Terminally Ill Adults (End of Life) Bill

Debate between Baroness Jay of Paddington and Baroness Butler-Sloss

Friday 13th March 2026 Lords Chamber

[Baroness Jay of Paddington (Lab)]

My Lords, it seems to have become a regular feature of these Committee sittings that the noble Lord, Lord Deben, and I disagree—but I think we disagree with courtesy, and I hope we disagree on the basis of real understanding. However, it is extraordinary that we have got to this stage in the Bill and he does not seem to accept that those on this side of the House—or rather, those of us who support the Bill, as it is not an “on this side of the House” issue—are in favour of palliative care. We have always been in favour of palliative care and have always said that the two go together.

I have not had the honour of serving in the other place, as the noble Lord has done, but I have had experience of sitting on other Select Committees of your Lordships’ House on this particular matter—not the immediately past one, but on others—where we looked in detail and travelled to those places where assisted dying is in place. There is absolutely no evidence that assisted dying, when introduced, does anything other than improve palliative care, because it improves the understanding that people have of discussions about end-of-life care, death and the general issue, which can be debated more openly.

I am not trying to take the point made by the noble Baroness, Lady Murphy, any further, but one of the things that has concerned us in this Committee is that there is so much emphasis in so many of these amendments on the detailed administration—the noble Baroness used the word “nitpicking”, which noble Lords did not like—and the very small print, and so much less focus on those people who are actually going to hope to take advantage of this legislation: patients and people who are dying, and people who are reaching the end of their life. I remember that in a previous debate my noble friend Lady Hayter said this, but I have been rather shocked by the emphasis, for example, on the bureaucracy and structure of the commission and so on, which has not emphasised the position of those people who are dying.

[Baroness Butler-Sloss (CB)]

My Lords, I remind the House of the extraordinary common sense of the noble Baroness, Lady Cass, who pointed out that there may well be a lack of suitable doctors of one sort or another, and they may have to put up with what actually is the reality.

Terminally Ill Adults (End of Life) Bill

Debate between Baroness Jay of Paddington and Baroness Butler-Sloss

Committee stage
Friday 14th November 2025 Lords Chamber

[Baroness Butler-Sloss (CB)]

My Lords, I declare that I was a vice-president of Hospiscare in Exeter. I am probably the only person in this Committee who has tried cases of capacity, again and again, both as a High Court judge and in the Court of Appeal. One case was so difficult that the Court of Appeal, where I was presiding, sat until 1 am. Noble Lords may not have thought that the Court of Appeal did that very often. It is important for your Lordships to realise that some cases that I tried were extremely easy to try—one in particular involved a Miss B, who was obviously competent—but other cases were extraordinarily difficult. One case—the one that we did until 1 am—concerned somebody with a needle phobia who was expected to need a caesarean, and she objected because she could not bear the idea of a needle. At one in the morning, we took the view that she did not have the mental capacity to decide on her caesarean. She was hugely relieved and had the operation without any trouble. But that was not a unique case—the time was, but not the problem.

[Baroness Jay of Paddington (Lab)]

My Lords, I of course enormously respect the experience of the noble and learned Baroness and her ability to make these judgments. I am sorry that she had to sit until 1 am. But does she feel that those decisions would have been more or less complex and difficult if she had been judging them on the basis of ability?

[Baroness Butler-Sloss (CB)]

I have not the remotest idea. It is such an important point that I would have to go away and reflect. I am not commenting on ability or capacity; the point I am making to the Committee is about the difficulty of this for a doctor, or several doctors—probably GPs. The Royal College of Psychiatrists, of which I am an honorary fellow, has said firmly that it wants nothing whatever to do with the panel or with this, so doctors who are not psychiatrists will decide, with other people, whether somebody has or does not have capacity. That is what is currently in the Bill.

I warn your Lordships that this can be difficult, particularly when it involves depression. I had a friend, a solicitor, who suffered from depression. She said that she used to fall into a black pit and try to crawl up the sides, which were slippery. It was clear to me that, when she was in that depression, she certainly did not have the ability to make serious decisions. So I warn your Lordships about the potential problems of assessing capacity.