Terminally Ill Adults (End of Life) Bill

Baroness Lawlor Excerpts

Friday 16th January 2026 Lords Chamber

[Baroness Cash (Con)]

My Lords, I support this group of amendments for a specific reason. I tried to ask the Minister this question during their closing speech last week, but there was not time. The Equality and Human Rights Commission gave evidence at the Select Committee—I declare an interest that at the time I was a commissioner, but am no longer—in writing and orally, expressing grave concern about the adequacy of the equality impact assessment. The points coming up in support of this group raise real questions around this.

I ask the noble and learned Lord, Lord Falconer, to say when we will see addressed the gaps identified in that evidence given by Alasdair Henderson, a commissioner at the EHRC, and in a follow-up letter written to the noble and learned Lord, Lord Hope, identifying specifically where the EHRC was concerned. When will we see a follow-up to that? It seems to me that many of the points in this and subsequent groups are about the vulnerabilities of individuals because of certain protected characteristics and the lack of protection for them. The EHRC has expressed no position on this Bill but is very concerned about it. I think the same applies to many Members of this House. We need answers to these questions to inform this debate fully.

[Baroness Lawlor (Con)]

My Lords, I will speak to my Amendments 40 and 59. The changes I propose may seem puzzling or pedantic, but, when dealing with legislation about life and death, every word matters. My amendments aim to bring the same care for language to subsections (2) and (3) as is used in subsection (1), which sets out that only if the conditions in paragraphs (a), (b) and (c) are met then assistance to end a person’s life, in accordance with Clauses 8 to 30, may be provided. If any of these conditions is not met then the action is subject to the existing criminal provisions of the Suicide Act 1961.

As they now stand, subsections (2) and (3) do not set out conditions in this way. Rather, they describe other parts of the Bill. Clause 1(2) is framed as an observation about Clauses 8 to 30, and Clause 1(3) apparently sets out a geographical marker for the certain steps provided for elsewhere in the Bill that “must be taken”. Subsection (2) therefore seems entirely redundant, since it purports merely to note what is said elsewhere. Subsection (3) is puzzling. Is the “must” a mistake or should it be “may only”?

Perhaps more important than such redundancy, inelegance and imprecision in drafting is that, in their present form, subsections (2) and (3) do not deprive those who act in contravention of the paragraphs they contain of the protection of the law from assisting suicide. They fail to make it explicit that this remains prohibited and punishable unless it meets subsections (2)(a), (2)(b), (3)(a) and (3)(b). My amendments would remove this perhaps unintentional looseness—the sponsor may wish to comment on the intentionality or otherwise—by making it explicit that assistance to end a person’s life may not be provided unless subsections (2)(a), (2)(b), (3)(a) and (3)(b) are all met.

[Baroness Berridge (Con)]

My Lords, I support Amendment 38, which raises for the first time in your Lordships’ House the complex issue of those who may be physically terminally ill but also have long-standing mental illnesses. While the legislation cannot be used only for mental illness, under Clause 2(4), cases where there is physical and mental illness can be very complex and particular safeguards will be needed. My main questions around those safeguards are for those who may be detained under the Mental Health Act, and are matters more for the Minister than the sponsor.

I served on your Lordships’ Select Committee on the Mental Health Bill. A person detained under the Mental Health Act may yet still have capacity to make some or most of their own decisions. If someone has gone through the process in this Bill with a six-month prognosis but is outliving it, they can also have regular periods of being detained under the Mental Health Act. It is important that we are clear about the position legislatively for the patient, clinicians and their family. What is the position? Which of these statutes will make clear which piece of legislation takes priority, if it is the case, as I understand it, that there are scenarios where both pieces of legislation could apply to a particular patient? You can be terminally physically ill and detained under the Mental Health Act but still have capacity, so you would be under the TIA as well as the Mental Health Act.

For clinicians, this relates to the strident evidence given to the Select Committee of your Lordships’ House on this Bill by Professor Alex Ruck Keene KC. This was partly outlined by my noble friend Lord Goodman previously in Committee when he was speaking about teaching clinicians on capacity and the criminal law. He said:

“I need to be able to say, with crystal clarity, ‘You’re no longer in that zone”—


meaning the suicide prevention zone—

“you’re now in the zone of the Terminally Ill Adults (End of Life) Bill’”.—[Official Report, 14/11/25; col. 522.]

Obviously, the suicide prevention zone he was referring to is a general duty for clinicians to all patients, but it is highly relevant when there is detention under the Mental Health Act. When you are thinking of a patient under the Mental Health Act, it focuses that issue down.

It is important to know which regime takes precedence for the family. This Bill is about individual autonomy, so the family are irrelevant. The new Mental Health Act, however, has extensive powers for nominated persons—and that is often family members—to exercise certain powers and even to discharge the patient. It is also key for the patient who has capacity but is under the Mental Health Act and has a six-month prognosis. Under the Mental Health Act, they can be made to take treatment—treatment that may well then mean they do not want to take the action in their existing declaration under the TIA. Has the Minister considered how the new Mental Health Act relates to this situation?

This issue exemplifies that the Committee of this House is actually trying to provide a White Paper or consultation function. The problem I have outlined, and that Mr Ruck Keene outlined, stems from the different philosophy of each of these pieces of legislation. The terminally ill adults Bill is all about personal autonomy, but the Mental Health Act is about treatment of illness, prevention of harm and preservation of life. This Bill is the state enabling and enhancing autonomy to take your own life, but the Mental Health Act is the state taking away some of your autonomy to preserve your life and prevent you taking it. One of the guiding principles in the new Mental Health Act is enhancing choice and autonomy, precisely because the Act’s powers take away some of an individual’s autonomy, even when they still have capacity. Given that we have different philosophical bases for two pieces of legislation, no wonder there is not the crystal clarity needed, as Mr Ruck Keene outlined, by him and other clinicians.

In practice, there is a human face to this. Take, for instance, a young adult who lives at home. They have been out of secure care for decades, they have always been treated well, their suicidal ideations have been managed, and they are well known to the local services, but they now have a terminal physical diagnosis and a six-month prognosis. They have gone through the procedure in the Bill but are now outliving that prognosis. Under the powers of admission for mental illness, they are treated, and, having been treated on a number of occasions, no longer want to exercise their declaration. But their family carers go on an extended holiday, so they go to stay with other family in a different part of the country. They become mentally ill and they are admitted, and they have capacity under the Mental Health Act. Can their declaration under the TIA Bill be used in this situation, or do they have to be treated? Do the nominated persons have to be told? If you are exercising a TIA declaration, you are no longer under the Mental Health Act.

Could it be that the TIA Bill is actually used without the family being told, which we know is the scenario given by evidence from medical examiners? They come home and their relative has died, and no one knew they had just been accepted on a clinical trial at the local hospital.

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The noble Baroness rightly draws attention to the Suicide Act. Clause 32 specifically spells out that someone is protected from prosecution under the Suicide Act only if the steps within the Bill have been gone through. I agree with the noble Baroness’s approach, but I do not think that it is legally necessary.

[Baroness Lawlor (Con)]

I thank the noble and learned Lord the sponsor for his response, and I agree with him on Clause 1(1), as I said. However, my amendment seeks to bring the same precise language to subsections (2) and (3), because the conditions are not set out in the same way as they are in subsection (1); they are more descriptive. I tabled the amendments for that reason.

[Lord Falconer of Thoroton (Lab)]

They are more descriptive, but the provisions say “must” each time. Clause 32 says that someone can escape the consequences of the Suicide Act only if they have complied with all the provisions. I in no way disagree with the point that the noble Baroness is making but, as a drafting legal matter, I think it is covered.

[Baroness Lawlor (Con)]

Is the “must” there only a “may”?

[Lord Falconer of Thoroton (Lab)]

I am sorry; I did not quite get that.

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[Baroness Lawlor (Con)]

I find the “must” in Clause 1(3) a bit puzzling. The noble and learned Lord can see that it reads:

“The steps to be taken under sections 8, 10, 11 and 19 must be taken … when the terminally ill person is in England or Wales, and … in the case of the steps under sections 10 and 11, by persons in England or Wales”.


My question of clarification is whether the steps in Sections 8, 10, 11 and 19 must be taken; is it not that they only may be taken?

[Lord Falconer of Thoroton (Lab)]

It is. The reason the two are different is that Clause 1(2) describes what is coming later in Clauses 8 to 30; Clause 1(3) is a mandatory requirement that the steps that come later have to take place when the person is in England or Wales. So they do different things. Subsection (2) is descriptive, and subsection (3) is a legal requirement. I am very happy to say that the shadow Attorney-General is nodding, which is very strengthening on this.

The one point that I have not dealt with properly, or at all, is that which the noble Baroness, Lady Berridge, made about the interaction between the Mental Health Act and the Bill. I was not sure which specific amendment she was referring to; it may have been Amendment 38, but I do not know. However, as far as I can see, there is no legal difficulty in this Bill sitting with the Mental Health Act because, as long as these conditions are satisfied, the patient is entitled to have an assisted death. There is nothing in the Mental Health Act that would prevent that. I am more than happy to have a more detailed conversation with the noble Baroness and Professor Ruck Keene, if she wishes to bring him along and he is willing to come.

I hope that I have dealt with every amendment put forward.

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Moved by

[Baroness Lawlor]

30ZA: Before sub-paragraph (i), insert—
“(ai) not wanting to cause distress or be a burden on their families,”

[Baroness Lawlor (Con)]

My Lords, I support all six sub-paragraphs in the amendment in the name of the noble Baroness, Lady Foster of Aghadrumsee, which was moved by the noble Lord, Lord Weir of Ballyholme, and is supported by the noble Baroness, Lady Fox, and the noble Lord, Lord Empey. However, I urge that there should be an additional sub-paragraph. As they stand, the sub-paragraphs in Amendment 30 provide a checklist to help those deciding whether to allow an assisted suicide to go ahead to determine whether the person has been led to the decision by an improper type of motivation.

Some of the types of motivation listed here are improper because, if permitted, they would risk leading to a situation where people, under some circumstances, are pressed or influenced into suicide as a way of solving social problems. We have heard quite a bit about that today.

My extra subclause mentions families explicitly and would add to the idea of not being a burden on the family that of not causing distress. It is all too easy to imagine families pressing, influencing, perhaps coercing, an ill person into a suicide they do not genuinely desire by appealing to altruistic feelings that they do not want to be a burden or to cause distress, especially to those they most love. Even worse, it is all too easy to imagine how, in the dismal future of a world where the Bill becomes law—

[Lord Falconer of Thoroton (Lab)]

Just so that I can properly respond to this, which amendment in the group is this addressed to?

[Baroness Lawlor (Con)]

It is addressed to Amendment 30ZA amending Amendment 30. It is on page 2 of Today’s Lists.

It is all too easy imagine such appeals by a family to altruistic feelings. They do not want to cause distress or be a burden, especially to those they most love. In the dismal world where the Bill has become law, such ways of thinking will have become a social norm. That is very easy to imagine.

My amendment is designed to make that future a little less dismal, by putting in an obstacle to this insidious form of coercion by those the person in question may love most.

[The Deputy Chairman of Committees (Baroness Kennedy of Cradley) (Lab)]

My Lords, the noble Lord, Lord Shinkwin, is taking part remotely. I invite the noble Lord to speak.

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[Lord Falconer of Thoroton (Lab)]

This is not a technical point, but the way the amendment is drafted is very confusing. If your mental illness makes you come to this conclusion, that may well go to capacity. I am not clear what is being got at in relation to the mental health issue. However, if the position is that you may have a mental health condition but are perfectly capable of making a decision, you should be allowed to make it.

[Baroness Lawlor (Con)]

My Lords, I thank all noble Lords who have contributed to this group. I am very grateful for the attention focused on the problems that people face in their lives, particularly those who have exceptional difficulties in exercising freedoms that we, as has been pointed out, all take for granted.

This suite of amendments sought to try to restrict the possibility of others pressurising people, particularly people in this very difficult position, to take a decision to seek assisted suicide under the Bill which they might not otherwise have taken had they had the support and had they not had the disabilities which have been mentioned in these amendments. They also seek to restrict the Bill to those who wanted to relieve pain only.

I am afraid I have been a bit disappointed, if I may say, with the noble and learned Lord the sponsor. In stressing autonomy and choice by one person, he is, I fear—perhaps inadvertently—neglecting the autonomy and choice of those who may want to live with their disability, with whatever ailment they have been born with or developed over their life but are facing terminal illness. We are concentrating on the autonomy of the person, but we are not giving enough attention in the Bill, I fear, to those who feel pressure, who feel they are a burden and who wish to avoid causing distress to those they love.

In doing so, we are doing a great disservice to the men and women of this country who do not want to be a burden to those they love. That burden is increased by virtue of the cost of living and the difficulties they have in making choices. We are putting the choice of those who want it and who have firm, clear intent, over those who may not wish to do it but feel pressured for the reasons of their life and their circumstances into doing so. I shall withdraw my amendment for now, but I hope to bring it back, if the noble Baroness, Lady Foster, wishes to bring hers back, and support the other amendments in this group.

Amendment 30ZA (to Amendment 30) withdrawn.

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[Captain of the Honourable Corps of Gentlemen-at-Arms and Chief Whip (Lord Kennedy of Southwark) (Lab Co-op)]

My Lords, to help the Committee, I will interject to say that it has just gone 5 pm. Basically, we have two options. Both involve us finishing at 5.30 pm. We can either carry on this debate, which is absolutely fine. We have recorded the number of Lords who are present, so I can move to adjourn the House at a convenient point around 5.30 pm. Alternatively, if the debate is coming to an end, we can hear the Front-Bench speeches and then adjourn at 5.30 pm. I do not mind what we do, but we are going to adjourn at 5.30 pm. It is in the hands of the Committee.

[Baroness Lawlor (Con)]

My Lords, I have added my name to these amendments from the noble Lord, Lord Frost. I agree with what has been said. I agree with the need to avoid euphemism. The noble Lord, Lord Frost, raised the point, and the noble Baroness, Lady Fox of Buckley, came back to it, that some will object to the phrase “commit suicide”, but I will make a stronger case on that point.

With regard to many cases of suicide, these reservations would be justified. “Commit” implies clear intention by the person concerned to take his own or her own life, but, as we have heard throughout this debate on the Bill so far, suicide can be the result not so much of firm, clear intent, but of the perpetrator sliding inexorably into hopelessness about the circumstances of their life or being confronted by a lack of help. If the inability to cope with such misfortune leads to depression and then suicide, I agree that it is misleading to talk of committing suicide, but the cases envisioned in this Bill are quite different. As the Bill makes clear, the person must have a clear, settled and informed wish to commit suicide. Here, then, “commit suicide” is indeed the appropriate phrase.

Moreover, the phrasing in the Bill, in terms of assistance to end one’s own life, carries, as has been said, a risk of confusion between what the Bill proposes—the deliberate action to bring life to an end—and the normal practice of doctors, as the noble Baroness, Lady Finlay, mentioned earlier, which is to ease suffering and sometimes to use palliative measures that might, although this is not their aim, shorten life. The advocates of the Bill have often spoken in a way that blurs this distinction. It is important that the phrasing of the Bill guards against such confusion.

[Baroness Royall of Blaisdon (Lab)]

My Lords, I recognise that the noble Baroness, Lady Fox, will have heard this before, as will have many others, but the fact of the matter is that the Bill talks about assisted dying. “Dying” tells you what it is all about, so I do not think that we need to have the word “suicide”. I say this because I have spoken with the families and loved ones of people who wish to have an assisted death; those who wished that their loved ones had had an assisted death, because they could see the suffering endured by the person who died and the people who were caring for them; and those who are left behind. I have had many conversations and those people all feel strongly that those who want to have an assisted death are not committing suicide; they want to regain some control and want to live for the last few months of their life with some comfort. Just because they ask for an assisted death does not mean that they are actually going to fulfil that, but it gives them and their families comfort. So, please, can we not talk about suicide? We are talking about dying and that is absolutely fine. I do not wish for the people who are already suffering or the people who are caring for them to have more distress in their lives.