Terminally Ill Adults (End of Life) Bill
Debate between Lord Blencathra and Lord Markham
Lord Blencathra (Con)
My Lords, this may be a convenient point to speak to two amendments in my name in this group. My Amendment 320ZA complements Amendments 39B and 39C, which I briefly touched on in the last debate, by making explicit that non-medical motivations cannot drive an assisted death. It draws a distinct line between medical suffering and social abandonment. International evidence shows that non-medical motivations dominate assisted dying requests. In Oregon, “being a burden” is cited by nearly half of all applicants. Parliament must decide whether it is comfortable legislating for that. This amendment ensures that England and Wales do not drift into a model in which existential distress, loneliness or, in the words of the noble and learned Lord, “sheer misery” or lack of care become accepted reasons for state-facilitated death. It also responds directly to the Equality and Human Rights Commission, which warned that subtle pressures from lack of services can drive people prematurely towards death. This amendment ensures those pressures are addressed, not endorsed.
My other Amendment 332AA operationalises the “ask why” concession. The noble and learned Lord, Lord Falconer, said he is “attracted” to requiring clinicians to ask why a person wants to die but unless the answer has consequences, the question is meaningless. This amendment ensures that when the answer is, “I am a burden” or “I cannot afford care,” or “I am alone”, “I am fed up” or “I am miserable”, the process pauses and support is provided. It reflects the evidence from the Royal College of Psychiatrists and British Geriatrics Society, both of which emphasise the need for holistic assessment. It ensures that treatable depression, unmet care needs or social pressures are addressed before an irreversible decision is made. This is safeguarding, not obstruction. It ensures that assisted death is not used as a substitute for care.
My amendments matter because, first, they protect genuine choice. A decision driven by lack of heating, housing or social care is not the same as one driven by intractable physical decline. These amendments stop the law becoming a backdoor response to social failure.
Secondly, I believe they are a practical safeguard, not a veto. This is not a blanket ban; it is a procedural pause to address fixable problems—social support, benefits, palliative referrals—before a final medical judgment is made. Thirdly, clinicians need clarity. Doctors must be able to ask why and act on the answer. These amendments would give them a clear statutory duty to do so, reducing moral and legal ambiguity. If the noble and learned Lord, Lord Falconer of Thoroton, truly believes this Bill is about free, informed choice, will he oppose leaving people to die because the state failed to provide basic support or will he back these modest, targeted safeguards?
Lord Markham (Con)
The main point here is that, by definition, you are eligible for assisted death only if you have been diagnosed to be within six months of the end of your life through a terminal illness. That is the reason that you are applying for an assisted death. That is motivation for doing it, because clearly it is not like those people want to die. We have talked to many people, and I am sure a lot of people have, and they desperately do not want to be in this situation.