Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

Friday 5th December 2025 Lords Chamber

[Baroness Stroud (Con)]

My Lords, I want to speak in support of the noble Baroness, Lady Berger. I will limit my remarks because some of them have already been made by previous speakers. I think the reality is that maturity is a scale and choosing to proceed with assisted dying at the age of 18 poses difficult questions, which we must grapple with, about the neurological maturity required for true, settled and informed consent on a matter of such gravity, and not just particular circumstances. I intend to speak in a subsequent group to Amendment 22 in the name of the noble Baroness, Lady Grey-Thompson, but some of the points I will make then are also relevant to this group.

I note that research undertaken by the Sentencing Council in 2024, which focused on aggravating and mitigating factors in sentencing guidelines, has this to say about age and maturity:

“Age and/or lack of maturity can affect … the offender’s responsibility for the offence and … the effect of the sentence on the offender. Either or both of these considerations may justify a reduction in the sentence”.


The report goes on to note:

“In particular young adults (typically aged 18-25) are still developing neurologically and consequently may be less able to: … evaluate the consequences of their actions … limit impulsivity … limit risk-taking … Young adults are likely to be susceptible to peer pressure and are more likely to take risks or behave impulsively when in company with their peers”.


I do not want to cross over into debate on the subsequent group, but this seems highly relevant to our deliberations on the appropriate age for assisted dying. Of course, age and maturity are mitigating factors only, and therefore discretionary, but it seems extraordinary to me that the principle of maturity is one which is accepted in a legal context, and there remain calls for dedicated sentencing guidelines for 18 to 25 year-olds in recognition of this, yet the Bill as drafted does not seem adequately to account for this in a similar manner with regard to the permanent decision to end one’s own life. I would be grateful if the noble and learned Lord, Lord Falconer, could comment on this when he responds to the debate.

The autonomy on which the Bill is purportedly built must be grounded in safeguards commensurate with the irreversible nature of the proposed act. With regards to the age of eligibility, I do not believe the Bill as drafted meets this standard. For these reasons and more, I support the amendments in the names of the noble Baronesses, Lady Berger and Lady Lawlor, as well as those in the name of the noble Baroness, Lady Goudie, and the noble Lord, Lord Moylan.

[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.

--- Later in debate ---

[Lord Moylan (Con)]

My Lords, I rise to speak briefly to my Amendment 9 in this group. Before I do so, I thank the noble and learned Lord, Lord Falconer of Thornton, for making clear his intentions as regards moving his amendments in Committee. I wrote to him twice about this without getting a clear answer, but there has been a clear answer today, which is that he is not going to press amendments to which there is objection. It is good to know what his intentions are because otherwise we could end up in a situation, which I think would not be convenient to the Committee and would certainly contradict our normal practice, of having to hold Divisions in Committee that normally would be deferred, very properly, to Report. I welcome what he said.

My Amendment 9 is fairly easily disposed of because the noble and learned Lord has explained that both he and I, and indeed the noble Baroness, Lady Goudie, in her Amendment 8, have identified one of a number of blatant errors in the Bill where it says two different things in two different places, and we have drafted amendments to correct that. That is essentially what they do. We have drafted them differently. I think the sensible thing would be if the noble and learned Lord did not press his Amendment 6 today because it would pre-empt mine. Instead, I think the sensible and normal thing, the courteous thing, would be to say that he will discuss the drafting with the noble Baroness, Lady Goudie, and me outside the Committee between now and Report so that we have agreement on the appropriate amendment. I prefer not to have my amendment pre- empted, since I say, with some humility in front of the noble and learned Lord, that I think mine is better drafted than his.

[Baroness Hollins (CB)]

My Lords, I will speak briefly to Amendment 405 because the Equality Act is relevant to it. It provides a legal duty to provide reasonable adjustments for disabled people, which is defined quite broadly and I think would include a person who was terminally ill. The amendment is currently worded that the doctor must

“take all reasonable steps to ensure that there is effective communication”.

Will the noble and learned Lord consider changing his drafting to say that the doctor must “ensure reasonable adjustments are provided to ensure effective communication”?

[Lord Shinkwin (Con)]

My Lords, I rise to speak on Amendment 405. It is a pleasure to follow the noble Baroness, Lady Hollins, and to echo some of the points she touched on. I clarify that of course the amendment is in the name of the noble and learned Lord, Lord Falconer of Thoroton. I do so because, as a disabled person who was on the National Disability Council in the late 1990s developing codes of practice and advising the then Government on the importance of language—a point that the noble Baroness has just mentioned—I fail to see how changing the Bill’s wording from

“must first ensure the provision of adjustments for language and literacy barriers”,

which was the language of the amendment adopted by the other place, to “take all reasonable steps” can do anything other than weaken this Bill.

The noble and learned Lord would have us believe that this is just a drafting change; indeed, he said in his opening remarks that it makes it “clearer”. I contend that this is no drafting change because, yes, it changes the sense of meaning. The amendment would take us backwards because it would fundamentally weaken one of the Bill’s safeguards, such as they are, which was inserted as a result of Jack Abbott’s Committee amendment in the other place, and which the Bill’s sponsor in the other place described as “very sensible”—she was happy to support it.

I have a few questions for the noble and learned Lord that I would be grateful if he could answer in his closing remarks. Is this Committee being asked to believe that today the Bill’s sponsor in the other place is happy for the noble and learned Lord, in effect, to overrule her? Can he confirm in his closing remarks that she and Mr Abbott have been consulted, or is it that, together, the noble and learned Lord and Ms Leadbeater have decided to water down one of the few safeguards in the Bill because, well, it is only the House of Lords so no one is going to notice? The whole point of the Bill is to make it as easy as possible for people to have assisted dying, so let us minimise the constraints.

I began my career at the Royal National Institute for Deaf People during the first Blair Government. It was an exciting time. To the credit of Tony Blair and the noble Lord, Lord Hutton, who was Health Secretary, digital hearing aids were introduced on the NHS. The RNID, when I worked there, was listened to, and it should be now. So could the noble and learned Lord explain why this amendment implicitly ignores the finding made this year by the RNID and SignHealth in their report that some patients did not understand their diagnosis or treatment?

As a disabled person, I thank our Labour colleagues most sincerely. I know that I owe a debt to the Labour Party’s long-standing and noble—in the true sense of the word—commitment to advancing disability rights. However, this amendment underlines an inescapable but painful truth. The Bill makes a mockery of that fine, noble and honourable tradition. It shreds a tradition that deserves to be preserved, not sacrificed in such a profoundly cynical and misleading way as to make out, as the amendment does, that this is somehow only a drafting change.

There is a reason why not one organisation of or for disabled people supports the Bill; they know that disabled people need the Bill like a hole in the head. I marvel that the noble and learned Lord does not seem to realise that the Bill is dangerous enough already without the removal of provisions that would at least acknowledge the obligation to first ensure that communication adjustments were made; for example, for people with learning disabilities or users of British Sign Language.

The last thing that we as a House should be doing is endorsing an attempt to make the Bill an even poorer piece of proposed legislation than it already is. Noble Lords could be forgiven for thinking that that was not possible, but, as the noble and learned Lord’s Amendment 405 clearly states, he is perfectly capable of making his poorly drafted Bill even worse.

--- Later in debate ---

[Baroness Grey-Thompson (CB)]

I would not be able to accept the amendment as tabled because I have numerous other amendments on disability, language, BSL, different levels of interpretation and Makaton that are all important when having these conversations. Following the offer that the noble and learned Lord made to the noble Lord, Lord Shinkwin, I would be delighted to join the meeting as well, to see how the noble and learned Lord’s amendments can be improved to move further down the road. What we are trying to do is to make sure that people go into this decision-making process clearly understanding the decision they are taking.

[Baroness Hollins (CB)]

If such a meeting were to take place, I would be delighted to ask the noble and learned Lord to consider the alternative wording I proposed when I spoke to the amendment.

[Lord Falconer of Thoroton (Lab)]

First, both noble Baronesses would be very welcome to attend this meeting, which is expanding all the time. Secondly, the language the noble Baroness, Lady Hollins, proposed was “reasonable adjustments”, which is in the first draft but not the second. The reason we have not used the wording “reasonable adjustments” is that it comes from the disability Act. We want to do that and then go wider, and our amendment therefore gives greater width.

[Baroness Hollins (CB)]

It is the Equality Act, not the disability Act. I suggested that the definition of “disability” in the Equality Act, with respect to something like this, would in fact include someone with a long-term condition or mental illness, as well as any other disabling condition that the noble and learned Lord may be referring to.

[Lord Falconer of Thoroton (Lab)]

The noble Baroness is right that it is the Equality Act, not the disability Act; I apologise for that. If we were to restrict it to that, we would restrict it to a particular thing, and we think that it should be wider that. Again, we can talk about that at the ever-expanding meeting.

On Amendment 416, the noble Lord, Lord Ashcombe, was particularly exercised by the fact that the second doctor would not see the report of the first doctor; he would have some degree of problem with that. The noble Lord will know that, where a second doctor is brought in—where a referral is made to a new practitioner—the co-ordinating doctor must provide the new doctor with a copy of the previous report. If the new doctor is satisfied as to all the matters mentioned in Clause 11 on capacity et cetera, he or she then has to say why he or she disagrees with the previous doctor. The noble Lord’s legitimate sharpness in relation to that point was based, I think, on an improper understanding of Amendment 416, which will allow this to happen only once the new doctor sees the report of the previous doctor.

In the light of my exchange with the noble Lord, Lord Moylan, which was right for us to have, I will not move my amendment. Although the noble Baroness, Lady Coffey, was kind enough to indicate that she will withdraw her amendment to my amendment, because the noble Lord, Lord Moylan, thinks his drafting is better, we will have to wait and see what happens on Report. Do not hold it against me when I come back with the same amendment on Report.