Terminally Ill Adults (End of Life) Bill

Lord Carter of Haslemere Excerpts

Friday 30th January 2026 Lords Chamber

[Lord Frost (Non-Afl)]

I am coming to my conclusion. It is somewhat safer with the two criteria of autonomy plus life expectancy and of unbearable and irremediable suffering. It limits the scope of the moral and legal change, or regression as I would see it, that we are undertaking here. That is why I have tabled Amendment 84 and why I think it is so essential.

[Lord Carter of Haslemere (CB)]

My Lords, I added my name to Amendment 84 since I think the noble Lord, Lord Frost, has struck gold with this amendment. Requiring

“unbearable suffering … which cannot be relieved by treatment”,

raises four critical issues at the epicentre of the Bill. First, his amendment exposes the total unreliability of a six-month prognosis of a terminal illness, as we have heard from numerous noble Lords. Trying to predict life expectancy is a hopeless exercise, especially when medical advances are improving at such a phenomenal rate. As the noble and learned Lord, the sponsor, said in relation to a prediction of six months to live, we are not dealing with certainty. I am with him on that.

Let me give the Committee an illustration from a real case. I know of somebody who was given a 5% chance of living for 10 years because he was suffering from an advanced aggressive cancer. It is not exact, but a 5% chance of living for 10 years approximates broadly to a reasonable expectation of dying within six months. That was 21 years ago and, as far as I know, I am still here—noble Lords will correct me if I have got that wrong. It does sometimes feel slightly otherworldly, listening to these debates.

Secondly, the requirement in Amendment 84 for unbearable suffering that cannot be relieved by treatment would have the obvious merit of bringing the effectiveness of palliative care into play, which is not currently the case as the Bill stands. As we know, the experts say that palliative care relieves pain in most cases and can help people who want to die to want to live. That is why a full assessment by a palliative care specialist is so important, as earlier amendments sensibly proposed. But the noble and learned Lord has said he is

“incredibly opposed to unbearable suffering as the root”

of this Bill. His view is unsurprising since the effectiveness of palliative care would significantly reduce the Bill’s impact.

So the noble and learned Lord falls back on the personal autonomy argument, telling the Select Committee that the essence of the Bill is autonomy—you have a choice, it is autonomy—and it would give people the option of an assisted death if they have simply had enough of life. This is the third issue that would be resolved by Amendment 84. Should the National Health—health—Service really be assisting a person to kill themselves if they have simply had enough of life, whether or not they are in pain and whether or not their feelings relate to their terminal illness? Is that what a health service should be doing? That starts to look very much like assisted suicide.

Fourthly, I respectfully suggest that the noble and learned Lord gets on the Clapham omnibus and asks anyone who supports assisted dying the reasons why they do so. Overwhelmingly, they will say that people should not have to suffer unbearable suffering. Yet, astonishingly, you will not find the words “pain” or “suffering” anywhere in the Bill. I read it word for word last night at great length to check that point. I could not find those words. Without any reference to unbearable suffering, there will be a massive disconnect between the public’s expectation and the Bill’s contents.

Let us be clear: the vast majority of the public are not on the edge of their seats watching our deliberations. Very few indeed will have read the Bill. They will therefore have a view of the Bill based on the common-sense assumption that people seeking an assisted death will be suffering unbearable pain. The compelling amendment from the noble Lord, Lord Frost, injects that common sense into the Bill by providing for that, and I heartily support him and Amendment 84.

[Lord Taylor of Holbeach (Con)]

My Lords, I am reluctant to involve myself in this debate, but I see this whole legislative process as being about practicalities in the end. It is good that we have had an exposition of the articulation of the motivation of the people seeking success for this Bill, but I am very concerned as a citizen because I think this is about palliative care and relief from suffering.

The Bill should have been about those very matters. However, it is not. It is about all the incentives, from government to public authorities. For those people that the legislation actually motivates, it is about promoting the idea that assisting dying—or assisted suicide—is available; whereas the medical profession prefers, and what all the medical colleges have said they want to see, is proper palliative care. We do not want a competition for the funding of one against the other. I can see that in individual and family lives—and the social life we have together, governed by a Government—the pressures are not going to be towards relief of suffering through palliative care but for assisted suicide. I do not agree with that and that is why I oppose the Bill.

Terminally Ill Adults (End of Life) Bill

Lord Carter of Haslemere Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

I want to reiterate the question: are we keeping our prison population in mind as a vulnerable group in the Bill? Particularly when our prisons are overcrowded and, to be extremely frank—although I think the noble Baroness, Lady Fox, was franker—the desire to remove people from the system is high. I fear how the Bill could play out among the prison population and hope that noble Lords will give further consideration to this important issue.

[Lord Carter of Haslemere (CB)]

My Lords, I want to make a very brief intervention in relation to the prison population. It is only the second time I have spoken on the Bill. I declare an interest as a trustee of the Prison Reform Trust.

The suicide rate among male prisoners is four times as high as that of the general population. In the year to 2024, 89 male prisoners committed suicide. The Prison Service has a duty of care towards the prison population to protect them from committing suicide—to stop it. The Government run the Prison Service, so they must have a view on what to do about a prisoner whose suicide the Prison Service has correctly thwarted under its duty of care but who then requests an assisted death under the Bill. How will the Government balance those two conflicting things?

That is my short intervention—to ask that question. I wholly support all the comments made by the noble Baroness, Lady Fox, the noble Lords, Lord Moore and Lord Farmer, the right reverend Prelate the Bishop of Gloucester, and others on this crucial issue. I am genuinely interested to know what the noble and learned Lord, Lord Falconer, makes of this dilemma for the Prison Service and the Government.

[Lord Deben (Con)]

My Lords, the moments in the Bill that most concern me are when it gets nearest to saving money. There are several occasions on which that appears to be the case, particularly when talking about people for whom many have no sympathy at all, and when you are talking about a service in which we all know we are failing. It cannot be true that any Member of this House believes that our prisons are as they should be. Yet we imprison more and more people. We imprison twice as many people as the French or the Germans. I still do not understand why we cannot take this seriously, but we still go on doing it.

First, can one really think that someone in prison circumstances finds it possible to make the same kind of decision as people who are not? Just simply, those circumstances are the pressures, the crowding and the fact that you are not in any company that you would have chosen. I do not believe that those are the circumstances in which the Bill’s proponents meant for decisions of the sort we are talking about to be made.

The second issue is: what about the pressures there? We have been talking about the concerns of those who find themselves under pressure. Do we really believe that there will not be many prisoners for whom the whole issue will be presented as, “You will be better off and we will be better off if you make this decision”?

The third issue is surely this: we know that prisoners have much worse healthcare than people outside prison. Therefore, the fact that they are told that they have but six months to live is much more difficult than it would be if they were in normal circumstances. I put it no more sharply than that, but it does seem to be true.

Fourthly, earlier on, we were talking very strongly about the difficulty that the Government are willing to fund this when they are not funding palliative care for very large numbers of people in the country. I therefore come back to my deep concern that it will become so much easier for people to die than to continue.

The right reverend Prelate, whose experience is remarkable and whom I admire enormously for her work in the prisons, has reminded us of how old the prison population is and how much older it is becoming. I just do not think that those of us in this House who really believe that our major job in this Bill is to protect the vulnerable can possibly agree that people in prison should be included under the Bill. We should take them out.

--- Later in debate ---

[Baroness Merron (Lab)]

First, I am referring to the amendments before us. Secondly, I am advising on risk and workability, again for the assistance of your Lordships’ Committee, which, as is correct and proper, will make the decision.

These amendments appear to treat people with EHCPs differently from those who do not have them. This could give rise to potential incompatibility with Article 14 of the ECHR, when read with Article 8, and would require reasonable justification for differential treatment.

Finally, as noble Lords will be aware, the amendments in this group have not had technical drafting support from officials, so the way they are drafted means that they may not be fully workable, effective or enforceable. However, as I have said, the issues raised are rightly a matter for noble Lords to consider and decide.

[Lord Carter of Haslemere (CB)]

My Lords, the Minister referred to a number of articles of the ECHR, but she has not referred to Article 2, which is the duty on a state to protect life. That is why the courts have imposed a duty of care on the Prison Service and the Government to protect prisoners from committing suicide. My question goes back to what I said earlier: how do the Government reconcile that duty with a vulnerable prisoner applying for an assisted death? How does that square with the duty under Article 2 and the duty of care to prisoners?

[Baroness Merron (Lab)]

I refer the noble Lord to the provisions within the Bill. His earlier question was very much about policy. I am sure that my noble and learned friend will also refer to this, but this is a matter of policy and therefore it is for Parliament to decide.