Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 13th March 2026 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

If there are not enough people with the requisite expertise to people the panels then there will not be panels to do the job. That is why the broad categories have been adopted in the Bill. The Royal College of Psychiatrists has expressed views in relation to this, as has the British Association of Social Workers. However, it is necessary for us to find people to do this process, because the workability of the scheme depends on it, and we believe it is possible to do that. We recognise the concerns that have been expressed, including by the noble Baroness, who is right to say that if we do not have people who can people the panels then we cannot do the process.

On the broader issue of what happens if we have people in one part of the country but not another, it will be for the voluntary assisted dying commissioner to ensure that, when a panel is required, it can be provided.

[Baroness Berger (Lab)]

I have listened closely to all of my noble and learned friend’s responses and remarks on this sizeable group of amendments—by my count, there are 105 amendments. While a handful have been presented by the sponsor, my noble and learned friend, the overwhelming majority have been put forward by noble Lords on all sides of the Committee, largely informed by the evidence that we heard at the Select Committee and by representations made by professional bodies and medical colleges outside of this place that wish us to improve the Bill. That is the job we were tasked to do by the other place and by our colleagues.

I have listened closely to every single word of my noble and learned friend’s response and heard every reason why every single one of these amendments should not be accepted. I did not hear what could come forward to make the changes that people think should be made to this Bill to make it safe, particularly for vulnerable groups, and to ensure we do not see coercion. Reflecting on his response, does my noble and learned friend intend at a future moment to come forward with anything that would put in the Bill things that would make the material differences that are the reason and impetus behind noble Lords putting forward these amendments?

[Lord Falconer of Thoroton (Lab)]

I have thought very carefully about the amendments we have gone through. I am sure they are all based on attempts to improve aspects of the process, such as the appointment of the panels, how the panels operate and the privacy issues. I should say that very considerable thought went into those issues before the Bill was drafted and as it went through the other place. I have given detailed reasons as to why I think the amendments we have debated would not really improve the position. For those reasons, after giving it considerable thought, I think that the Bill probably reached a better conclusion on, for example, the “must” and “may” issue that the noble Baroness raised and the need for special extra expertise. I have given it careful thought, but I do not think any of the amendments we have gone through would improve the Bill.

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A multidisciplinary panel would give a clearer view of what the Bill claims to do. We must avoid doctor shopping. I think all of us would agree that palliative care is incredibly important. I wish that that had been part of the Bill, so we could have debated it in more detail. We have to look at the whole person. This is a model that we should at least consider.

[Baroness Berger (Lab)]

The noble Baroness, Lady Grey-Thompson, made some important points, as have been made by other noble Lords, about the drugs. Given the context of this debate, as we deliberate these amendments and later amendments, it is worth sharing that the Delegated Powers and Regulatory Reform Committee of this House, in its important report about the extension of delegated powers in the Bill—of which there are now 48—had specific concerns about substances, drugs and the detail missing from the Bill. In fact, the two specific themes that are relevant are the lack of specification of approved drugs and the lack of regulation of approved substances. The Bill currently uses two delegated powers for something that would usually be described in the Bill, but it is instead in delegated legislation. That perhaps provides some context as to why these amendments have been put forward.

[Lord Empey (UUP)]

My Lords, I want to deal with probing Amendments 887A and 888A, in my name. Throughout the process there has been a potential clash between what decisions might be made here and what decisions might be made in the devolved nations. In the other place, an amendment was introduced by the sponsor of the Bill as it progressed to extend certain parts of it to Northern Ireland and Scotland, as well as England and Wales. My colleagues at the other end tried to put an amendment down to probe why this was done. Unfortunately, it was not taken, so the matter was never really debated.

I remind the House that Clause 37 deals with the regulation of approved substances and devices for self-administration. It says that:

“The Secretary of State must by regulations make provision about approved substances”,


and that has the extent of the entire United Kingdom. These regulations also deal with

“the supply or offer for supply, or administration, of approved substances … the transportation, storage, handling and disposal of approved substances”,

and

“keeping records”.

It says provisions must be made

“about the manufacture, importation, preparation or assembly of approved substances … or in connection with the monitoring of matters”

and so on,

“requiring persons specified in the regulations, in specified cases, to give information to the Secretary of State”.

As things stand at the moment, there is no plan by the Northern Ireland Executive to introduce an assisted dying Bill, and there is no Private Member’s Bill currently in the Chamber. Some of these regulations would, in my view, cut across the role that is currently played by devolved Ministers and devolved departments.

This is what I am trying to get at and to probe. It does not, incidentally, confine the extent to Clause 37. In fact, other clauses extend the Bill’s extent as well—Clauses 43, 54, and 56 all apply to the whole of the United Kingdom. I do not understand that. If the noble and learned Lord could enlighten us, that would be most helpful. As I said, they are probing amendments. The point I am trying to tease out in Committee is why that was introduced if it was not in the original Bill and why that extension was made, because, as things stand, there are no plans for an assisted dying Bill in Northern Ireland—not from the Executive and there is no Private Member’s Bill currently.

I totally accept that this Parliament has the right to legislate for the entire United Kingdom, irrespective of devolution. But, at the end of the day, the Bill says:

“The Secretary of State must by regulations make provision about approved substances”.


There is no argument about it—this has to happen. The extent of those regulations would be the entire United Kingdom. Whether Northern Ireland and Scotland want it, it is going to happen, according to this clause. Why is that the case? If there is no assisted dying available—and in many cases, it would be a devolved matter anyway—why are we regulating for the provision of these substances in all parts of the United Kingdom? That is what I want to know, and I will be grateful for the noble and learned Lord’s contribution in the wind-up.

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[Lord Falconer of Thoroton (Lab)]

When I said that I am really focused on how to provide a proper assisted death and that that is not a technical question about whether the NHS will provide it, I did not mean to say that it is not important for this issue to be resolved. If I did, I misspoke, but please do not read me as saying that. That is an issue on the way to the Bill providing a compassionate and workable way of providing an assisted death to those who want it.

As to the second part of the question asked by the noble Lord, Lord Harper, about my view in relation to it, it is that it is ultimately for the Secretary of State for Health to decide how it is provided. The power is given to the Secretary of State to decide that in Clause 41, with the amendments that I have put down in relation to it. It gives him power to commission it himself or through a variety of other bodies. That might involve some body other than the NHS providing it. Ultimately, it is for the Secretary of State to decide how that is done. I think I have said enough on the scheme proposed by the noble Baroness, Lady Finlay.

I will go on to substances. There is a range of amendments in relation to substances. We shall come back to substances in relation to Clauses 27 and 37. They are in this group because they relate in part to the scheme proposed by the noble Baroness, Lady Finlay. She proposes designated pharmacies so that only particular pharmacies can do it. It is again—this is the wording of the Bill—for the Secretary of State to decide how substances are to be selected, how drugs and devices are to be approved, and then how they are to be dealt with. Subject to my amendments, which give more limitation to Clauses 27 and 37, I think the right principle in relation to that is that it is for the Secretary of State to decide how properly to regulate and choose the substances, and he or she is to do it only after taking proper advice.

[Baroness Berger (Lab)]

On that very point about Clause 37, I am sure my noble and learned friend is aware of the updated Delegated Powers and Regulatory Reform Committee report alluded to by the noble Lord, Lord Stevens, a moment ago. On that clause, it states that there are still “highly inappropriate” provisions in the Bill, particularly on Clause 37, specifically in relation to the substances that would be used for an assisted death. I heard what my noble and learned friend said, but it is the complete opposite of what the report released yesterday says and what remains in the Bill. The amendments that my noble and learned friend has brought forward do not yet address the concerns expressed by that very important committee in its report.

[Lord Falconer of Thoroton (Lab)]

I accept what my noble friend says. I hope she has read my note to the committee, which it published, in which I accept that further work is required, in particular on Clause 37. I accept in principle that I have to come back with further amendments in relation to Clauses 27 and 37.

The noble Baroness, Lady Hollins, has made a series of creative suggestions. She is addressing this in a way that is separate from the proposal from the noble Baroness, Lady Finlay of Llandaff. She says that her proposals on substances should apply irrespective of which scheme it is. I need to consider some of them in detail. My noble friend Lady Blake has indicated why some are difficult to integrate into substances for assisted dying. I am particularly interested in the relationship between the Medicines and Healthcare products Regulatory Agency and the approval of these drugs; that needs further thought on the sponsor’s part. In addition to the amendments that I am proposing to Clauses 27 and 37, I should consider them as I think they are valuable.

For the reasons given by my noble friend Lady Blake, I do not support the amendments proposed by the noble Baroness, Lady Grey-Thompson, in relation to clinical trials. Although the MHRA has a part to play, I also accept the limitations on that put forward by my noble friend Lady Blake.

I have seven amendments in this group: Amendments 624A, 708A, 708B, 710B, 862B, 877B and 878A, all of which relate to limiting the power in Clauses 27 and 37, and include a requirement for consultation in respect of the Minister. I do not think that they are contentious, although I accept that people think that I should go further. In the respect that I have mentioned, I am more than willing to think about going further. If and when we reach those amendments, I expect the Committee to agree to them.

I deal finally with the question from the noble Lord, Lord Empey, in relation to Northern Ireland. He asks why the Bill extends the power of the drug regulator in this respect to Northern Ireland. The noble Lord will know that drug regulation is a matter for the whole of the United Kingdom so must be dealt with by a statute in this House. We are not suggesting that Northern Ireland should change its current law, but if there was a law change then there would be no reason why the drugs authorised in whatever process the Secretary of State agrees to should not apply to Northern Ireland. That is why it refers to Northern Ireland.

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That is true in general, but, as the noble Baroness, Lady Monckton of Dallington Forest, so movingly, passionately and powerfully put it, people who have Down syndrome often want to keep people happy. What if they hear that suggestion? I am putting this very badly, but it is an abomination that it should even be there on the possibility list. I would like to hear the noble and learned Lord at least concede that point, if nothing else today. That would be worth coming for.

[Baroness Berger (Lab)]

It was so moving to hear the contribution from the noble Baroness, Lady Monckton, and the points that others made about the words that people may hear, including people with learning disabilities. I was reflecting on the evidence we heard at the Select Committee from the National Down Syndrome Policy Group. It is not just the words that people may hear; it is also what they see in front of them. In particular, what was really striking—I had not thought about this—was that even the uniform of the doctor who is having that conversation could suggest a position of authority that someone with a learning disability should show acquiescence to. I thought that was something for us to consider in the light of all these important amendments.

[Baroness Fox of Buckley (Non-Afl)]

That is very helpful. When I see a uniform, I get a bit quivery as well—

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 27th February 2026 Lords Chamber

[Baroness Lawlor (Con)]

We are proposing and debating a piece of legislation at this moment. We are concerned about the safeguards in the current proposed piece of legislation. The noble Baroness, Lady Gray of Tottenham, has proposed that the reviewing panel must raise with the person considering assisted suicide whether they have discussed it with their nearest and dearest. That is a different matter from what the noble and learned Lord has raised. We are discussing a piece of proposed legislation and I am discussing an amendment proposed by another noble Lord.

It is very important for those on whom we have depended and may still depend that we form a society and, as human beings, give support and love to one another—a mother or father who wishes only to support their child, perhaps terminally ill, to live their life as best they can; a daughter, son or sibling supporting their loved parents, sister or brother; or a spouse or best friend.

I do not agree with the premise of the Bill that we are autonomous human beings to dispose of ourselves just as we wish. Whatever freedom we have as human beings is rooted in a network of social relations and responsibilities, especially to our kith and kin. We therefore need to do whatever is possible to ensure that a person’s ultimate decision to end their own life is taken within a familial and social context. This amendment, which I support, promotes that end.

[Baroness Berger (Lab)]

My Lords, I will speak to my Amendments 466, 471 and 474, as well as to Amendments 472 and 485 in the name of my noble friend Lady Gray of Tottenham; I will make different points on those. These are all forms of amendments that were tabled but not debated in the other place. They all seek to strengthen the effectiveness of the voluntary assisted dying panels as a safeguard, because that is what we have been told they have been put forward to provide.

My first two amendments would mean that questioning both the co-ordinating or independent doctor and the person seeking an assisted death is mandatory and not at the panel’s discretion. It is extraordinary that, in light of all the evidence that we heard across the 13 panel sessions of the Select Committee, the Bill currently does not ensure that the panel asks questions of every person seeking an assisted death.

Noble Lords will be aware that, as we have heard, the panels were added to the Bill in the other place two-thirds of the way through Committee in order to replace the High Court, which we were originally told was part of a judge-led process. The panel process has never been piloted or consulted on, and it appears to have been based on the Spanish system—a system of guarantee and evaluation commissions—but of course the Spanish law is very different from the Bill that we are scrutinising, which we have been assured is narrower and safer. The Spanish system, which allows for both assisted dying and euthanasia, does not require a terminal illness from which a person is likely to die within six months, as the Bill that we are scrutinising does; it requires only—in translation—a serious and incurable illness or a serious chronic and impossible condition. The Spanish legislation provides for considerably wider categories. I am sure that those of us concerned about vulnerable people being made to feel that they are a burden are very glad that the sponsor has not proposed them here.

The requirement for a terminal illness with a six-month diagnosis is a meaningful safeguard only if it is properly tested. How can it be said that a panel has done its job if it has not asked a single question of the doctors? How can it establish that the person has not been pressured or coerced just by passively hearing their prepared statement, which may have been drafted under the eye of their abuser? In what way is any of this a suitable alternative for the rigour set out in the first iteration of the Bill, which included the High Court? That is why I believe that these amendments are necessary.

This concern was expressed very well to the Lords Select Committee by Dr Luke Geoghegan, who represents the British Association of Social Workers. He set out the following about how safeguarding usually works in this country and how it differs from the approach of the panels that is currently set out in the Bill:

“An allegation is made or a concern is raised and that concern is investigated, and then that allegation or concern is either upheld or it is not. The challenge for the panel”—


the voluntary assisted death panel—

“is that here this model is flipped. Can we be sure that this person is not affected by safeguarding or coercion issues? It is often impossible to prove a negative, but we can make reasonable assessments on the balance of probabilities”.

The real issue here is that the panel system means there is no other side seeking to show that the test for eligibility has not been met, and there is no cross-examining of the witnesses who say that it has. In the absence of such a legal process—usually the hallmark of our British system—having the panel at least ask some questions of every applicant for an assisted death is surely the absolute minimum that must happen if we are to have confidence in it as a safeguard.

Amendment 474 would make a more discretionary change. It would add a requirement to “consider hearing from” a person’s family and other treatment and care providers. I reiterate that, in the amendment as set out, it is not mandatory. In advance of explaining the amendment, I will provide a counterview to some of the things that we have heard so far. We have heard the discussion about family members in the context of agency. I will talk about it in the context of the variety of autonomy and the context of establishing coercion.

Family members and those who have provided care for the person are likely to be privy to information that has a significant bearing on the panel’s deliberations and decision. Perhaps a son or daughter knows that someone new has recently entered the life of their vulnerable parent, has slowly taken control of their finances and has encouraged them to cut contact with others.

I set out this point reminded by the evidence that we heard from Age UK and the existence of different types of abuse, but particularly romance fraud. In the Select Committee, we heard that Age UK had been contacted

“by families who say, ‘Hang on, I’m really worried that there is this person in my mother’s or father’s life and I’m not sure what their intentions are’”.

The evidence talked about

“the moral hazard for people who stand to gain from older people after their death”.

An example of this could be a carer who knows that the person has struggled with suicidal feelings long before their illness worsened or knows the reason behind the source of their despair. Perhaps, while quietly attending to the needs of the patients they are responsible for, a carer has overheard a friend or family member suggest to the patient that it really would be easier all round if they were to end things sooner rather than later with the help of trusted professionals. I know that we would like to think that this does not happen, but I have spoken already in this Chamber about the first-hand experience of hearing how that is unfortunately the case in some instances.

I am aware that there is a power in the Bill to hear from “any other person”, but this is left so open as to add little in the way of assistance or direction to the panel. My amendment, therefore, responds to the evidence we heard from the professional bodies and provides an explicit steer while still allowing for the panel to conclude that additional evidence is not likely to be helpful or that the process of seeking it would be too onerous.

I also support Amendments 472 and 485 in the name of my noble friend Lady Gray, who unfortunately is unable to attend today. Amendment 472 would require the panel to ask the person whether they have discussed their requests for an assisted death with their closest relatives and to discuss the reasons if they have not. Amendment 485 would provide that this requirement would not apply in the exceptional circumstances where a panel chooses not to hear from the person. These amendments, like mine, seek to highlight the vital insight that family members may have into the person’s wishes or eligibility. If the panel is able to place the person’s request for an assisted death in the context of their relationships, they are more likely to be able both to understand an undeclared motivation behind the request and to detect any coercion or undue influence.

As the Bill has progressed, it has frequently been noted that doctors rarely make serious decisions on their own. The sponsor, my noble and learned friend Lord Falconer, has acknowledged this, which is why the panel itself is so often referred to as multidisciplinary. Here, I note the expertise of the noble Baronesses, Lady Finlay and Lady Cass, and others, who have rightly pointed out that the medical assessments themselves should also be multidisciplinary. However, it is also true, as we heard at the Lord’s Select Committee, that patients rarely make decisions on their own. We heard from the Royal College of Psychiatrists that there is very pure personal autonomy, where somebody makes a decision uninfluenced by anybody else, but that does not reflect the way that people usually make decisions, which is as part of their relationships with others, and that is very normal.

Professor Charles Foster told us that, in the real world,

“decisions about how we exercise our autonomy are made in the context of our relationality”.

We discuss with our relatives what should happen. If someone chooses not to tell their immediate relatives or loved ones about such a momentous decision as ending their life prematurely, that is noteworthy. There may be good reasons for it, as set out by my noble friend Lady Hayter, but that should be for the panel to establish. These amendments do not offend against autonomy and they would not oblige a person to tell their family or friends anything, but they would enhance the information available to the panel and move it further towards being an effective safeguard against coercion and undue influence or an otherwise unwanted assisted death.

A secondary point to these amendments is to make it at least a little less likely that families will have to go through the trauma of finding out about the death after it has happened. Our Select Committee was told by the Royal College of Pathologists that in cases where death is unexpected, families often find out about the death of a loved one when they receive a call from the medical examiner. If passed, the Bill is likely to increase the number of cases where that happens and will put a great strain not only on families themselves but on the professionals who find themselves in that position. I am conscious of time, but it is worth reflecting on, and I ask noble Lords to look at the comments from the Royal College of Pathologists, as that was explained to us.

Amendments 472 and 485 seek to minimise these impacts as far as possible. They would not create an obligation on the person to involve their next of kin, but they might encourage them to have that conversation if they feel able to do so. Ultimately, the more information that is available to the panel about a patient’s circumstances and relationships, the more confident we can be in the panel’s decisions and the regime it would create.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

[Baroness Levitt (Lab)]

I am not going to take any interventions, I am sorry. I am simply giving the Government’s view. We are very short of time. I apologise to the noble Baroness.

[Baroness Berger (Lab)]

Would my noble friend—

[Baroness Levitt (Lab)]

I am not taking any interventions.

These amendments create a further risk of incentivising the use of palliative care when it is not in line with the wishes of the individual. If a patient has relevant and available palliative care options, as with all treatment options, it remains their decision whether to pursue them.

Lastly, I turn to Amendment 832 in the name of the noble Baroness, Lady Hollins. The Government have workability concerns in relation to the amendment, which states that no person may access an assisted death unless a consultant from palliative medicine has

“confirmed in writing that all appropriate specialist palliative and end-of-life care options … have been discussed and, so far as reasonably practicable, tried or considered”.

This appears contrary to usual clinical practice, whereby the involvement of specialist services depends upon an assessment of need and on the wishes and preferences of the patient. As Amendment 832 excludes people from eligibility unless they have tried or considered particular options for care, this could give rise to legal challenge on the basis that it is not justified under Article 2 or 8 or may amount to unjustified discrimination under Article 14.

Crime and Policing Bill

Baroness Berger Excerpts

Committee stage
Tuesday 9th December 2025 Lords Chamber

[Baroness Berger (Lab)]

My Lords, it is a privilege to follow the noble Baronesses, Lady Bertin, Lady Kidron, Lady Benjamin, Lady Kennedy, Lady Boycott and Lady Shawcross-Wolfson, the noble Viscount, Lord Colville, and the noble and learned Baroness, Lady Butler-Sloss, all of whom who have made significant contributions. I do not wish to reiterate what has been said too much, but I want to speak today in support of Amendments 290, 291, 292, 298 and 314 in the name of the noble Baroness, Lady Bertin, concerning sexualising children, pornography that mimics abuse and nudification. I put on record my thanks to the noble Baroness for her important and vital work in this area, and recognise the toll it must have taken.

The consumption of violent pornography is having a devastating effect on adults and on the children being exposed to it. We have heard the research from the Children’s Commissioner that indicates the average age at which children in the UK first see pornography to be around 13, but a substantial minority are encountering it significantly earlier, including in our primary schools. I should declare an interest: I have two primary-aged children. I have a daughter who is eight and a son who is six, and I am terrified at the prospect of either of them being exposed to this type of material. We know that this material is having an adverse effect on the physical, sexual and mental health of hundreds of thousands of people in our country. I want to touch on a couple of particularly concerning areas: pornography that mimics abuse and nudification.

We know that, for too long, companies hosting pornographic content have been allowed to host whatever material they like online, regardless of its harm. I echo some of the comments that have been made; it is extraordinary that we have a situation where it is not allowed offline, but it is allowed online and anyone can reach it from the phone that they hold in their pocket.

Amendment 290 would make it an offence to glorify or advocate for child sexual abuse. I do not know how anyone can question the aims of that amendment; it is critical. We heard about this on the previous day in Committee. It is both repulsive and shameful, but it is worth reiterating, that the UK is the third-largest consumer of child sexual abuse videos that are streamed from the Philippines. We rightly have laws on hate speech in this country. We must equally have laws that deal with this type of heinous advocation of child sexual abuse. This is not something over there; it is happening every single day in our country, and we have to take responsibility for it.