Terminally Ill Adults (End of Life) Bill

Baroness Blackstone Excerpts

Committee stage
Friday 13th March 2026 Lords Chamber

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I have added my name to Amendment 149 in the name of my noble friend Lady Grey-Thompson. I also support the principle underpinning Amendments 150, 151 and 154, all of which aim to prevent a medical practitioner initiating discussions on assisted dying under Clause 5 of the Bill.

Like the noble Lord, Lord Shinkwin, I thoroughly agree that doctors must not be permitted to initiate conversations about assisted dying to patients. Let me tell your Lordships why. Doing so would breach their fundamental duty of care to their patients at the very point when the patient may well be at their most fragile—newly diagnosed and frightened about what the future holds. It would not be a neutral clinical act but an intervention laden with power, meaning and consequence. The very suggestion of assisted death from a doctor at such times risks being heard not as an option but as a judgment.

Not long ago, during the scariest time of the Covid-19 pandemic, disabled people were contacted by their GPs to ask them to allow permission for DNR notices to be placed on their medical records should they be hospitalised after contracting the virus. Disabled people were horrified; many contacted me and other parliamentarians to know why they were being treated differently from non-disabled people. They said that it felt as though catching Covid would be a death sentence. Thankfully, the Secretary of State for Health rectified the issue, reminding doctors that their actions were in contravention of the Equality Act and the Human Rights Act, but the damage was already done. Disabled people who relied on their doctors for their health and well-being felt betrayed and unworthy of life-saving treatment.

If a medical practitioner raises the possibility of an assisted death, the patient’s feeling of security and trust will be damaged in the same way as during the pandemic. Your Lordships have often heard me say that I count my blessings every day because my doctors support and celebrate my life, however ill I become. I feel secure knowing that they will do their absolute best, however grim my prognosis may be. Reliance on that assurance is critical to the well-being of patients, especially those with long-term disabilities.

If assisted dying is to become an option, it must be one that is strictly patient-initiated, tightly defined and clearly demarcated from ordinary clinical care. It must sit within a system that prioritises palliative care, practical support and the affirmation of life; otherwise, it will be seen as the simplest and most straightforward option for the patient, their family and friends, the NHS and society as a whole.

The doctor-patient relationship is inherently unequal, and never more so than after a terminal or life-limiting diagnosis. When a doctor introduces the possibility of assisted dying, however delicately phrased, it carries weight. For many patients, particularly those who already feel themselves to be burdensome, costly or devalued, the message risks being internalised as a subtle signal that their lives are no longer worth living.

We must also confront the reality of acute vulnerability. A diagnosis of serious illness often brings shock, despair and temporary suicidal thoughts—feelings that, with time, treatment and compassionate support, frequently pass. This is why I support my noble friend Lady Grey-Thompson in her Amendment 149, which seeks to address this. Depression, unmanaged pain, fear and loneliness are not unusual bedfellows for people with a terminal diagnosis. Medical practitioners are not specialists in disentangling these states.

If we are serious about safeguarding autonomy, our first duty is to ensure that people are offered care, hope and practical support, not an expedited exit at a time when they feel most afraid. I therefore hope the noble and learned Lord will recognise this and come back with his own amendments on Report, to ensure that the subject of assisted dying is raised only by the patient and never by a medical practitioner. I would be very pleased to meet him between now and Report to explain further why this is so essential for the legislation to be safe in practice.

[Baroness Blackstone (Lab)]

It is with some trepidation that I speak, since I realise how passionately the previous speakers think about what they have said. The first small point I want to make is that the noble Baroness, Lady Campbell, referred to Report—we are not going to have a Report stage, because we have taken so long in dealing with all the many, many amendments that have been tabled.

Leaving that on one side, we have to realise that doctors’ main objective is to try to alleviate suffering. This is what those of us backing the Bill believe it does: it will alleviate suffering—sometimes terrible suffering—and torment by allowing people to choose the time of their death when they are already dying. We must not forget this. If we accept that this is the role of doctors, that this is what they try to do in their professional work, we must allow them to discuss at an appropriate point, in their judgment, all the possible options that are available to the dying person. If the Bill were enacted, one of the options would be an assisted death if they had reached that point. So to say that a doctor in a close relationship with his or her patient would be unable to raise this as a possible option would be entirely wrong.

I advise everybody, if they have not done so already, to look at what the BMA says about this. It has specifically briefed against prohibiting doctors from initiating discussion about assisted dying under the Bill, warning that it will be detrimental to patient care. I accept this piece of advice from the BMA. It is a view that many doctors, and some in this Chamber, too, would actually adhere to and agree with.

I very much hope that this group of amendments will not be accepted. It does not mean that at the end the patient is not the one who makes the decision about whether to request an assisted death—of course he or she does. But it just becomes one of the options that is available to them, and that is an option I believe we should allow them to be aware of.

[Lord Goodman of Wycombe (Con)]

My Lords, I will speak to my Amendment 151, which is supported by the noble Lord, Lord Carlile, and the noble Baronesses, Lady Fox and Lady Hollins. It was also referred to approvingly by the noble Baroness, Lady Campbell, in her earlier remarks. My amendment would prohibit medical professionals from raising assisted dying as an option, unless explicitly requested by the patient.

I will be very brief in introducing this amendment, by pointing out to the Committee that it goes to the heart of a juxtaposition suggested by the Bill. On the one hand, we have an increasingly large, frail, vulnerable, often elderly population, who may not have the full autonomy that the sponsor of the Bill suggests. On the other hand, we have a National Health Service that, by the nature of events, is almost always underfunded and feels that it will be underfunded. If you put those two things together, there will be an inevitable pressure to cut costs and present the cheaper option to the patient who is seeking guidance.

I have carefully read the sponsor’s words in Clause 5 and it is true that, on paper, the patient must be offered the option of palliative care as well as that of an assisted death. However, in these circumstances of financial restriction, I am concerned about the patient being steered in a certain direction. I will not regale the Committee with horror stories from abroad, usually from Canada, about precisely this taking place. Were I to do that, the sponsor of the Bill and others would, quite rightly, point out that there are safeguards in the Bill that are not present in Canada. I would point out in return that safeguards can be whittled away over time. In making that point, I mean nothing to the detriment of the sponsor of the Bill; I am sure that he does not mean it to happen but, over time, people can make amendments and changes to legislation.

I will step back from this amendment and look at it in this way. I believe that assisted dying is intrinsically problematic and, if the Bill ever got further, I would vote against it at Third Reading. However, my concern while we are here is to improve the Bill. If we are to have such a Bill, I want it to be in the best—I should say the least bad—condition possible. Noble Lords know that nothing in the amendment would alter the basic architecture and structure of what the sponsor of the Bill has proposed—in relation to the first doctor, the second doctor, the panel, proxies, the regime for regulating substances or any of that. The amendment would do nothing whatever to prevent anyone seeking an assisted death. All it would do is to prevent a medical professional raising it.

Therefore, I suggest to the noble and learned Lord the sponsor that, if he wants to make some progress with the Bill, he might accept this amendment or one of the many others in this group to a similar end. I look forward to hearing him when he replies but, whether he does accept it or not, this amendment would write a safeguard into the Bill that is not there, and I commend it to the Committee.

--- Later in debate ---

[Baroness O’Loan (CB)]

My Lords, I will speak to Amendments 150, 156, 166 and 205, to which I have put my name, and in support of other amendments in the group.

As drafted, the Bill would permit a discussion about assisted dying with the patient before any requirement to discuss expert palliative care. The noble Baroness, Lady Blackstone, said that it would be irresponsible not to allow this. In Australia and New Zealand, doctors are not permitted to initiate such discussions.

As drafted—

[Baroness Blackstone (Lab)]

Doctors in Australia are now allowed to do so. The law has been changed there.

[Baroness O’Loan (CB)]

I accept the noble Baroness’s intervention, but they certainly thought it was a bad idea, and there is further discussion in South Australia about the issue.

If I may go on: as drafted, the Bill will permit discussion about assisted dying before discussion about palliative care. It would come as something of a shock—

Humanist Weddings

Baroness Blackstone Excerpts

Monday 3rd February 2025 Lords Chamber

[Lord Ponsonby of Shulbrede (Lab)]

I can answer that for the noble Lord, Lord Lilley. A registry office wedding is legally binding in the eyes of the law in England and Wales. A humanist wedding which is not conducted in a registry office would not be legally binding in that sense. A humanist getting married in England or Wales would essentially have to go through a two-stage process to be married in the eyes of the law in England and Wales.

[Baroness Blackstone (Lab)]

My Lords, I congratulate my noble friend on dropping the rather meaningless phrase “in due time” and telling the House that this is going to be done in the coming months. By that, I assume that it will be within 12 months, because he said in the coming “months” and not in the coming “years”. Can he assure the House that we will have legalised humanist marriages within the next year—in other words, in 12 months?

[Lord Ponsonby of Shulbrede (Lab)]

I am very glad that noble Lords have noticed the change in wording since the last time this matter was discussed at Oral Questions. The commitment is that in the coming months we will review the situation in the light of the Law Commission submission, and we are well aware of the Labour Party’s commitment in the manifesto.

Sentencing Review and Prison Capacity

Baroness Blackstone Excerpts

Wednesday 23rd October 2024 Lords Chamber

[Lord Timpson (Lab)]

When I first walked into the Ministry of Justice and was told that the prison population goes up by 80 people a week, I thought that was manageable. But when you times that by 52, and then by five, you realise the scale of the problem. There are a number of examples of similar situations where people have done things differently. While we have a big problem on our hands, we need to make sure that it becomes a big opportunity to change things, because something is clearly not working.

I will give noble Lords the example of Texas, where they decided that a number of non-violent and first-time offenders would not go to prison but would serve community sentences instead—a number of other states have done similar things. I mentioned earlier that highly prolific low-level offenders actually went to prison for longer. Texas also introduced good-behaviour credits, an incentive scheme for people to behave in prison. Crime went down by 29% and 16 prisons have closed. So we should take hope from the fact that, if we use the evidence and take our time, we can learn from other examples. However, it will take time for the increase in prison numbers to slow down: these things, unfortunately, do not happen quickly enough.

[Baroness Blackstone (Lab)]

My Lords, I greatly welcome the Statement and the Government’s decision to tackle penal reform, which is long overdue. It is absolutely right to put far more emphasis on non-custodial sentencing. If I have any reservations, they are about embarking on another prison-building programme. The problem is that supply creates demand. Does my noble friend the Minister agree that the decision to expand the number of prisons should be reviewed in the context of improvements in non-custodial sentences and their effectiveness, and in the context of David Gauke’s review of sentencing? There is also a case for closing some prisons, even if new ones are to be built, because many are appalling buildings with inadequate accommodation and terrible facilities, and they should go. Perhaps the Minister could also address that question.

[Lord Timpson (Lab)]

When I walked into Preston Prison, there was a big board next to the governor’s office, with the names and dates of all the governors of the prison from when it first opened. The first governor started working there in 1798; I walked up the same steps that the first prisoners walked up in 1798. So, clearly, we have a problem with lots of old, dilapidated prisons, house blocks and other parts of the prison estate; unfortunately, we need to build new prisons.

It will take time for our reforms to reduce reoffending. It is one of my goals, and I managed to get it into my job title: Minister for Reducing Reoffending. The more we can reduce reoffending, the fewer prisons we will need. Maybe in 20 years’ time we will look to close the prisons built in 1798—but, for now, I am afraid, we need all the space we have got.

Humanist Marriages

Baroness Blackstone Excerpts

Tuesday 29th November 2022 Lords Chamber

[Baroness Bakewell]

To ask His Majesty’s Government when they intend to give legal recognition to humanist marriages.

[Baroness Blackstone (Lab)]

My Lords, I beg leave to ask the Question standing in the name of my noble friend Lady Bakewell on the Order Paper.

[The Parliamentary Under-Secretary of State, Ministry of Justice (Lord Bellamy) (Con)]

My Lords, the Law Commission recently published its report on reforming wedding law in England and Wales. We must consider the 57 recommendations in full. It is important that we balance the needs and interests of all groups, religious and non-religious, and very carefully consider the implications of changing the law. I hope to be able to publish our initial response in the first part of next year.

[Baroness Blackstone (Lab)]

My Lords, I thank the Minister for his reply but I must say that I am a little disappointed by it. The Law Commission, to which he referred, took no position on this question. It did not make a recommendation one way or the other. That is because this is a political decision. What is preventing the Government from going ahead and laying an order under the 2013 Act, getting it done now, and stopping once and for all the discrimination against humanists in this area?

[Lord Bellamy (Con)]

My Lords, in a nutshell, the Government’s position is that to lay an order under the 2013 Act solely in favour of humanists would discriminate against other groups—Muslims, Sikhs, Hindus and so forth—in permitting them to have a particular form of marriage not available to other groups. The Government’s position is that we must go forward together and solve the whole problem. I will elaborate in a moment on what the problem is.

Assisted Dying Bill [HL]

Baroness Blackstone Excerpts

2nd reading
Friday 22nd October 2021 Lords Chamber

[Baroness Blackstone (Ind Lab)]

My Lords, I support this Bill, as an assisted dying law is needed to address the unacceptable suffering of dying people and the dangerous lack of protections in the current law. Since assisted dying was last debated, we have stronger, more compelling evidence that the current blanket ban on assisted dying does not work. We know that people are forced to travel overseas to exercise control over their death, that some people remain beyond the reach of even the best palliative care and that others are being driven to end their lives in lonely and violent ways.

My grandmother was in the third of these categories. Terminally ill in hospital, riddled with cancer and suffering horribly, she desperately wanted to die. One night, she took her own life by swallowing sleeping pills that she had brought into hospital with her. My mother found the empty pill bottle in her bag the next day. How much better it would have been for her if assisted dying had been available, allowing her children and grandchildren to be with her, providing her with comfort, affection and love, instead of her terribly lonely death after prolonged suffering.

Research published this week by Dignity in Dying estimates that, like my grandmother, up to 650 dying people end their lives each year and up to 6,500 try to do so. We must acknowledge just how many people are adversely affected by the current blanket ban on assisted dying. In 2015, during the Committee stage of the Assisted Dying Bill of the noble and learned Lord, Lord Falconer, amendments tabled to the Bill that would have inserted the phrases “assistance with suicide” and “commit suicide” were rejected by this House in recognition that the word “suicide” does not accurately reflect the assisted dying process. Some opposing this Bill are, again, referring to assisted suicide, but they should know that they are out of touch with the public when giving this description of what this Bill would legalise: 73% said that the Assisted Dying Bill was the appropriate title, whereas just 10% said it should be the Assisted Suicide Bill.

People who are terminally ill and near the end of their lives want to control the way they die. Presenting this as suicide is misleading: it does not reflect the academic literature or the views of dying people and their families. A change in the law would reduce anxiety and horrible suffering. It would create a law that would be open, transparent and, above all, humane, with strong protection through appropriate safeguards for the vulnerable. It would respect public opinion, given that 80% of people of faith and an overwhelming 84% of the general population support assisted dying.

Assisted Dying Bill [HL]

Baroness Blackstone Excerpts

Friday 18th July 2014 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I congratulate my noble and learned friend Lord Falconer on introducing this Bill. Parliament must have the courage to consider these issues, as the Supreme Court has said. The current law is not working and those who claim that it is are being complacent. The law now needs to be clarified, as others have already explained so well.

We live in a society that promotes individual autonomy and values allowing its members to choose how they spend their lives. We value freedom of speech, of association and of movement. We value tolerance and allowing people to make their own choices, even if we wish to make different choices. The same freedom of choice that applies to how we live should also apply to how we die. If we respect human rights, we should not deny those who know that they are dying the right to bring their lives to a more rapid end to alleviate their misery.

I do not normally talk about my own experience in this House but today I will break my own rule. I have been haunted for a long time by the death of my grandmother, to whom I was very close. Hospitalised with terminal cancer, she longed to die and to escape her agonising pain. She told my mother that she had a bottle of sleeping pills with her, prescribed before she went into hospital. The morning after my grandmother died, my mother found the empty pill bottle in her handbag. She had made her decision without being able to talk about it, and taken the pills with no one to hold her hand or comfort her—with no one to say goodbye to—by herself in a hospital bed.

When my former husband was diagnosed with stomach cancer and given six to nine months to live, eventually becoming overwhelmed by horrible pain and terrible discomfort, he was cared for at home by superb hospice nurses, for whom I had the greatest admiration. But it was harrowing for him and for those who loved him. Ten days before he died, he said to me, “I just want this to come to an end”. I asked the health professionals if they could help him to die as he desperately wanted. Of course, they could not.

Those who argue that palliative care can always ensure a peaceful and painless death are flying in the face of the evidence, as I know from my own experience. I greatly admire the doctors who have chosen this specialism, and of course I want to see more patients benefiting from palliative care, but I would admire them much more if they admitted that not everyone can be freed by this treatment from the viciously painful death that they are suffering. It would be more compassionate to accept this and to reflect on a system that combines palliative care with legally assisted dying for those whose suffering has become unbearable.

I have received many letters from members of the public describing the horrors of the prolonged and painful deaths of people they love, or violent and lonely suicides such as that of my grandmother. These letters are of course anecdotal, as is my own experience, but what is not anecdotal is the strength of public opinion about the need for a change in the law. As others have said, opinion polls show that an overwhelming proportion of those asked favour change. A recent survey also showed that most Anglicans, Catholics and Jews back assisted dying. So I beg religious leaders to respond to the views of their congregations. I also hope that those who are against this carefully constructed Bill will think again by looking at the evidence from Oregon, where assisted dying has not led to the slippery slope or to countless dying people being pushed into it.

Let us be clear: the safeguards in the Bill are strict. The numbers wishing to make use of its provisions will be limited. Let us therefore back it in the interests of love for our fellow human beings, compassion, the relief of suffering and respect for the right of individuals to make their own decisions.