Lord Scriven
Main Page: Lord Scriven (Liberal Democrat - Life peer)
Baroness Finlay of Llandaff (CB)
My Lords, this group of amendments is about the process of information giving. The lead amendment, Amendment 39A, is about the person having an understanding.
In any process of giving information, there is no point just giving the information: broadcasting it, if you like. You have to check that the person has understood it. Usually, in clinical practice, that is done by asking the patient, “Can you tell me what you have understood from what I have just told you?” That allows the patient to repeat back. Sometimes, you find that they have not understood it at all. Sometimes, you find that they have over-understood and brought in other sources of information, and you can then deal with misinformation that comes in and that might be relevant to them. That process is behind consent. The signing of a consent form is simply verification that the process of handing over and receiving information has happened. It is not the signature that matters, it is the process.
I will deal very briefly with something that came up before lunch—
Lord Scriven (LD)
The noble Baroness is absolutely correct that it is the process. In the Bill, there would be two doctors who, after sitting down and discussing with the patient their understanding, have to write an independent report that details the very things that the noble Baroness has noted, which are within the provisions of the Bill, and then goes to the independent commissioner. What is missing in the Bill that would describe the process that the noble Baroness has given that would require extra provision to determine that the two doctors have not just understood that the patient has signed the form but have detailed in the report why they think the patient both has capacity and has given consent?
Baroness Finlay of Llandaff (CB)
If I may, I would like to come on to the issue of the information around drugs, because that is key. But I did not want people to think that simply signing the form was adequate.
Withdrawing ventilation, which was raised earlier, is a fundamentally different situation from this. If a patient is on a ventilator, they would have died earlier without that intervention. When they withdraw consent for ventilation to continue, you still have a duty of care towards them. You need to go through all the processes as to what you will do when you withdraw the ventilation and how that will be managed, so the patient understands how long you expect it to take and that they will die without the ventilation. They must understand that they are dying of the disease that they would have died from previously. That is quite different from to the proposal in this Bill about lethal drugs. I will come on to those lethal drugs now.
This has been sold out there to the public as if this is a Hollywood death—as if you take one little tablet and that is the end of it. In evidence to the Select Committee on 22 October, the noble and learned Lord, Lord Falconer, stated that the substance used
“will be safe, efficacious and not cause suffering”.
I would like to know the basis on which he can say that with assurance.
Baroness O'Loan (CB)
My Lords, that is what I just said—why must the doctor discuss with the patient their wishes in the event of complications arising? Why is there no requirement to explain and discuss the risks of complications?
Lord Scriven (LD)
Does the noble Baroness accept that, under the GMC, for any intervention that a doctor takes, they must explain to the patient the risks and the benefits and then ensure that the patient understands them? It is normal medical practice and has been written in the Bill to make sure that is the case and is written within the report.
Baroness O'Loan (CB)
We are seeking to establish whether this is a regime under the health regulation or where else it lies. I think there are questions to ask.
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.
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 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.