Terminally Ill Adults (End of Life) Bill

Baroness Hayter of Kentish Town Excerpts

Friday 27th February 2026 Lords Chamber

[Baroness Hayter of Kentish Town (Lab)]

My Lords, I am quite shocked at what I have just heard. However, before I respond to that—I am sorry, I really am quite shocked— the noble Lord, Lord Murray, has said again, and it was objected to last time I raised this, that this is a life-or-death matter. These people are dying anyway and, therefore, a refusal of assisted death does not mean that the person will continue to live. They are going to die anyway and, indeed, may still commit suicide. We seem to forget that. If they do not get the assisted dying, they may still go abroad or commit suicide themselves, in ways that we know are not always reliable.

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[Baroness Coffey (Con)]

My Lords—

[Baroness Hayter of Kentish Town (Lab)]

It is Committee; the noble Baroness can come in later.

As I say, the noble Baroness, Lady Finlay, will be able to speak to Amendment 459 afterwards. One consideration has to be that the person has informed their children of their decision for an assisted death. I cannot be the only person who knows people for whom there is completely no relationship between parent and child. The child could be aged 60 and have been living abroad for years. They might not know their parent is ill and may not have been in touch with them for 40 years. But somehow we are going to have to try to track down children. Also, the ill person may not want their child to know that they are ill. We are all old enough now; we have had lots of friends go through this. I had a friend who did not want his daughter to know he was terminally ill because she was facing her own health issues at that time. But this would somehow lay down that despite the desire of a father, in that case, nevertheless that child has to be found and told that their parent not only wants an assisted death but that their parent is dying and wants an assisted death.

I really wonder about this denial of agency. If that person does not want to tell their child, according to Amendment 459, they have to make

“adequate arrangements for another person to inform the children”—

who might live abroad, or whatever—

“of the assisted death and provide bereavement support”.

I just wonder what world we are living in where, when someone is reaching the end of their life, some agency of the state demands that they tell them whether they have any children, whether they know that those children are still alive and where they are, and has to tell that child that their parent is ill and that—in a way, a smaller matter—they want to bring forward that death a little bit so that it is not too bad at the end.

Some of these ideas seem to me to exclude from our consideration the patient concerned. They seem to put everyone else in a position of taking decisions. The noble Baroness, Lady Cass, spoke earlier about the amendment that wants more and more specialist advisers brought in. Can we just sometimes revert to remembering that we are talking about seriously, terminally ill people who surely have some agency over their life? If they are refused this, they can still commit suicide but they will probably do it, as a friend’s father did, by going into the garage, blocking the bottom of the door so that no air can get through, turning the engine on and killing themselves that way. I wonder sometimes whether we are remembering that people are facing a terrible end and we just ought to have a little respect for them.

[Baroness Finlay of Llandaff (CB)]

May I intervene on that, given that my amendment is being questioned? Let me explain. When looking after people who are parents, a conversation is often about what the children know. Telling the children about someone’s impending death is extremely difficult for most parents. Usually, it is because the person who is ill wishes to protect those children; they think that, by not telling them and preparing them, they are somehow protecting them. The way children are informed needs to be age appropriate and appropriate to where that child is.

I do not suggest in this amendment that it should be an agent of the state. The amendment refers to making

“adequate arrangements for another person”.

That could be anybody. It is about asking whether they have somebody who will inform those children—or not—about the death. As for bereavement support, it might simply be about telling them in person and letting them talk about it for an hour over a cup of tea, or it might be much longer, depending on the needs of the individual—because bereavement is a very individual thing as well.

I am concerned that we could legislate and somehow believe that, by someone having an assisted death, rather than a death for which there has been preparation, the impact on any children in a family will be less, because the evidence is that it will not.

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[Baroness Berridge (Con)]

When I mention drafting changes, I mean in relation to the timing of this. As drafted, it would need to be done before the application is granted, and it may be that the requirement to go to the local authority could be at the same time as having approved it, not before. But, yes, this would be an additional requirement on the panel.

I hope the noble and learned Lord the sponsor or the noble Baroness, Lady Finlay, can help with my second point on the principle of the Bill. The noble Baroness, Lady Hayter, referred to the situation based on autonomy: the individual wants to do this and does not want to tell relatives. If we are strict purists about that—we had evidence on this at the Select Committee—then with this Bill there could be a situation where the first time anyone hears about the death is when the medical examiner telephones a relative.

I have tabled amendments in a different group on a requirement to nominate next of kin who are over the age of 18. I think it would be useful for the Committee to know what the situation is if someone acts completely autonomously like this and the body is there. Does the noble and learned Lord the sponsor need to bolt on a provision so that there is a public health burial? That is the continuation of the logic of this that you can do this alone, with no one in your life knowing about it. Therefore, to exercise that autonomy fully, there would need to be a public health burial, with everything done before anyone in the family knows. That is a conceptual difference. The noble and learned Lord and I spoke about this in a meeting in relation to what the law is, and it would be good for him to clarify the situation. Can the medical examiner not call anybody and go forward with a public health burial?

[Baroness Hayter of Kentish Town (Lab)]

Does the noble Baroness understand that, quite often, people die and their family does not know about it?

[Baroness Berridge (Con)]

Absolutely, and therefore the medical examiner’s evidence is that, when they have the body in that circumstance, they are under an obligation, we think, to locate and find a relative. Sadly, this happens more frequently than we would like to think, and the local authority powers to perform a public health burial then become apparent. So, yes, there are these situations.

It is important to clarify this in relation to this Bill, because we have this evidence from the medical examiner that the first the family might know is when they are called by the medical examiner. We need to be clear about that and about the position of families. Is this personal autonomy—that is the conceptual point—so fully and properly enacted that there would be a public health burial, without any obligation to inform anybody that this is happening?

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[Lord Harper (Con)]

I shall speak briefly to the three amendments that I have tabled in this group, to start off with. First, Amendment 472A would slightly tighten up the requirement for the panel to speak to the person’s proxy, when they have a proxy. Currently, as the Bill is drafted, they may speak to the person’s proxy, but I think that they should speak to the person’s proxy. There are no criteria set out about how they make that distinction. Given that the person’s proxy will have signed the declarations that kick off this process, they should speak to them. I do not anticipate it being a very long conversation, but it is essential that they do so.

Amendments 495D and 496D reference the appeal mechanism in Clause 18 and set out a time limit in line with normal tribunal and administrative appeals—so somebody has to appeal against the panel’s notification of the refusal of the grant of certificate within 10 calendar days. I shall not labour the point, but it is just sensible to have a time limit to make sure that there is a clear process.

I had intended to limit my remarks to that, but I have done the dangerous thing of actually listening to the debate, and I wanted to reference my noble friend Lord Jackson of Peterborough’s amendment. It came out in the contributions of the noble Baronesses, Lady Fox and Lady Hayter—a perfectly reasonable difference about exactly where we need to have transparency and balances against privacy. The noble Baroness, Lady Hayter, is perfectly at liberty to disagree with the noble Lord, Lord Jackson, and she obviously does, but I was surprised that she appeared to take against him for the temerity of even tabling his amendment. She said she was shocked. The presumption in the Bill as drafted, as far as I read it, is that in Schedule 2 the panels are to determine referrals in public; that is their default procedure. I give way to the noble Baroness.

[Baroness Hayter of Kentish Town (Lab)]

That is very helpful, because I can say what I said to my noble friend in private. Had we been doing this Bill at the sort of speed I hoped we would, I would have tabled an amendment that it should be in private. My personal view is that it should be. Because of the way things are happening—I will say no more—I have not tabled those sorts of amendments.

[Lord Harper (Con)]

That is very helpful. It enables me to make this point, because this is where we have a disagreement. It gives the sponsor of the Bill the opportunity to set out why the Bill is drafted as it is. I will set out why I think my noble friend’s amendment is broadly right, but perhaps there is a comparison with what we already do in similar cases. That may give the noble Lord, Lord Carlile, the opportunity—he may not wish to say so—for another “told you so” moment, as it is a judicial comparison.

The presumption in the Bill is that panels will do the referrals in public. There is a “subject to” on that: the chair of the panel can decide to do it in private if they feel that is appropriate. I accept that there is a balance to strike because, for obvious reasons, these panels are making decisions about personal, private matters. It is also right that there is some transparency. My noble friend Lord Jackson’s amendment would give quite a big window, 28 days, to publish the notice of the panel meeting. It would also include the name of the person.

The comparison I looked at, which I thought was a reasonable one, was what the Court of Protection does. It makes decision about sensitive financial and welfare matters. It used to be the case that the Court of Protection’s presumption was to sit in private and not hear cases in public. That has changed over time. The presumption now is that cases are heard in public. Again, my understanding is that there is the ability for the judge presiding on those cases to decide for them to be in private if that is felt necessary. Even when they are in private, I understand, members of the public can make applications to go and listen to those cases. I think that is all right and proper. That appears, I presume, to be where—the noble and learned Lord, Lord Falconer, is nodding.

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[Lord Harper (Con)]

I do. The reason why I partly agree with my noble friend Lord Jackson is that I had a look at what the Court of Protection does in terms of publicity—the bit that the noble Baroness, Lady Hayter, objected to. It publishes hearings in advance—not 28 days—but it does not publish the full name of the individual. It publishes initials and what the case is about: the broad category of the decision. That strikes me as quite a good balance, which provides transparency but maybe avoids people coming to “watch a spectacle”, to quote the concern of the noble Baroness, Lady Hayter.

However, there is some necessity for it to be in public. The reason for that is also set out in the Bill, which says the panels

“must hear from, and may question, the co-ordinating doctor … must (subject to subsection (6)) hear from … the person to whom the referral relates”.

At this point, I agree with the noble Baroness, Lady Berger. That should absolutely be a must; there should not be an exception. If it is the case, as I understand from the appearance of the noble Lord with me on a media programme, that the exception is designed for cases where the person’s medical situation is very severe, they should not necessarily have to come to the panel, but at least one member of the panel should absolutely still have to go and talk to them. It really should not be okay for the panel to authorise somebody to have an assisted suicide without ever having spoken to the person concerned.

[Baroness Hayter of Kentish Town (Lab)]

I am sorry that we are doing this, but the person will be at home, very often, and bedridden. Are we actually expecting a panel to go to their home, into their bedroom, and do this there? Again, this is not the sort of world that I know from some of the people who I see living in surroundings where it would be quite difficult even to put a spare chair in their bedroom—they could be on oxygen, or whatever—for someone to see them there.

[Lord Harper (Con)]

These are difficult issues, but the panel is being asked to authorise their death, so this is a serious issue. I accept that this is uncomfortable, and I am not suggesting the entire panel would rock up at their home, but at least one member of the panel ought to have to talk to them. The idea that the panel would authorise somebody to have an assisted death, never having spoken to them, is frankly appalling.

I shall just finish, because I want to stick to time—although I am conscious that the noble and learned Lord nicked a bit of it to explain to the Committee. I shall finish by saying that the amendments that have been put down are very helpful, because we have fleshed out this very sensible issue of how much of this should take place in public.

The other reason for it being in public is because, otherwise, there are two groups of people the panel is asked to talk to. It may hear from and question any other person and may ask any person appearing to have relevant knowledge. The problem is that, if these hearings are done in private and no one knows they are happening, I do not know how the panel is supposed to know who any of these people are; these people are not going to be able to make themselves known to the panel. So there is a clear argument about where you draw the line and there is clearly a balance to strike between openness, transparency and privacy, but it seems to me that this is a good debate for the Committee, and I want to hear where the Bill’s proposer thinks that balance should be struck. We have heard a little bit about that, and we can hear a little more later.