Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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It will depend on the circumstances. If, for example, the doctor had a very severe doubt about whether somebody was being coerced, I would expect them to ask very many questions about their domestic circumstances. Suppose, however, it was somebody who was clearly not, on the face of it, at the slightest risk of coercion—a person of 60 in the full flush of his or her pomp, as it were—and who had said, right from the outset, “I can’t bear the thought of this illness”, and the idea that this person has been coerced is not really plausible, then I would expect the doctor to be asking different questions from the sorts of questions that they would be asking if the circumstances of somebody’s home life were completely different. It would obviously depend on what you knew as the doctor, or had found out as the panel, about the circumstances of the individual.

Baroness Royall of Blaisdon Portrait Baroness Royall of Blaisdon (Lab)
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I apologise for interrupting my noble and learned friend, but I just point out that the BMA itself is very clear that the doctors should be able to make their own judgment in all these cases.

Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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As I understand it, Amendment 222, in the name of the noble Baroness, Lady Hollins, would establish a specialist service to provide psychological assessment and support and then bereavement support for those seeking an assisted death. My noble friend Lady Merron has indicated the difficulties in relation to that. On the question of a psychological assessment, the position is that some work has been done abroad in relation to this. California introduced, in addition to what was required by the law in a particular part of California, a psychiatric assessment for everyone who wanted an assisted death but concluded that that was not necessary because the numbers of psychiatric assessments were producing nothing. It was only where special requirements were required that suggested it was a good thing. So I respect the suggestion but I do not think it is necessary.

Baroness Royall of Blaisdon Portrait Baroness Royall of Blaisdon (Lab)
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My Lords, I support the Bill. I'm grateful to Kim Leadbeater for her work, and to advocates such as my courageous friend Esther Rantzen. I am also grateful to my noble friend Lady Berger for showing us a way forward, in terms of a committee, and for setting out a clear timetable.

While I warmly welcome the compassionate and moderate tone of last week’s debate, from which we learned a lot, like my noble friend Lady Thornton, I was dismayed at the conflation made by some of suicide and assisted dying. This is not just about careless language; it is actively damaging to people who are already suffering. Let us be clear: people who choose assisted dying are not suicidal. They are dying and they want to regain some choice, control and dignity where it has otherwise been stripped away. We should hear the views of terminally ill people, some of whom had a letter published in the Independent this week:

“We are not suicidal – we want to live, and to make the most of the time we have left with the people we love. But we are dying and we have no choice or ability to change that … We are not seeking to make a choice between living and dying but between two kinds of death … To equate choice and control over the timing and manner of inevitable and imminent death with suicide is deeply insensitive to those of us facing this position”.


Australia’s leading suicide prevention organisations have warned that confusing these terms can delay access to suicide prevention services for people in distress, and complicate or delay care for people with terminal illness who are seeking an additional choice at the end of life. When in 2021 I asked the Government to provide data on the number of people who take their own life every year, I did so because this debate needs to be guided by evidence and the lived experience of dying people and their families. The best available evidence estimates that around 300 terminally ill people end their own life at home every year in England. These deaths are recorded as suicides, but it is clear from talking to and listening to bereaved family members that these are not people who wish to end their own life but people who are taking drastic and often violent steps to control an inevitable and imminent death.

There is absolutely no evidence that assisted dying undermines or runs counter to effective suicide prevention strategies, nor is there evidence to suggest that legalised assisted dying leads to a shift in attitudes towards suicide. Figures from Victoria in Australia show a slight decrease in suicide rates since it introduced assisted dying.

In 2021, at Second Reading of the Assisted Dying Bill of the noble Baroness, Lady Meacher, I said:

“The current blanket ban on assisted dying does not eradicate demand for choice at the end of life; it simply forces people to take matters into their own hands in loneliness and in fear”.—[Official Report, 22/10/21; col. 495.]


Those words remain true today. We continue to hear of dying people taking their own life and we continue to hear about the devastating impact this has on their families. It is time to change the law.

I am a humanist. I respect those who believe in the sanctity of life and I subscribe to many of their values, but this Bill will not compel anyone to act against their conscience. It provides agency and choice for people who are near death, with the ability to decide how they spend their final days—whether they have faith or no faith. I am confident that the scrutiny of the Bill will be as robust in your Lordships’ House as it was in the Commons. We will do our work with compassion and diligence, improving the Bill, including by making anorexia outwith the Bill. But we must always be mindful of our duty to respect the primacy of the Commons.

Prostate Cancer

Baroness Royall of Blaisdon Excerpts
Wednesday 3rd September 2025

(2 months, 3 weeks ago)

Lords Chamber
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Baroness Royall of Blaisdon Portrait Baroness Royall of Blaisdon (Lab)
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My Lords, I am grateful for this debate, understanding that when men have prostate cancer and when they die, their loved ones also suffer. I welcome the review by the national screening committee, and I look forward to its conclusions. But in parallel, there must be change in the guidance given to GPs to ensure that men at the highest risk are informed of the risk and offered a PSA test.

If the screening committee decides to recommend targeted screening, which I fervently hope that it will, it will take years to implement. It is crazy that current NHS guidelines prevent GPs discussing the disease with those who are most likely to have it, and late diagnosis of incurable cancer. The system benefits men who are aware of the issue and able to interact with doctors, entrenching biological and societal inequalities. It cannot be right that it is awareness, not risk, that determines who gets tested. This exacerbates inequality and leads to death. Surely, if a GP is in front of a black man or a man with a family history of the disease, they should say, “Have you thought about a test for prostate cancer?” The noble Lord, Lord Patel, and others rightly say that PSA tests are not always accurate. Yes, we need better tests, but, in the meantime, we have PSA tests, so let us use them, because targeted testing saves lives.

Raising awareness is critical. and I pay tribute to the wonderful work of charities such as Prostate Cancer UK, with its great campaigns and whose badge I usually wear. I urge the Minister to work closely with those charities and to embrace the research they are undertaking all the time. I look forward to a positive response from her.