Terminally Ill Adults (End of Life) Bill

Baroness Smith of Newnham Excerpts

Friday 30th January 2026 Lords Chamber

[Baroness Jay of Paddington (Lab)]

My Lords, I wonder whether the House will listen to the point made by the noble Baroness, Lady Gerada, which is that she is probably the only person in the House—and certainly the only person who has spoken this morning—who has had practical experience of assessing people. She spoke very well about the issues which have been raised this morning in relation to the Covid epidemic, saying that, “There was not a clinical or ethical necessity to see people face to face to make proper judgments”. I really want the House to accept that someone with that practical experience should be listened to.

I will make one other short point, which is that I am again surprised, frankly, by the number of people who have spoken this morning who, without, as it were, even mentioning the question of the circumstances of those who are terminally ill and are asking for assistance, talk so much about administrative procedures, the way in which a network might be formed, or the way in which technology could be used. Frankly, I would like to hear a little more from everybody who contributes about the circumstances and problems of those who are actually seeking assisted dying and who may well be those who, frankly, for one reason or another—because they are physically in a way that they cannot do it, or they are perhaps geographically remote or have other circumstances which prevent them being able to access a face-to-face agreement or a face-to-face assessment—none the less very much want an assisted death for their terminal illness. Their concerns should be the ones we primarily consider.

[Baroness Smith of Newnham (LD)]

My Lords, the noble Baroness, Lady Jay, just asked us to consider the circumstances of those who are seeking an assisted death, but I would like to give a salutary lesson—I am sorry to disagree with the noble Baroness, Lady Gerada.

My father was taken ill during the Covid pandemic. He did not have a smartphone and was not able to have an in-person consultation. He had jaundice. The message he came away with from speaking to a doctor on the telephone—the doctor had never met him—was, “It’s pancreatic cancer”. My father then spent weeks saying goodbye to all his relatives and friends. By the time relevant tests had been done, it was shown that he did not have pancreatic cancer.

That demonstrates one of the flaws of doing something remotely, which is: what are the messages? The doctors are not getting the cues and the patient is not necessarily hearing what the doctor is saying. I am sure that the doctor did not say, “Mr Smith, you have pancreatic cancer”—clearly, they could not have said that—but that was the message that my father heard. I therefore very strongly support the amendments in the name of the noble Lord, Lord Evans of Rainow, and two of the amendments from the noble Lord, Lord Blencathra.

However, I want to express one serious reservation about Amendment 406A from the noble Lord, Lord Blencathra. If the discussion has to be taken by video conference, it might not be appropriate to say that in every circumstance the only person who should be on that call is the patient. We all know that, when you go to the doctors, even if you are there in person, you have capacity, you are a rational person and you do not have any cognitive difficulties, you do not hear everything. Sometimes, if it is a difficult diagnosis, you do not take everything on board. For some people who are told that they have a terminal diagnosis and understand that that is the case—unlike in the false case of my late father, who did not have a terminal condition at that stage—we know what their settled will is. There are several people in your Lordships’ House who have what their settled will is very clearly on record, in the public domain. But there will be other people with whom the doctor has never spoken before, so they cannot know whether it is somebody’s settled will in a way that the legislation requires.

If, then, there has to be a video conversation, or indeed an in-person conversation, it might be appropriate for there to be an independent advocate or somebody else who would support that person and could say, “The doctor did not really say that, you know”. We need to think about real-life cases. Yes, we need to understand from the medical profession, and it needs to be from the perspective of somebody with a terminal diagnosis, but we also need to understand the reality for ordinary people who do not have the advantages of the internet or the accessibility that Members of your Lordships’ House have.

[Baroness Keeley (Lab)]

My Lords, I will speak on face-to-face consultation; my Amendment 483 on this is in a later group.

During the Covid-19 pandemic, it was briefly made possible for the making of a will to be witnessed by videolink rather than in person. This change could have been made permanent, but instead the Government decided that the videolink provision should cease from January 2024. The law is now again that the witness must have a clear line of sight of the person making the will. Are these precautions any less important when assessing whether someone truly wants an assisted death and is not being coerced than when establishing what should happen to their assets afterwards?