Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Sandhurst

Committee stage
Friday 27th February 2026 Lords Chamber

[Lord Deben (Con)]

I think it perfectly right for the noble Baroness to have intervened because I referred to her, and I apologise.

I want the noble and learned Lord proposing the Bill to face three issues that are centred around these amendments—which I am dealing with, I say to the Whip. These amendments are trying to meet the genuine concerns of people who are not necessarily opposed to the Bill. They want to make sure that this key person knows what his or her job is, is appointed in a way the public can have confidence in, and is not the harbinger of what has been called mission creep. Those are three very simple things to ask for.

This is the thing that really worries me. I say this directly to the noble and learned Lord, Lord Falconer. I cannot understand why, at the beginning of the Bill’s passage, he did not say, “First, we know that there is a problem that it used to be thought this Bill had a judicial element to it and it does not now, and I am prepared to look at how to change that. Secondly, we know that the professional bodies have real concerns, and I am going to present my answers to those. Thirdly, I know that there is much in this Bill that is not specific enough, which is why the Select Committees have said it is inappropriate and unacceptable in its present form, and I will put those things right”. Had he said those three things, we would have been a long way forward with the Bill.

Therefore, the Bill is being held up not by filibustering but by the fact that the people who have put it forward are so determined that it will pass that they are not willing, it seems to me, to listen to reasonable comments—even from people who have restrained themselves from entering into the bear garden they have managed to stir up in the media.

[Lord Sandhurst (Con)]

My Lords, Amendments 430 and 434 in my name go to the practice in operation. I will introduce them by making this point. I was one of the seven people fortunate enough to be identified in the Observer a couple of weeks ago as having tabled a lot of amendments. Contrary to what the Observer—and the quite numerous hostile messages I have received by letter or email—suggested, these amendments, together with all the others I have tabled, except for two relating to the victims of industrial disease, were put forward by the Law Society of England and Wales and by the CLADD group at King’s College London. The latter, for those who were not here the other week, is a group of a distinguished psychiatrist, psychologist, social scientist and lawyer with a particular interest in this and related issues. They and the Law Society are neutral on the principle of the Bill but want to see a safe and effective Bill. Amendments 430 and 434, together with others I have tabled, are aimed at that.

Amendment 430, some will be pleased to see—others will not—is for a streamlined, non-panel basis. It would insert a new clause saying:

“This section applies where the Commissioner receives … a first declaration … a report about the first assessment … which contains a statement indicating that the coordinating professional is satisfied as to all of the matters … a report about the second assessment of the person which contains a statement indicating that the independent professional is satisfied as to all of the matters … The Commissioner must, as soon as reasonably practicable, consider the person’s eligibility to be provided with assistance”.


He or she may then

“consider the person’s eligibility personally … refer the person’s case to a person qualified to sit on the Assisted Dying Review Panel”,

or

“refer the person’s case to a multidisciplinary panel”.

In practice, this means that it would be a modified procedure where there is agreement between the co-ordinating and independent professionals. The commissioner could then consider the application alone or refer it to the panel, so it would not necessarily have to go to the panel. A full panel would be mandated only if the independent professional is not in agreement with the co-ordinating professional that the criteria are met, or if it becomes clear during the modified procedure that further evidence is needed.

Some of those who are not in favour of the Bill may be concerned that this amendment could potentially weaken the process. I remind the Committee that Dame Caroline Swift, latterly a High Court judge but formerly lead counsel in the Shipman Inquiry, has said she is afraid that safeguards on assisted dying are likely to be eroded. We have to be very careful, because Dame Caroline Swift was right at the sharp end of looking at this. That is important, as she has seen what happens with a rogue doctor. She said:

“Those safeguards may seem adequate now but they are likely to be eroded over time. As Leading Counsel to the Shipman Inquiry, I saw how this had happened with the safeguards for the issuing of cremation certificates … Over the years, the second doctor’s role became diluted, they were seldom independent of the first, rarely examined the body and the signing of the second form became little more than a ‘tick box exercise’”.


My Amendment 430 might later be at risk of leading to dilution, but I hope it is an indication that there might—in clear cases, where everyone is agreed early on—be a way of moving it on swiftly, to the advantage of someone who is really anxious to go down this course and has capacity and all the other requirements. I hope that will be seen as a positive move and not a wrecker’s move. I am surprised that no one has come to me since this was tabled and said, “That’s a good idea; we’ll stick it in the Bill”.

Amendment 434 would amend Clause 16 and is simply intended to make it clear beyond doubt that referral to the panel is mandatory wherever the independent professional is not satisfied that all the requirements are met. The Law Society believes, and I agree, that as it stands it is not necessarily mandatory, and it should be. So, I ask rhetorically, why not? Are these not both jolly good amendments?

Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Sandhurst

Committee stage
Friday 6th February 2026 Lords Chamber

[Lord Deben (Con)]

My Lords, I am hoping that I am going to help the noble and learned Lord, Lord Falconer, and I am sure he will be pleased with that help. We have been discussing some fundamental issues of interest to the people who are going to have to carry this Bill through. Therefore, I recommend three very simple things to the noble and learned Lord.

First, the sooner we know what the noble and learned Lord’s amendments are going to be, the very much better it will be. It would allow some of us to help—certainly not me, but the experts—to make sure they are adequate. Secondly, I support the noble and learned Baroness, Lady Butler-Sloss, in her demand that we should know as much as possible in advance. Thirdly—and the gravamen of my points—if you talk to people outside, many of them have no idea about the details of the Bill and have a general view either in favour or against it. However, when you talk to people who have some real understanding of the Bill, the issues which concern them most are those where they feel there is not adequate clarity, especially for the medics and others who are going to be involved.

This debate has been different, if I may say to the noble and learned Lord, from previous debates on this area. It has concentrated on the lack of clarity around what we really mean by competence. We have made the distinction between the competence that is satisfactory to make important but immediate decisions that can be reversed and the competence necessary to make fundamental decisions, where a person needs a longer-term ability.

It therefore seems to me that it would be advantageous to the noble and learned Lord’s whole cause if he could take this very seriously. If he can find a proper answer, which satisfies the sensible things that have been said, it will go very much further—this is a rather delicate sentence, which I hope the noble and learned Lord will not take amiss—to repair the impression that every amendment is shoved off. These are not amendments to treat with anything but the very greatest of care.

[Lord Sandhurst (Con)]

My Lords, I will speak to Amendment 581A. It reads:

“In the event that the assisting professional has doubts as to the person’s capacity for the purposes of subsection (5)(a), the assisting professional … must take steps to assess the person’s capacity, including (if they are not a person meeting the requirements under section 12(6)(b)) seeking the advice of such a person, and … may not proceed further until, with the benefit of such advice as is received under paragraph (a), they have satisfied themselves that the person has capacity to make the decision to end their own life”.


This is aimed at the very moment when the applicant, if I can use that neutral term, is about to be provided with the substance with which life will be ended. It is the very end of the process. The assisting professional is there. The amendment would require that, if they had doubts as to that individual’s capacity, they sought advice from a practising, registered psychiatrist. What could be objectionable about that? Why would it not be necessary, if the assisting professional had doubts? Should it not be mandatory? We know that people’s capacity can fluctuate if they have certain conditions. I see the noble and learned Lord nod as I say that. In this situation, when the final decision of whether to end life is being made, it is critical that the assisting professional has confidence, based on proper knowledge, that the applicant has the necessary capacity.

This amendment, together with a fair number of others that I have put forward, was put to me by CLADD, the Complex Life and Death Decisions group at King’s College London. Others have mentioned the group today, but I think it necessary, because I shall refer to it again, to explain who it is and what it does. The group has substantial expertise in a range of relevant disciplines. It is concerned that any Bill such as this is drafted in the best way to ensure that it operates in practice without avoidable dangers.

Because this is the first of its suggested amendments, I will say a little more about them. The group comprises psychiatrists, psychologists, lawyers and social scientists. They are serious academics who come at this without side; they are simply anxious that those involved at the sharp end have the best framework in which to operate. Its chair is Professor Bobby Duffy, professor of public policy and director of the Policy Institute. Other members include: Professor Gareth Owen, professor of psychological medicine, ethics and law and an honorary consultant psychiatrist at the prestigious South London and Maudsley hospital; Alexandra Pollitt, its director of research who specialises in mental health policy and public health; Professor Ruck Keene, an honorary King’s Counsel based in the Institute of Psychiatry, Psychology and Neuroscience at the Dickson Poon School of Law and a Wellcome research fellow researching mental capacity law, mental health law and disability law; Professor Katherine Sleeman, the Laing Galazka Chair in Palliative Care based at the Cicely Saunders Institute at KCL; a director of engagement, Suzanne Hall; and an NIHR doctoral fellow, Dr Liam Gabb.

They are therefore a range of absolutely top-class professionals who know about the detail. They have real, practical experience and academic expertise, and it is really important that their concerns, which I shall express on this occasion and elsewhere, are registered as being serious. They are not from people who are saying, “Don’t have such a Bill at all”; they are saying, and this is really important, “If we are going to embark on this course of helping people to die with medical assistance”—I will not use pejorative terms—“then it must be done properly”.