Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Baroness Jay of Paddington

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Deben (Con)]

My Lords, this is the point where we come to the heart of the reason why I find this Bill so difficult. I know what sort of society I have spent my life trying to produce and work for: a society that cares, particularly for the vulnerable. I was accused by the noble Baroness of being patronising the other day. If it is patronising to defend the vulnerable, I plead guilty.

[Baroness Jay of Paddington (Lab)]

My Lords, I must respond to that. I certainly did not accuse the noble Lord of being patronising. I said that I thought there were difficulties in health policy when we accepted some of the old—and, now, more old-fashioned—concepts in which the medical profession seemed to be patronising. I was not referring to parliamentarians.

[Lord Deben (Con)]

I will not take it, therefore, as I did on the occasion when she mentioned it.

What I want to say to the Committee is simply this: many people in many institutions will be tempted to look at the price of death as against the price of life for those who are very seriously ill. There is no doubt at all that all the countries that have already enacted laws of this kind have found this to be a problem. They have all found the difficulty that, for people who have been given about six months to live—even if that is a false diagnosis—there is a tendency to say, “Well, they’re going to die anyway”. A number of noble Lords and noble Baronesses who support this Bill have said that.

I want a society that cares about those people right to their last moment in which they die. That is what I think we are here to do. I hope that does not sound too sentimental, but this is about the difference between kindness and love. Love is something with a backbone that cares for people right to the end and makes sure that they do not feel a burden. We cannot do that for everybody, but the trouble with this particular Bill is that it does not make it absolute and determined that we do look after people and that we find out whether they feel a burden and help them not to feel a burden.

Any of us who has had loved ones who are ill know that, even if they are not seriously ill, the very first thing they do is feel a burden—a burden on their spouses and on other people. That is what decent people do. Other decent people spend their time trying to make sure that they do not feel a burden. Other decent people try to see what is at the heart of their misery—that is the phrase that is used. We should be here to try to remove the misery from people in their last six months, just as we should throughout the whole of their lives. Those who are proposing this Bill seem so committed to getting it through somehow that they think we must not in fact consider what the rest of society is.

I know that the noble Baroness, Lady Blackstone, hopes to interrupt me, but, before she does, I will just say this. I am not one of those Conservatives who believes in the kind of free market operation where you do not deal with things at all. I am, in that sense, a socialist; I believe in the individual in society. The whole problem with this emphasis on autonomy is that it is not acceptable unless you see the individual in society. The trouble with the Bill is that it tempts those who find it more convenient to allow people to kill themselves because it is more expensive for them to continue to live.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Baroness Jay of Paddington

Committee stage
Friday 16th January 2026 Lords Chamber

[Lord Deben (Con)]

It seems to me that this an opportunity for the noble and learned Lord to help the Committee and speed the Bill. Here are a whole series of amendments designed to deal with the genuine concerns of the experts who are going to have to actually carry this law into effect if we are to pass it. Some of us may have strong views about the principle, but we have a duty to do our best to make the Bill work.

One of the problems people have is that the noble and learned Lord has so far not been willing to tell the Committee that he will meet concerns by proposing amendments himself. In this particular group of amendments—which is why I tried to wait until the end of it, because it is not only on an individual amendment that I speak—there are a whole series of reflections of the concerns of those who will have to deal with the Bill when it is passed.

This is an occasion in which we can overcome a lot of the concerns—I might even say suspicions—that there is no intention of changing anything, and that it will just be pushed through, however long it takes, in order that there should not be a concern at the other end of the Corridor. I am sure that the noble and learned Lord does not really think that, but he needs to reassure the Committee. We will get much further, much faster if he can look at these amendments and say he is going to bring forward amendments that reflect the concerns here, which themselves reflect the concerns of the various medical bodies in particular, in order that the Bill will be a more effective Act.

If the noble and learned Lord does not do that, there is a very serious criticism of the Bill, that we are not reflecting in this House the concerns of those who, next to the people who make this choice, matter most: the people who have to implement it. All the medical bodies have reservations. Some few are opposed to it in principle. I am perhaps more interested in those who are not opposed to it in principle but who are concerned about it in practice. If we are not prepared to make the changes that make them happy—though perhaps “happy” is the wrong word—and able in good conscience to support the Bill and follow it through, then we will not have done our job as this reforming House. I say this because I have become rather weary with the fact that what appears to be true is that there are those for whom this is so important a doctrinal position that they are not prepared to consider that this particular formulation needs alteration.

Therefore, I ask the noble and learned Lord, when he comes to answer, to consider very seriously a willingness to say, “I will go through these amendments, talk to the people outside if necessary and bring forward the kinds of amendments that will meet the real concerns of those people upon whom I am going to depend for the efficacy of this legislation if it is passed”. If the noble and learned Lord is unable to do that, more and more of us will begin to wonder whether this is really a debate in which we are trying to improve the Bill and make it the best legislation possible, or merely one that will be prolonged for as long as possible in order to put through the exact same Bill to the House of Commons. Frankly, if it is that, all of us who have doubts about it should redouble our doubts. If it is not that, we have a duty to help the noble and learned Lord to get the best Bill possible. It is in his hands, and this may well be the moment for him to show his hand.

[Baroness Jay of Paddington (Lab)]

I wonder whether the noble Lord would accept the actual evidence of one member of the medical profession who gave evidence to the Select Committee. She reflected many of the concerns that people who support the Bill agree with. She said that, when the healthcare professions

“get it wrong … it is usually because we are being paternalistic”.

A great many of the amendments in this group are very well intentioned and meaning in their concern for patients, but we must allow for the fact that they rely on an assumption that the medical professions, in their doubts, may act paternalistically.

I have been married for a very long time to a doctor. He would certainly say that the practice of medicine has changed hugely in his lifetime, and that when he first qualified as a young doctor, the field was paternalistic. However, now there is a much greater assumption that the words, intentions and wishes of the patient should be the ones that carry force. That is obviously the philosophy behind so many of these amendments, which, in a sense, seek to reintroduce the paternalistic attitude of the medical profession. In contrast, those of us who support the Bill are much more concerned to support its underlying principle of the autonomy of the individual patient.

[Lord Deben (Con)]

I hope that it was an intervention, because, if so, I am able to comment on it. If we start talking about paternalism, we will go backwards in time. We are not really talking about that at all; we are talking about the legislation of this House and the House of Commons. We are talking about how we produce legislation that works. What worries me is that there are a lot of words being used, such as “paternalism”, “kindness” and others, that are making us less precise. Law has to be precise enough for it to be properly implemented.

Frankly, the intervention of the noble Baroness sums up something else. There is a paternalism among some in this Committee who feel that they are so right about the Bill and that they can therefore ignore the comments of people who are trying very hard to overcome their own prejudices—if that is the right word—to get the Bill right. I find it a bit discomfiting to be lectured to, from time to time, as if I should not be making any of these comments because I do not seem to understand the higher views that are being presented. After being a Member of Parliament for 40 years and knowing what goes on in families in terrible circumstances, all I am trying to do is protect people. That is my job; it has been my job all my life. In response to the noble Baroness shaking her head, I say: that is not paternalism; that is the role of leadership in any circumstances. It is what decent people do, and, above all, it is what kindness demands.