Terminally Ill Adults (End of Life) Bill

Lord McColl of Dulwich Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I have attended and spoken at most of the debates on euthanasia over the last 35 years, and one feature that has always struck me is that they have been full of anecdotes. Perhaps we ought to consider that the Greek word “anecdote” means “unpublished”, which is arguably what most anecdotes should remain.

I will avoid anecdotes and stick to my practice over the last 50 years, looking after people who are dying. Perhaps I can best illustrate that by referring to a lady aged 28 who came in with an inoperable cancer of her throat. She was in pain and in great respiratory distress, and I said to her to that I could relieve all her symptoms with an intravenous injection of an analgesic. I said to her, “Would you like me to do that?”. She said yes. I put a needle into her vein and started to titrate her, as it were, with a very powerful drug, and I was amazed at how much I had to inject. Eventually, all her symptoms went. She died three weeks later, having had three weeks symptom-free.

Cicely Saunders, with whom I was a contemporary at Guy’s and St Thomas’ Hospital, was the founder of the hospice movement. She devised this technique of keeping the level of analgesia in the blood at a constant level. She found that it was best to prevent pain rather than wait until it had come. That worked, and the patient was much more wide awake and could enjoy what life remained with this technique.

One of the worrying features of this whole subject is that many of those who are keen on euthanasia have taken it into their heads to rubbish the hospice movement and spread rumours that it does not know how to relieve pain. This is a lie. I have worked in hospices for all these years, and that is not the case. They say, “Oh, well, we weren’t allowed to give more analgesia because of the law”. There is no law that prevents that. You can give as much as is needed. That is what Cicely Saunders promoted and did so very well.

We hear a lot about freedom, that people must have freedom. A man came into a hospice, and he had multiple myeloma, so it was infecting his bone marrow and releasing large quantities of calcium. Too much calcium in the blood means the heart stops beating. He said, “No no, I want euthanasia”. They said, “Look, you are having a drug that keeps your calcium down to stop you dying. If you want to die, all you have to do is stop taking the drug”. He never stopped taking the drug until the day he died—so much for freedom.

Terminally Ill Adults (End of Life) Bill

Lord McColl of Dulwich Excerpts

Committee stage
Friday 27th February 2026 Lords Chamber

[Lord McColl of Dulwich (Con)]

My Lords, I wish to speak to my Amendment 941. As a medical professional, I know only too well that medical interventions can be driven by financial motives; organ harvesting for a profit is one such example. When medical interventions are financially motivated, the best interests of the patient may be compromised. This amendment would help to prevent such compromise. It would deter the sort of financial abuse that could happen during the course of the assisted suicide process and would protect, in particular, the most vulnerable. I commend it to the Committee.

[Lord Sandhurst (Con)]

My Lords, I wish to speak to 21 amendments in this group. It is my misfortune that they have all been shoved together, giving me around 30 seconds on each one.

It is really important that the powers of the panel are clearly defined and that what we end up with is in accordance with what Parliament wants and intends. Each of the amendments that I have put down comes from either the Law Society or the CLADD group; to this extent, I endorse entirely what my noble friends Lord Murray and Lord McColl just said. The management of evidence gathering in the process is vital. My amendments aim to try to put that into some sort of proper regime that is set out on paper before the Bill becomes statute.

Amendment 929A is aimed simply at panels being able to consider cases with expertise appropriate to the particular nature of the case. It says that

“the Commissioner must have regard to the nature of the expertise required to determine the particular circumstances of the person”

in question. We know that there is a lack of psychiatrists in this country—it is in the public press all the time—so it is important that, when this process kicks off, there are sufficient psychiatrists who are willing and able to sit on these panels and to devote the necessary time, because they will have to make assessments. There is a risk that the commissioner may struggle to find enough of them.

Amendments 922 and 923A ask that there be sufficient people and say that they must be specified in regulations. In particular, they must have expertise in relevant matters as set out in regulations, so the Secretary of State would have to identify what expertise will be required and who is to address it.

Amendment 927A asks that one of the panel’s members

“must be a legal member”.

We cannot possibly have panels that do not have a lawyer on them. There must be a legal member with the expertise to deal with the particular case. Indeed, I note that, in giving evidence to the Select Committee, Sarah Hughes of Mind said that

“it is really clear that the safeguards described in the current Bill are not adequate”.

The British Association of Social Workers has also said that the current safeguards are not enough. Those are disinterested, important bodies with expertise in this area.

Amendment 928 aims at the target of medical expertise. There must be someone on the panel who can take a properly informed view of the diagnosis being given to the applicant.

The point of Amendment 473 is to insert the word “evidence”, which is very important, because it is not clear what the status of these panels and of the material given to them will be. The word “evidence” means that, or will have the effect that, the panel will clearly operate as a formal body. It would not make it a tribunal, but it would make the process formal and the panel act properly.

Amendment 479 would enable the panel to

“require a local authority or an NHS body to arrange for a report to be made dealing with such matters relating to the person as the panel may direct … or … such other person as the authority, or the NHS body, considers appropriate”.

There is more to it. This is the equivalent of Section 49 of the Mental Capacity Act 2005, which gives the power to the Court of Protection to get reports from the NHS or local authorities in order to allow it to discharge its inquisitorial powers. We need something similar here. It would reinforce the seriousness of the panel.

There are other provisions in this amendment to make it plain that the panel can appoint an expert to test evidence if it does not have its own expertise. It needs to have that power. In an appropriate case, the panel may hear evidence on oath, but it will be under no obligation to. That is in my proposed new paragraph (h). There may be cases where it is very anxious about some of the things it has heard, and it may think that putting someone on oath makes them think very seriously about telling the truth, the whole truth and nothing but the truth.

I will move on. I am trying to take this at a gallop.

Amendment 465 is another Law Society amendment. It would show that, although the panel is not a court, it is a formal body by using the word “evidence” in the provisions. That word will make the panel take it seriously. I am not suggesting that the people on it will be lightweight people, but the process is important. Those of us who are lawyers in particular will know that process is important, and it affects how panels and tribunals conduct themselves. If it is not to be called evidence, it will not have that same effect. The Law Society suggests that it is currently unclear precisely what status the information being received will have. It will not be a court, but it will be a formal body, and that provision occurs in some other amendments—Amendments 470 and 476, and possibly elsewhere.

How does the noble and learned Lord, Lord Falconer, understand the panel’s evidence-gathering powers? Will it be exempt from the normal rules of medical confidentiality and data protection? Will it be able to gather evidence from witnesses even if the patient does not want details to be shared? Will it be an executive public authority, subject to the limits that apply to the Government, or will it be a judicial body with unique powers? To say it is quasi-judicial does not answer the question; it is either one or the other. We need to know what powers it will have. Will it be those of an independent tribunal or not? This picks up the observation made by my noble friend Lord Murray.

Amendment 494 would mean that the panel would have to notify relevant bodies if it considers that the person meets the criteria but the request was made because the service provisions had failed in the past. This would be important in monitoring the Bill’s impact on health and social services. It would show whether someone has come for this because provision has not been made. That would be important in looking forward and seeing how we can improve the delivery of health services to the public. It is not a barrier, but it will provide valuable information.

Amendment 934, another Law Society amendment, would require the Secretary of State by regulations to make provision for how the chair of a panel is to decide whether to grant a person’s request that the panel sit in private, including the factors to be taken into account and the processes to be followed. Will it be sitting in private? Will it be sitting in public? How is this to be addressed? These are important practical questions that are bound to arise on the ground.

Amendment 934A, another Law Society amendment, states:

“For purposes of the law of contempt, where a panel determines a referral in public, then unless the panel provides to the contrary, publication of information about the person to whom the referral relates shall be treated as contempt of court, as if (in any relevant legislation) for the word ‘court’ were substituted ‘panel’”.


The panel will not be a court, but it will be hearing very sensitive information in public hearings by default. These amendments seek to ensure that such information about a person is not made public. The late and, I would suggest, great Sir James Munby remarked that

“judges are kept up to the mark by two things—having to comply with proper procedure and being exposed to the public gaze”.

He said that the same thing should apply to panels.

The Law Society told the Select Committee:

“What is unclear at the moment is where the panels will be held and how people would know about them”.


Obviously, consideration about whether the panels are private or public, and then where the powers would come from potentially to restrict the information and then being able to be made—

Terminally Ill Adults (End of Life) Bill

Lord McColl of Dulwich Excerpts

Committee stage
Friday 13th March 2026 Lords Chamber

[Lord Harper (Con)]

My Lords, I will come on to the exposition by the noble Baroness, Lady Finlay, on this group of amendments shortly. I will also pick up on the important and perfectly fair point raised by the noble Baroness, Lady Jay of Paddington, following on from the speech of my noble friend Lord Deben, about what end of the telescope you are looking at this from. She was right to challenge those of us who are focusing on the safeguards. It is also important that a Bill passed by Parliament is workable.

However, there is a reason, if I may just gently say to the noble Baroness, why we are focused in the way we are. It was put extremely well by Johann Lamont, who Members opposite will know was the leader of the Scottish Labour Party between 2011 and 2014. This is in the context of the debate on a different but similar piece of legislation currently going through the Scottish Parliament. She said:

“In my time as MSP I came to appreciate the challenge of understanding that something can be of benefit to some but the unintended consequences for others matter just as much. We should not just ask how it might help some but ask what if it means undesirable results for others”.


In effect, that is the nub of what we are trying to do here.

The Bill’s proposals, perfectly understandably, are focused on those who wish to seek assisted suicide. Those of us focusing on the safeguards in the Bill are worried about all the people who may be adversely affected: the vulnerable, disabled people and—before we fixed the gap in the Bill, which took a very long time to do—those with anorexia. Those are the two perspectives, both of which are valid, and that is what the debates in your Lordships’ House are trying to reconcile in this legislation.

The other very important issue—I am pleased to see my noble friend Lord Markham in his place, because he rightly often references this—is public opinion. On an issue such as this, it is more important that Members of Parliament, including Members of this House, do what they think is right. This is a very important moral question. We should do what we think is right, explain why we are doing what we are doing and then allow ourselves to be judged. People will draw conclusions about your Lordships’ House based on how we conduct ourselves and how we debate this legislation.

Since the proponents of the Bill are often happy to quote polling, it is worth just putting on the record some recent polling by Whitestone Insight for Care Not Killing. Whitestone Insight is a member of the British Polling Council. The key findings are very relevant to this group of amendments. When the public were asked whether they would support a law that enabled patient choice if it risked harm to vulnerable people, 42% said they would oppose such a law, and only 35% said they would support it. More than twice as many respondents strongly prioritised safety over choice, rather than choice over safety, which is not the position of the noble and learned Lord, Lord Falconer, who frequently says to us that the important thing here is autonomy. That polling is important, because that is indeed the job this House is trying to do. It is about making sure that the legislation contains appropriate safeguards, so that it ends up being used only by those who have exercised a genuine wish to do so and not anybody else. That is incredibly important.

Having said that, I turn to the group of amendments put forward the noble Baroness, Lady Finlay of Llandaff. I listened very carefully to what she said. She set out a very good, workable proposition on how to ensure that such decisions are made by a genuine multidisciplinary panel that is clearly separate from the people providing care. She set that out in a detailed way and explained it very well. Noble Lords are free to disagree with her, but I do not think that anybody could reasonably argue that this has not been done in a careful and thoughtful way, informed by her years of clinical experience in palliative care. So, it behoves all of us, whether we agree with her or not, to give her proposal due weight. When the noble and learned Lord, Lord Falconer, responds, I hope he will take time to reflect on her proposal and, even if he does not agree with all of it, see if there are some things that are worthy of taking forward, from his own perspective, even if he cannot support all of them.

One of the important things the noble Baroness referred to—we have already discussed this and is not universally agreed with, but I strongly support it—is keeping the provision of assisted suicide separate from the provision of NHS care. That is very important for several reasons. Assisted suicide is not a healthcare treatment, so it is very important that it be kept separate from healthcare provision, partly for the reason set out very ably by my noble friend Lord Deben: if vulnerable people and other patients facing a terminal illness and needing palliative care think that, at some point, the people providing that care are going to try to end their life, encourage them to do so or put pressure on them to do so, the practical effect will be to put them off seeking palliative care at all.

My noble friend is right that many people fear, if they think there is going to be bad news, approaching doctors and healthcare professionals. Those involved in healthcare delivery know that many people seek medical treatment too late. Speaking as a man, men are particularly bad at going to see the doctor—far worse than women—leaving it until it is too late. That is something we should not be encouraging. We should be trying to make sure that people are comfortable in seeking support. It is important that, when they seek palliative care, they are clear about what they are getting and are not confused.

The points made by the noble Lord, Lord Stevens of Birmingham, are informed by his enormous experience in running the National Health Service. Clearly, in this country, there is an enormous amount of support for the principles of the NHS, whatever the level of performance is at any given time. It is also clear that the founding principles of the NHS would need to be altered to be able to deliver assisted suicide. I personally think that it would be best not to alter the founding principles of the NHS in order to do that. If you are going to do it, that should be an explicit decision of Parliament; it should not be a decision taken by Ministers.

If it is the wish, as I believe it is, of the sponsor of the Bill, the noble and learned Lord, Lord Falconer, to have this as an NHS service, it should be explicitly written into primary legislation, with the necessary consequential changes to what the NHS does. That should be a clear-eyed decision that Parliament takes, with all the consequences that flow from it—we have debated those, and I will not repeat them here—such as challenges about whether decisions will be taken because of funding and resource reasons, and about pushing people down one path rather than another. We have heard examples in previous debates where that has already happened, such as the Liverpool care pathway. For those reasons, I support the amendments set out so ably by the noble Baroness, Lady Finlay. The points put forward by the noble Lord, Lord Stevens, are also very worthy of consideration.

Finally, I return to a point I made earlier in supporting the noble Baroness, Lady Berger. I accept that the noble and learned Lord, Lord Falconer, does not agree with everything we say, but I hope he accepts that all the royal colleges he referenced, having looked at the Bill, do not take a view on the principle, but do not support the legislation in its current form. So, even if the noble and learned Lord is not minded to support these measures, I hope he will at least listen to the concerns other people have expressed and take these as practical mechanisms to try to improve both the Bill and its workability. I hope he accepts them in that spirit.

[Lord McColl of Dulwich (Con)]

Is the noble Lord aware of a rather alarming story from Holland that is relevant to the separation of the two services that he mentioned? A gentleman witnessed the euthanasia of his mother. It was done by an anaesthetist, who came in and said to the lady, “Now, I’m just going to put a needle into your vein and inject this medicine, and you’ll go off into a wonderful sleep and have no further worries”. A month later, the gentleman was involved in a road traffic accident, and he had to have an emergency operation in that very hospital. He was waiting for the anaesthetist to come in, and he was horrified, because it was the same anaesthetist that had dispatched his mother. The anaesthetist used the same words: “I’m just going to put a needle into your vein and give you an injection and you’ll go off into a deep sleep with no worries”.

[Lord Harper (Con)]

I am grateful to the noble Lord for that information, but I am conscious that, because of his intervention, I am well over time. I am going to conclude my remarks there and allow the Committee to hear from the next speaker in the debate.