Terminally Ill Adults (End of Life) Bill

Baroness Butler-Sloss Excerpts

Friday 13th March 2026 Lords Chamber

[Baroness Jay of Paddington (Lab)]

My Lords, it seems to have become a regular feature of these Committee sittings that the noble Lord, Lord Deben, and I disagree—but I think we disagree with courtesy, and I hope we disagree on the basis of real understanding. However, it is extraordinary that we have got to this stage in the Bill and he does not seem to accept that those on this side of the House—or rather, those of us who support the Bill, as it is not an “on this side of the House” issue—are in favour of palliative care. We have always been in favour of palliative care and have always said that the two go together.

I have not had the honour of serving in the other place, as the noble Lord has done, but I have had experience of sitting on other Select Committees of your Lordships’ House on this particular matter—not the immediately past one, but on others—where we looked in detail and travelled to those places where assisted dying is in place. There is absolutely no evidence that assisted dying, when introduced, does anything other than improve palliative care, because it improves the understanding that people have of discussions about end-of-life care, death and the general issue, which can be debated more openly.

I am not trying to take the point made by the noble Baroness, Lady Murphy, any further, but one of the things that has concerned us in this Committee is that there is so much emphasis in so many of these amendments on the detailed administration—the noble Baroness used the word “nitpicking”, which noble Lords did not like—and the very small print, and so much less focus on those people who are actually going to hope to take advantage of this legislation: patients and people who are dying, and people who are reaching the end of their life. I remember that in a previous debate my noble friend Lady Hayter said this, but I have been rather shocked by the emphasis, for example, on the bureaucracy and structure of the commission and so on, which has not emphasised the position of those people who are dying.

[Baroness Butler-Sloss (CB)]

My Lords, I remind the House of the extraordinary common sense of the noble Baroness, Lady Cass, who pointed out that there may well be a lack of suitable doctors of one sort or another, and they may have to put up with what actually is the reality.

[Baroness Hollins (CB)]

My Lords, I fully endorse the amendments from my noble friend Lady Finlay, and I think they deserve rereading. There has been a huge misunderstanding of what she actually described. This was not something drafted on the back of an envelope: it is based on years of work spent thinking about how it could work. Her amendments simplify and strengthen the Bill, making the whole process more transparent and more likely to be subject to evidence-based improvement in future, if an assisted death service is approved. My noble friend’s amendments may go some way to addressing the continuing concerns of the medical royal colleges.

However, my main amendments in this group concern the regulation of substances proposed for use in assisted dying. I recently co-authored an editorial in BMJ Supportive and Palliative Care called Untested, Unlicensed, Unregulated: Prescribing and Oversight Issues in Physician-assisted Dying/Suicide. I thank the noble and learned Lord, Lord Falconer, for tabling amendments that attempt to address these matters. My amendments would amend his Amendments 624A and 708A.

In this country, drugs intended for clinical use are subject to evaluation and oversight by the Medicines and Healthcare Products Regulatory Agency, the MHRA, which assesses their efficacy, quality and safety before they can be licensed for human use. These frameworks were specifically designed to ensure that drugs used in healthcare meet appropriate evidence and safety standards before they reach patients. I ask the noble and learned Lord why he is reluctant to rely on the established regulatory framework, and instead proposes the development of a separate framework specifically for substances used in assisted dying. My amendments to his amendments, as well as my Amendments 699 and 709, propose that the Secretary of State, when specifying a substance in regulations, must have regard to recommendations of the MHRA and that the established committee is required to report to the MHRA.