All 3 Debates between Baroness Grey-Thompson and Baroness Finlay of Llandaff

Terminally Ill Adults (End of Life) Bill

Debate between Baroness Grey-Thompson and Baroness Finlay of Llandaff
Baroness Finlay of Llandaff Portrait Baroness Finlay of Llandaff (CB)
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I have already spoken to Amendment 459 and am finishing off speaking to it.

I will move on to Amendments 475 and 939 in Schedule 2. There is concern over the operation of the panels and safeguarding responsibilities, just in terms of the information that comes forward. Someone with relevant information would be allowed to come forward to the panel with appropriate evidence and be afforded whistleblower protection, in the type of situation described by the noble Baroness, Lady Berger, where there is a new person on the scene who others may feel has malintent, for one reason or another.

In the Bill’s current model, medical assessments that have previously gone to the panel will not be monitored contemporaneously. They could be poorly reported, they will not be reviewed and this could hide errors, unconscious bias and discrimination. The role of the panel will be to issue a certificate. In Amendment 493, I have suggested that the certificate should have validity for six months and, in the event that the person has a longer prognosis—we have many examples of that—it is renewable rather than having to start the process again because they have outlived their prognosis.

However, the appeal mechanism to a panel seems to be one-sided. The person can appeal against a refusal to give them a certificate, but there does not seem to be a mechanism for appeal. My Amendment 499 seeks to allow information to be brought to the panel that it may not have known about when it gave a certificate. This may relate to domestic abuse that had been hidden, to coercion or pressure, to any information that the diagnosis may have been wrong, to recent emotional or psychological trauma, or to depression or metabolic disturbance which might have impaired capacity.

Amendment 932 is a very practical one concerning the provision and distribution of panels around England and Wales. It has not been made clear how many panels there would be or that there needs to be fair distribution. I have suggested a minimum of three per region in England and a minimum of three in Wales. For the geography, topography and population, I think three would work for Wales. However, areas of England with high population density, or very large rural areas, would probably need more to enable the panel to visit the patient face to face for an assessment. It is completely inappropriate to expect a patient to go to see a panel when they are already ill or to rely on remote consultation rather than having the ability for face-to-face discussion. Those face-to-face discussions must be subject to the confidentiality that you would expect in any medical consultation. I hope that we will not be suggesting that this would be publicly available.

I suggest that, as has been said, these panels came in two-thirds of the way through and a panel can take testimony from others. However, in terms of getting information about the person, as the Minister of State for Courts and Legal Services said in Committee on this Bill:

“It is not a court or a tribunal … They can make the request, but they cannot compel someone to attend”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee, 12/3/25; col. 1102.]

Baroness Grey-Thompson Portrait Baroness Grey-Thompson (CB)
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My Lords, I want to pick up on a couple of points that have been debated this afternoon, and those raised by the noble Lord, Weir, on the impact on disabled people. I seem to have completely failed in all the debates to get across the fear that disabled people feel with this Bill being debated.

Jennyfer Hatch in Canada had Ehlers-Danlos syndrome, experienced organ failure and was approved for MAID. It made me think of the letter that the Minister, the noble Baroness, Lady Merron, wrote to the noble Lord, Lord Moylan, this week, about the combination of illnesses that would qualify a person for this service. That is why disabled people are so worried. The combination of their disability and other conditions would make them eligible, even though we have been told that there is nothing to worry about. Can the Minister confirm what I understand the noble Baroness, Lady Merron, said when she wrote to us: that a combination of impairments would enable somebody to enter?

I strongly support the amendment from the noble Baroness, Lady Keeley. That is really important because in another case from Oregon, Joan Lucas, who had ALS, was approved for this service; her children filled out the form. There was no question about it; they just took it and she was approved, which is quite worrying.

I thought the debate on somebody dying by suicide was really interesting, and I am going to use “assisted dying” in this context. One of the reasons we are told we cannot use “dying by suicide” is because dying by suicide and this process are completely different. I am not really sure that we can have it both ways. We need to give a little more thought to that.

I get quite upset when we are constantly told that people are dying anyway. I apologise to the noble Baroness, Lady Hayter, but we have to find a better form of words. People may be dying, but the process and the experience they have as they go through that might vary considerably. Sometimes the language that we use in the Chamber can be quite dismissive of the amendments that we are trying to bring to make the Bill safer. We still never seem to hear the word “safe”, we just hear “workable” all the time.

My amendment in this group, Amendment 924, is about protecting older people and being able to make sure that any abuse or risk of coercion can be assessed. It is really about how the panels gather this information. It has already been mentioned that the British Association of Social Workers has said that the safeguarding is not enough. Hourglass has said that one in five of over-65s has experienced abuse, and on 15 June last year, which was World Elder Abuse Awareness Day, there were calls from numerous organisations to do more. The British Psychological Society has said that elder abuse is a “hidden epidemic”, and the scope is huge: it can be physical, emotional, financial or sexual; there is also neglect and self-neglect.

While the Domestic Abuse Act 2021 gives a framework, challenges persist of social isolation, caregiver abuse, power dynamics and, again, financial abuse. The role of professionals and how they report back on this is really important. I absolutely understand what my noble friend Lady Hayman is saying about not making the system overly complicated, but we have to find a holistic way of supporting people.

SafeLives has said that older people experience abuse before seeking help for twice as long as those who are under 61. Last year Age UK reported the fact that older people are overlooked by policymakers, service providers and programmes that are designed to support victims and survivors. Until 2021, people over 75 were not even asked about their experience of domestic abuse, so the lack of data means that there is an assumption about who is being abused. The ONS introduced new survey questions, which render comparison nearly impossible. Of course, the perpetrator of the abuse could be an adult child. What we found out is that women are at higher risk from their partners and men are at higher risk from adult children. Many organisations have talked about the need for professional support, which is really important.

When I am sitting in the Chamber and we talk about people becoming older at the age of 61, I wonder what the average age of the House of Lords is. I believe it is still 71, and everyone is incredibly active, but this is not the real world—on so many levels, it is not.

Terminally Ill Adults (End of Life) Bill

Debate between Baroness Grey-Thompson and Baroness Finlay of Llandaff
Baroness Finlay of Llandaff Portrait Baroness Finlay of Llandaff (CB)
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I have looked after thousands and thousands of patients, and I have to say that I have never come across someone who said they wanted to be terminally ill and to have their metastases or whatever. No, people want to live well but accept that death is a natural part of life. That is quite different from talking about deciding that someone is going to be given lethal drugs to foreshorten their life.

The benefit of the amendments proposed by the noble Baroness, Lady Berger, is that they fit fair and square with the Title of the Bill, which is about terminally ill adults, and make it clear that this is about terminal illness and cannot be masqueraded as anything else. Yes, there will be multiple factors, because of course someone who is already seriously ill but is content with their life will not seek assisted suicide—that goes without saying. However, we also need to be clear about differentiating medication, which is where we give a substance with the intention of achieving an improvement to the person’s well-being, from the large cocktail of lethal drugs that we debated previously, and I am not going to revisit that.

I have a concern when we label all these patients as having pain and suffering. Evidence from other countries is that pain and suffering are not the prime reason why people are going for this. I see the noble Baroness, Lady Jay, nodding, and I remember well from the Select Committee that we were on that we heard repeatedly that there were multiple existential factors that made someone’s life have so little meaning and worth that they felt they wanted to go for assisted suicide. However, we have to put some boundaries around it, because literally thousands of people in this country feel exactly that—that their lives are of no worth—and they feel suicidal. As Professor Louis Appleby, the lead suicide prevention adviser to the Government, has said,

“I’m worried once you say some suicides are acceptable, some self-inflicted deaths are understandable and we actually provide the means to facilitate the self-inflicted death. That seems to me to be so far removed from what we currently do and from the principle that’s always guided us on despairing individuals, that it’s an enormous change with far-reaching implications”.

The amendments would provide a ring fence and some safety barriers. Sadly, there are literally thousands of people in society who are suicidal. We heard a lot about that in relation to young people and the algorithms on their phones that they get into with social media and so on. There are an awful lot of people who are profoundly depressed and a lot of people in poverty, and when they become ill that may take them down one further notch, and there are a lot of people who just feel unloved. We have to make sure that the Bill sticks to what it claims to do, which is to be about terminal illness.

Baroness Grey-Thompson Portrait Baroness Grey-Thompson (CB)
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My Lords, in other groups last week, I covered issues of why I was concerned about people requesting assisted suicide because they feel like a burden, so I will not seek to rehearse those, but we should care about the other reasons why people’s decisions might be impacted, not least because in 2022 Marie Curie said that when someone is given a terminal diagnosis they are quite often financially impacted by that. So not only do you have the trauma of the diagnosis but other things happen and fall apart very quickly around you.

I know that Members of the Committee from all sides have worked on welfare reform and on the Legal Aid, Sentencing and Punishment of Offenders Act—all designed to provide better support for people who may need it. It is great to hear that there are GPs who will offer support on benefit claims and to put other things in place, but I cannot quite understand and work out where in the process people would be signposted back to the GP. We know that there is often a long waiting list for people to get a GP’s appointment; would one or both of the two doctors actually help somebody with a benefits claim or who would they signpost to? That is an important part of understanding the process.

Assisted Dying Bill [HL]

Debate between Baroness Grey-Thompson and Baroness Finlay of Llandaff
Friday 7th November 2014

(11 years, 4 months ago)

Lords Chamber
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Baroness Finlay of Llandaff Portrait Baroness Finlay of Llandaff
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I will be very brief. It is admirable how the House has coped with what appears to be slightly confusing. It is wonderful that we have clerks and Whips who understand more than the rest of us do, as it unfolds.

This stand part debate is very important, partly because the two issues of transitional care and the needs of very young adults are critically important, as is the point made about suicide tourism. I am sure that that was never intended by the noble and learned Lord, Lord Falconer, but this was the only place that it could come up in the Bill, and I am glad that my noble friend Lady Howe raised it.

I had sought previously to clarify “assisted dying”, and that the first clause should be titled “Assistance with suicide”, because this is about assisted suicide—it is not about physician-administered euthanasia. All the debates that we have had are as such, and I hope that when the Bill is reprinted we will be able to have a more accurate title to Clause 1. It is assistance with suicide, not physician-assisted euthanasia.

Baroness Grey-Thompson Portrait Baroness Grey-Thompson
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My Lords, I apologise, but I would like to speak briefly because I had six amendments that dropped out due to the amendment of the noble Lord, Lord Pannick.