Should it become law, the Terminally Ill Adults (End of Life) Bill would be the most significant change to British society for a generation. Those judged to be terminally ill, with six months or less to live, could be helped to die – if assessed as eligible by two doctors. A committee of 23 MPs has spent the past six weeks scrutinising the bill. Their aim: to produce legislation that will allow those who are suffering to end their lives in dignity, while ensuring the most vulnerable are protected from coercion and misuse of the bill’s powers.
“We didn’t achieve that,” Naz Shah told me when we met in her Westminster office. “And that’s really sad for me.” Shah, the Labour MP for Bradford West since 2015, is one of just nine committee members who voted against the bill at second reading. It was never going to be easy to push through amendments against the wishes of the majority (including the bill’s sponsor, Kim Leadbeater). But Shah is “disheartened” – a word she used often during our conversation – about where we are. The UK, she said, has a reputation of “being the mother of all parliaments”, but “this bill, I’m afraid, has let us down in a big way”.
Shah went into the committee “trying to fix things”. Though she voted against the bill, she is moved by the “heartbreaking stories” of those who have witnessed a loved one suffer, and genuinely believes in the merits of a safe law that could help people. But at the moment, she feels “disheartened that I will not be able to vote for the bill, because it’s just not fit for purpose”.
This is the first interview Shah, 51, has given about assisted dying. We sat down less than 12 hours after the final marathon committee session ended in the early hours of 26 March, and though clearly sleep-deprived, she remained sharp. “The one thing that is glaringly obvious is that this is not how we do legislation,” she told me. The lack of an impact assessment for the committee to examine is an issue the MP returns to repeatedly (she has been told it will be published on 7 April). “How can you legislate on something that you don’t even know what the impact is going to be?”
She also finds it extraordinary that the committee was asked to scrutinise a bill on whose implementation there is very little detail: “We have no idea what the [assisted dying] service will look like. We don’t have a model. We don’t know who could provide this service, who couldn’t provide the service. Is it going to be hospices? Is it going to be charities? Is it going to be for-profit? That’s not good enough.”
Shah scored an early victory in persuading Leadbeater to allow the Royal College of Psychiatrists to give evidence to the committee, having initially refused. The committee’s job was “not about getting the bill through”, Shah argued, but rather “getting the right information so we can scrutinise whether it is fit to go through the House”. But most amendments that Shah believes would have made the bill safer failed. She called for a 28-day cooling-off period between someone first receiving a terminal diagnosis and any discussion of assisted death. It didn’t go through. Provisions to prevent doctors talking to 16- and 17-year-olds about assisted dying were voted down. Changes that would rule out those with anorexia being eligible for assisted dying were rejected. And attempts to strengthen the bill to protect victims of domestic abuse against being coerced into ending their lives were not accepted.
For Shah, who was forced into marriage at 15, this is personal. “My life has been defined by domestic violence,” she said. “I’m a former Samaritan. I’m somebody who’s tried to commit suicide on two occasions, and had my stomach pumped on two occasions.”
Shah was hurt the most by Leadbeater’s arguments against those who claimed the bill authorised assisted suicide by the state. “The people we are dealing with are not suicidal,” Leadbeater said. “They very much want to live; they do not want to die, but they are dying.”
“I was like, whoa, I didn’t want to die,” Shah told me. “I wanted to live.” Implying that someone who’s in “the depths of despair doesn’t want to live” or the opportunity to “thrive and survive”, she believes, reveals a fundamental misunderstanding of suicide.
Shah is particularly worried about the impact the legislation could have on women. “This is a gendered bill,” she insisted. “It will affect women more from a femicide perspective.” Jane Monckton-Smith, a leading authority on coercive control, has described the bill as “the worst thing potentially that we’ve ever done to domestic abuse victims”. Shah believes the bill “is ultimately an amendment to the Suicide Act. That worries me,” she said, pointing out that deaths by suicide among victims of domestic abuse now surpass the number killed by an intimate partner.
Shah is also steadfast in her belief that doctors should not be able to raise assisted dying with patients who have not raised it themselves. Several palliative care doctors who gave evidence explained that a doctor initiating the discussion could be interpreted by some as a suggestion to end their lives. “Are we going to be that committee that ignored the evidence of the experts who deal with this issue on a daily basis on the front line with those very people at the end of life who the bill is actually aimed at?” Shah asked colleagues during committee proceedings. “Or are we going to risk being part of a future assisted dying bill scandal because we placed ourselves above those experts by supporting a view of a wider body?”
Critics of the bill have been accused of scaremongering by fellow MPs. “I am scared [of the bill’s consequences],” Shah told me – but that is not the same as scaremongering. She fears a future in which the “daughter who didn’t want her father to die” or the “parent who didn’t want their kid to die” seek answers. “I do not want to be the person who says, ‘We knew this was coming. We failed. We failed our society.’ That is not what I want.”
But Shah’s biggest concern regards the lack of scrutiny the bill demands for the process of securing an assisted death. The initial requirement that a High Court judge approve requests has been replaced with approval from a panel, including a psychiatrist, social worker and legal professional. The implementation of the bill will also no longer be overseen by the chief medical officer, but by an assisted dying commissioner – which Shah sees as akin to assisted dying proponents marking their own homework. “There’s too many loopholes,” she said. “I don’t think this bill has [provided a safety net] in any way, shape or form.”
When I asked Shah what new safeguards the bill contained, given some had been removed, she was uncharacteristically silent. Instead, she highlighted how few measures aimed at toughening up the bill had been agreed to. Of about 150 amendments made to the bill by the committee, 30 came from those who had originally voted against it. According to Shah, five were “tidying-up” amendments, such as strengthening the word “may” to “must”. Another three introduced mandatory training to detect coercion. That leaves 22. “So, when there’s this narrative of ‘we have listened,’ no: that’s not true. The evidence is there in black and white. The biggest changes to the bill… all of these big-ticket items – the ones that have weakened it, in my opinion – have come from the bill sponsor.”
Kim Leadbeater insists the committee process has made “already the strongest assisted dying legislation anywhere in the world even safer and more robust”. Having been through the bill line by line, Shah is not persuaded. Had this version of it been voted upon at second reading, she does not think it would have passed. “We set out to improve it,” she told me. “I think it’s got worse on lots of issues… The bill we have today is weaker than the one that we voted on in November 2024.”
Others agree. Shah told me she’s spoken to “quite a few” Labour MPs who have changed their minds from being in favour to against. “Somebody very bluntly said, ‘Oh no, I’m definitely not voting for this. I ain’t having my old man being coerced and feeling that he’s a burden and he has to go. I ain’t having that.’” Around 60 MPs said they voted in favour at second reading because of the proposed oversight by the High Court. Others have told journalists they would only continue to support the bill if doctors were prohibited from proactively raising assisted dying.
MPs will vote on further amendments to the bill at the report stage, expected on 25 April. It is possible the Commons could also vote that same day on whether to approve the bill at third reading. Will the legislation pass the next hurdle? “I genuinely don’t know,” Naz Shah replied. “I don’t want it to go through as it is.”
[See also: The Tories have one last advantage against Reform]
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