Terminally Ill Adults (End of Life) Bill

Lord Rook Excerpts

Friday 30th January 2026 Lords Chamber

[Baroness Wheeler (Lab)]

I will shortly make an announcement to that effect.

[Lord Rook (Lab)]

My Lords, I will speak to Amendments 99, 102 and 105 in the name of my noble friend Lord Hunt of Kings Heath, who cannot be in his place today. For reasons that will become apparent, I have also added my name to the amendments. I declare an interest as the carer for a family member with long-term dementia.

Taken together, these amendments address a single fundamental problem in the Bill, namely the current definition of terminal illness. It is too broad, too vague and therefore too vulnerable to expansion—by interpretation, pressure and, ultimately, the courts. These amendments seek not to frustrate the Bill’s stated purpose but to clarify it. They seek to ensure that eligibility rests on being already dying, not on age, disability, long-standing conditions or cognitive decline. That clarity matters not only for patients but for clinicians, families and the credibility of the law itself.

Amendment 99 makes clear that being elderly is not of itself a qualifying condition. This should be uncontroversial, yet the current drafting risks conflating age, frailty and terminal illness. Evidence to the Lords Select Committee repeatedly warned that older patients commonly present with multimorbidity: multiple long-term conditions interacting in ways that make prognosis deeply uncertain. Professor Martin Vernon told the Select Committee that, in such cases, prognostication is “extraordinarily difficult”, particularly where frailty blurs the line between disability and terminal illness. If we do not explicitly exclude age, we will risk encoding ageism into statute.

Amendment 102 provides similar clarity in relation to dementia, confirming that it is to be treated as a disability, not a terminal illness in itself. This reflects both clinical reality and ethical responsibility. Dementia has an unpredictable course, and many people live for years with meaningful relationships and quality of life. In 2008, my father was diagnosed with mild cognitive impairment, a form of dementia. In 2010, he was diagnosed with Alzheimer’s disease. As a family, we expected that these diagnoses would dramatically shorten and limit his life. His condition has declined in the 16 years that have followed; he now requires considerable support from family members and a heroic team of carers. Despite this, he continues to live with a good degree of independence and a real quality of life. While his dad jokes continue to get worse—they should definitely be subject to a terminal diagnosis—he continues to be someone of good humour. If you had told me a decade ago that we would be sitting tomorrow at the Cherry Red Records Stadium, hoping and praying for AFC Wimbledon’s first home win since September, I simply would not have believed you.

In line with my father’s experience, your Lordships’ Select Committee on the Bill heard compelling evidence that the six-month prognosis safeguard is particularly unreliable, especially when it comes to cognitive conditions. To treat dementia as terminal by default would place profoundly vulnerable people at risk, especially given the well-documented difficulty of assessing capacity when cognition fluctuates. We will obviously come to the issue of capacity in later amendments.

Finally, Amendment 105 addresses congenital, genetic and lifelong conditions, which are present from birth and compatible with long-term survival. This is a necessary safeguard. Evidence to the Commons Bill Committee made clear that the Bill’s current language—phrases such as “inevitably progressive” and “cannot be reversed by treatment”—is worryingly elastic. Clinicians warned that, without clarity, even manageable conditions could fall within scope, particularly if treatment is refused or unavailable. We have seen this in Oregon, where qualifying conditions under a similarly broad definition have come to include arthritis and complications from a fall. This is not a path that this House should leave open.

Underlying all three amendments is a shared concern about scope creep. The Equality and Human Rights Commission, as we have heard today, warned at Second Reading that Clause 2 lacks sufficient clarity to be applied consistently by medical professionals. Human rights experts told the Lords Select Committee that the six-month criterion could itself become the basis for Article 14 challenges, precisely because it is arbitrary and weakly justified. Once Parliament establishes an autonomy-based model with clear boundaries, pressure for expansion is not hypothetical—it is inevitable.