Terminally Ill Adults (End of Life) Bill

Debate between Lord Katz and Lord Falconer of Thoroton

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Katz (Lab)]

To repeat—and I hope this helps—the Government do not see any major workability concerns. Our concern is specifically with the drafting, in that it uses different language from language that already exists in the Bill. We feel there is a risk of duplicating existing requirements in Clause 12 for the assessing doctor to explain and discuss with the person what approved substance would be provided and how it would bring about death. There could be the risk of that duplication, but there are no major workability issues.

[Lord Falconer of Thoroton (Lab)]

My Lords, I thank everybody who has taken part in this interesting and important debate. The amendments fall into four categories, all of which overlap. The first category is the amendments from the noble Lord, Lord Blencathra, which say that the patient has to have demonstrably understood the information about diagnosis, prognosis, treatment and the drugs that will be prescribed. The noble Baroness, Lady Coffey, says that “demonstrably” should be put before “informed”. She also seeks to insert into the Bill what is regarded as the Montgomery v Lancashire test from the Supreme Court—that is the third one. The fourth is that a number of noble Baronesses and noble Lords have indicated that they want to be absolutely clear that the patient is properly informed of the effect of the drugs, any side-effects, any complications and what is going to happen.

I have thought very carefully, listening to the debate, whether one needs to make any changes to the Bill in order properly to reflect that the patient has to be properly informed before they make their decision. There is absolutely no doubt on anybody’s part in the course of this debate that, before any decision is made, the person has to be properly informed, and that means they have to be properly informed on prognosis, diagnosis, palliative care options and what the effect will be of the drug being administered, including side-effects, complications and what may happen in relation to complications.

As far as the Bill is concerned at the moment, Clause 1(2) says that steps need

“to be taken to establish that the person … has a clear, settled and informed wish to end their own life”.

“Informed” there plainly has a meaning well acquainted to the law: that they know enough material to be able to take the decision. Enough material to take the decision in relation to prognosis and diagnosis would need to involve knowing what the level of certainty of the diagnosis is, what possible steps could be taken to alleviate the position and the various risks in relation to that, the effect of the drugs on me physiologically—the lethal drugs, if I choose to have an assisted death—what the risk of complications is and what would happen if I got complications. Without that material, it would not be “informed”. That reference to “clear, settled and informed” is then repeated four times, significantly, throughout the Bill.

First of all, in Clause 10(2), the first doctor has to be satisfied that the person has a clear, settled and informed wish to end their life. Secondly, the second doctor has to be satisfied that the patient has a clear, settled and informed wish. Thirdly, the panel has to be satisfied that the person has a clear, settled and informed wish. Fourthly, at the point that the assistance is given, the provider of the assistance, the co-ordinating doctor, must be satisfied at the time the approved substance is provided that the person has a clear, settled and informed wish to end their own life.

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[Lord Katz (Lab)]

I thank the noble Lord, Lord Blencathra, for tabling these amendments. I note his wish to keep this brief so that we can move on to a later group to discuss the issues that he raises in greater breadth.

Amendment 39C seeks to exclude anyone whose primary motivations for the request for an assisted death are financial concerns, lack of housing or lack of social support. This would require someone to establish the motivations of a person requesting an assisted death. It is not clear who would make this assessment or how they would make it. It is also unclear how a number of the phrases in the amendment are meant to be interpreted and assessed, including “financial concerns”, “lack of housing” or “lack of social support”, because these terms are not defined. The amendment also conflicts with later provisions of the Bill setting out how eligibility is assessed in more detail, which would cause confusion. If passed, considerable further policy and drafting work would need to be done to clarify the intent.

In the spirit of brevity, I make no comment on the other amendment in this group. However, as noble Lords will be aware, the amendment has not had technical drafting support from officials.

[Lord Falconer of Thoroton (Lab)]

My Lords, I am grateful for how this has been dealt with. We have discussed this a lot, at Second Reading and in Committee. I have made clear that, while suffering may very often be the cause of somebody wanting an assisted death, it is not the trigger for it as a legal requirement. Why people want to end their life in the context of a terminal illness is for them to decide. The effect of these amendments is that a person is entitled to an assisted death only if the reasons for them wanting the assisted death are the symptoms, suffering or prognosis of the terminal illness. I am not in favour of inquiring as to precisely what is the cause. Severe misery may well be the cause in the context of a terminal illness. In my view, this provision would unduly limit the entitlement to an assisted death, so I am against these amendments because they go right against the principle of the Bill.

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[Lord Katz (Lab)]

I thank noble Lords for their considered contributions on the motivation for assisted dying. Before I go into the meat of my comments, I join the noble Lord, Lord Kamall, in thanking the House clerks and staff for all their efforts and dedication in allowing us to sit for longer on a Friday to consider these weighty issues properly.

I also share the noble Lord’s comments about our wider motivations across the House, and about generally in politics wanting a better society. For what it is worth, I find myself in agreement with the noble Lord, Lord Deben, that, indeed, no man is an island. Whether that makes me a classical liberal or not, I am not sure—probably not.

These amendments seek to amend the eligibility criteria for assisted dying, to require that the person’s wish to end their own life is due to their terminal illness rather than to other reasons. I will keep any detailed comments limited to the amendments on which the Government have major legal, technical or operational workability concerns.

Amendments 320ZA and 332AA, tabled by the noble Lord, Lord Blencathra, seek to prevent people being eligible for an assisted death if they are motivated by non-medical factors such as loneliness, poverty or lack of services. There are various workability issues with these amendments, which I will briefly outline to aid noble Lords’ consideration. First, it could be challenging to establish whether someone is seeking an assisted death as a result of specified factors, given that a person’s motivations could be complex. Furthermore, a wide range of factors could be deemed as non-medical, given that the term is not defined and the list given is non-exhaustive. It is also unclear how the patient or doctor are meant to proceed if these factors are present.

I raise no major workability issues with the other amendments in this group, which are rightly a matter for your Lordships’ House to decide. However, I would like to set out their potential effects, which noble Lords may wish to consider. The amendments would require a person’s terminal illness to be a motivation for them seeking an assisted death, but, as drafted, they do not require it to be the only or primary motivation. It is arguable that every person seeking an assisted death under the Bill would be doing so in some way because of their terminal illness, so it may be that, in practice, the amendments would not impact on who is eligible.

The noble Lord, Lord Kamall, asked me some questions. I would push back on his first question around how the Government envisage a process or system for establishing motivation beyond condition: we genuinely think this is a policy decision, and that is one for my noble and learned friend Lord Falconer, the Bill’s sponsor, and those others who support the Bill. On his question about any work or research that NHS England has undertaken, I do not have that answer at my disposal, but I am very happy to take it back and write to him.

Finally, I would just like to mention that none of the amendments in this group has had technical drafting support from officials, so the way they are currently drafted means that they may not be fully workable, effective or enforceable.

[Lord Falconer of Thoroton (Lab)]

My Lords, I join with the noble Lord, Lord Kamall, and my noble friend Lord Katz in thanking the staff for staying for so long this evening. I also congratulate the Committee on what was a very high-quality debate at the very end. We did incredibly well to have such a high-quality debate in the last hour or two at 6 pm. Thirdly, this is not in any way to denigrate the debate; it has been threaded through the whole of these Committee stages. Indeed, we had a quite similar debate last week, which the noble Lord, Lord Harper, referred to.

I will make three specific points about the amendment. There is a group of amendments, but at the heart of the lead amendment is that you should be entitled to an assisted death only where your motivation is

“because of the terminal illness”.

My noble friend Lord Katz adverted to this, but it is almost impossible to see that that has any real meaning in the context of a person who is, in fact, terminally ill. If any of us became terminally ill, it is almost impossible to imagine that the terminal illness would not have an effect on any decision that we would take, in particular a decision on whether we wanted an assisted death. The noble Lord, Lord Moore, touched on this. I do not know that I would put it in exactly the same way, but, to “Why do you want an assisted death?” they might say, “Well, obviously, I am terminally ill, and I have other factors as well”. So I am not sure that the amendment has any real impact.

Secondly, there is an underlying issue. I ask the noble Lord to let me finish—then, by all means, he can come at me at the end.

Secondly, there is an underlying issue. The noble Baroness, Lady Cass, said that perhaps breathlessness and pain should be the only justification, because that is all that doctors could properly measure. Again, that indicates a significant disagreement between us about the principle of the Bill. I do not shy away from saying that the principle of the Bill is that, once you are diagnosed with a terminal illness, then, subject to the stringent safeguards being satisfied, you should have the option of deciding for yourself how you die. If you go down the route that my noble friend Lady Berger, in her amendment, wishes us to go down, this, in my respectful submission, would be an impossible task.