Terminally Ill Adults (End of Life) Bill Debate

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Department: Department of Health and Social Care

Terminally Ill Adults (End of Life) Bill

Lord Mackinlay of Richborough Excerpts
Friday 12th December 2025

(2 days ago)

Lords Chamber
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Lord Mackinlay of Richborough Portrait Lord Mackinlay of Richborough (Con)
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My Lords, I will speak for just a couple of seconds as I am very mindful of time. I support Amendments 24 and 458 in the name of the noble Baroness, Lady Grey-Thompson. We have had very little debate about the issue of pregnancy. I am quite shocked by that, given that there are administrations around the world with many years of experience, such as Oregon, which had similar legislation in 1997, and Belgium, which had it in 2002. They considered the issue of pregnancy during these very delicate discussions on assisted dying.

I am somewhat disappointed and concerned that the noble and learned Lord, Lord Falconer, has not addressed this, and I really hope that this can be addressed on Report. There is a world of difference between a very early pregnancy and a baby close to full term, which is reflected in our Abortion Act. May I therefore give the noble and learned Lord some advice? When this does come back on Report, the issue of pregnancy should be addressed, as it has been in other jurisdictions.

Lord Winston Portrait Lord Winston (Lab)
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My Lords, as Amendment 24 has been tabled and pregnancy has been spoken about, I now feel that I ought to just make one point very quickly. The noble Baroness, Lady Grey-Thompson, quite rightly presented a lot of statistics about cancer, but that she did not address the issue of cancers of the pregnancy itself. That is a serious issue. Choriocarcinoma, for example, is a fatal disease; it is rapidly metastatic, can cause issues all over the body and is not easily treatable. It could easily be that somebody who was pregnant with that, who would test pregnant with that condition, would be eligible. I therefore ask the noble Baroness to consider not pressing her amendment and to reconsider the wording of it, because I do not think that it would be an acceptable amendment later on. Both early in pregnancy and in late pregnancy, this would be a real risk.

Lord Mackinlay of Richborough Portrait Lord Mackinlay of Richborough (Con)
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I will just come back on that, if I may. I would also say that the wording in the amendments in the name of the noble Baroness, Lady Grey-Thompson, is insufficient, because it is a far more complex issue than that. As I said, there is a world of difference between a very early embryo in the first few weeks and a close to full-term pregnancy. I certainly hope that this Committee would agree that point.

Baroness Coffey Portrait Baroness Coffey (Con)
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My Lords, I really had hoped that we would get to the next group but, as it is clear that we will not, I will raise a couple of points and some questions. The increasing number of older prisoners has already been mentioned. This is largely driven by sexual offences, particularly those of historical sexual abuse. While we of course need to treat people appropriately, I suggest that, wrongly, the majority of the public would not care if sexual abuse offenders or murderers killed themselves. It is, however, our duty as stewards of the Crown to consider these matters carefully.

It so happens that, in the next group, we would have got to a particular situation about halting treatment, or what could happen as a result of halting treatment. There are situations in Australia where prisoners who have been diagnosed with cancer have then declined treatment and have been able to take up assisted dying. One thing that is happening is the rise in prisons of natural deaths. In the 12 months to September 2025, there were 221, and that is with the Ministry of Justice not even knowing and waiting for further information. That is a significant increase from 123 in 2010, which reflects the older age.

It is important that we have compassion, so it is surprising to me that there has been a yearly average of only 9.5 early releases of prisoners on compassionate grounds over the last 15 years. There was just one in 2022, seven in 2023 and no figures yet for 2024. The policy framework is deliberately sparing. Meanwhile, a legal ruling earlier this year allowed an applicant, Mr Khan, out. It is worth considering—it may not be possible at this stage in the response by the Minister or the sponsor—and thinking ahead to Report. Where are we going with this? It should not just be that the ECHR does not allow this.

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Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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It is just such an obscure proposition that we should not determine our policy in relation to it.

Moving on to pregnant women, the amendments say that no pregnant woman should have the right to an assisted death and that everybody who wants an assisted death must have a pregnancy test. The noble Baroness, Lady Grey-Thompson, made it clear that the second was a probing amendment and not a serious proposition. In relation to pregnant women, I completely accept what is being said, particularly by my noble friend Lady Berger, about what the statistics show. Again, safeguards can adequately deal with this and I am not in favour of any change in relation to it. We should remember that what we are dealing with here is somebody who has only six months to live. Homeless people—

Lord Mackinlay of Richborough Portrait Lord Mackinlay of Richborough (Con)
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There is a big issue here. Other states around the world which have had assisted dying for some time have differences of view. In Oregon, which has had assisted dying since 1997, there is a requirement to keep the mother alive for as long as possible, particularly when there is a viable foetus. The Netherlands takes a completely different view, with foeticide—where the foetus must be terminated by one means or another, often by intracardial injection of potassium chloride—before the mother can be euthanised.

At which end of the scale does the noble and learned Lord prefer these things? The royal colleges are against this whole system, yet we will be relying on them to fill in the gaps in this legislation. It is incumbent upon us to fill in those gaps for them, because they are not keen on this.

Lord Falconer of Thoroton Portrait Lord Falconer of Thoroton (Lab)
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The noble Lord puts it accurately. Some countries have taken one view and other countries have taken another. It is clear from the choice that I am supporting that we take the view that pregnancy should not be a bar to it, though inevitably, as the noble Baroness, Lady Grey-Thompson, said, there should be questions in relation to appropriate people, whether they are pregnant or not, which may have an effect on the result. On the more detailed questions, based on what I am saying, they would not arise in the Bill.

Going on to the third category, homeless people, again with six months to live or less, will very frequently, as my noble friend Lady Gray said, have complex needs and complex lives. I am very strongly against that right to an assisted death being taken away from them, but the safeguards will apply, to be sure that it is their clear and settled view and not the product of coercion.

Finally, the noble Baroness, Lady Berridge, raised the education, health and care plan. The range of people with an EHCP is very wide, as everybody knows. I am again very against excluding everybody from the significant provisions of the Bill, because the protections are there. They can go up to the age of 25 and, as I indicated last Friday, for people aged 25 and under we should think of whether there should be enhanced protection. That would include everybody up to the age of 25, including those under an education, health and care plan. In the light of those indications, I hope—