Terminally Ill Adults (End of Life) Bill

Debate between Lord McCrea of Magherafelt and Cookstown and Lord Scriven

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, on Friday 16 January 2026, the noble and learned Lord, Lord Falconer, defended the Bill’s provision for informed consent by arguing that the existing drafting already mandates comprehensive disclosure of information. He rejected Amendment 42 in the name of the noble Baroness, Lady Finlay, which would require patients to be fully informed. He argued that was unnecessary because the specific obligations listed in the Bill already ensure that the patient receives all necessary information. However, these amendments identify further gaps and the weakness in the noble and learned Lord’s reliance on the Bill’s current drafting to guarantee informed consent. Evidence of complications, lack of data, prolonged death risks—all these show that there are downsides and pitfalls, rather than simply a peaceful exit.

Proponents, some of whom we have heard today, tell us about prolonged and painful deaths from illness, but they seem to close their minds to long and potentially painful deaths for those who walk the path suggested by noble Lords. There are two mentions of complications in the Bill, but nowhere is there an explicit requirement to explain and discuss the risks of complications, despite this forming a standard part of GMC and NICE guidance on informed consent. I wonder why that is.

[Lord Scriven (LD)]

Will the noble Lord point out in the Bill any clause that moves away from the normal GMC duties of a doctor in terms of either consent or capacity? If the noble Lord could explain that, it would be very helpful when he continues his argument.

[Lord McCrea of Magherafelt and Cookstown]

I am very happy to address that matter. What the noble Lord, Lord Scriven, left out is as significant as what he said. I will come to that.

Clause 12(2)(d) requires a doctor to

“discuss with the person their wishes in the event of complications arising in connection with the self-administration of an approved substance”.

Notice that it says “the self-administration of an approved substance”. That is somewhat different to what was mentioned a few moments before—that they want the doctor giving the injection.

In Clause 39(1)(g), there is a requirement for the Secretary of State to issue a code of practice on

“responding to unexpected complications that arise in relation to the administration of the approved substance”,

and Clause 12(2)(c)(iv) requires the doctor to discuss

“the nature of the substance … (including how it will bring about death and how it will be administered)”—

but not that it may not be successful. The existing areas of medicine have guidance and case law on informed consent and risks, but the Bill creates an area of no guidance, no precedent and doctor confusion.

--- Later in debate ---

[Lord Scriven (LD)]

I am not sure whether the noble Lord is aware that the GMC duties of a doctor are a legal requirement for a doctor to practise in the UK. The doctor therefore has to go through all those, regardless of what is in this Bill, to ensure that the patient is informed and understands the decision that is being taken by them.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

If that is so, then let us put it into the Bill. Let us be sure that it is in the Bill so there is no ambiguity. I notice that the noble Lord, Lord Scriven, does not want that. That is why I am wondering—

[Lord Scriven (LD)]

My Lords—

[Lord McCrea of Magherafelt and Cookstown (DUP)]

Unlike other Members, and unlike the mover of the previous amendment, I have given way. He did not.

[Lord Scriven (LD)]

Just to inform the noble Lord, I have tabled no amendments, I have made no point about what I wish or do not wish to see, and I am not the sponsor of the Bill. In relation to what the noble Lord has said about the legal requirements of the GMC, I am pointing out the duties of a doctor and how the GMC as the regulator applies those to the individual practice of a doctor in the UK.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

And I am responding by saying that if we want to be sure that there is no ambiguity whatever—we are talking about the issue of life and death and, by what was suggested earlier on, inside a matter of days this was all to be over—there should be clarity. I would have hoped that the noble Lord would want that too.

Terminally Ill Adults (End of Life) Bill

Debate between Lord McCrea of Magherafelt and Cookstown and Lord Scriven

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, earlier on in the debate, there was a discussion concerning members of the committee, on who was or was not called, or who was denied the right to be called to it. I suggest that the straitjacket of the time this House allocated probably did not allow the relevant committee the appropriate time to call everyone that it thought was appropriate. It ought to have been given more time, but it seems that it had to be rushed.

Concerning the Mental Capacity Act, Margaret Flynn, chair of the National Mental Capacity Forum, said it was designed to protect us

“when others start to make decisions about our lives … Assisted dying was not on the table during the Law Commission’s consultation which resulted in the MCA”.

Therefore, the suitability of the Mental Capacity Act 2005 as a test for a decision to end one’s life is a major source of debate. I believe the many experts and professionals arguing that it is insufficient for this specific irreversible decision.

The MCA was not designed for assisted dying. It was created to safeguard people who lack capacity in decisions about their care, treatment or finances. Assisted dying was not on the table during the Law Commission’s consultation. The Royal College of Physicians, as the noble Lord said a moment ago, said that applying the MCA to the decision to end one’s life is an entirely novel test in uncharted territory with no experience or precedent. It is a very low threshold. The Royal College of Physicians argues that assessing a person’s mental capacity to decide to end their life is an entirely different and more complex determination, requiring a higher level of understanding than assessing capacity for treatment decisions.

[Lord Scriven (LD)]

I have listened very carefully to the noble Lord and a number of others. I am still struggling to understand what the higher test of ability would be, over and above the Mental Capacity Act. Will the noble Lord let the House know what that higher test is that people would have to go through on ability rather than capacity?

[Lord McCrea of Magherafelt and Cookstown (DUP)]

The noble Lord knows that I am not a proposer of the change of words. I am dealing with capacity. Therefore, I am also dealing with the fact that professionals within the field have stated that to use the Mental Capacity Act for a decision to end one’s life is an entirely novel test and uncharted territory for which there is no experience or precedent. That is not my statement; that is the statement of professionals within the field. They say also that to decide to use it for the decision to end one’s life is an entirely different and more complex determination requiring a higher level of understanding than assessing capacity for treating decisions.

Capacity can fluctuate in terminally ill patients due to physical fatigue, illness, medication or delirium, making the irreversibility of the decision risky under this framework. Therefore, I ask this Committee to think carefully in trying to base its whole argument on this being good legislation because mental capacity is the deciding factor.