Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Friday 6th February 2026 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I wonder if I might briefly apologise to the Committee. I was reading a quote—they were not my words. The quote was about a young woman who was said to have committed suicide. If we are going to be respectful of everyone, we must drop the word “commit”. It is not a crime to end your own life. I know that, for the relatives of those who have taken their own lives by suicide, the term “commit” can be deeply offensive. But as many people in this Committee will know, when you have experienced the suicide of someone very close to you, it lives on, in the way that a death also lives on in the person left behind. But I apologise, because it was a quote I was reading, and I think we should return to the topic of the amendments before us, if we may.

[Baroness Berger (Lab)]

My Lords, I am going to do as the noble Baroness, Lady Finlay, has requested and carry on with the group of amendments before us. To echo the sentiment just expressed about the language we use in this place—and it does matter—there are Members on all sides who have used the term “commit suicide”. Suicide is no longer a crime or a sin and, on that basis, for people affected by suicide and those left behind, it is a good reminder that we should all endeavour wherever possible, as the media tries to do outside this place, not to use that terminology.

In reference to one of the points just made by the noble Baroness, Lady Gerada, we will come back to these issues in some later amendments. Complicated grief can arise from an assisted death, and I shall propose some amendments to address that and to think about the people who are left behind. We certainly have evidence of that in other jurisdictions. We also know that adverse complications can arise from the drugs people ingest through an assisted death, which can have far-reaching consequences for the people left behind. We will debate that later.

As a signatory to Amendment 87A, I welcome the fact that these important changes will be accepted, along with Amendment 87. However, I want to add some additional information. It is important to acknowledge that these amendments do not address all the gaps connected to eating disorders. There is no protection for people whose eating disorders may bring them within scope of the Bill’s definition of terminal illness in other ways. That includes refusing treatment rather than food, which is addressed in Amendment 92, which I do not believe the sponsor would accept at the moment, or a person with bulimia sustaining damage to their organs through vomiting.

Why does this matter? We have talked about anorexia, which is a fatal disease and one of the mental health conditions that leads to the greatest loss of life through mental illness. However, it represents only a minority of eating disorder cases in the UK. A large population study published in 2017 found that anorexia accounted for just 8% of eating disorder cases. We know that bulimia is far more common, but it can also be fatal, with well-established risks including sudden cardiac death, severe electrolyte disturbance and rupture of the oesophagus. The amendment rightly focuses on anorexia but, as someone who is a signatory to Amendment 87A, I acknowledge that we must do everything to provide protection to all people with eating disorders in this country, including bulimia.

[Baroness Parminter (LD)]

My Lords, I rise to speak to Amendment 101, which I drafted to try to close the dangerous loophole in the Bill whereby people with eating disorders could qualify for an assisted death, contrary to the intent of the sponsors to limit the Bill to people with a terminal life-limiting illness. That there is a raft of amendments on this matter shows that the Committee recognises that that loophole exists, which is welcome; indeed, I welcome all the amendments in this group.

My focus has consistently been on the deadliest of all eating disorders—that of anorexia, as was so well articulated by the noble Baroness, Lady Hollins. My particular worry with the Bill as it stands is that, if treatment is delayed, withheld or withdrawn, the physical health of people with a mental illness could deteriorate to a life-threatening degree. They would therefore then be subject to the provisions of the Bill.

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[Lord Deben (Con)]

The fact is that none of the organisations that will have to carry this through have no objections to the Bill. They have asked us to try to change the Bill so that they can do their job. That is what I was trying to say. Some have a principled opposition, but most want a better Bill. If we are going to have a better Bill, that is what we are here to do. I object to the fact that my time is being taken up with trying to help and then I am told that somehow or other it is filibustering.

[Baroness Berger (Lab)]

I just want to clarify that many of these organisations—including five royal colleges, the British Association of Social Workers and all the organisations for and on behalf of disabled people—are neutral on the principle of assisted death, but no external organisation will attest to the safety of the legislation we are discussing today and on previous days. I think that should be of concern to us all.

[Baroness Royall of Blaisdon (Lab)]

My Lords, many points have been made around the Chamber about disability. The most recent large survey, carried out by Opinium in February 2024 of nearly 11,000 respondents in the UK, showed that 75% of the general population were supportive of the Bill and 14% opposed it. Of those who had a disability, 78% were supportive and 14% were opposed. It is very important to put those figures on the record.

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Moved by

[Baroness Berger]

107: Clause 3, page 2, line 21, at end insert “, save that section 3(3) of the Mental Capacity Act 2005 (inability to make decisions) shall not apply to assessments of capacity under this Act.”
Member's explanatory statement
As the Bill includes two extended periods for reflection, this amendment would disapply section 3(3) of the Mental Capacity Act 2005, which provides that the fact that a person is able to retain the information relevant to a decision for a short period only does not prevent them from being regarded as able to make the decision.

[Baroness Berger (Lab)]

My Lords, I support of Amendments 107, 108 and 109, in the names of my noble friends Lord Hunt of Kings Heath and Lord Rook, who are unable to be with us today for good reasons. These amendments go to the heart of a question the Committee must answer honestly: what level of capacity is required for the state to assist a person to end their life, and, crucially, is the existing framework of the Mental Capacity Act 2005 sufficient for a decision that is irreversible, permanent and final?

Amendment 107 addresses a specific but serious problem. Section 3(3) of the Mental Capacity Act provides that a person may be regarded as having capacity even if they can retain relevant information only for a short period. That may be entirely appropriate for many decisions in everyday life, and even for some serious decisions. However, this Bill requires something very different. It requires a person to form, retain, reflect upon and reaffirm a decision to die over an extended period—potentially weeks or months. If someone cannot retain the relevant information beyond a short period, they cannot meaningfully engage with the reflection periods that are built into the Bill. This amendment would therefore disapply Section 3(3) of the Mental Capacity Act for the purposes of assisted dying alone, recognising that the bar for deciding to die must be higher than for any other decision.

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[Lord Markham (Con)]

As the noble Baroness herself said, we debated both deprivation of liberty and the Mental Capacity Act and its use extensively—I think it was on 14 November—and I believe the sponsor, the noble and learned Lord, Lord Falconer, agreed to look at extra safeguards around deprivation of liberty, being aware that there are many items we are all hoping to get through.

On the length of this debate—obviously, it will be up to noble Lords to decide how much time they want to take—we have covered these areas to a large degree, so what does the noble Baroness hope for in terms of the extensiveness of the debate this time? Does she hope that we can refer back to the previous debate and move quickly to get the response from the sponsor?

[Baroness Berger (Lab)]

I endeavoured to keep my remarks brief, and I believe I did so, taking under five minutes. The point of the amendments is very specific, around eligibility, which we had not discussed. We talked more broadly about the concerns around the Mental Capacity Act, but not specifically in the context of capacity. Obviously, we listened closely to the sponsor of the Bill’s response to the earlier debate, and the point raised in these amendments was not in any way addressed. These are additional points, beyond the principle and the wider concerns about people who are under deprivation of liberty and those who will be considered under the Mental Capacity Act. Clearly, we have listened to the experts, who have raised many concerns about the Mental Capacity Act, but the purpose of these amendments is to address eligibility.

I hope that the sponsor of the Bill will give us some more colour and detail about amendments he might come forward with on Report. But we have been in Committee since the middle of November, and in the absence of anything so far coming forward from the sponsor on the Mental Capacity Act and deprivation of liberty safeguards—I think this speaks to the concerns of many in this House—we are therefore compelled to bring forward these amendments to raise these issues. If something did come forward, that might enable us to withdraw future groups of amendments altogether, and maybe that will be the case. I look forward to the sponsor’s response.

[Lord Falconer of Thoroton (Lab)]

It may assist in the light of that exchange if I indicate what my position is. We had a debate some weeks ago about the question of people who had had their liberty deprived within the preceding 12 months. That would obviously include those who were still the subject of a DoL order or a DoL application, and the noble Baroness’s amendment refers to a number of other categories as well, which are similar and which I think would be included. I indicated explicitly in the debate that I think it would be appropriate for me to bring forward explicit extra protections in relation to those people, and in particular, those extra protections might include a specific compulsory further psychiatric examination for that purpose. I have been in discussions with various people in the House in relation to that, and I am seeking advice from officials and others so that I will be able to bring forward proposals on Report. I hope that very much helps my noble friend Lady Berger.

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[Lord Falconer of Thoroton (Lab)]

If that is a reference to whether there should be the affirmative rather than the negative procedure, may I take it away? That seems a reasonable request. May I get back to the Committee on that?

[Baroness Berger (Lab)]

My Lords, we have debated for just over two hours and some very significant issues have been raised. It is worth outlining briefly why this group matters, particularly in the context of what is happening beyond this place and considerations and representations being made in the media.

It was last week that Esther Rantzen told us that the Bill

“only applies to terminally ill people like me”.

The campaigners we hear from reassure us that it would obviously be something that they “freely choose and have fought for”. There are noble Lords who said at Second Reading in this place:

“I want that choice for myself”.—[Official Report, 12/9/25; col. 1786.]


It centres those who have no doubts about their capacity to make this decision and no doubt that they would freely choose, but it removes from the room people who are not like us. It is our job to balance the needs of those with true agency, for whom this will be a free choice, with those who may be pressured or led towards this path, in particular because of the inadequacies of the Mental Capacity Act.

It is clear that there remains significant concern about the relationship between the existing test in the Mental Capacity Act, brought forward in 2005, and the decision to have an assisted death under the Bill. At the risk of stating the obvious, a decision to have an assisted death was not in contemplation for the architects of that Act back in 2005, so it is not surprising that we have heard such a range of questions and concerns, both from noble Lords and from experts outside this Committee, including the Royal College of Psychiatrists.

I listened closely to my noble and learned friend’s remarks to the noble Baroness, Lady Finlay. It may be helpful for noble Lords to be aware that, back in the other place, the desire to use the Mental Capacity Act was largely pragmatic as it is what doctors are used to, not because it is the best framework for this decision. I reflect on the comments from the Health Minister, Stephen Kinnock, who said in the Commons that it is “a known quantity” and a well-established piece of legislation. He went on to say that doing things differently would cause “operational challenges and confusion”, and that a different approach would add complexity. This bunch of amendments has pragmatic, specific proposals for adjustments to address what we are trying to do within the constraints of the legislation. Perhaps this would have all been ironed out if we had gone through some proper pre-legislative scrutiny, as we would have done had this been a government Bill.

In particular, I acknowledge the expertise of the noble Baronesses, Lady Hollins, Lady Cass and Lady Finlay, in this debate. The debate has raised some serious questions about what these specific provisions of the Mental Capacity Act mean for the weakest and most vulnerable: the endorsement of unwise decisions; presumption of capacity; brief retention of information, and whether that is sufficient; a duty to support decision-making, which risks becoming a duty to facilitate a decision to die; and relying on time-specific capacity.

I have in front of me so many different important points raised by noble Lords from across the Committee. In the time we have available, I am not going to mention all of them, so I hope noble Lords will forgive me for that, but it is worth reflecting on just a handful. The noble and learned Baroness, Lady Butler-Sloss, raised the very important concerns about people with variable dementia and people who are sectioned. The right reverend Prelate highlighted the biases experienced by people with learning disabilities and the discrimination they face. The noble Baroness, Lady Finlay, talked about the need for clarity for doctors and how we can at least endeavour to make the Mental Capacity Act fit for purpose in the Bill. The noble Baroness, Lady Cass, reminded us all that assisted death is not a medical treatment. I again reflect on the important representations from the noble Baroness, Lady Grey-Thompson, on the concerns raised by the disabled community and the particular challenges not addressed in the Bill.

Given that my noble and learned friend Lord Falconer indicated in his response that he will defend the Mental Capacity Act as the foundation for the Bill, it is disappointing that he has dismissed the specific provisions that could be set aside and could make a difference. I welcome his earlier intervention, when he said that he would bring forward amendments that would introduce additional assessment in particular cases, but that question is different from the one being asked today, about how we can be confident that the test itself is the right one.

I was particularly concerned by my noble and learned friend’s response to the question from the noble Baroness, Lady Grey-Thompson, about whether a disabled person would be safe. He said that no one would be overpressed into making a decision to end their life. I think that, for many of us here, it is not about being overpressed: we do not want anyone to feel pressed at all. I hope that he will further consider that question, including how experts, who still have so many doubts, can be consulted in more detail.

Given that we first started talking about these issues in this place before Christmas, and in order to expedite our deliberations, I hope that we will not have to wait until Report and that the amendments he mentioned will be brought forward as soon as possible. We understand that he has a wealth of civil servants and legal experts at his disposal; perhaps they can help him to act even quicker. My noble and learned friend has outlined that he is not prepared to accept any of the amendments proposed in this group, but we would like to see what he intends to propose as an alternative. I know that everyone is concerned that we should expedite our deliberations, in the light of the later groups, and that would help us all enormously.

[Lord Falconer of Thoroton (Lab)]

I said “overpressed”, but I did not mean that; I meant to say pressed. I apologise for saying “overpressed”.

[Baroness Berger (Lab)]

With that, I beg leave to withdraw my amendment.

Amendment 107 withdrawn.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[Lord Birt (CB)]

My Lords, we are discussing one of the most important decisions that any individual might make in their lives. It is important for the individual and for the state. I think that it is appropriate to ask that the critical meetings with the medical practitioners should be face-to-face, because that allows a degree of intimacy and nuance which, frankly, the world of Teams, however valuable it is, does not. There are three doctors involved in the process set out in the Bill and, at the very least, for the second doctor who is going to co-ordinate the process, it is reasonable to require that that meeting be face to face.

[Baroness Berger (Lab)]

My Lords, very briefly, I support the amendment that is calling for face-to-face consultations to take place, rather than only in exceptional cases. I want to reflect on why this matters. We know from other jurisdictions that many of these assessments are being done online. It is a really important question for us to consider whether we would want that in our country—and if not, it should be in the Bill. In addition, my comments are informed by the evidence that we were presented with in the Select Committee and drawn from my experience of meeting a number of elderly constituents over the course of nearly a decade as a Member of Parliament.

I reflect particularly on the women I met in their 70s, 80s and 90s who shared their experiences of domestic abuse. This conversation and these amendments matter because this legislation does not happen in a vacuum. The Labour Government today are rightly concerned with addressing the public health emergency of violence against women and girls in our country and has an important landmark mission and goal of halving violence against women and girls over the next decades. The NHS is playing its part and enhancing its efforts in tackling and violence against women and girls, focusing particularly on early identification. There is a lot of other very important work going on via training and investment, and I commend the work of many colleagues who are dealing with this on a daily basis. It was the experts that told us that to identify coercion, undue influence and pressure, doctors and other professionals need to look at someone’s body language. It is not just the words we say, how we say them, the volume or the tone—it is our non-verbal cues and what our body says. It is what we do not say that often shares an important message.

I listened very carefully to the counterchallenge of noble Lords so far. I do not think there is anything to stop the Bill from stipulating that, in exceptional circumstances, the doctors, or the independent advocates or panel members can visit an individual. But I would much rather that we had legislation that supports the Government’s important aim to reduce violence against women and girls, rather than something that will exacerbate the very serious problem that we know that too many women in our country face, particularly at their most vulnerable moments, which includes the end of life.

[Lord Hamilton of Epsom (Con)]

Can the noble Baroness recall that last week she told the House that 23% of six-months-to-live diagnoses turned out to be wrong and that people lived longer? Does that not make the whole position of face-to-face diagnosis much more important when doctors so often get it wrong?

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Baroness O'Loan (CB)]

My Lords, I will speak to Amendment 38 in my name. I have put my name to five other amendments in this group, all of which seek to ensure clarity on what in the Bill involves identifying vulnerability and providing protection for those who may be subject to coercion or who may be unaware of their rights.

I support Amendment 27 from the noble Baroness, Lady Finlay. The importance of this derives from the current structure of the Bill and the massive deficiency in the Bill’s provisions. As the DPRRC said, the Bill does not say how assisted death services are to be provided. This is a huge black hole in the middle of the Bill. It does not tell us where, when, by whom and how services are to be delivered, and is indicative of how unfit the Bill is.

As the noble Baroness, Lady Finlay, said, Clause 41 confers significant Henry VIII powers on the Secretary of State, requiring him to make provision to secure arrangements. Clause 42 permits Welsh Ministers to make provision, but there is no provision in the Bill that came from the Commons. The noble and learned Lord, Lord Falconer, has not introduced any amendments to address this lacuna. Does the noble and learned Lord intend to do so?

Those who were meant to deliver this service have not been consulted. As the BMA said,

“our view is that assisted dying should not be part of the standard role of doctors or integrated into existing care pathways – it is not something that a doctor can just add to their usual role”.

In 2024, 45% of BMA members said that they were not prepared to actively participate in the process, while 19% were undecided. Where does the patient get neutral, unbiased information? Dr Mulholland, from the Royal College of General Practitioners, said:

“The shape of the service is not set out in the Bill … GPs need to have a space where they can step away from it: that is the key point that we want to get across. For those who want to take part, it may be that they decide to do it, but it would have to sit outside the core general medical services that we provide at the moment”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee, 30/1/25; col. 277.]


Chris Whitty said in oral evidence that Parliament should resolve this. How does the noble and learned Lord, Lord Falconer, intend to resolve it?

As a consequence, a person, particularly one who—for a variety of possible reasons—has no family or friends who can support them, when advised by a doctor that voluntary assisted death could be provided to them because of their condition, is intensely vulnerable. This could happen even when they have made no request for such provision. It may come as a significant shock to them, on top of their existing vulnerability as a consequence of the diagnosis and prognosis that they have received. In such a situation, the patient—isolated, vulnerable and accustomed to believing that a doctor will always seek to help their recovery and do no harm, and possibly even thinking that assisted death means palliative care rather than death—will need some independent person to talk to, if only to try to ensure that they understand what they are committing to. As far as I can see, there is no such provision in the Bill.

The Bill does not even say that the person who makes the request to die, provided for in Clause 1, line 13, must be the person referred to in Clause 1. Relatives, friends, a professional adviser or indeed anyone else could initiate the process. Hence I have put my name to Amendment 31, which would add the words “their own” to the phrase “on request”. Further, since the Bill does not exclude Sections 9 and 11 of the Mental Capacity Act, someone with a lasting power of attorney under that Act could request assistance on behalf of the individual concerned. Once that request is made, the provisions follow. Amendment 68A, in the name of the noble Baroness, Lady Coffey, is vital, because it ensures that someone with an LPA cannot assist the process. Does the noble and learned Lord, Lord Falconer, accept that this is a very real gap that this amendment must fill? If he does not accept the amendment, can he tell the Committee how he intends to ensure a person’s voluntary wish to end their life in these circumstances?

Amendment 38 in my name excludes from eligibility those with serious mental health conditions. It concerns whether they wish to die as a symptom of a specific illness and applies to those with conditions

“known to cause episodic or chronic suicidal ideation, including but not limited to bipolar disorder, borderline personality disorder, major depressive disorder, or schizoaffective disorder”.

It seeks to distinguish between those who might seek an assisted death as an autonomous choice and those who are seeking suicide because of a serious history of mental health or disorder. Some mental health conditions have suicidality as a feature of the disorder. These people are, by very definition, at high risk of suicidality and self-harm. The intention of the Bill should not be to view these people as the same as those who have made a voluntary choice to end their own lives. Serious mental health conditions impair decision-making and affect a person’s ability to make the irreversible decision to die. The amendment is limited and mental health issues such as depression or anxiety would not be within its scope. Dr Annabel Price noted that around 20% of terminally ill patients have diagnostic depression and that

“around 10% will have a wish to hasten death”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee, 30/1/25; col. 270.]

This is strongly linked to feeling suicidal. Professor Owen gave evidence that even sub-clinical mood problems or anxiety can affect judgment.

As the Royal College of Psychiatrists said in evidence, as the voice of psychiatry and an organisation that has campaigned for decades to prevent people dying by suicide, it is important that we directly acknowledge that the passing of this legislation would result in amendments to the Suicide Act. What then would this mean for suicide prevention efforts among the terminally ill population in England and Wales? A duty of care is imposed on clinicians to protect the safety and well-being of their patients, including those who are at risk of self-harm or suicide by the Mental Health Act, the Mental Capacity Act and the Human Rights Act.

In 2011, the commission of the noble and learned Lord, Lord Falconer, resolved that doctors must be satisfied that there is no treatable mental condition contributing to the suicidal wish. Is the noble and learned Lord now satisfied that these serious mental conditions are irrelevant to doctor and panel approval? I hope he will indicate that he will accept this amendment, but, if not, what amendments could he offer to establish protections for these individuals?

I also support the noble Baroness, Lady Finlay, on Amendment 28, which seeks to ensure that fast-track benefits are made to those who qualify, so that they do not end their lives for financial reasons. In so many cases, the availability of financial support that may be critical is not known about. When my brother died of cancer a couple of years ago, we had no knowledge that such support should have been made available to him. There are many others in similar circumstances who may opt for assisted death because their situation cannot be improved as it could be if the financial help that should be made available were to be made available.

I also support Amendment 39, which deals with the situation in which a person in care may be suffering from undiagnosed dementia and all that goes with that. It is important that there is a dementia assessment in the three months preceding an application for assisted death, given the Government’s figures on undiagnosed dementia, which range from 29% to 71% of cases in primary care. Many of us, sadly, have seen people we know and love in care homes, and our experience has told us that they are suffering from undiagnosed dementia. It can take time for a diagnosis to be reached, especially where an individual with dementia still understands the questions they may be asked and how to answer them, although they cannot remember whether they had a visitor to that day and do not even understand why they have to see a doctor.

People can be very convincing, even when suffering from fairly advanced dementia. A visiting doctor, one of two independent doctors, will not necessarily identify undiagnosed dementia in a single visit. Amendment 39, which would require a specific clinical assessment for dementia in care homes, is a very necessary safeguard. The question for the noble and learned Lord, Lord Falconer, must be: would it be satisfactory for a patient with undiagnosed dementia, deemed compliant by an overworked care home staff member, to be signed off by a doctor who has met them once—always remembering that the second doctor does not have to meet them at all?

Amendment 68 makes a categorical statement that nobody can take a decision on behalf of anyone else. Such clarity is very necessary, as I am sure the noble and learned Lord, Lord Falconer, will accept. If he does not accept this amendment, can he provide details of any amendments that he will table to ensure that nobody, other than as provided for in the Bill, can take a decision that someone else should be helped to die?

[Baroness Berger (Lab)]

My Lords, I will speak to Amendment 31 in the name of my noble friend Lady Ritchie. It would clarify that the request for assistance to end one’s life must come from the terminally ill person, leaving no room for doubt over whether someone else is able to make the request for them. This may seem like a statement of the obvious, given that eligibility under the Bill depends on both a clear, settled and informed wish to die and an absence of coercion. But there are situations where it is possible to imagine the request being initiated by another person who claims to be speaking on the ill person’s behalf, and an assessing doctor being persuaded to go along with it.

The Bill contains a number of provisions that are designed to allow another person a substantive role in the process, from the independent advocate who helps a terminally ill person to engage with their options, to the proxy who can sign a first or second declaration on their behalf. It is not difficult to envision such a person taking it on themselves to tell a doctor that the ill person is interested in having a preliminary discussion under Clause 5, or being the one to make an appointment that they explicitly say is for the purposes of a first declaration under Clause 8. Neither scenario is explicitly ruled out by the Bill. Of course, there are no limits specified to the role of independent advocates in particular. This is just one example of the many things that are not in the Bill and are left to be decided through regulations later on. We might even imagine a partner, relative or friend purporting to speak on behalf of an ill person telling the doctor that he or she is shy, exhausted or overwhelmed, when in reality they are acting in their own interests.

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[Lord Falconer of Thoroton (Lab)]

The commissioner for the EHRC raised a number of points in relation to the risk of discrimination under the convention. The Government have done an equality impact assessment and, broadly, they adopt the approach that it is unlikely that the courts will interfere in a deliberate choice made by the Government, or the legislature in this case, as to what the limits would be of an assisted dying Bill. I agree strongly with that. It is the approach that the English courts have reflected in relation to assisted dying, and it is the approach that the European Court of Human Rights has taken as well. I therefore do not think that the views expressed by the commissioner to the Select Committee are right, but I am more than happy if the noble Baroness, Lady Cash, would like to raise specific ones—or all of them—she can do so with me, and I can raise them with the Government as well.

[Baroness Berger (Lab)]

On this particular point, there is something fundamental that would equip all of us in this Committee, irrespective of our views on the principle of the Bill before us, which is the equality impact assessment—it is lacking. The equality impact assessment came forward from the Government only at the end of Committee in the House of Commons. The response from the Equality and Human Rights Commission is that that assessment is wholly inadequate and is in no way commensurate to the length and detail that we would expect on a government Bill.

We have obviously already heard from the Minister in response to the current set of amendments, but I would urge that, in future responses, we hear from the Government about whether they might be forthcoming with an updated equality impact assessment in order to inform our discussions, debates and deliberations on what we might be considering going forward. So far, what we have heard from the Equality and Human Rights Commission is that we do not have the information before us. As the commission responsible for this legislation, it has some serious concerns, particularly in terms of the societal impact of this Bill that has in no way been addressed or deliberated by the Government in the way that it would have been otherwise.

[Lord Falconer of Thoroton (Lab)]

First, I do not agree with the proposition that it was a bad equality impact assessment. Secondly, the noble Baroness, Lady Cash, legitimately raised the question of differing economic circumstances and whether that could that lead to discrimination. If differing economic circumstances could lead to discrimination—the point that she quite properly raised—then almost every single piece of assisted dying law throughout Europe would be contrary to the European Convention on Human Rights. One has to provide some degree of realism about what the limits of the law are. What the courts here and in Europe are saying is that this is a sensitive and delicate area where they will defer to legislatures.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

Moved by

[Baroness Berger]

16A: In paragraph (ca), leave out “been” and insert “had an application to be”
Member’s explanatory statement
This amendment would ensure that someone who so lacks capacity in one area that an application has been made to deprive them of their liberty will not be found to have capacity for the decision to seek assistance to end their own life, which is otherwise a legal possibility under the Mental Capacity Act 2005’s approach to capacity.

[Baroness Berger (Lab)]

My Lords, Amendments 16A and 114A, which were tabled by the noble Baroness, Lady Keeley, address the fact that for the last 10 years there has been a substantial backlog of applications for deprivation of liberty safeguards assessments. This backlog grew after there was a Supreme Court ruling in 2014 on Cheshire West. Following that ruling in 2014, the criteria for what constituted a deprivation of liberty assessment led to a surge in applications for DoLS assessments. Back in 2013-14, there were around 13,000 assessments. This grew to over 332,000 applications in 2023-24.

The last reported backlog of deprivation of liberty safeguards assessments back in October of this year was more than 123,000 applications. That is more than 123,000 cases where a person so lacks capacity in one area that an application for a deprivation of liberty safeguards assessment has been made, but our overstretched social workers and local authorities have not been able to process it.

I hope we can all agree that people whose incapacity to make basic decisions is so severe that they are deprived of their liberty, or for whom an application has been made for the deprivation of their liberty, are the most vulnerable members of society, and that the protection of people who lack capacity is a solemn duty. The state looks after their interests because they cannot.

Amendments 16, 16A, 114 and 114A provide a fundamental safeguard to protect this group by excluding them from making a life-and-death decision, both when they have been deprived of their liberty in the last 12 months or—as these amendments particularly seek to achieve—while they are waiting for the assessment to be made to deprive them of their liberty.

In conclusion, while considering these amendments, and in addition to addressing the delays outlined by the noble Baroness, Lady Finlay, we might also reflect that our current social care workforce has struggled so much with the backlog of assessments, as I have described, that the last Government were not able to implement the changes to the deprivation of liberty safeguards assessments contained in the Mental Capacity (Amendment) Act 2019. It is worth pointing out that the Bill seeks to create a new and additional role for social workers on the panels, and in that context, I hope noble Lords will consider these amendments.

[Baroness Butler-Sloss (CB)]

My Lords, for the reasons given by the noble Baronesses, Lady Finlay and the Lady Berger, I support all these amendments.

Perhaps your Lordships, and particularly the Whips, will forgive me if, very briefly, I go slightly wider. I am one of the oldest Members of this House. I do not like the Bill but I am here, like other noble Lords, to try to make it work. It needs scrutiny and improvement. However, we must get it to Third Reading. If we do not, there is a very real danger that the reputation of this House, which not only I but all your Lordships care about deeply, will be irreparably eroded.

This morning I listened to the “Today” programme. I agree with every word of what the noble Baroness, Lady Grey-Thompson, said, but there was a perception that we are being unreasonable. What we can do, perhaps, is not expect to be entitled, exercise self-restraint, deal with the amendments relatively briefly, and not make a point if someone has already spoken on the point you were going to make. We really must get to Third Reading. Forgive me for saying all that.

--- Later in debate ---

[Baroness Berger (Lab)]

My Lords, just in advance of withdrawing the amendments, I would like to put on record the magnitude of this issue. In the last recorded year, there were 141,925 people who had the deprivation of liberty safeguards—DoLS—standard authorisations granted, and only 3% of the applications that were fully assessed and completed were not granted; 97% of applications were granted. I have listened very closely to what my noble and learned friend said and I look forward to the meetings that we will have, further to our deliberations today. On that basis, I withdraw my amendment.

Amendment 16A (to Amendment 16) withdrawn.

--- Later in debate ---

[Baroness O’Loan (CB)]

I cannot comment on the deliberations of the committee. I think there are others here who possibly can.

[Baroness Berger (Lab)]

My Lords, for the record, I inform the Committee that there was only one vote taken in the Select Committee. The vote was on whether the committee should receive written evidence; that vote was taken and the committee did not receive written evidence, which is a great shame because we would have heard from so many groups that people are raising in their contributions today. So, for the record, there was only one vote taken. There were many witnesses whom people on all sides wished to hear from. There was a deep regret that we were truncated and had only those three weeks to have those 13 panel sessions. If we had had more time, we would have been able to hear from many other groups. Again, for the record, only one vote was taken, which was not to take written evidence.

[Baroness O’Loan (CB)]

I thank the noble Baroness for her intervention, which is very helpful. All I was trying to say is that we are aware of many situations in which people are subject to coercion and where there are financial and other interests that cause people to be subject to pressure or to think that perhaps they are a burden. The autonomy which currently exists in the Bill in terms of decision-making, where there is no provision for access to police and medical records, does not ensure sufficient protection for a vulnerable individual who is making an application for assisted death. That is why these amendments are important, so that the GP who is faced with dealing with the situation and all those involved can have access to other documents.

--- Later in debate ---

[Baroness O'Loan (CB)]

My Lords, I have put my name to Amendments 22 and 24 in the name of the noble Baroness, Lady Grey-Thompson, and support the other amendments in this group, which relate to the fact that prisoners, people detained under a hospital order, homeless people and those who are pregnant require special care because of their situations.

Suicidal ideation and depression as a result of incarceration, with limited ability to access outside resources due to imprisonment, are very common among prisoners. One study found that 61% of elderly male prisoners had a mental disorder. Primary care mental health services are still being developed in prisons to provide for conditions such as depression, anxiety, post-traumatic stress disorder and learning disabilities. That vulnerability, combined with a terminal illness and probable lack of access to good palliative care, means that their welfare is a special responsibility of the state. Special arrangements must be made to ensure that they do not feel they have no option other than to opt for assisted death.

Suicidal ideation is also very common among the homeless. The noble Lord, Lord Bird, recently spoke eloquently in your Lordships’ House about the problem of poverty, which so often results in homelessness and the hopelessness which accompanies poverty. Solutions to things such as poverty and homelessness should not involve offering people assisted death rather than a home, possibly in sheltered accommodation, in which they may be able to flourish.

The noble Baroness, Lady Grey-Thompson, spoke eloquently about pregnancy. I want to add just a couple of things. Pregnancy is not an illness, but pregnant women are at a higher risk of mental illness. The Maternal Mental Health Alliance reported that at least one in five women develops a mental illness during pregnancy or within the first years after having a baby and that maternal death due to mental health problems is increasing and suicide remains the leading cause of death in the first year after birth.

[Baroness Berger (Lab)]

I declare an interest as chair of the Maternal Mental Health Alliance. The figures have been updated; currently, one in four women experiences a mental health condition in the perinatal period, either during pregnancy or in the two years after birth.

[Baroness O'Loan (CB)]

I thank the noble Baroness for her intervention. I also want to raise the risk of domestic abuse, which is much higher during pregnancy. The Maternal Mental Health Alliance says that up to 30% of domestic abuse cases begin during pregnancy.

Ending someone’s life with lethal drugs while they are pregnant raises additional layers of moral, legal and medical concern—for example, consent, the viability of the baby, conflicts of interest, et cetera. Pregnancy causes drugs to be processed differently. The rate of absorption is affected by physiological changes. That could mean a slower or more prolonged death from the approved substances for both mother and child. Women are particularly vulnerable, and the safeguards just do not seem to be in the Bill at present.

The amendments from the noble Baroness, Lady Berridge, in this group relate also to those up to the age of 25 who have an EHCP, which may be provided to vulnerable children, including those with special educational needs and mental health concerns.

Finally, the noble Baroness, Lady Hollins, has told us that young people with complex needs may be at a higher risk of internalising negative societal values about their disabilities. The National Down Syndrome Policy Group states that people with learning disabilities can be highly suggestible and prone to acquiescence bias, agreeing with authority figures to please them.

There may also be diagnostic overshadowing, the risk that a young person’s desire to die might be as a consequence. In this context, a young person with an EHCP, for example, might request assisted dying not because their condition is intolerable but because the social care and support legally promised to them has failed to materialise, making their daily life situation unbearable. That could be misinterpreted by clinicians as a rational choice due to their disability. It is therefore the case that special provisions, such as those identified in these amendments, are necessary to ensure proper support, and that the various vulnerable groups of people do not feel that they have no choice.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

Moved by

[Baroness Berger]

4: Clause 1, page 1, line 6, leave out “18” and insert “25”

[Baroness Berger (Lab)]

My Lords, my Amendments 4, 249, 257, 304, 337, 446 and 448 raise the eligibility for the provision of assistance under the Bill from 18 to 25.

There is no reason, either in law or in principle, why we should assume that 18 is the right age for eligibility for an assisted death. It is not only an arbitrary starting point; it is contrary to the mounting evidence of when the brain is fully formed, which I shall come to in just a moment. When I asked the Children’s Commissioner, Dame Rachel de Souza, whose role it is to promote and protect the rights of children and young people, what she thought of 18 being used as a cliff edge for eligibility under the Bill, she answered:

“The reality of life on the ground, as those of you who work with health will know, is that 18 is not really a thing … when it comes to the most vulnerable, that is extended to 25”.


She went on to say:

“I think that we are missing a trick by thinking somehow 18 is the cut-off. I really do strongly think that. I would like the committee to consider that”.


Noble Lords will be aware that there are a range of existing circumstances where 25 is already seen as a threshold to adulthood, instead of 18. This is particularly relevant when we consider vulnerable young people with a terminal illness, whom we need to consider in this legislation—lest we forget that children are not currently mentioned in the Bill.

The point was forcefully made to the Select Committee. The Children’s Commissioner said:

“They are the children I am worried about: children with special educational needs, children who are already in hospital with life-limiting diseases, children who have EHCPs—education, health and care plans—that provide support for them until the age of 25. The reason they do that is that they are vulnerable, whether it is mental health concerns, whether it is because they have had terrible lives and might have all sorts of problems, including suicidal ideation. It is a real concern”.


Noble Lords will know that local authorities are responsible for preparing and maintaining EHCPs for children and young people with special educational needs up to the age of 25. Our local authorities have a statutory responsibility for young people up to this age, particularly those in care and those with special educational needs. It was more than a decade ago that the Department of Health, in its document Future in Mind, recommended an extension of child and adolescent mental health services up to the age of 25 to end the practice of discharging young people out of mental health services at 18.

In the context of criminal justice, I am mindful of the words of the noble and learned Lord, Lord Falconer, himself, who said in his speech in 2021 on the Police, Crime, Sentencing and Courts Bill that a whole-life term should never be imposed on an offender aged 18 to 20 but only on “somebody unequivocally an adult”. I hope that he will agree with me that death is not a less weighty matter than life in prison.

We have heard concerns during the progress of this Bill from experts who work with teenagers and young adults that it will be safer and more in line with the evidence to raise the minimum age for assisted dying to 25. It is by this point that the brain is more fully developed and decision-making capabilities are more secure. In general, the brain does not finish developing until a person is in their mid-20s, which is particularly the case for the prefrontal cortex, which governs our decision-making functions and our ability to think flexibly about potential outcomes.

Noble Lords may have seen research announced only last week by the University of Cambridge which suggests that the brain is fully developed only in our early 30s. I believe that we are here to make good law, and one way we do this is to listen when experts speak and to take their counsel. The simple fact of having enabled experts to give their evidence to this House over recent months does not amount to adequate scrutiny if that evidence simply languishes on the pages of Hansard, instead of being used to shape our work.

Of course, I know that an assisted death would be available only to young people with a six-month prognosis, but we know that it is not always accurate. It is, as I have learned, particularly difficult to get right with young people, who can go on to live for years beyond an initial terminal diagnosis. In its written evidence to the other place, the charity Together for Short Lives wrote:

“We are concerned that the requirement for an accurate prognosis to be provided for a person to be considered as ‘terminally ill’ may result in ambiguity when considering the eligibility of young people with life-limiting and life-threatening conditions whose prognosis is uncertain. Whilst the majority of adults only need palliative care at the end of their lives, many young people with life-limiting and life-threatening conditions require palliative care over a much longer period, often from birth or even in the womb. During this time, it is common for their conditions to fluctuate, meaning many young people may experience relatively long periods of stability. It is therefore much more difficult to provide an accurate prognosis and identify when a young person is moving towards their end of life stage”.


Together for Short Lives also recommends that under this Bill we consider how those aged 18 to 25 with EHCPs—education, health and care plans—will be affected.

The Bill as it stands is at risk of pushing young people with life-limiting conditions into thinking that reaching the age of 18 means that they are not obliged to consider whether they should continue to live or not. What does this say about how we value their lives?

We also cannot ignore the unique responsibilities faced by young people today. We know that social media has become a powerful driver of harm. Research from the Molly Rose Foundation, a suicide prevention charity, shows that vulnerable young people are disproportionately exposed to posts that glamorise suicide or present suicidal thoughts as normal, appealing or even fashionable. Alarmingly, 68% of young people with low well-being are being served this type of content. In such an environment, how can we claim to be safeguarding young people if, beyond the hospital bed, the digital world is telling them that their lives are not worth living? If this content is impacting young people when they are well, how much more so will it play on the mind of a terminally ill young person? To allow access to assisted dying at an age when external pressures are so pervasive, and when identity and resilience are still forming, risks compounding vulnerability rather than offering protection.

When families, carers and local services should be striving to provide the very best care, we would instead be sending them the confused and dangerous message that 18 year-olds are instead now ready to choose and plan their own deaths. This is of particular concern when we consider young people with learning disabilities, and how competence should be established in those cases, particularly given the fact that young people with learning disabilities receive worse healthcare in general, as evidenced by the National Child Mortality Database. In its learning disabilities and autism study, it exposed the fact that children aged four to 17 with a diagnosed learning disability accounted for 31% of all deaths, despite only 2.5% of children in the UK having a diagnosed learning disability.

There are challenges with a health service that misses lots of health issues for this group of children and young people because of communication and advocacy barriers. The 2023 report, Learning from Lives and Deaths—People with a Learning Disability and Autistic People, found that 42% of deaths of people with a learning disability were rated as avoidable, compared with 22% for the general population.

It is in this context, and for all the other reasons I have set out, that I am strongly persuaded that raising the age of eligibility to 25 is the right thing to do. I am also haunted by the words of one child that were shared with the Select Committee. The young person said:

“I’m in care. I’ve got disabilities. The Government will pay for me to die under this Bill, but it won’t pay for me to live”.


I conclude with a final contribution from the from the Children’s Commissioner, where she said:

“I would far rather that we erred on the side of caution, protecting those who have had terrible lives, terrible experiences, have been abused, have had their families turn them out, protecting those who are suffering from extreme mental illness, protecting those with special educational needs and disabilities, protecting anorexic children who are heading into adulthood, and saying, ‘Let’s err on the side of caution and go for 25’”.


I am clear that we must continue to say to children and young people, “Yes, your life matters. Even if it will be a short life, it matters”. We must amend the eligibility for assistance under the Bill to 25. I beg to move.

[Baroness Watkins of Tavistock (CB)]

My Lords, I support this amendment in principle, based on the research in relation to cerebral development. I think it is well made and an example of something that we are really here to think through to enhance the Bill. However, I point out that the Bill excludes anybody with a lack of capacity, so several of the people that the noble Baroness referred to would not be entitled to consider assisted dying.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

I guarantee to the noble Baroness that the age is not going to go down from 18 as far as this Bill is concerned. The future is not in my gift, unfortunately. However, as far as the future is concerned, it is extremely unlikely that a subsequent Parliament is going to reduce that age.

[Baroness Berger (Lab)]

My Lords, this has been an important debate that really has encapsulated what this House is here to do. There are, of course, other amendments in this group from the noble Baroness, Lady Goudie, and the noble Lord, Lord Moylan, that we have not discussed. It is worth just putting on record that these seek to prevent discussions with children and will be an essential question to scrutinise and discuss in the next group.

I just wish to very briefly respond to three points that have been made during this group, because it is relevant and important to conversations that will no doubt continue because of the weight of opinion and support that has come forward for these amendments.

I listened very closely to the noble Baroness, Lady Fox, and I just want to make clear that, for all these young people, it is not the exception. It is impossible to imagine a young person who would not have an EHCP. That is the context in which I presented and spoke to these debates. It is not just a small group: we anticipate all of them, apart from a young person who might receive a terminal diagnosis over the age of 25 and will not have time to have an EHCP. Otherwise, we are considering all young people in this context of an EHCP that local authorities have a statutory responsibility for, and it is in that context that I make those representations.

I listened very closely to my noble friend Lord Winston, and he did make some important comments. It is clear that there are some elements of brain development that do evolve and complete by the age of 18, but there are many others that do not. Global experts and authorities on adolescent brain development such as Professor Laurence Steinberg, Professor Casey, who is the expert on neurobiological maturation, and Professor Jay Giedd, who is the MRI pioneer in adolescent brain research, all say that the prefrontal cortex responsible for executive functions does not reach its maturity until the early to mid-20s, continuing to develop well past the age of 18, and that an 18 year-old does not yet have the capacity.

I am reminded again that we have heard a lot of comments from Professor Sarah-Jayne Blakemore. She is the leading UK neuroscientist on adolescence, and she has said that an 18 year-old does not yet have the fully mature capacity for long-term planning and evaluation of consequences that characterises adult executive functioning. We should listen to her comments very closely.

Finally, my noble friend Lady Hayter said that young people would not be asked—it would be something they would request. I would point out that the Bill does enable a doctor to raise this with anyone from the age of 18. It is in that context that I have brought forward these amendments.

I will not refer to all the other important contributions and comments that have been made, but I want to make one final point. It has been very clear from the debate in the other place that even some of those most in favour of assisted dying in principle are highly concerned about the risk of children and young people being drawn into it. The amendments in this group have sought to act on both their concern and the evidence that this House took during our own Select Committee. In all the debates we have had on the Bill, and will no doubt continue to have, we have to grapple with the simple fact that there is no going back if we get it wrong. For young people in particular, we should, as we have been asked to do, err on the side of caution.

I am very glad to hear that my noble and learned friend Lord Falconer will consider an assessment for those aged 19 to 24, but I urge him to accept the simplest and strongest safeguard of all, which is to raise the eligibility to 25. I look forward to further discussions on these matters. With that, I beg leave to withdraw the amendment standing in my name.

Amendment 4 withdrawn.

--- Later in debate ---

from the Bill.

[Baroness Berger (Lab)]

My Lords, I will very briefly raise my serious concerns about the three amendments that remove the specification for domestic abuse training. They are Amendments 290, 366 and 931. In the Commons, this was a significant area of concern for all MPs, specifically the risk to those suffering domestic abuse, and, as such, the sponsor of the Bill there accepted the amendment that introduced explicit requirements for training on domestic abuse, including

“coercive control and financial abuse”.

I listened very closely to the intervention from my noble and learned friend about the definition contained in Clause 56(2) that refers to control and financial abuse. But just because the definition of domestic abuse in the Bill includes coercive control and financial abuse, that does not mean training on domestic abuse will always include both those things. A training provider would not have an obligation under the Bill to cover all aspects of the definition, whereas the Bill, as currently drafted and as we received it, includes specifically both coercive control and financial abuse in that training. I urge my noble and learned friend to reconsider those amendments, based on the contributions in the other place, and to ensure that training covers and encompasses all those specific elements.

[Baroness Finlay of Llandaff (CB)]

My Lords, I have some questions for the noble and learned Lord, Lord Falconer, about his Amendment 6, because my concerns also relate to the amendment in the name of the noble Lord, Lord Moylan. It does not seem to reflect the way that seriously ill children behave.

I have looked after children dying of malignancies. They knew that they were dying and asked really straightforward questions. They would ask about how they would die and would want to have in-depth conversations. I recall one little boy who asked me if he could play football in heaven, after another little boy in an adjacent room had died a few weeks earlier. These children asked for explicit details and wanted to have lots of conversations. Another one said that he would die after his goldfish died. Sadly, that was prophetic and when he was close to death, he asked his divorced parents to come in and promise to look after his siblings together. These children know each other; they want to ask questions and need to have them answered.

I am not sure how, with Amendment 6, doctors are meant to respond to these children when they ask questions. At the moment, you respond gently and openly, and explore with them what they are really asking about in an age-appropriate way. I have a concern that this could make people feel risk-averse about having open communication with these children, and let children remain isolated with their fears. They hear about assisted dying on the news and in the media; the ethical aspects are part of the senior school curriculum in some areas. I am really concerned that Amendment 6, while well-intentioned, and the adjacent amendments, might actually make the day-to-day looking after of these children as they are dying more difficult.

Amendments 170 and 405 seem to lower the threshold for communication. I am grateful to the noble Baroness, Lady Coussins, for pointing out that whenever an interpreter is used they must be a registered public service interpreter, to avoid the poor communication scenario which I referred to last week. Speech and language therapists are essential, so can the noble and learned Lord, Lord Falconer, explain how with one would judge “effective”, as is listed in his amendment, and assess “reasonable steps”? These seem very subjective and I am not sure how they would be monitored. Others have spoken to the other amendments, so I look forward to hearing the comments from the noble and learned Lord.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

My Lords, I am grateful for all the interventions. These changes are only drafting changes. Some legitimate points were made, particularly by the noble Baronesses, Lady Finlay and Lady Lawlor, but they did not really go to the drafting points.

I go to the concerns various Members have expressed. Amendments 6 and 7, tabled by the noble Baroness, Lady Coffey, would prevent doctors having a conversation with people—I am not saying this in a bad or a good way, but that is what she wants to do—particularly before they reach 18. There is a point there, but it is nothing to do with the change I have introduced in my Amendment 6. My amendment would simply make it clear that there has to be a preliminary discussion before you can go ahead to assisted death. I have done that to make it clear that it is one of the eligibility conditions; it says nothing about what should be talked about or whether such a conversation should take place under the age of 18.

In fact, as the noble Baroness, Lady Coffey, said, Clause 6 states:

“No registered medical practitioner or other health professional shall raise the subject of the provision of assistance in accordance with this Act with a person under the age of 18”.


I do not think that the noble Baroness’s amendment would add to that protection. The key point is that all Amendment 6 is doing is saying that you have to have a Clause 5 discussion.

The next point, raised by a number of Peers, is that I am watering down the protection in relation to domestic abuse. That, as a matter of drafting, is wrong. It is only a matter of convenience that, having defined domestic abuse as including everything so defined in the Domestic Abuse Act 2021, you get coercion, control and economic abuse as forms of domestic abuse. To avoid having to repeat that every time the Bill refers to training, I have simply referred to domestic abuse, and that is then defined at the top of page 41. I very much hope that people will accept that that is the position.

The noble Baroness, Lady O’Loan, who is shaking her head, raises a different point about the position in relation to abuse that is not domestic. Perhaps your lawyer is exercising undue influence on you. That is a point that I will respond to in writing, but it is not a point raised by my drafting change, because all the restrictions have been in relation to domestic abuse, not to what the lawyers would call undue influence. But it is a perfectly legitimate point, which I will come back to in correspondence with her.

[Baroness Berger (Lab)]

On this very point, and for the record, I think many noble Lords will want to hear specifically how my noble and learned friend’s Bill will ensure that, when it comes to the training, all elements of domestic abuse as set out will be covered in that training, particularly given the concerns raised both here and in the other place.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Goddard of Stockport (LD)]

I respectfully accept that position. The problem is that the more I speak, the more I will be intervened on, which is the opposite of what I am trying to do; I am trying to speed the process up.

All I am trying to say is that we all want the best Bill possible. I get that. If that cannot be managed, something else will have to happen. I was only trying to bring in the evidence of three former Directors of Public Prosecutions. One of them, because people had said, “We’ve had no real-life experience”, actually advanced to us, “I’ve got Parkinson’s disease and I’m going to die. I have a terminal illness”. He actually said that to the committee, and added that if the Bill passed he hoped to avail himself of it. That is just one little anecdote from probably the only person who gave evidence who actually has a condition, which he confirmed to us freely. He was not asked to do that.

All I am trying to do is balance the evidence, because a lot of people are quoting evidence. I want to try to redress that a bit and to gently move this on a bit quicker. I have completely failed, because I have been standing up for nine minutes. I apologise to the Committee for taking up too much time.

[Baroness Berger (Lab)]

I am very grateful to the noble Lord for giving way. I will make a point that has been raised on a number of occasions, about what happened in the other place and the number of hours that were dedicated to the Bill there. It is important to put on record that this House received a Bill that is very different from the Bill as it was first presented to the House of Commons. Many hours were taken up in the other place on a Bill that was completely altered. I will point to one particular issue. The process massively changed from a judge-led process to a panel. In fact, of the 91.5 hours of debate in Committee in the other place, 62 were on a Bill that still had the High Court process in it. So we have to reflect in our deliberations that many hours were rightly taken scrutinising the Bill in the other place, but we have now received it in a very different form.

[Lord Goddard of Stockport (LD)]

I accept the noble Baroness’s position. Perhaps a High Court judge might resolve the issue, then.

Terminally Ill Adults (End of Life) Bill

Baroness Berger Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, I shall be very brief. The definition at the beginning is a most important matter. I am quite clear, having heard noble Lords make a number of very sound observations, that “capacity” is an essential term. That is the first thing. However, it is not sufficient, and it has to be added to. I say that because the Mental Capacity Act states explicitly that a person is not treated as lacking capacity merely because they make an unwise decision. That is a very different situation from what we will be dealing with in many cases going forward. I urge the House, when this comes back on Report and preferably beforehand, and the promoters, to consider adding simply “and ability” so that it reads “capacity and ability” because they are different concepts, and they are necessary if this is to work properly in future.

[Baroness Berger (Lab)]

I wish to respond briefly to two points. I have every admiration for the noble Baroness, Lady Hayman, and I definitely concur that we have a responsibility in this House. I also gently remind this House that there were a number of Members of the other place who said, both in writing to their constituents and in their spoken contributions in the House, that they were essentially outsourcing the job to this place for us to ensure legislation that is fit for purpose. I regret that that is the case. I think there are many of us on all sides of the debate, on both sides of this House, who would wish to see a government Bill, which has been the case with previous Private Members’ Bills that have been adopted by the Government. We would have more time and opportunity to ensure that we have robust legislation.

In the absence of that, in the process that we find before us, I want to share with the Committee—I was going to bring it up in the next group but in light of the comments and the contributions that we have heard so far I think it is important to share on record—the comments that we heard in the Select Committee from the Royal College of Psychiatrists. It is a professional body that was called to give evidence on behalf of its members as one of the pillars of the process, as one of the pillars of the panel.

We heard from Dr Annabel Price, who is the lead for the Royal College of Psychiatrists on the Bill. She is an eminent expert in this space. She shared with us that the college had very carefully thought through its position and its views and that it had asked for a review of the Mental Capacity Act’s suitability because it believes that the Bill currently states that a person is eligible if they have the capacity to make a decision to end their own life, but this framework has not been tested for this particular decision. There are principles within the Mental Capacity Act that the college is not certain are compatible with this decision and need to be thought through more carefully.

I think we should heed that warning and listen very carefully to that college whose members will be responsible should this legislation go through. Therefore, in the context of the amendment moved by the noble Baroness, Lady Finlay, I think it is important for us to consider this in terms of how we inform our debate going forward, which is relevant to this group and to the group that follows.

Goodmayes Hospital Mental Health Facility

Baroness Berger Excerpts

Thursday 13th November 2025 Lords Chamber

Asked by

[Baroness Berger]

To ask His Majesty’s Government what assessment they have made of failings at Goodmayes Hospital mental health facility.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, what happened at Goodmayes Hospital was totally unacceptable and I offer my sincere condolences to Alice Figueiredo’s family and loved ones, who have suffered an unimaginable loss. The trust failed in its basic responsibilities to Alice, and I expect—and we are working to ensure—that it will prioritise the safety of its services. I understand that the trust has taken steps to improve services and reduce risk, including changes to ward environments, better training in suicide prevention and investment in recruitment and retention.

[Baroness Berger (Lab)]

I thank the Minister. It was back in July of 2015 that Alice Figueiredo took her own life using a bin bag from a shared bathroom. She was just 22 years old. Recently leaked documents reveal that, just four months later, another young woman from the same ward attempted to harm herself in an almost identical manner. However, these are not isolated incidents. In 2023, three women died in a Priory psychiatric hospital within two months. I ask my noble friend the Minister: what are the Government doing to ensure that therapeutic care is provided, and lessons are really learnt, so that we do not see any further tragic loss of life from any aspect of the mental health in-patient estate?

[Baroness Merron (Lab)]

I am grateful to my noble friend for raising this in this way. National guidance is being developed, which is expected soon—in January—on plastic bag use in mental health settings. The Thirlwall inquiry has also recently reviewed progress against the important recommendations of the report of Professor Williams, which were very much addressed at the role of healthcare regulators of NHS bodies and the CPS. In addition, the NHS national oversight framework now gives a transparent assessment of the performance of every trust in England, which means that those with the greatest challenges or concerns will receive enhanced support. In addition, it means that the CQC, as we move it to a new intelligence-led model, is able to conduct rapid response inspections where concerns are identified, so that we can get on top of problems before they produce the tragic consequences my noble friend refers to.

Artificial Intelligence: Safeguarding

Baroness Berger Excerpts

Tuesday 4th November 2025 Lords Chamber

Asked by

[Baroness Berger]

To ask His Majesty’s Government, following recent reports by Open AI that many people have exhibited signs of suicidal ideation or other mental health emergencies while messaging a generative artificial intelligence chatbot, whether they have plans to safeguard such individuals.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, safeguarding people experiencing suicidal ideation or a mental health crisis is a priority. We recognise the growing use of generative AI chatbots and the potential risks that they can pose, particularly when people seek support during moments of acute distress. Whether content is created by AI or humans, the Online Safety Act places robust duties on all in-scope services, including those deploying chatbots, to prevent users encountering illegal suicide and self-harm content.

[Baroness Berger (Lab)]

My Lords, ChatGPT is giving British teens dangerous advice on suicide, eating disorders and substance abuse. A report from the Center for Countering Digital Hate found that, within two minutes, the AI platform would advise a 13 year-old how to safely cut themselves; within 40 minutes, it would list the required pills for an overdose; and, after 72 minutes, it would generate suicide notes. Can my noble friend confirm that Ofcom will treat ChatGPT and other chatbots as search engines under the Online Safety Act, and assure the House that the regulator has both the powers and the will to enforce the protection of children code when it comes to generative AI platforms such as ChatGPT?

MBRRACE-UK Report 2025

Baroness Berger Excerpts

Thursday 23rd October 2025 Lords Chamber

Asked by

[Baroness Berger]

To ask His Majesty’s Government what assessment they have made of the MBRRACE-UK 2025 report Saving Lives, Improving Mothers’ Care 2025: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2021–23.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, although the maternal mortality rate has slightly decreased recently, this report makes it quite clear that further urgent action is needed. That is why this Government have launched an independent investigation into NHS maternity and neonatal services, with interim findings expected in December. Moving from care to prevention, the publication of a new maternal mortality care bundle planned for next month targets the five key areas that disproportionately contribute to maternal mortality.

[Baroness Berger (Lab)]

I thank my noble friend the Minister for her reply. I want to ask specifically about the issue of late maternal deaths, which were significantly higher in this reporting period. Deaths linked to mental health issues, including suicide and substance use, were the leading cause of late maternal deaths. Almost half of women who died by suicide were from the most deprived areas. What can we do to stop it being the case that if you are from a poorer background, you are most likely to take your life during this period? Would the Minister consider introducing an urgent referral pathway for women with complex social needs?

[Baroness Merron (Lab)]

My noble friend is quite right in her observation. The maternal care bundle will be a real focus for change and tackling inequalities. Maternal mental health is one of the areas that has been identified for urgent action, because of the ability to improve outcomes and reduce inequalities. Identified pathways, as she describes, are part of the solution that we have under way.