Terminally Ill Adults (End of Life) Bill

Debate between Lord Carlile of Berriew and Baroness O'Loan

Committee stage
Friday 30th January 2026 Lords Chamber

[Baroness O’Loan (CB)]

My Lords, I have put my name to Amendment 66, in the name of the noble Baroness, Lady Coffey. At present, the Bill makes no allowance for any restriction on the possibility of the use of non-human assessment and automated administration devices during the application and decision-making process for assisted death. Obviously, AI will be used for recording meetings and stuff like that—I am not a quill and paper person to that extent—but AI has already been proposed for use in killing patients in the Netherlands, where doctors are unwilling to participate.

The Data (Use and Access) Act 2025 established a new regulatory architecture for automated decision-making and data interoperability in the NHS. It provides that meaningful human involvement is maintained for significant decisions—decisions which may affect legal status, rights or health outcomes. Of course, assisted death would come within that definition.

That reflects the purpose of the NHS. We have talked about its constitution. I looked at the constitution and the guidance. It says that the purpose of the NHS is

“to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives”.

I know that the noble and learned Lord, Lord Falconer, is going to put down an amendment suggesting that the constitution and guidance will have to be amended, but the current situation is that that is the purpose of the NHS. The assisted suicide of patients is certainly not provided for in the NHS, nor should AI be used in the crucial assessment and decision-making process for assisted dying, given the extreme difficulties in identifying coercion and assessing nuanced capacity, and the irreversible nature of death. What plans does the noble and learned Lord have to address these issues?

In the Commons, amendments were passed allowing the Secretary of State to regulate devices for self-administration. The amendment was not put to a vote; in fact, only seven votes were permitted by the Speaker on the more than 80 non-Leadbeater amendments. The Commons have accepted that devices will be used for self-administration. Of course, the assisted suicide Bill requires self-administration. Nothing in the Bill prohibits a device that uses AI to verify identity or capacity at the final moment. If a machine makes the final go/no-go decision based on an eye blink or a voice command, have we not outsourced the most lethal decision-making in a person’s life to technology? I have to ask: is this safe?

Public education campaigns on assisted suicide are explicitly allowed for in Clause 43. The Government have said that there will be an initial education campaign to ensure that health and social care staff are aware of the changes, and that there would likely be a need to provide information to a much wider pool of people, including all professionals who are providing or have recently provided health or social care to the person, as well as family members, friends, unpaid carers, other support organisations and charities. That controls only government activity. The other observation I would make is that I presume the public education campaign will inform families that they have no role in a person’s decision to choose assisted death, and that the first they may know of an assisted death is when they receive the phone call telling them that the person is dead. It is profoundly important that people know this.

There is nothing to prevent an AI chatbot or search algorithm helpfully informing a patient about assisted dying services and prioritising assisted dying over palliative care search results. By legalising this service, the Bill will feed the training data that makes these AIs suggest death as a solution. I would ask the noble and learned Lord, Lord Falconer, how he intends to police that situation.

There is also a risk of algorithmic bias. If prognostic AI is trained on biased datasets—we know the unreliability of the prognosis of life expectancy—it could disproportionately label certain demographics as terminal, subtly influencing the care options, including assisted dying, presented to them. The National Commission into the Regulation of AI in Healthcare established by the MHRA in 2025 is currently reviewing these risks to ensure that patient safety is at the heart of regulatory innovation. I ask the Minister: will that work cover assisted dying?

The AI Security Institute’s Frontier AI Trends Report in December 2025 highlights that:

“The persuasiveness of Al models is increasing with scale”,


and:

“Targeted post-training can increase persuasive capabilities further”.


In a healthcare context, this raises the risk of automated coercion, where the person interacting with a chatbot or an AI voice agent might be subtly persuaded towards certain end-of-life choices. The AISI has said that safeguards will not prevent all AI misuse. We have to remember that there will be financial incentives to provide assisted suicide; after all, the CEO of Marie Stopes received between £490,000 and £499,000 in 2024. There is big money, even though this will be charitable or NHS work. Clause 5 allows doctors to direct the person to where they can obtain information and have the preliminary discussion. That sort of information could be an AI or a chatbot at the present time.

Dr Sarah Hughes, giving evidence to the Lords Select Committee, said there was a real risk of “online coercion”. With newly developed AI functions and chatbots, we already know there are cases all around the world of individuals being coerced into all sorts of different behaviours, practices and decision-making. There is also an issue of misinformation around diagnosis and prognosis. Hannah van Kolfschooten questioned who has ultimate responsibility if the technology fails. She said:

“In traditional euthanasia settings, a doctor is accountable, but in AI-driven scenarios, accountability could become ambiguous, potentially resting between manufacturers, healthcare providers, and even the patient”.


AIs also have a record of encouraging suicide. We know that, and we have seen terrible cases among young people; they have no regard for human life.

Evidence shows that doctors suspect only 5% of elder abuse cases. Detecting subtle coercion requires, as was said in the previous group, professional judgment to interpret things such as non-verbal cues, body language and discomfort. AI systems are ill-equipped to handle these nuanced, non-quantifiable elements. It is imperative for trust in the system that the individual circumstances of each request for assisted death are recorded and are available for interrogation, or even potentially a criminal investigation, by the panel or another regulatory authority. The only insight as to what happened in the consulting room will come from these records. The patient will be dead. The current provision in the Bill does not provide any protection against the use of AI, which has algorithmic bias, to protect an individual in these circumstances. Can the noble and learned Lord, Lord Falconer, explain how he proposes to deal with these concerns?

[Lord Carlile of Berriew (CB)]

My Lords, I will add only a very short sentence to my noble friend’s excellent speech, and it is what AI says about AI. It says: “AI is technically capable of providing advice or information relating to suicide, but it is critically dangerous to rely on it for this purpose”. Enough said.

Police Reform and Social Responsibility Bill

Debate between Lord Carlile of Berriew and Baroness O'Loan

Wednesday 11th May 2011 Lords Chamber

[Lord Carlile of Berriew]

My Lords, I hope that I will be forgiven the discourtesy of absence from some parts of this debate because of a commitment in a Committee Room upstairs. I join others in welcoming my noble friend the new Minister. I learnt the other day—indeed, I am bound to say that she told me herself—that she is an extremely good cook. In this Bill, she has as ingredients the meat of police commissioners, the wine of the licensing provisions and the hot spice of universal jurisdiction, but it may be difficult for her to produce a dish that is up to her usual culinary standard at the end of our discussions. Having been a Member in the other place with her, I can confirm her reputation for being doughty, determined and, above all, dangerously disarming.

I pay tribute to my noble friend Lady Harris for the way in which she moved the amendment. She was very persuasive, but I am bound to say that, with great respect, I disagree with her profoundly. I would like to remind the House of one or two things that have happened. Before the coalition, the Liberal Democrats were solidly in favour of democratic accountability for the police service through elected police authorities, to which we will return later today. The Conservative Party, the larger partner in the coalition, has been consistently in favour of the election of police commissioners. Both parts of the coalition have been solidly in favour of democratic accountability for the police through some kind of elected person or body through which the police service for a police area should be accountable. The amendments proposed by my noble friend Lady Harris would destroy that determination. I do not think that we have reached the point in coalition politics at which we should distance ourselves from the strongly held views of both parties because we are wedded to some old practices, which, in my view, do not stand the tests of scrutiny that have been relied upon by my noble friend. Indeed, what we should be discussing, if we are to discuss this at all, is the form of democratic accountability rather than whether there should be democratic accountability. These amendments would wreck the first Part of the Bill completely, for which reason I am opposed to them.

On police authorities, we will have a debate later about Welsh police authorities. With great respect to my very distinguished colleagues in this House who will speak in favour of basically no change in Welsh police authorities, I do not think that they could be more wrong, and I do not think that anybody could be more wrong than to say that what we have at present is a democratically accountable system that does the business really well. If one were just to stray into Wales for a moment and walk down the streets of Llanfair Caereinion, Llanfyllin or Llanrhaeadr-ym-Mochnant and ask people on those streets to name a single member of the police authority for their police area, unless one had happened to bump into a member or one of his or her nearest or dearest, they probably would not have a clue that a police authority existed, let alone who those members were.

In a professional capacity as a barrister, I have worked for and with police authorities and I have seen them in operation—I have seen very good and I have seen much less good. As a Member of the other place for a constituency in rural Powys, I had dealings with the police force and the police authority for those 14 years, and I can say very clearly that if anybody was concerned about the police they did not go to the police authority or any member of it, because they had no idea where to go. By and large, they went to their local Member of Parliament, who then processed the issue or complaint for them.

If one looks at some police authorities—it would be invidious to name names or issues, particularly as some of my experience is shrouded in professional confidentiality—one can be far from confident that every issue has been dealt with in a way that the public would regard as properly accountable and transparent. Indeed, there has been an issue involving a chief officer this week which has been well publicised and which raises many issues about the performance of that police authority and the relationship between that police officer and the public that he supposedly serves as the paragon of policing.

This amendment is going far too far. We should carry out the examination of police authorities that the Bill predicates and should not waver one bit from a form of democratic accountability, whatever that form be.

[Baroness O'Loan]

My Lords, first, I welcome the Minister to her onerous new responsibilities. She has a particularly difficult Bill to deal with.

Policing operates only with the consent of the people, and it has long been the experience in the United Kingdom that that consent depends very largely on the extent to which the people can trust in the independence and impartiality of the policing service which is delivered to them.

I want for a moment to refer to the situation in Northern Ireland in which policing became very seriously politicised and the consequences of that politicisation. In the first instance, there was a loss of community confidence in the police, which over the period of the Troubles crossed from the nationalist republican community into the loyalist community. It is important to acknowledge that the loss of confidence was right across the community. That led to a lack of support for the police in critical moments. I am thinking in particular about things like demonstrations, which are becoming more prevalent on the streets of the United Kingdom. It led to the loss of the flow of active information to the police, and the extent to which people were prepared to come forward and tell the police things. They very often told me as Police Ombudsman that the decisions that they made were based on whether they thought they might be listened to anyway. So people stopped providing information—sometimes information relating to the commission of crimes—and that led to the necessity for greater use of other mechanisms for collecting information, with the additional costs attached to those, all the complexities of the Regulation of Investigatory Powers Act and the potential for the increase in corruption. Ultimately, the loss of confidence in policing led to a lack of proper accountability in Northern Ireland, and we saw what happened, and we saw the necessity for the commission headed by the noble Lord, Lord Patten, and all the consequences which derived from that. Members of the House will now have gathered that I stand in support of the noble Baroness, Lady Harris.

I want to consider what it is that we are contemplating in this election of a police commissioner. The noble Baroness, Lady Harris, has identified the deficiencies in what a police commissioner could deliver which is not currently delivered by a police authority. I speak as a former member of the Police Authority for Northern Ireland, and I know the extent to which authorities go in extending their reach and bringing people in. When you combine that with the district and community policing partnerships that exist across the country, there is very significant outreach between the police, the police authority and those who are served by policing. The imposition of a single elected person would almost inevitably result in the election of someone who was politically affiliated. Political affiliation could be very damaging to policing and could lead to decisions in the allocation of resources which may well not reflect the needs of the marginalised, the poor, the vulnerable, the disabled and many other constituents of our community.