2 Lord Shamash debates involving the Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Lord Shamash Excerpts
Friday 6th February 2026

(3 days, 3 hours ago)

Lords Chamber
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Lord Young of Norwood Green Portrait Lord Young of Norwood Green (Lab)
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Thank you. I checked before I left, so I am puzzled.

The noble Lord, Lord Pannick, referred to situations where, as set out in the Bill,

“‘the person has an inevitably progressive illness or disease which cannot be reversed … and … the person’s death in consequence … can reasonably be expected within six months’”.—[Official Report, 30/1/26; col. 1261.]

We know from all the evidence we have heard that trying to predict when someone will die is not a precise science, but that is not really the point of this Bill. It is about ensuring that people have a right to choose and are doing so in circumstances where we can feel reasonably confident that safeguards are there.

I look at the safeguards in the Bill, and this is a very cautious step forward:

“Initial request for assistance: first declaration … Witnessing first declaration … First doctor’s assessment … Second doctor’s assessment … Doctors’ assessments: further provision”.


Some noble Lords are speaking as though we have just one doctor, who may not be very mature or experienced. That is not the case in this Bill. It is much more careful and cautious. The noble Baroness, Lady Jay of Paddington, reminded us last time that

“one of the international facts that supports entirely the position he is taking is that, in the … 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”.—[Official Report, 30/1/26; col. 1262.]

I understand that there is a real difference of opinion in this House. Some feel that, if we make this step forward—I listened carefully to the noble Baroness, Lady O’Loan—without putting more things in the Bill, it will be unsafe. I do not take that point of view. We are giving people, as the noble Lord, Lord Pannick, said, the right to choose. That may not accord with the views of all noble Lords. Others want us to take into account degree of suffering and all sorts of circumstances, but I do not accord with that. I take the view that we in this House are trying, with some difficulty, to ensure that we have a Bill that gives people the right to choose and has significant safeguards. Can it guarantee that we can tell people exactly when they will die? Of course not. Minister Wes Streeting announced recently that we will make significant improvements in cancer treatment, which will change people’s lives fundamentally. On those grounds, I hope the House will continue to support this Bill.

Lord Shamash Portrait Lord Shamash (Lab)
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My Lords, can I address the Committee on a personal note? My late brother-in-law suffered from muscular dystrophy, a horrendous progressive disease that many noble Lords may have come across. In the last years of his life, he was pushed around in a wheelchair. It was very difficult for the family, particularly for my wife, his sister.

Lord Wilson of Sedgefield Portrait Lord Wilson of Sedgefield (Lab)
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Order. The noble Lord is not on the list. He was not there last week and should therefore not be taking part.

Lord Shamash Portrait Lord Shamash (Lab)
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Is the Committee prepared to hear me?

None Portrait Noble Lords
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Yes.

Lord Shamash Portrait Lord Shamash (Lab)
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Thank you. I apologise to the Front Bench about that.

The problem was, in the later part of his life, his lungs began to give way. I remember him saying to me, in the last two or three months of his life, “I just wish somebody could help me so that I could end my life”. Watching a member of your close family die from a horrendous disease is something I hope the House will take into account. I am very concerned about Amendment 105 because I think is very tough indeed, and I sincerely hope that the House will reject it.

Lord Winston Portrait Lord Winston (Lab)
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Would the noble Lord agree that the word is “suffocated”, rather than “die”?

Lord Shamash Portrait Lord Shamash (Lab)
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I apologise. Yes, the word is “suffocated”—he was suffocating as his lungs began to fade.

Lord Farmer Portrait Lord Farmer (Con)
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My Lords, I support the amendment tabled by the noble Baroness, Lady Coffey. I am going to talk about my sister, whom I asked before she died whether I could bring her case before your Lordships. She said yes, so I have.

My sister had a very unhappy life; she was badly abused when she was a child and tried to kill herself three times before she was 20. Thankfully, she stayed alive until she was 75, and all the time she expressed her will as, “I don’t want to live”. When I was introduced here, she was here, and she said, “I’m glad I’m alive”, which I was very happy about. However, thereafter, she developed lung cancer. She had been a smoker, and she was obviously dying but she refused treatment. She allowed the lung cancer to kill her, but at all times, she had the option to have treatment for it. She had the autonomy to take the positive route, but she decided not to. She did not have any assistance from anybody else, and she died fairly peacefully when she was 75. I wanted to bring her case to your Lordships’ House in support of what the noble Baroness, Lady Coffey, was saying.

It is being portrayed as if you just take one little tablet and it is a Hollywood death. I am afraid that the evidence is not like that; we will come on to that later on. So I am concerned that, unless we make sure that people are able to make good decisions, they will not be able to. I beg to move.
Lord Shamash Portrait Lord Shamash (Lab)
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My Lords, I listened very carefully to what the noble Baroness, Lady Finlay, said. She has put an enormous amount of work into the background of this Bill. One thing she did not address was the wording of the change from “capacity” to “ability”. It seems to me that the Mental Capacity Act runs like a thread right through the Bill to where we get to the issue of consent and what have you.

It may be that the Chief Medical Officer, Chris Whitty, considered that in his comments. The House might be grateful to receive, or hear, extracts from the Mental Capacity Act, which talks initially about an impairment; in this case it would be an illness. It talks about two tests: the diagnostic test and the functional test. The diagnostic test concerns being ill. The functional test is to understand the relevant information about the decision, including the consequences of each option. The second one is about retaining the information—holding on to the information long enough to make the decision—and then using or weighing the information as part of the decision-making process, and then being able to communicate that decision. That seems to me to be clearly about capacity, not ability, and I invite the noble Baroness to withdraw her amendment.

Lord Pannick Portrait Lord Pannick (CB)
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My Lords, I agree with the noble Lord, Lord Shamash. The noble Baroness, Lady Finlay, speaks with enormous authority based on enormous experience, but we are considering an amendment which seeks to replace “capacity” with “ability”. As Clause 3 of the Bill makes very clear, “capacity” is the term used because there is a well-established, tried and tested scheme under the Mental Capacity Act 2005.

By contrast, the word “ability”, which the noble Baroness seeks to insert, is inherently uncertain; it has no defined legal meaning. There are later amendments to this Bill, to Clause 3, which do seek to address the concept of capacity in the context of this Bill. They are very important amendments and I look forward to our debates on them—but to insert “ability” as the governing concept would simply cause confusion.