Terminally Ill Adults (End of Life) Bill

Lord Pannick Excerpts

Friday 30th January 2026 Lords Chamber

People with anorexia do not stop eating voluntarily, and many eating disorders, including anorexia, can be life-threatening without involving cessation of food and fluids. Amendment 90 would address this gap and further protect people with anorexia.

[Lord Pannick (CB)]

It is a great pleasure to follow the noble Baroness, Lady Campbell of Surbiton, and to say how pleased I am, as I am sure all noble Lords are, that she is very much still with us. I hope she will be for many years to come.

This is an important group because, as has been emphasised, scientific precision is of course not possible in this area. Nobody could say that a doctor can tell you that you will die within six months. But the Bill does not so provide. Its conditions require only that the doctor, and the panel in due course, are satisfied that

“the person has an inevitably progressive illness or disease which cannot be reversed by treatment, and … the person’s death in consequence … can reasonably be expected within six months”.

The term “reasonably be expected” recognises the absence of scientific certainty and absolute knowledge in this very difficult area.

The noble and learned Lord will give his view on this in due course, but why, in my view, is the Bill right to so provide? It is because—we are down to the fundamentals of this legislation—if I am told by my doctor that, sadly, I have an inevitable progressive illness or disease and my death can reasonably be expected within six months, I should have the choice of saying that I wish to end my life by taking advantage of the provisions of this Bill. Each of these amendments seeks fundamentally to undermine the core of the Bill and the philosophy that guides it. I entirely accept that its opponents disagree, but this is the core of the Bill and why it rightly so provides.

It is no answer to these provisions and this philosophy that, happily, having been given that prognosis, I may well, should I choose not to exercise the powers under this Bill, live for seven months, 12 months, two years or however long. It would be wonderful if my doctors were incorrect, but it is my choice, having been given that prognosis. That is what this Bill is about—we have taken days debating this—and it is right and proper that we ensure that that decision is made on a voluntary basis and that there is no coercion. But, once those conditions are satisfied, if I am told by my doctor that that is my prognosis, it should be my choice whether to use the provisions of this Bill.

[Baroness Jay of Paddington (Lab)]

My Lords, does the noble Lord agree with me that one of the international facts that supports entirely the position he is taking is that, in the now 33 jurisdictions where assisted dying is allowed, it is usually the case—I cite one or two—that, following that suggestion by a doctor, or prognosis or however you want to describe it, over a third of those who make the choice he has described then do not use the provision? There is no question that they want to die; they are simply using it almost as an insurance policy.

[Lord Pannick (CB)]

The noble Baroness makes an important point, because this Bill is concerned with providing choice. Of course there is no mandatory obligation, but, if you are given this information, you should have the right—it is your life—to decide whether you wish to take advantage of these provisions. In many cases, if it were me or my family, I would argue strongly that there are other options and other things should be done. But it is a choice, and people should have that choice. That is the philosophy and what has guided so many jurisdictions around the world. Many noble Lords do not agree with that, which is their right, but that is what this Bill is all about.

[Baroness Falkner of Margravine (CB)]

My Lords, the noble Lord rightly emphasises that choice is an essential element of this. But in so emphasising, he appears to cast “choice” in a very black and white manner as if it can suggest, not perhaps 100%, but 99% certainty, one way or another. I am sure the noble Lord is very grateful that he has never been in the situation of the patient sitting in that chair, having a conversation with a doctor, as I have, unfortunately. I can tell him that it is not a conversation with one doctor; it is a conversation across a multiple range of people, because doctors want you to have second opinions and speak to others to see if they might think of how you might ameliorate your illness, particularly in the case of cancer.

Doctors do not tend to give you that choice—telling you that it is reasonably likely that you will be dead in six months; they are more likely to say, “Let’s see if X, Y or Z treatment or drug will perhaps help you. We need to try that for a little while”. When you do that, you see what the results are. In the impact assessments, we are told that 66% of people in the two jurisdictions referenced were cancer patients. The noble Baroness, Lady Jay, is right to say that 40% of those cancer patients did not exercise their right. I said this at Second Reading, so I am not going to repeat it, but potentially one reason why they did not exercise that choice is because that certainty of choice changed. The situation changed as they went along, and perhaps that is why they did not exercise it. So much emphasis on choice perhaps is unwise in this uncertain world.

[Lord Pannick (CB)]

The noble Baroness began by asking about my experiences. I do not really want to talk about my personal experiences, except to say that those I have loved have faced a terminal diagnosis. I am very familiar with all of this on a personal basis, as I am sure is everyone—or almost everyone—in this Committee, and our experiences, of course, guide our view as to the merits or otherwise of this Bill.

[Lord Moylan (Con)]

May I ask the noble Lord a question? This is not a trick question; I sincerely want to know his opinion from a legal point of view. The Bill refers—and he has said it refers—to a reasonable expectation of death within six months. Normally, and this was a point made by the noble Baroness, Lady Finlay of Llandaff, just now—and I have some amendments later which address this specifically—a prognosis given by a doctor in a particular case would be an average of the sort that we call a median. That is, 50% of people in your position will die within six months, but 50% will live longer than six months. Which one are you? Would that 50% constitute for him a reasonable expectation, or would he expect a higher threshold to apply in a case such as this?

[Lord Pannick (CB)]

I do not think any doctor, any panel or any court would adopt that type of approach to a complicated issue of this sort. They would rely on the judgment of the doctor, who no doubt would be well aware, or should be well aware, of the provisions of this Bill, if enacted. The doctor will exercise his or her judgment and be able to tell the patient whether there is a reasonable expectation of death within six months. The doctor will give that judgment, and whether you are eligible under the Bill depends on that. It is as simple as that.