Terminally Ill Adults (End of Life) Bill

Baroness Fox of Buckley Excerpts

Friday 5th December 2025 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I have an amendment in this group and I support the noble Baroness, Lady Berger, in this. I just want to add to earlier comments. The transition from children’s to adult services at 18 is well known to be a very confusing and destabilising period during which key clinical relationships are lost and important elements of a young person’s history may not be carried forward. These factors are directly relevant to assessing decision-making capacity and identifying safeguarding concerns for individuals aged 18 and above who may seek assisted dying. I think that raising the minimum age would allow for any medical advances—for example, with emerging new treatments that might change a young person’s prognosis. It is important not to be too hasty.

I also want to comment on the Scottish Sentencing Council and to add that, again, there is something about the developmental process which is still under way which can increase susceptibility to influence, vulnerability to risk-taking and the likelihood of short-term, emotionally driven decision-making. We have only to think about the fact that in that age group, the biggest cause of death is actually accidental death. Research done by the Sentencing Council and other research shows that maturity may be delayed by adverse childhood experiences. It is therefore reasonable to assume that some young adults with serious illness may carry such developmental vulnerabilities into their decision-making around the end of life. The Sentencing Council guideline suggesting lower culpability and a greater capacity for change than in older adults endorses the suggestion that we should change the minimum age to 25. This is an irreversible decision. We need enhanced safeguards for this age group, and I support the amendments.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, let me just state that, for very different reasons, although I have a great deal of respect for both the noble Baronesses, Lady Lawlor and Lady Berger, in this instance I have serious qualms about these amendments in relation to raising the minimum age for receiving assistance to end one’s own life to either 21 or 25. I think we need to hold on to the standard age where we consider adult responsibility to begin—that is 18—as the Bill does. I worry that we are already getting ourselves into a tangle on age issues. For example, the proposal is now to lower the voting age to 16. I wonder how the sponsor of the Bill will hold the line at 18 when those newly enfranchised 16 to 18 year-olds start demanding equal entitlements from 16. Logically, those teens will have a point when they argue, “If you trust us to decide on the future of our country, why not trust us to decide on the future of our own fate if we fit the other eligibility criteria?” I would like some reassurances from the noble and learned Lord, Lord Falconer, that this age slippage will not happen, but also that 18 is a watertight age in terms of eligibility, and there are other amendments later on.

Conversely, I ask the noble Baronesses whether there is a danger of unintended consequences in using the argument that the young brain has not developed sufficiently at 18 to make such important decisions. It makes me anxious when neurodevelopment research is cited about cognitive development and a lack of maturity about anyone under the age of 25. That is used to challenge the decision-making capacity of anyone below the ages of 21 or 25. I fear that it could be used regressively. How can we trust 18 to 25 year-olds to vote, or be asked to take on any adult responsibilities, if their brain is still developing? Where are we going to end up? I think we need to avoid unintentionally institutionalising state paternalism that robs young adults of their individual rights and limits the choices on their own fate in various ways. The cultural shift to infantilise the post-18 cohort, which is a broader problem, is, in my opinion, regressive.

Finally, I am very sympathetic to the concerns that have been raised here already. It might be worth considering some kind of carve-out for 18 to 25 year-olds on EHCPs, but that would be an exception, not a rule. Viscerally, the idea of any young person of 19 or 20 having a terminal diagnosis and then being offered the choice of an even earlier death fills me with horror, gives me the chills and is tragic. But I still think that 18—if tightly protected by the sponsors of the Bill—is adequate in relation to age safeguards. There are plenty of other safeguards that I am worried about without adding to them.

I also think that there is a problem of the Bill creating a culture, for the young in general, of suicidal ideation. However, these amendments do not resolve those broader problems.

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[Lord Falconer of Thoroton (Lab)]

On the comments that the noble Lord refers to, in relation to whether you should impose a whole-life term on somebody under 21, I recognise, as the Sentencing Council does, that issues of immaturity might make that inappropriate in certain cases. However, on this position, the question is: what is the age at which you might be capable of taking a settled decision? The concerns that the Committee has expressed about people aged between 18 and 25 make me think that the right course is to consider whether there are ways to deal with that that the House would feel are satisfactory on Report. I think that is the right course.

[Baroness Fox of Buckley (Non-Afl)]

Could I have some reassurance that with changing the franchise to 16, there will not be any slippage in relation to this Bill from 18 downwards? That is a reasonable question because, according to some people, 16 is now mature enough and adult enough to decide the fate of the country and decisions made here. Is there not a danger? Can he guarantee that this will not happen?

[Lord Falconer of Thoroton (Lab)]

I guarantee to the noble Baroness that the age is not going to go down from 18 as far as this Bill is concerned. The future is not in my gift, unfortunately. However, as far as the future is concerned, it is extremely unlikely that a subsequent Parliament is going to reduce that age.

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If those under the age of 18—or better, a higher age—are to be properly protected, will the Bill not state unambiguously that no discussion involving the revelation of assisted dying is permitted, even if those people raise the subject, on pain of practitioners being made ineligible under the Bill?

[Baroness Fox of Buckley (Non-Afl)]

My Lords, the noble Baroness, Lady Keeley, explained some of my concerns, which I found very helpful. I have a couple of questions for the noble and learned Lord, Lord Falconer.

Why does an independent doctor’s report no longer have to say why there was a refusal? I do not understand why the words “reason for refusal” have been omitted; could that be clarified? One of the things that will be very important in reassuring those of us with concerns about safeguarding being taken seriously is having as much transparency as possible in the process and ensuring the constant recording of information.

I am troubled by Amendment 418 and the word “unwillingness”, and not understanding, probing or having any way of finding out why somebody is unwilling. I understand that unwillingness might well refer to not being available or not being able to be so. However, if a doctor steps away, maybe because they feel uncomfortable about family members, undue influence or some kind of coercion taking place—all the things we have heard about—it seems relevant that that information be recorded somewhere, because it is a red flag and an early warning. That doctor’s opinion is only an opinion—the second doctor does not need to take any notice of it—but it would at least say that something is wrong; whereas, if the information just says that the doctor is not doing it because he is unwilling, we do not know anything.

In this process, there surely has to be a way of checking all the time that everybody knows that things are being done in good faith. I am afraid that some of these drafting amendments seem unintentionally to make things more obscure. The wording does not help to give us more information; rather, it removes information. Therefore, I would like the noble and learned Lord to look at redrafting his redrafting, so that we can have a bit of clarity.

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[Baroness Fox of Buckley (Non-Afl)]

I think I understand what has been said there but, for clarification, is the withdrawal explicitly queried anywhere? I am under the impression that there is nowhere where you say, “Why are you withdrawing? Is it for this reason or that reason?”. I am delighted that the noble and learned Lord agrees with me that certain withdrawals suggest something that should be noted down. Where in the Bill—forgive my ignorance—does that happen? I do not see it anywhere and I would be grateful if he could refer me to it.