Terminally Ill Adults (End of Life) Bill

Lord Wolfson of Tredegar Excerpts

Friday 30th January 2026 Lords Chamber

[Baroness Lawlor (Con)]

My Lords, to add to what has been said, AI is based on large language models, which involve big datasets. I ask your Lordships to consider whether such large datasets, based on assessing a snippet of data to assist diagnosis, are a good way of assessing individual patients. They were not designed to assess individual patients. Every doctor will tell you that each individual case is different, and that diagnosis can vary. I am very grateful to the noble Lord, Lord Stevens, for sharing the results of the 98,000 cases that were assessed for accuracy. Therefore, I am not sure that it is a suitable tool to assess and diagnose individual cases.

[Lord Wolfson of Tredegar (Con)]

My Lords, I approach this amendment in a largely exploratory spirit, because it raises an interesting and increasingly relevant question about the role artificial intelligence might play in the operation of legislation of this kind.

Much of what the Bill requires involves assessments of different natures. We have discussed a number of these at length in Committee, such as questions of capacity and voluntariness, and the presence or absence of coercion. These are judgments that are normally understood as being made by human decision-makers, who draw on their professional experience and have a direct interaction with the individual concerned. At the same time, this is 2026, and we are all aware that artificial intelligence is becoming more prevalent across the Civil Service and even in government departments. Sometimes, in relation to the latter, I am reminded of the Imelda Marcos line, “Better nouveau riche than no riche at all”—and perhaps better artificial intelligence than no intelligence at all. But the concern is that the use of AI is often incremental and not the result of a conscious policy decision or choice. In response to my noble friend, I am not aware of an entire judgment put together by artificial intelligence, but I am aware that sometimes, judgments have been found to dip into artificial intelligence to assist.

--- Later in debate ---

[Lord Taylor of Holbeach (Con)]

My Lords, I am reluctant to involve myself in this debate, but I see this whole legislative process as being about practicalities in the end. It is good that we have had an exposition of the articulation of the motivation of the people seeking success for this Bill, but I am very concerned as a citizen because I think this is about palliative care and relief from suffering.

The Bill should have been about those very matters. However, it is not. It is about all the incentives, from government to public authorities. For those people that the legislation actually motivates, it is about promoting the idea that assisting dying—or assisted suicide—is available; whereas the medical profession prefers, and what all the medical colleges have said they want to see, is proper palliative care. We do not want a competition for the funding of one against the other. I can see that in individual and family lives—and the social life we have together, governed by a Government—the pressures are not going to be towards relief of suffering through palliative care but for assisted suicide. I do not agree with that and that is why I oppose the Bill.

[Lord Wolfson of Tredegar (Con)]

My Lords, I seek the indulgence of the Committee to say a word about my amendment. I am not speaking with my Front-Bench hat on, so to speak, because I understand that this group is going to carry on next Friday. I am in the middle of a trial and cannot attend then. I will speak to my amendment in this group now and will not summarise from the Front Bench but limit my comments to my amendment and the points which arise from that.

My Amendment 83B seeks to add

“despite any treatment they may be receiving”

It ties in with a point made by noble Lord, Lord Pannick, which I will come to in a moment because it is all tied together. The trigger for my amendment is in Clause 2(1), which reads:

“For the purposes of this Act, a person is terminally ill if”


and then there are two conditions, both of which have to be satisfied. The first is that

“the person has an inevitably progressive illness or disease which cannot be reversed by treatment”,

let us say—God forbid—one has pancreatic cancer, and it cannot be reversed by treatment. The second condition is that

“the person’s death in consequence of that illness or disease can reasonably be expected within six months”.

Two points arise out of that. First, there is the point which comes directly from my amendment, which would add

“despite any treatment the person may be receiving”.

Without this, it is unclear whether the six months is with treatment or without; in other words, you have pancreatic cancer and it cannot be reversed by treatment, so condition (a) is ticked. But when it comes to (b)—

“in consequence of that illness or disease”—

does it mean that illness or disease itself untreated or does it mean notwithstanding the treatment you have been given? I suspect it is the latter that the noble and learned Lord intends, but it is far from clear. It actually reads more like the former, although I suspect that it is the latter. That is why I tables my amendment, and I respectfully invite the noble and learned Lord to consider it. As I say, I apologise to him, the Minister and everybody if I am not here next week to hear the fulsome response.

The other point which arises from the “can reasonably be expected” wording is the question of whether that is the 50% point or not. I am sorry that the noble Lord, Lord Pannick, is not here, but it seems to me as a matter of law that if I have a legitimate expectation in public law, I do not need to have a more than 50% expectation of it happening. There was authority at the highest level in the House of Lords that “legitimate expectation” means reasonable expectation. I am comforted—as always—by nods from the noble and learned Baroness, Lady Butler-Sloss.

Therefore, as a matter of law, I can have a reasonable expectation of X, even if I do not think that X is more likely than not. That is an important point which perhaps the Committee will consider going forward. People are reading that as a 50:50 mean or median. However, I can have a reasonable expectation of it raining tomorrow, for example, even if I think there is only a 30% chance of it. That is a reasonable expectation: it is not more likely than not.

I do not want to stray too far from my own amendments so I will now sit down, but I am grateful to the Committee for its indulgence.

[Lord Carlile of Berriew (CB)]

My Lords, I would never stand in the way of a colleague who has a trial. I hope it is an important trial that will improve general knowledge.

[Lord Wolfson of Tredegar (Con)]

My Lords, I am defending the interests of a Labour-supporting newspaper.

[Lord Carlile of Berriew (CB)]

Well, there we are: we know that the noble Lord adheres to the cab rank rule.

We have heard three very cogent speeches from the noble Lords, Lord Frost, Lord Carter and Lord Taylor, about the suffering point. If we look at the discussion we have had this afternoon, we now have a clear and stark difference between assisted suicide based on suffering and assisted suicide based on choice. I agree entirely with the noble Lords, Lord Frost and Lord Taylor: the public expect this Bill to be dealing with suffering. The public understand this Bill to be dealing with great suffering. They understand that the choice to have one’s life ended is based on great suffering, although it does not say so in the Bill. That must be clarified by the sponsor.

On the other side of the argument, we heard a very eloquent speech from my noble friend Lord Pannick, with whom I have a lot of sympathy. It is not generally known that, as he said, he has very personal experience of the issues arising from this Bill. However, the choice he is suggesting comes very close to being a choice for anyone who is seriously ill, not just someone who is seriously ill with an expectation of death within a certain limited period, whatever that happens to be. I fear that those of us who, like the noble and learned Lord the sponsor, are trying to reach the end of our process in the House of Lords on the basis that there will be a Bill, so it must be the best it can be, are not focusing on what choice really means.

We are talking about informed choice, accurate choice, if we can achieve it. I bear in mind very much what my noble friend Lady Finlay said. We are talking about a protective choice: the duty of the state to protect the citizen, even when they are making a choice. We do not, as citizens, have unlimited free choices in what we do; therefore, protection is important. It must be a morally sound choice, because that is part of our polity. We do things that are morally sound, and the Government protect us from those which may not be. It must be a choice founded on medical and scientific integrity: and there is the rub, going back to the points my noble friend Lady Finlay made about the uncertainty of the scientific and medical integrity of what is proposed.

For those reasons, I support the amendments that are focused on choice. I will mention three other amendments that I also support. The first is Amendment 76, which is not in my name but in that of the noble and learned Lord, Lord Garnier, but he is not able to be here for the latter part of today’s proceedings and I agreed to mention it at his request.

Amendment 76 would do something very simple. In Clause 2(1)(b), it would add one word, “direct”, so that a person is terminally ill if, in the amended paragraph (b), their death as a direct

“consequence of that illness or disease can reasonably be expected within six months”.

It may not be the perfect word, but it is about facts and the consequences of those facts. I agree very strongly with the noble and learned Lord, Lord Garnier, that if there is to be a death of someone through the assistance of a third party, which is what the Bill is fundamentally about, then it cannot be just a consequence, or one of the many consequences, of the illness. It has to be the, or at least a, major consequence of the illness. That is the purpose of that amendment: there has to be a bond, as it were, between the illness or disease and the death which ensues.

The next amendment is Amendment 93. It suggests leaving out Clause 2(3) altogether as it lacks clarity as to when an assisted death would be permitted. The subsection says that

“treatment which only relieves the symptoms of an inevitably progressive illness or disease temporarily is not to be regarded as treatment which can reverse that illness”.

What if the relief that is provided for an inevitably progressive illness provides not only relief from the symptoms but extra time to the person who is suffering from the illness or disease? I argue that if it allows extra time, the individual concerned will be having a new experience: they will be seeing what can happen if their symptoms are relieved. They need to discuss with their medical advisers whether they can have that relief of their symptoms again and whether it will prolong their life if they do. The relief may cause a fundamental change of heart by the individual. Therefore, I do not believe that there should be any possibility of the six-month period being elongated in any way by that relief. Indeed, I believe that the period should start again if such relief is given so that the person concerned can have an informed choice.

The third amendment is Amendment 96, which suggests leaving out Clause 2(4), which says:

“For the avoidance of doubt, a person is not to be considered to be terminally ill only because they are a person with a disability or mental disorder (or both)”,


followed by an important further sentence that I will not read out because of time. This subsection fails to deal with the proportionality between the disease, which is the terminal illness, and the disability or mental disorder, or both, from which that person also suffers. It is a complex little conundrum, but a very important one. I believe that proportionality needs to be clarified so that the Bill can be the best possible Bill we can have.

We have much still to learn about the issues that have been under discussion. I invite the noble and learned Lord, Lord Falconer, to consider these carefully and present some draft amendments to us before we meet again in a week’s time.