Terminally Ill Adults (End of Life) Bill

Baroness Hollins Excerpts

Friday 12th December 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

My Lords, I will act immediately on the words of the noble and learned Baroness, Lady Butler-Sloss, and respond briefly to what the noble Baroness, Lady Finlay, and my noble friend Lady Berger said. Basically, they are referring to the problem of people who lack capacity and who have had their liberty deprived because their lack of capacity is so severe that they cannot be trusted to be free. That normally takes place in the setting of a hospital or a care home, but it can also take place in the setting of a private home; that is where the Cheshire East cases come into play.

The noble Baroness, Lady Finlay, said that this should be a yellow flag. If your lack of capacity is so serious that your liberty is taken away, it indicates that something is seriously wrong. The principle of the Mental Capacity Act 2005 is that capacity should be looked at on a case-by-case basis. There will be cases where someone’s liberty is taken away where they would not necessarily lack capacity in relation to very serious issues.

I should have declared this before. Apart from my receiving money from Mr Bernard Lewis to pay for an assistant and having Dignity in Dying pay for the publication of some printing that went to Peers, my wife was, until very recently, a designated family judge and sat in the Court of Protection. I should disclose that.

Among the sorts of case that come before the courts —they will come before the courts, not a local authority—are those of people who desperately do not want to leave their home. Eventually, they will have to have an order from the Court of Protection, meaning that they have to leave; this is sometimes accompanied by a deprivation of liberty order. Many of those people, even though they are moved somewhere else, would still have the capacity to make a decision in relation to assisted dying.

How do we deal with the perfectly legitimate points made by the noble Baroness, Lady Finlay? I have had the opportunity to discuss this with the noble Baroness; I thank her for that. The answer is that there should be some form of enhanced protection to deal with what she says is a yellow flag. I suggest to the Committee that I speak to those Peers who are interested—including my noble friend Lady Berger and the noble Baroness, Lady Keeley, who sadly cannot be here today—to see what form that enhanced protection could take.

I hope that in the light of what I have indicated, we can move on to the next amendment.

[Baroness Hollins (CB)]

My Lords, I would like to comment on this group in response to what the noble and learned Lord, Lord Falconer, has just said.

In its recent briefing for Peers, the Royal College of Psychiatrists gave its view:

“Assessors should be required to take all practicable steps to work with professionals involved in a person’s health and social care, and to talk to a relative, carer or nominated friend, including by accessing medical notes from both primary and secondary care”.


It expressed concern that

“a consideration of suicide protection duties are being bypassed by the Bill in its current form”

due to unmet need not being formally assessed. A previous DoLS is relevant to consideration of current capacity to decide to end one’s life. What would be the mechanism for reliably ensuring information that there has been a DoLS before it gets to the assessors and the panel?

Having mentioned the Royal College of Psychiatrists, I would like to make a short statement. The college has asked me to respond to the allegations about its leadership made by the noble Baroness, Lady Murphy, on 14 November, our first day in Committee. The president of the college, Dr Lade Smith, wrote to the noble Baroness asking her to withdraw her allegations, as they are inaccurate. But although the noble Baroness was present in the Chamber the following week, no clarification was provided. As a past president myself, I beg leave to set the record straight.

The college’s recommendations on the Bill are, in fact, based on 18 months’ consideration by a cross-college working group involving membership surveys, debate with members on proposals before other jurisdictions, and discussions with colleagues in other jurisdictions where assisted dying is practised. The president is clear that Dr Annabel Price, the appointed college lead for the Bill, has accurately represented its views when giving formal evidence to both Houses. With the Bill before the Lords, the Royal College of Psychiatrists is focusing on how to make it safer for people with mental health needs and learning disability needs, and better aligned with the responsibilities of psychiatrists. I feel that, in the light of the discussion on DoLS, this is an appropriate statement to make.

[Baroness O’Loan (CB)]

My Lords, I have put my name to Amendment 16. I also support Amendments 16A, 114 and 114A because the very general definition in Clause 1 of a terminally ill adult who has the capacity to take their own life does not contain any consideration of those who have been deprived of their liberty under Section 4 of the Mental Capacity Act. It is an unfortunate reality that many of those detained in hospitals or care homes are detained because they lack the capacity to make a decision about their own care or treatment. As the noble Baroness, Lady Finlay, said, in such circumstances it is surely axiomatic that there should be careful consideration of cases involving individuals subject to a DoLS.

As the noble and learned Lord, Lord Falconer, said, even assessing the capacity of someone with dementia or another neurological condition, for example, can be profoundly difficult. This is not just because of the frequent fluctuation of both capacity and the extent to which any identified capacity enables the making of a particular decision; a medical practitioner or social worker who meets a person for the first time may be misled as to the capacity they actually have. As the Royal College of Psychiatrists noted in its written evidence,

“an assessment of a person’s mental capacity to decide to end their own life is an entirely different and more complex determination requiring a higher level of understanding”

than in other assessments of capacity.

In the 1997 case of Re MB, the noble and learned Baroness, Lady Butler-Sloss, said:

“The graver the consequences of the decision, the commensurately greater the level of competence required to take the decision”.


Capacity assessment is not a precise science. The unique context of this Bill makes taking a cautious approach appropriate. It is common sense that there is a likely correlation between incapacity in one area, so extreme that the state must deprive the person of their liberty, and incapacity to decide whether to end one’s own life. People whose incapacity for basic decisions is so severe that they are deprived of their liberty are the most vulnerable members of society.

I want to give your Lordships a brief example. I was aware of a woman in her late 80s who had been assessed and was subject to a DoLS. She objected to it and appealed against it. Intellectually, she was enormously able, possessed of considerable social skills despite her dementia. She was able to persuade those dealing with her appeal that she had capacity despite the very real concerns of her family, who knew the extent of her incapacity. The DoLS was lifted and she went back to her own home. Shortly afterwards, she was found playing golf in the road in her pyjamas at two o’clock in the morning. She was going to the supermarket at 4 am. She was leaving the door unlocked all night for her husband and cooking his dinner every night; he had died some 20 years previously.

That lady was my mother. She certainly would not have understood a suggestion that she should opt for an assisted death. The DoLS was subsequently reinstated. This is not an unusual situation. If the noble and learned Lord, Lord Falconer, rejects these amendments, how does he consider that such vulnerable individuals can be protected from making this final decision, although they may not understand exactly what they are doing?

--- Later in debate ---

[Baroness in Waiting/Government Whip (Baroness Anderson of Stoke-on-Trent) (Lab)]

I am sure that my noble and learned friend will respond to that in the debate, but the noble Baroness has just intervened on an intervention. The Chief Whip made clear reference to that earlier.

[Baroness Hollins (CB)]

My Lords, I welcome the comments from the noble and learned Lord. General practice is very different today from when I practised as a GP earlier in my career; it was certainly not as part of a multidisciplinary team.

I added my name to the very reasonable Amendment 21 tabled by my noble friend Lady Grey-Thompson. The debate has not been about whether assisted dying should be part of a GP’s role; it has, very helpfully, focused on the importance of continuity of care and accurate records.

I congratulate my noble friend Lady Gerada on her first contribution in Committee; she is correct that GPs now work as part of a multidisciplinary team. I think that patients accept that, but they also expect that a doctor is ultimately responsible for their care when they are seriously ill. Perhaps Amendment 21 could meet the noble and learned Lord’s requirements if it were amended to refer to the medical practice rather than to the general practitioner.