Terminally Ill Adults (End of Life) Bill

Baroness Stroud Excerpts

Friday 5th December 2025 Lords Chamber

[Lord Winston (Lab)]

My Lords, I suggest that the noble Baroness, meaning absolutely well in a clearly very emotional area, has forgotten the real science. She is not a neuroscientist; indeed, I do not think that the commissioner is a neuroscientist. The greatest expert in the United Kingdom on teenage neuroscience is almost unquestionably Sarah-Jayne Blakemore, who works partly in London, partly in Cambridge and of course has been working extensively at UCL for a long time. She has studied teenagers in great detail, and it is very clear from her work on teenagers making decisions that they can make decisions in the right environment and in the right circumstances. I think one has to be very, very careful about making assertions about teenagers. There are many people well over the age of 25 who cannot make these decisions either. I think we have to be quite clear that we may need to take this sort of thing into consideration, but I do not think it is necessarily relevant to this amendment.

[Baroness Stroud (Con)]

My Lords, I want to speak in support of the noble Baroness, Lady Berger. I will limit my remarks because some of them have already been made by previous speakers. I think the reality is that maturity is a scale and choosing to proceed with assisted dying at the age of 18 poses difficult questions, which we must grapple with, about the neurological maturity required for true, settled and informed consent on a matter of such gravity, and not just particular circumstances. I intend to speak in a subsequent group to Amendment 22 in the name of the noble Baroness, Lady Grey-Thompson, but some of the points I will make then are also relevant to this group.

I note that research undertaken by the Sentencing Council in 2024, which focused on aggravating and mitigating factors in sentencing guidelines, has this to say about age and maturity:

“Age and/or lack of maturity can affect … the offender’s responsibility for the offence and … the effect of the sentence on the offender. Either or both of these considerations may justify a reduction in the sentence”.


The report goes on to note:

“In particular young adults (typically aged 18-25) are still developing neurologically and consequently may be less able to: … evaluate the consequences of their actions … limit impulsivity … limit risk-taking … Young adults are likely to be susceptible to peer pressure and are more likely to take risks or behave impulsively when in company with their peers”.


I do not want to cross over into debate on the subsequent group, but this seems highly relevant to our deliberations on the appropriate age for assisted dying. Of course, age and maturity are mitigating factors only, and therefore discretionary, but it seems extraordinary to me that the principle of maturity is one which is accepted in a legal context, and there remain calls for dedicated sentencing guidelines for 18 to 25 year-olds in recognition of this, yet the Bill as drafted does not seem adequately to account for this in a similar manner with regard to the permanent decision to end one’s own life. I would be grateful if the noble and learned Lord, Lord Falconer, could comment on this when he responds to the debate.

The autonomy on which the Bill is purportedly built must be grounded in safeguards commensurate with the irreversible nature of the proposed act. With regards to the age of eligibility, I do not believe the Bill as drafted meets this standard. For these reasons and more, I support the amendments in the names of the noble Baronesses, Lady Berger and Lady Lawlor, as well as those in the name of the noble Baroness, Lady Goudie, and the noble Lord, Lord Moylan.

[Baroness Hollins (CB)]

My Lords, I have an amendment in this group and I support the noble Baroness, Lady Berger, in this. I just want to add to earlier comments. The transition from children’s to adult services at 18 is well known to be a very confusing and destabilising period during which key clinical relationships are lost and important elements of a young person’s history may not be carried forward. These factors are directly relevant to assessing decision-making capacity and identifying safeguarding concerns for individuals aged 18 and above who may seek assisted dying. I think that raising the minimum age would allow for any medical advances—for example, with emerging new treatments that might change a young person’s prognosis. It is important not to be too hasty.

I also want to comment on the Scottish Sentencing Council and to add that, again, there is something about the developmental process which is still under way which can increase susceptibility to influence, vulnerability to risk-taking and the likelihood of short-term, emotionally driven decision-making. We have only to think about the fact that in that age group, the biggest cause of death is actually accidental death. Research done by the Sentencing Council and other research shows that maturity may be delayed by adverse childhood experiences. It is therefore reasonable to assume that some young adults with serious illness may carry such developmental vulnerabilities into their decision-making around the end of life. The Sentencing Council guideline suggesting lower culpability and a greater capacity for change than in older adults endorses the suggestion that we should change the minimum age to 25. This is an irreversible decision. We need enhanced safeguards for this age group, and I support the amendments.

--- Later in debate ---

[Baroness Stroud (Con)]

My Lords, I seek clarity on a point raised in precisely this exchange between the noble Lords, Lord Harper and Lord Lansley, particularly on the issue of “ordinarily resident”, following the enthusiasm expressed for aligning the language of the Bill with the usual terms of the NHS.

If we aligned “ordinarily resident” with NHS maternity care, for example, it would act as a definition for who pays but not for who receives the service. All pregnant women are entitled to the service of NHS maternity care; it is only whether it is free that depends on your residency, nationality and immigration status. Those ordinarily resident get free care, while overseas visitors and those not settled may have to pay charges, although care is never refused, and payment plans are available. Can the noble and learned Lord confirm that the enthusiasm for alignment with existing NHS terms would not extend to a widening of service eligibility, and thereby the UK becoming a destination venue?

[Lord Meston (CB)]

I seriously question whether Amendments 11 and 11A are necessary or useful. Following on from what has just been said, my experience in the courts is that the concept of ordinary residence stated in the Bill is well established in our law, workable in practice and well understood by practitioners and judiciary, particularly in family law, where it most often appears. It is a tried and tested expression.

To impose the more stringent precondition of permanent residence, requiring, in effect, unbroken physical presence, could unnecessarily—and, I suggest, unkindly—restrict the mobility of those who are seriously ill, or becoming seriously ill, who might be entitled to the benefits of the Bill if it is enacted. Such people, particularly those who have a clear, stable and lasting residential connection to England and Wales, should not be left to fear that they cannot make even a brief visit away from home, fully intending to return, in case that visit away is said to have changed or interrupted their permanent residence and thereby stopped the clock on their eligibility for assistance under the Bill’s provisions, requiring the qualifying period of 12 months to restart from the beginning. That, I suggest, would be a great disservice to such people and would not be any improvement to the Bill.

As for “domicile”, as others have already said, it is a notoriously difficult concept to define. You can have only one domicile at any one time. It can be a domicile of origin, a domicile of dependency or a domicile of choice. In the explanatory statement to the amendment seeking to introduce the concept of domicile, it is suggested that it would tighten the eligibility requirements. In reality, it would do little more than complicate them—indeed, in some situations, it could loosen them.

You can retain your domicile of origin in this country even if you have not lived here for years. You can also acquire a domicile of choice or revive a domicile of origin immediately on arrival in this country with no minimum period of residence. I therefore suggest that the substitution of “domiciled” for “ordinarily resident” would not be helpful to anyone. I suggest that we should adhere to the concept of ordinary residence.