Terminally Ill Adults (End of Life) Bill

Baroness Keeley Excerpts

Friday 13th March 2026 Lords Chamber

[Baroness Berridge (Con)]

My Lords, probing Amendment 200C, in my name, would prohibit people from raising with children assistance in taking your own life, and deals with the method by which the issue of assisted dying can be raised with someone under 18. It particularly should not be raised online. The amendment seeks to extend Clause 6.

I first note my support for Amendment 210, just outlined by the noble Lord, Lord Rook, on the consequences for breaching Clause 6. Further, I wish to support Amendments 157 and 164, in the name of my noble friend Lord Ahmad and spoken to by my noble friend Lord Evans. It is entirely sensible to enable people to opt out of being offered such an assisted suicide service.

The Bill seems to have no limit, nor is it probably possible to place a limit, on the number of times assisted suicide could be raised with a patient, so it is surely consistent with autonomy to give the patient the right to opt out. One need think only of a GP surgery, and the number of GPs or nurses you see. If each of those people raises it with you, that could possibly even border on harassment. Conceptually, it is an extension of the freedom of conscience that we give to organisations and clinicians to opt out of the service. I hate to think that even dealing with a GP surgery could perhaps become part of Patchs.

This leads me on to the means by which issues can be raised, which has radically changed, and why my amendment includes online. I am grateful to the noble and learned Lord for filing comprehensive amendments in relation to advertising, but the issue of raising it with someone under the age of 18 is different. I would like assurance from the noble and learned Lord that this use of social media—for instance, someone sending a TikTok or something like that about assisted suicide—is covered by Clause 6.

That example may seem straightforward, but, once again, it brings into focus the analogue nature of the Bill. If ChatGPT, for instance, in response to a question which it mishears, tells someone under the age of 18 all about assisted dying in the Bill, is that covered by the amendments on the prohibition of advertising that the noble and learned Lord has raised? Could a bot or algorithm operate without direct human intervention and raise with a child the issue of assisted dying?

Noble Lords will be aware—the noble Baroness, Lady Berger, has spoken much on this—of the cases that are currently being taken against ChatGPT, in which OpenAI is the litigant. It is being sued for giving suicidal information to young people, who have, incredibly sadly, acted on that information. Has the noble and learned Lord spoken with technology experts about the Bill to ensure that all of these situations have been fully considered? By my reading, I do not believe that they are covered by the prohibition on advertising. As I say, advertising and raising it with someone seem to be two different concepts.

I used the word “person” in the amendment, not just “healthcare professional”, as there are numerous situations and relationships where children might have assisted dying raised with them—obviously that includes at school or college. Does the noble and learned Lord envisage that there will be guidance in this regard, and which one of the many delegated powers would be used under the Bill? What about youth groups, faith groups, sports clubs, carers or school transport? Parents need to know who is allowed to raise this potentially life and death issue with their children.

Assisted dying law will shape how children understand the value placed on life, disability and dependence. Vulnerable children may internalise the message that society is more willing to facilitate their death rather than fund their long-term care and inclusion. The concern of parents and carers around how this issue is raised with children could make the issue of PHSE teaching—namely, sex education—in schools look uncontroversial.

Although the scope of the amendment is wide—as I have said, it is probing—at least it is clear, whereas, alas, Clauses 6 and 56 are not. The phrase “No health professional” is in the title of Clause 6. It then uses the phrase:

“No registered medical practitioner or other health professional”


within the clause. This is a mixture of the definition of health professional in Clause 56. Usually, when you have an interpretation clause stating a definition such as “health professional”, you would then expect that term to appear consistently within the Bill. Nowadays, all you have to do is Ctrl+F to find every example to ensure that there is consistency throughout the legislation. Due to this mix of use of terminology, are physios or OTs included in these definitions and therefore within Clause 6? Although I accept that Clause 6 was added in the Commons, I am disappointed that the noble and learned Lord, the sponsor, has not got ahead of the curve here and laid his own amendment.

Finally, can we have clarification on whether the registered medical practitioner in Clause 5 can be a private GP or healthcare professional? People may have a financial interest as we believe there can be private providers of assisted dying services. It may be that I am correct in that understanding, and I presume the noble and learned Lord, Lord Falconer, will want to ensure that there is no conflict of interest or incentive in the matter. It is possible that the matter has been covered in the developments under the law since the medical devices report. However, due to the lack of pre-legislative scrutiny, it is not clear and I would be grateful if the noble and learned Lord could clarify that.

[Baroness Keeley (Lab)]

My Lords, I will speak to my Amendment 155, which is different to the amendments in the name of the noble Lord, Lord Ahmad, on patients who opt out. My amendment ensures that when a person has previously cancelled the process of obtaining assisted dying—having considered it as an option and then rejected it—they can continue to discuss their terminal illness freely with their medical practitioner without being pressed to reconsider assistance to end their life.

As we are hearing, we have had a great deal of evidence on this issue. In its written evidence, the Association for Palliative Medicine of Great Britain and Ireland observed:

“Doctors influence decisions made by their patients in conscious and unconscious ways and are themselves shaped by their personal and professional life experiences … if the patient clearly rejects AD, they may suspect that other treatments suggested by this doctor are driven by an agenda to shorten their lives or may otherwise result in this. This could lead to patients opting not to engage with palliative care or to the loss of trust in a medical practitioner or in the medical profession at a crucial time in people’s lives”.


There is a clear danger here. If a patient has already considered and rejected assisted dying and their doctor raises it again, it may appear as though the doctor is pursuing an agenda to shorten that person’s life. That risk to trust at the very moment when trust is most needed should not be created by the legislation before us.

I also want to refer to evidence given to the Commons by Dr Vicki Ibbett, an NHS specialty doctor in psychiatry with extensive professional and personal experience of suicidal ideation. She expressed serious concerns about the impact of the Bill on suicide prevention work and highlighted that the voices of people with lived experience of suicidal ideation were not heard in oral evidence sessions. Speaking about terminally ill people who may experience thoughts of not wanting to be alive, Dr Ibbett wrote:

“Thoughts of wanting to die have a known association with being given a cancer diagnosis and learning of being terminally ill … Suicidal ideation may have arisen as part of the response to a new diagnosis with a terminal prognosis. It may, therefore, be part of an ‘adjustment reaction’. Adjustment Disorder often settles without professional intervention. If it persists additional support may be beneficial. Assisted suicide should not be facilitated”.


My Amendment 155 therefore seeks to ensure that a doctor may not raise assisted dying with a patient whose medical records show they have previously cancelled a first or second declaration. When somebody has already walked back from that decision, the law should protect them from renewed pressure, intentional or not.

Finally, I will quote from a recent article by Jim McManus, national director of health and wellbeing at Public Health Wales, writing in a personal capacity. He wrote that

“no end-of-life decision happens in a vacuum. Choices are shaped by many things, and sometimes these are inequality, unmet need, patchy palliative care, and the grinding pressures of an overstretched NHS … People expressing a wish to die may be experiencing treatable depression, loneliness, or feelings of being a burden. The Royal College of Psychiatrists has raised concerns that the Bill’s safeguards are insufficient to protect people in exactly these vulnerable states”.


Amendment 155 is a small but vital safeguard, ensuring that when someone has stepped back from assisted dying, their decision is respected. At such a vulnerable moment, no patient should face renewed pressure; our priority must be to protect, trust and uphold compassionate, high-quality care at the end of life.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, what influenced me to look positively at a number of amendments in this group, and to table Amendment 150, was that some jurisdictions with assisted dying legislation explicitly prohibit doctors from initiating assisted dying discussions. I know that there was a bit of a row earlier about Australia, South Australia and New Zealand, but the truth is that people who have this legislation thought it was important to say that if a doctor raised this with the patient, it would breach professional misconduct. In fact, South Australia even used the wording “must not … suggest”. That is quite hard.

However, it is very interesting that this group of amendments holds importance for all of us. In other words, it cannot be assumed to be either filibustering or messing around, because we are citing places that have assisted dying, and they think that this is a very good and important safeguard—or that it is at least worth debating.

One reason they do that is the issue of autonomy, which I know is very close to the noble and learned Lord. The concern is that, if a doctor initiates discussions about assisted dying, it undermines the very principle of the Bill’s supporters, which is to ensure that the decision regarding assistance to end your own life is yours taken freely; it is patient-initiated. I was rather surprised to hear the noble Baroness, Lady Blackstone, cite the BMA. What happened to the patient-centric approach? We now have the BMA versus the patient. If a patient wants an assisted death, good—well, not good, but they can initiate the discussion and raise it themselves, if they want to; it is an autonomous decision.