendments is an example of scrutiny doing what it should: refining the law in response to legitimate concerns and grounding the process in the daily realities faced by dying people and those caring for them.
Centre terminally ill people
Alex Greenwich, an Australian MP who introduced a similar bill in New South Wales, recently spoke to UK peers and MPs:
“We won all the arguments against hostile amendments by asking colleagues to place themselves in the shoes of the person with a terminal illness.”
The result of this person centred approach, he said, is a safe, compassionate, and workable law for patients, families, and medical staff.
Many of the amendments before the UK Lords fail to place the dying person at the centre of the process.
One would force terminally ill patients to take a pregnancy test, regardless of age or sex. Another seeks a ban on the use of artificial intelligence in any aspect of assisted dying, which could render the law unworkable.
The central irony is that the more the bill is delayed, the less certain it becomes that even careful, constructive amendments will survive.
If the bill does not complete its passage by May when this parliamentary session ends, MPs could use the Parliament Act to bring an identical bill back in the next session and vote on it, with no guarantee that any amendments proposed by the Lords will be carried forward.
We, alongside colleagues on all sides of the debate, want to see this bill make proper progress and return to the Commons this session. If opponents succeed in talking it out, we fully support the use of the Parliament Act in the next session to ensure that the decision of the elected House is upheld.8
Different than suicide
Assisted dying is sometimes wrongly described—including by some of our colleagues in the Lords—as assisted suicide.
[Exitorial note – this is politically-driven semantics and makes no sense. Assisted suicide happens in Switzerland and there it is called by its name. If one does not like the political connotations of ’suicide’ let’s rename it for what it is ‘rational suicide’?]
Suicide is often sudden, unpredictable, and profoundly isolating.
Assisted dying, as proposed in this bill, involves careful assessment, safeguards, and support to people in later stages of a terminal illness.
It offers a choice of how to die, not whether to live.
To conflate these two experiences is inaccurate, risks compounding distress for patients and families, and undermines the seriousness with which these decisions are approached in clinical practice.
The special Lords Select Committee on the bill did not hear evidence from terminally ill people or the families of those who have died.
In contrast, we recently heard from Liz, whose brother died peacefully in a Queensland hospice with his family around him, nothing left unsaid.
We also recently heard from Anil, whose father, with end stage multiple sclerosis in the UK, took his own life using drugs obtained online.
One death was safe, planned, and controlled. The other, far from it. Neither death could have been avoided with suicide prevention measures; these men were dying and were determined to exert control however they could.
For patients, none of this is abstract.
The status quo already leaves many terminally ill people without the choice, protections, or support that a regulated system could provide.
Scrutiny matters, and safeguards matter.
But scrutiny only serves patients if it leads to decisions. For people who are dying, time is not a procedural issue. It determines whether careful, compassionate choices are available—or whether they remain out of reach.