Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Friday 27th March 2026 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

Royal colleges and trade unions want better guarantees. When we discussed the Employment Rights Bill—

[Lord Falconer of Thoroton (Lab)]

I am not sure what further guarantees the noble Baroness and the noble Lord have in mind, because they will know from the Bill that Schedule 3 amends the Employment Rights Act 1996. It incorporates that anybody who is being prejudiced against because they will not participate in terminal illness matters is given every single right under the Employment Rights Act. First, the idea that they are not being given the same rights as everybody else is wrong and, secondly, I am not quite sure what point the noble Baroness is making when she says that there should be more rights.

[Baroness Fox of Buckley (Non-Afl)]

I sat for many hours through the debates on the Employment Rights Bill. When I said that there was a plethora of rights and that we were overdoing it, I was treated with some contempt.

I have to finish. The fear is that once assisted dying is normalised as a medical treatment, health professionals would be obliged to offer it as a medical treatment or, even worse, be under some obligation to explain this therapeutic option as part of their duty of care for eligible patients. They could be held negligent for not offering this treatment against their conscience. That would seem to be the implication of case law in the Montgomery ruling, which ruled that all reasonable therapeutic options needed to be presented to and discussed with patients. The worry here is that civil liability protections do not cover—

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[Lord Falconer of Thoroton (Lab)]

We have discussed this before and the noble Lord, Lord Stevens, is right. He is referring to the 2006 Act—not the noble Lord’s Act but the one before it—which says that the obligation of the National Health Service is to provide treatment and care. There is then a question of whether that includes assisted dying, which is unresolved. If it is to be provided by the NHS then there must be some amendment to that Act, as it refers to the basic constitutional point.

That is of little assistance to a doctor who needs to know whether he could be in breach of any legal duty by not providing assisted dying. That is the key question that is raised—and it is unequivocally answered by Clauses 5 and 31.

[Baroness Fox of Buckley (Non-Afl)]

The confusion is that a doctor’s duty is to present a patient with all the possible treatments they could have. If they refuse to mention chemotherapy or that the patient could take this painkiller, they would be negligent and could get struck off. If assisted dying becomes a medical treatment, then, regardless of conscience clauses, a doctor would be under a duty to offer it as a treatment. If they did not, they would potentially be in breach of their medical role as a doctor and open to civil liability. Noble Lords cannot keep saying, “I have said opt-in, it’s fine, stop worrying, we’ve said that your duties are fine”. Those of us who are concerned about that doctor’s conscience are saying that if it is a medical treatment, their duty will be to offer it and that nothing said here will cancel that. They could lose their professional reputation and their job and end up in the courts. That is what we are worried about.

[Lord Falconer of Thoroton (Lab)]

May I say that the noble Baroness puts it brilliantly? Here is a range of treatments, or—deleting “treatments”—here is a range of things that can be done. One of them is assisted dying. The worry that the noble Baroness expresses is that if it is a thing that can be done, using it neutrally, if you do not tell the patient that then you could be negligent or in some problems. That is why, whether it is a treatment or not, we have dealt unequivocally with the problem by saying, “You are never under a duty to raise it”. It is not to be treated as being in the same category as the other treatments, such as chemotherapy. The noble Baroness, Lady Fox, expressed the problem exactly. We have addressed the problem. She may not like the answer but, as far as the doctors are concerned, they have complete clarity and complete protection.

Moving on from whether this is an opt-in or an opt-out—we have made it an opt-in, subject to the amendment being agreed—the next issue is the width of the opt-out in Clause 31. As I have pointed out, Clause 5(1) states:

“No registered medical practitioner is under any duty to raise the subject”.


Clause 31—I am sorry to weary noble Lords with this; we have looked at it a bit already—states:

“No person is under any duty to participate in the provision of assistance in accordance with this Act”.


That means that no person is under a duty to do the things referred to in Clause 26. Also:

“No registered medical practitioner is under any duty to become—the coordinating doctor … or the independent doctor … No registered medical practitioner, other than the coordinating doctor or the independent doctor, is under any duty to perform any function under or in connection with this Act … No health professional or social care professional is under any duty to respond”


to any request for information in connection with assisted death. Also, no

“registered pharmacist or registered pharmacy technician is under any duty to participate in the supply of an approved substance”.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 13th March 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

The panel has the power. Clause 17(4) says that the panel

“may ask any person appearing to it to have relevant knowledge or experience to report to it on such matters relating to the person to whom the referral relates as it considers appropriate.”

That power would include a power to ask the local authority to provide any information it wants.

[Baroness Fox of Buckley (Non-Afl)]

I thank the noble and learned Lord for a comprehensive and useful set of answers. I asked a rather more banal question—it was a long time ago—about workforce challenges. What if the social workers or the psychiatrists cannot be found? We are already acutely short of psychiatrists and social workers in general, and that is problematic in particular geographic areas. Could the noble and learned Lord comment on what will happen if the legal expertise, social workers or psychiatrists are not available in one part of the country? Will it be a postcode lottery?

My second question is this. Has the noble and learned Lord consulted the likes of the Royal College of Psychiatrists and the British Association of Social Workers about what the Bill will do to workforce pressures? It seems to me that it will affect workability. If these panels are so important and there are not enough people to sit on them, I am worried that there will be a watering-down, with the grabbing of any old social worker who wanders past. Maybe the noble and learned Lord could clarify that.

[Lord Falconer of Thoroton (Lab)]

If there are not enough people with the requisite expertise to people the panels then there will not be panels to do the job. That is why the broad categories have been adopted in the Bill. The Royal College of Psychiatrists has expressed views in relation to this, as has the British Association of Social Workers. However, it is necessary for us to find people to do this process, because the workability of the scheme depends on it, and we believe it is possible to do that. We recognise the concerns that have been expressed, including by the noble Baroness, who is right to say that if we do not have people who can people the panels then we cannot do the process.

On the broader issue of what happens if we have people in one part of the country but not another, it will be for the voluntary assisted dying commissioner to ensure that, when a panel is required, it can be provided.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

The way the noble Lord has put the question to me means that, plainly, this would be because of the illness, would it not? I want an assisted death because the illness is going to kill me. That seems quite a bad example.

[Baroness Fox of Buckley (Non-Afl)]

I appreciate that the noble and learned Lord is saying that we have covered a lot of this ground before, but there is one reason that people keep coming back to similar threads. The noble and learned Lord has in many instances said, “I’m listening to you. I’ll think about that”, and nothing happens. It is not reassuring and there are different ways of approaching this. I thought I had made some inroads. The noble and learned Lord was quite positive about the question of motivation being relevant.

A patient arrives at the doctors and says, “I’ve got a terminal illness”. The doctor says, “Why do you want an assisted death?” The patient says, “I’m costing my kids a fortune—their inheritance. The care home costs tens of thousands of pounds. I’m a burden”. The noble and learned Lord just suggested to the noble Lord, Lord Deben, that you would say, “That’s your choice”. As in an earlier discussion in relation to the NHS, we are talking about NHS doctors, whom you would think would say, “Let me have a chat with you about that” and challenge them. They cannot just say, “If that’s what you want, carry on”.

All those examples I gave—I will not go over the millions of better ones used in the past—show that this undermines autonomy and suggests that the state is indifferent to somebody, in effect, asking for help in a different way but the form it takes is, “I might as well have an assisted death”. If you listen to them, they might be asking for something else that the state can intervene and help them with, whereas we just go, “Assisted death? We can provide that. Any of that other stuff you want, like financial help or help with loneliness and all that—we can’t afford that. That’s not happening, but assisted dying? You’re on your way”. That is why we are worried, and it is why these amendments are worth taking seriously. The noble and learned Lord needs to come back with written amendments that will reassure some of us so that we do not keep repeating ourselves.

[Lord Falconer of Thoroton (Lab)]

That was not really an intervention; it was just a statement. I should have said to the noble Baroness, Lady Fox, that, as I said last week, I will make an amendment so that the question of why will be asked, but I do not depart from the proposition that autonomy should be the leading reason for it. We disagree about that, and the House can reject that view on Report, but I am explaining what my position is.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 16th January 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

It is very difficult and would be inappropriate to try to examine exactly why people make particular choices. Look at the first Amendment 30 proposal:

“not wanting to be a burden on others or on public services”.

Why does the thought that they are going to be a burden on their children become an unbearable thing for some people to go through? They might make that choice because of what has gone on in their lives, but it is totally inappropriate, impossible and wrong in a Bill such as this to say that we have to ask why they are in that position.

The next proposal refers to a mental disorder—

[Baroness Fox of Buckley (Non-Afl)]

If the doctor was required to ask what someone’s motivation was, and the patient said, “I just really don’t want to be a burden on my family; it’s too intolerable”, but they have been told they are terminally ill relatively recently, is it not possible that there could be an intervention that would say, “Maybe you won’t be a burden” and to go and talk to their family? One of the problems is that it is assumed the endpoint is there already, whereas if you ask the question, there is a possibility that you could offer an alternative. If somebody says, “I can’t face the pain”, you can tell them there is pain relief available. This is not trying to undermine the Bill totally, but it is possible that if the doctor responds with some options, the patient would be on their way. Why not ask for the motivation? That would surely be positive.

[Lord Falconer of Thoroton (Lab)]

That is a very important question. There is a difference between excluding certain motivations, which is what Amendment 30 would do, and asking why, which the noble Baroness, Lady Smith of Newnham, raised. I see force in the proposition that somewhere in the Bill, somebody has to ask why—for two reasons. First, as was raised previously, if you ask why, it might throw some light on circumstances that suggest classic coercion. Secondly, and separately, it might deal with exactly what the noble Baroness, Lady Fox, is referring to.

Take an utterly absurd example: someone says, “I want an assisted death because I cannot deal with the noise that’s going on in my head”. The doctor could then reply, “Well, actually, that’s a building site that will stop tomorrow”. If it is something like that, one should know.

I am attracted by the idea of something in the Bill that says why. That has to be asked somewhere down the line. This also connects with our previous discussions about the multidisciplinary team engaged in looking after the person, which might well have a much better view about why.

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[Lord Falconer of Thoroton (Lab)]

I am saying that everybody should have the choice. The way that one makes the choice is inevitably determined by how one got to the point where one had to make it. It is an impossible question. Why do we all make choices? They are all affected. Some people make them because they are richer or poorer than others, but I am not in favour of drawing financial distinctions. I hope that, in the light of my remarks, the noble Baroness— I cannot remember who started this—will withdraw her amendment.

[Baroness Fox of Buckley (Non-Afl)]

I blame myself for this, but the noble and learned Lord was about to say something about the mental health issue when I made a point, and we have not gone back to it. That is a very distinct question, so will he reflect on it?

[Lord Falconer of Thoroton (Lab)]

This is not a technical point, but the way the amendment is drafted is very confusing. If your mental illness makes you come to this conclusion, that may well go to capacity. I am not clear what is being got at in relation to the mental health issue. However, if the position is that you may have a mental health condition but are perfectly capable of making a decision, you should be allowed to make it.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 5th December 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

On the comments that the noble Lord refers to, in relation to whether you should impose a whole-life term on somebody under 21, I recognise, as the Sentencing Council does, that issues of immaturity might make that inappropriate in certain cases. However, on this position, the question is: what is the age at which you might be capable of taking a settled decision? The concerns that the Committee has expressed about people aged between 18 and 25 make me think that the right course is to consider whether there are ways to deal with that that the House would feel are satisfactory on Report. I think that is the right course.

[Baroness Fox of Buckley (Non-Afl)]

Could I have some reassurance that with changing the franchise to 16, there will not be any slippage in relation to this Bill from 18 downwards? That is a reasonable question because, according to some people, 16 is now mature enough and adult enough to decide the fate of the country and decisions made here. Is there not a danger? Can he guarantee that this will not happen?

[Lord Falconer of Thoroton (Lab)]

I guarantee to the noble Baroness that the age is not going to go down from 18 as far as this Bill is concerned. The future is not in my gift, unfortunately. However, as far as the future is concerned, it is extremely unlikely that a subsequent Parliament is going to reduce that age.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

The Bill makes it absolutely clear that it must be your own decision. Let us suppose that your views of the world are affected by the internet and that you are ill and an organisation is urging you to commit suicide, that organisation should be liable if that happens.

In Amendment 49, the noble Baroness, Lady Coffey, wants “person” to include a body corporate or an organisation in relation to pressure. If an organisation or a body corporate is putting pressure on a group of people or on individuals and that makes them do it—this is putting it crudely, but if an organisation says, “Do have an assisted death; it is the right thing for everybody or for you”—that should be covered by the Bill. The noble Baroness adverted to how “person” can generally include both corporate person and human person, but I can talk to her separately about that to make sure that it is covered.

[Baroness Fox of Buckley (Non-Afl)]

Some clarification is needed in relation to a number of points that you have made. How does anybody know, how does the doctor know, whether any of these scenarios have happened? Is there anything in the Bill that makes the doctor ask and explore? The word I proposed was “encouragement”—that you would ask not just “Were you coerced or pressurised?” but “Were you encouraged?”—because it would develop a richer conversation. Is there anywhere in the Bill where all the things that you have just said—apologies; I should not have said “you” but “the noble and learned Lord”—can be fleshed out, discussed and teased out?

Maybe I have got this wrong, but at the moment as I understand it, you fill your form in, somebody might even ask “Were you coerced?” and you say no, and that is that, out the window and then, Bob’s your uncle, you are eligible and off you go. It does not matter how often that process happens. The noble and learned Lord spoke about “first doctor, second doctor”, but if they do not all explore it, how will we know whether it was anything other than a yes/no? The noble and learned Lord has given a very rich explanation of what could have happened, but the Bill does not allow us to find out whether any of that will have occurred before the assisted death is enacted.

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.

Terminally Ill Adults (End of Life) Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

I will deal first with the central issue in this debate, which is the amendment from the noble Baroness, Lady Finlay. The wording currently mentions:

“A terminally ill person in England or Wales who … has the capacity to make a decision”.


The noble Baroness proposes that “capacity” should be changed to “ability”. From what the noble Lord, Lord Wolfson, says, I understand that we should read that with Amendment 115, although there is another amendment that the noble Baroness proposes in relation to Clause 3. But I accept what the noble Lord says in relation to Amendment 2.

With the greatest respect to the noble Baroness, Lady Finlay, she is suggesting that we remove “capacity” and replace it with “ability”. The noble Lord, Lord Sandhurst, put his finger on it when he said that “capacity” is well known to the law. You could not possibly have a Bill that did not refer to capacity because what it means, in the eyes of the law and of people in practice, is the ability to make the decision. As the noble Lord, Lord Blencathra, said, if you do not have capacity, you cannot make the decision. That applies right across the doings of human beings, and the law recognises that. If, therefore, you replace “capacity”—

[Baroness Fox of Buckley (Non-Afl)]

On a point of clarification, I thought that the idea of adding both words was very helpful, but when the noble and learned Lord says that you cannot make the decision without capacity, it is not any decision but this particular decision in this Bill. Can he reflect on a point that was made very well by one of his noble friends on something that happened in my family as well? Somebody with dementia was said to have capacity for a particular decision, but I would not have wanted my mother to have been trusted as having the capacity to decide whether to ask for assisted death.

The Mental Capacity Act is fantastically important, but is it appropriate for this decision—not any old decision but this decision—which is a bit more challenging than some of the decisions that the Mental Capacity Act is used to decide on?

[Lord Falconer of Thoroton (Lab)]

That is very well put and is exactly the question. Is it appropriate to bring the Mental Capacity Act into this Bill? I understand that whether you have an assisted death is an incredibly important decision. You cannot remove the word “capacity”, so you have to reject the amendment from the noble Baroness, Lady Finlay.

Her Amendment 115 effectively draws on how the Mental Capacity Act 2005 is currently drafted, except it adds two things. It removes the presumption of capacity and, separately, it requires the person making the decision to be aware of a variety of things that are connected with their illness. To summarise, the way the Mental Capacity Act operates at the moment is that if you are unable to understand information relevant to the decision, to retain that information, to use and weigh that information or to communicate your decision, you do not have capacity under the current Mental Capacity Act. The extent to which the things that the noble Baroness, Lady Finlay, has referred to in her amendment would be relevant would have to be weighed in the context of the decision that has to be made.

I am more than happy to debate whether we need to make the changes to the Mental Capacity Act that she is suggesting. For my part, I do not think we do. One thing that is absolutely clear is that the amendment proposed, as the noble Lord, Lord Sandhurst, identified, is completely ridiculous. You cannot remove the question of capacity from this choice. Putting aside some detail hurdles, there are two hurdles that need to be overcome in how this Bill is constructed. You have to be capable of making the decision, as the noble Lord, Lord Wolfson, said, and—completely separately—you have to make that decision completely voluntarily. It has to be your own decision, not the product of pressure.

We have had—and I say this with warmth and respect—a rambling debate going over a whole range of issues, miles away from the question of whether one should remove the word “capacity” and put in the word “ability”. If this House wants to make the law completely confused in this area, either put in the word “ability” or put in “capacity and ability”. I echo the speech of the noble Baroness, Lady Hayman, when she says we have to approach this in a grown-up manner, and to remove the word “capacity” is not a sensible way to deal with this.

I also echo those who have said that the idea of running two systems at the same time—the Mental Capacity Act system and the separate system proposed by the noble Baroness, Lady Finlay—is wrong and confusing. I congratulate the noble Baroness, Lady Fox, for spotting what the right decision is. Of course, under the Mental Capacity Act some unimportant decisions are taken, but a decision such as whether to have the ventilation removed from you if you have motor neurone disease, that will almost certainly lead to your death, is without a shimmer of a shadow of doubt a life and death decision.

The Chief Medical Officer of England and Wales, in evidence to the Lords Select Committee, said:

“it is far better to use systems that people are used to and that are tested both in practice and, where necessary, in law”.

He went on to say:

“I have a concern that you could have a conversation in one bed in a hospital where someone is talking about, for example, an operation where they might well lose their life, because they are frail and there is the operative risk, done under the Mental Capacity Act, and, in the next-door bed, someone is trying to do the same process of having a difficult conversation about someone who might die, or could definitely die, as a result of that decision, but using a different legal framework. The risks that that could lead to confusion are not trivial”.


I also echo what the noble Baroness, Lady Browning, who sadly is not in her place, said. There are problems about practically every aspect of how various parts of the health service work, but she was part of a process that considered how the Mental Capacity Act worked. The broad conclusion was that it was a good, workable Act, and we should not stray from it in this particular case. I invite the noble Baroness to withdraw her amendment.

Police, Crime, Sentencing and Courts Bill

Debate between Lord Falconer of Thoroton and Baroness Fox of Buckley

Lords Hansard - part two & Committee stage
Monday 22nd November 2021 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

I am very much obliged to everybody who has taken part in this incredibly important debate. It is terribly unfortunate that this debate is happening at this particular time—I am very glad to see the Minister nodding. This is incredibly unfortunate when we are talking about violence against women and girls, which is the big issue in relation to this Bill. This is no attack on the Whips, but they asked prior to the dinner break that we get on as quickly as possible. It is an incredibly unfortunate way for this House to look at legislation such as this.

I thank the noble and learned Lord, Lord Hope, for his support for Amendment 284, which concerns street harassment. I take note of what he said in relation to Amendment 285 and the difference between the penalties. He was suggesting that there might be a way to amalgamate the two. That suggestion seems to be very well made, and I hope that when we come back with this on Report, we might try to follow it up. I was grateful to the noble Baroness, Lady Bennett, for her support in relation to all of the amendments.

I take note of what the noble Baroness, Lady Fox, said in respect of the review on spiking. One is in a bit of a dilemma: there is already some degree of anxiety in relation to spiking. I think that what she was saying was, “Do not have an immediate review because that increases the anxiety,” but if you do nothing about it, the anxiety continues. My own judgment would be that one should have the review.

Separately, the noble Baroness, Lady Fox, asked whether one should be worried if one is criminalising through harassment conduct including speech. I do not think that that criminalises free speech, because the sorts of speech that we would intend to criminalise under the harassment crime would be cajoling, offensive behaviour—not expressing an opinion but insulting people or demanding sex or other things of people in a wholly inappropriate way. I do not think that would give rise to the risk of an attack on free speech.

[Baroness Fox of Buckley (Non-Afl)]

I suppose it is following on from what the noble Lord, Lord Marks, pointed out, about the broadness of that amendment. Since 2016, I have been subjected to a “fair amount of verbal”, as they say, walking around the Westminster village, from people who did not approve of my Brexit views. It was not pleasant: it was not sexual, but it was particularly obnoxious and offensive; but I do not know whether that should be against the law. I might have a moral view of it, but I would not want them all to be arrested. I am saying that, while verbal harassment is unpleasant, there is a question as to whether it should be made criminal. I just do not want everyone being locked up for things they say, even if what they say causes distress.

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[Lord Falconer of Thoroton (Lab)]

I completely take the noble Baroness’s point. The law has been very, very aware of that. There is a difference between people saying to you on the street, “I very much disagree with your views on Brexit” and others saying, “Why are you such a stupid, awful” and then a series of expletives, and chasing you down the street, just abusing you. The law is capable of making distinction.

[Baroness Fox of Buckley (Non-Afl)]

It was the latter rather than the former, I have to say.

[Lord Falconer of Thoroton (Lab)]

Then there might be a point where that becomes harassment.

I found the speech of the noble Lord, Lord Marks of Henley-on-Thames, to be terrible. He sounded like a Government Minister in relation to this, thinking of excuses why not to do something about harassment, not just against women—against other people as well—but particularly against women. I was very struck by the fact that the Minister at least acknowledged that there is a real problem in relation to this. Her speech accepted that something had to be done about it, which that of the noble Lord, Lord Marks, did not.

There was a difference between the view of the noble and learned Lord, Lord Hope of Craighead, which was broadly to accept the proposals that I am making in Amendment 284, and that of the noble Lord, Lord Marks, who raised two particular points in relation to street harassment. One was about the breadth of the offence, which is not limited to sexual matters. I do not think it should be limited to sexual matters. If somebody who is disabled is chased down the street by a group of people taunting them for being disabled, that should be harassment. The second point the noble Lord was worrying about was “ought to know”. The sort of conduct that we are seeking to criminalise here is where people behave in a way that is wholly unacceptable. If you say, “I did not know that it was criminal to wolf-whistle and chase somebody down the street,” the fact that you did not know that should not be any defence. Those were the only two points he made in relation to it.