Terminally Ill Adults (End of Life) Bill

Debate between Baroness Finlay of Llandaff and Lord Jackson of Peterborough

Committee stage
Friday 13th March 2026 Lords Chamber

[Lord Jackson of Peterborough (Con)]

As usual, the noble Lord makes a very apposite point and reinforces my arguments.

Time is pressing, so if I can beg the indulgence of your Lordships’ House, I will just develop slightly my support for the points that my noble friend Lord Shinkwin made at the beginning of this debate. The danger that terminally ill patients, accustomed to trusting medics who care for them, will sense that they should do what their doctor is telling them when they are only suggesting the option of assisted suicide is greatly heightened where, for instance, learning disabilities are in the mix. My noble friend made reference to Ken Ross of the National Down Syndrome Policy Group, who was quite right when he said:

“People with Down syndrome have a very complex and unique speech and communication profile. They are highly suggestible. Even someone wearing a uniform could suggest a position of authority to them and something they should show acquiescence to. The acquiescence bias risk from people with Down syndrome is extraordinary.”


This was mentioned by my noble friend.

“They could have a seeded view around what they think that person wants to hear and talk about without fully understanding the position”.

I assume that by “a seeded view”, Mr Ross means that the idea is planted in their mind, by a doctor mentioning assisted suicide, that this is what that doctor would prefer. Others, more expert, might put me right.

Other similar points were made by my noble friend Lady Monckton, in her superb speech, about the dangers of someone such as her daughter Domenica, who has Down syndrome, being advised by a doctor new to her that a terminal condition might mean it is best to have her life ended—without any legal obligation to discuss this with parents, other family members or someone independent, as the amendments from the noble Baroness, Lady Grey-Thompson, propose. As she said, fear, terror and a total lack of comprehension would sit alongside her daughter’s highly suggestible disposition.

The Commons, in fairness, did ensure that the Bill now has extra safeguards for those with learning disabilities, but these are focused on training and an advocate from the first declaration—far further down the road than the preliminary discussion. Actually, the experience in Australia is that training around the specific bespoke issue of coercion is very limited, and that needs to be looked at. Perhaps the noble and learned Lord will address that in his concluding remarks. This is when framing effects will occur and will be the starting point for vulnerable people misunderstanding the options or feeling pressure. By the time an advocate is in place, the person they are working for might have a fixed idea, which the advocate will not want to ride roughshod over. Clause 5 therefore needs strengthening to address this inconsistency, which is a key concern of experts in learning difficulties.

Hence the question that some noble Lords may be asking, about the need for prohibition, particularly where Down syndrome and learning disabilities are in play, because these might be the patients most likely to provoke cost concerns but least likely to discern that this motivation, not their best interest, is the main reason for raising the possibility of assisted suicide. I have to say that that would be a minority of cases, and I am not making that point about the vast majority of clinicians.

In conclusion, it is for these reasons that I strongly support Amendment 162 and others in this group.

[Baroness Finlay of Llandaff (CB)]

My Lords, I have two amendments in this group. We have heard a lot of comments about the real world and what is actually going on now, today, out there in healthcare. It will be very interesting to hear how the noble and learned Lord, Lord Falconer, responds to all the criticisms and to the way the inherent dangers in Clause 5 have been highlighted.

My Amendment 201 concerns children. A little boy with advanced malignancies said to me, “I'm going to die when my goldfish dies”. He went on to talk through what he wanted when he was dying and how he would play football in heaven with another boy who had died recently. Not long after, his goldfish was found floating. My strenuous attempts to resuscitate his goldfish failed, and he gently died soon after.

That was some years ago. Today, children live off the internet, not just off what they hear from other children. They know about the debate on this Bill—some raise it in “Learn with the Lord” sessions. If a child is asking questions about this, they must be able to express their fears if they are already ill. They often speak with remarkable frankness. Children’s awareness is phenomenal. They deserve gentle, honest planning of their care that also explains why they are ineligible for assisted suicide. Hence my wording, but the wording of the noble Lord, Lord Rook, provides much clearer guidelines for clinicians involved, to allow them to listen but in no way to hint that the child will be eligible.

Assisted suicide is not a medical treatment. It falls outside McCulloch and Montgomery rulings, hence my Amendment 159. As has been said, if a doctor raises assisted death unprompted, the implication is that this is something you should consider—a tacit implication that this might be your best option. Addressing the comments by the noble Baroness, Lady Hayman, it is a doctor’s duty of care to sensitively explore with open questions and careful listening, to discuss whatever the person wishes to discuss at their initiation. That is patient autonomy and control. Mencap, the Association for Palliative Medicine and the Royal College of Psychiatrists have all warned how patients’ trust gives doctors a dangerous ability to steer decisions if the suggestion comes from the doctor.

Listening with undivided attention is crucial in gentle, honest communication in the face of patients’ anguish. Patients hang on to our every word, so suggesting it as an option signposts them in that direction. It abandons suicide prevention duties under the Mental Health Act and the state’s duty under Article 2 of the European Convention on Human Rights. The amendments overall have a common theme of making the autonomy of the patient paramount in these discussions, their being able to raise assisted death in their own time, at their own pace and at their instigation. I hope these amendments will be taken heed of.

Children’s Wellbeing and Schools Bill

Debate between Baroness Finlay of Llandaff and Lord Jackson of Peterborough

Thursday 22nd May 2025 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, I rise briefly to support the very good amendment moved by the noble Lord, Lord Hampton. If we are spending significant amounts of money on collecting this data and building a database and we have some of the best research facilities in the world, it seems to be sensible when looking at longitudinal studies to utilise that data properly.

My second and more prosaic point is that maybe I am missing something, but it seems to me that subsection (5) and subsection (14) are at variance with each other. They are quite loosely drafted in new Section 16LB. Will the Minister comment on that, because the great thing about the noble Lord’s amendment is that it has pointed out that there seems to be a discrepancy between the two subsections?

[Baroness Finlay of Llandaff (CB)]

My Lords, I shall briefly speak in support of these amendments and of research. We do not need to have a national database established in order to do research because, first, research has to go through research ethics committees, so that is carefully scrutinised. You could take a representative sample of areas and use properly anonymised data. We can do that now. We can anonymise properly rather than using the old-fashioned pseudo-anonymisation, which was not helpful.

But in all these areas, I am afraid, we lack the evidence that we need to make sure that all our services are best targeted. When we are looking at very vulnerable children, we need to know which flags that are currently yellow flags should become red flags and which items do not show a correlation—although there has been an urban myth that they do correlate—so that the index of suspicion is appropriately targeted. To pick up on the point made by my noble friend earlier about having criteria, it is only through good research that we will get good criteria to determine the point at which we trigger an alert that a child is at risk and get that to happen earlier. It may well be that we are missing some important pointers just because they are not in people’s current consciousness, and there is a real danger in reacting to what I would call urban myths.