Terminally Ill Adults (End of Life) Bill

Lord Falconer of Thoroton Excerpts

Friday 21st November 2025 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I thank all noble Lords who have spoken today for their contributions on these important issues. As I have already made clear, I will keep my comments limited to the amendments on which the Government have major legal, technical and/or operational workability concerns.

On that basis, I will speak about Amendments 118 and 118B. Amendment 118, tabled by my noble friend Lord Hunt, could prevent a person from accessing assistance where there is no clear connection between their individual circumstances and the crime that their close relative is under investigation for or has been convicted of, even if the said crime took place some years in the past. Amendment 118B, tabled by the noble Lord, Lord Farmer, would expand the meaning of “close relatives” to include “friends”. It is not clear who would determine the meaning of “friends” in this context. I should also say that disclosure of personal data engages Article 8 of the ECHR and is regulated by the principles set down in the Data Protection Act. Detailed financial assessment of those connected to a person seeking assistance is likely to interfere with the privacy of those individuals, particularly where there are no signs of coercion. The necessity of doing so is difficult to assess in the round rather than considering this on a case-by-case basis.

I turn to Amendments 222 and 612, in the name of the noble Baroness, Lady Hollins. Amendment 222 proposes a new clause to oblige the Secretary of State to provide specialist psychological assessment and support for persons considering an assisted death and their families. It would also oblige the Secretary of State to establish bereavement support services offering psychological support before an assisted death to all persons concerned. The Bill does not require families to know about an assisted death in advance, so requiring the offer of psychological services to them could create an undeliverable obligation on the Secretary of State.

Amendment 612 would mandate the video recording of a person being assisted to end their own life. The amendment would also require the person to confirm in the video recording their identity, their wish to die of their own free will, their capacity and that they are acting without persuasion or coercion. The amendment would require that this recording is sent to the coroner within 72 hours of death and it would create a regulation-making power for the Secretary of State concerning the practical arrangements for the recording, storing and transmission of the recordings. Requiring that a person’s death be video recorded where they did not wish the event to be recorded could risk being a significant intrusion into their family and private life under Article 8 of the ECHR. Since the Bill includes several safeguards, this intrusion is unlikely to be considered justified, and this amendment could also raise GDPR issues and concerns.

Amendment 460, in the name of the noble Baroness, Lady Finlay, specifies a range of actions the panel must take into account when considering a person’s psychosocial and safeguarding circumstances. It includes a requirement to offer immediate access to safe housing and financial support where abuse is disclosed. As the Bill is drafted, neither the panel nor the commissioner is provided with such a function and it is not clear how this would interact with local authority responsibility for housing provision.

As for the other amendments in this group where I make no detailed comments, although they may be deliverable, some would be challenging to implement. For example, Amendment 47 would require assessing doctors and the panel to assess a person’s state of mind or private thoughts. Amendment 58 would require an assessment of indirect structural disadvantage, including poverty or lack of care. Although I raise specific workability issues with only a small number of amendments in this group, noble Lords will be aware that the other amendments in this group have not had technical drafting support from officials. The issues raised by these other amendments are rightly a matter for noble Lords to consider and decide on, but I note that the way in which they are currently drafted means that they may not be fully workable, effective or enforceable.

[Lord Falconer of Thoroton (Lab)]

My Lords, in this debate we heard deeply personal information from the noble Lords, Lord Empey, Lord McCrea, Lord Watts, Lord Polak, Lord Griffiths, Lord Carlile of Berriew and Lord Shinkwin, and the noble Baronesses, Lady Hollins, Lady Hayter and Lady Grey-Thompson. I express my profound respect for people being willing to share in that way. I make it clear that in nothing that I say do I in any way intend to disrespect any of what must have been quite difficult statements to make. I really treasure many of the things that have been said, whether for or against the Bill.

As all noble Lords engaged in the debate know, at the heart of the Bill—there is no dispute about this—the decision to have an assisted death has to be where the patient, to quote the Bill,

“has a clear, settled and informed wish to end their own life, and … has made the decision that they wish to end their own life voluntarily and has not been coerced or pressured by any other person into making it”.

There is no dispute in the Committee that there have to be appropriate and sufficient safeguards to ensure that there is no coercion.

The current safeguards in the Bill are as follows: first, a doctor has to be satisfied that the person is not being coerced. Secondly, a second doctor has to be satisfied that the person is not being coerced. Thirdly, a panel has to assess that the person is not being coerced. Fourthly, the first doctor—after a period of reflection, in signing a second declaration by the patient—has to be satisfied again that the person is not being coerced. Finally, the doctor providing the assistance has to be at the last moment satisfied that the person is not being coerced.

The two doctors who give the certificate at the beginning must both have had specialist training in domestic abuse, including training on identifying coercive control and domestic abuse, and including identifying the effect of financial control. The panel considering the matter must consist of a psychiatrist, a social worker and a senior lawyer. If either of the two doctors have any doubt about the position in relation to capacity, they have to consult a psychiatrist. Anybody who by dishonesty, coercion or pressure induces the patient to either execute a declaration that they want an assisted death or take the assistance is guilty of a criminal offence. If all that the person does by dishonesty, coercion or pressure is to induce the person to execute a relevant document, the maximum sentence is 14 years. If, on the other hand, if they induce the person to take their own life, then the maximum sentence is life.

The question before the House in this debate is whether those protections are adequate to ensure that there is not coercion. I have before me a number of amendments. Amendment 3 is proposed by the noble Baroness, Lady Finlay: she would like “independent” to come before “decision”. I wholeheartedly agree with her that the decision must be independent, in the sense that it is a free decision made by the person, unpressured or coerced in the way that I have described. I am always influenced by what the noble Earl, Lord Howe, says in relation to that; he said, “Reassure us”. There is no dispute between me and the noble Baroness, Lady Finlay, that it has to be an independent decision. Is it clear enough in the Bill? With the deepest respect to both the noble Baroness, Lady Finlay, and the noble Earl, Lord Howe, I point out that it specifically says that the person should have

“made the decision that they wish to end their own life voluntarily and … not been coerced or pressured by any other person into making it”.

With respect, I say that it is clear enough on the face of the Bill.

I turn to Amendment 45, that of the noble Baroness, Lady Fox, which would insert “encouraged” in addition to “coerced” and “pressured”. I have thought very carefully about this, and I am against putting it in. The reason is that I see the reality: somebody who is thinking about an assisted death will want to talk frequently to those who love them. They may want to talk to the multidisciplinary team which is looking after them. Let us suppose somebody says, “I really, really want to go now. Should I take that opportunity?” If somebody says, “I encourage you to make the decision that is best for you,”, what the noble Baroness is proposing is that that becomes a criminal offence, potentially imprisonable for 14 years or for life. To me, that does not seem sensible.

I turn to Amendment 46. The noble Baroness, Lady Finlay, asks for “influenced” or “encouraged” to be added. I have dealt with “encouraged”. With regard to “influenced”, the multidisciplinary team or the person’s loved ones may well—with the best motives—influence somebody to go ahead with it. I do not criticise them for that if that is what the person wants and if it helps. It seems to me, again, wholly inappropriate to go beyond “coerced or pressured”.

On Amendment 47, the noble Baroness, Lady Coffey, suggests that it should be “external or internally” pressured that one is concerned with. We can understand external pressure—that is, somebody pressurising someone else to do it, and pressure carries with it an inappropriate degree of influence—but how does one in practice deal with an analysis of what would make me, for example, want my life to end? My noble friend Lady Merron also referred to that. The pain, the lack of dignity, the sense that I am not the person that I was in front of my own children is internal pressure. It might include me thinking, “I do not want to go on with this; in part, I’ve only got two or three weeks to live, and I want it to end”. The internal pressure is making me come to that conclusion. It is impossible to ask people, in particular the law enforcement authorities, to investigate what is going on in my mind. I have thought very carefully about that. I reassure the noble Lord, Lord Ashcombe, that I have given each of these amendments very careful thought, because they are important, but, again, I do not think that is a practical solution.

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[Baroness Berridge (Con)]

My Lords, my name is on the amendment that the noble and learned Lord has just mentioned. This was also from Second Reading. There are loads of people signing forms saying that coercion or pressure has not happened. What is the situation with the internet? What is the situation for young people? We are failing young people if we do not make clear how that practitioner is going to know. Young people are pressured through non-human means nowadays.

[Lord Falconer of Thoroton (Lab)]

The Bill makes it absolutely clear that it must be your own decision. Let us suppose that your views of the world are affected by the internet and that you are ill and an organisation is urging you to commit suicide, that organisation should be liable if that happens.

In Amendment 49, the noble Baroness, Lady Coffey, wants “person” to include a body corporate or an organisation in relation to pressure. If an organisation or a body corporate is putting pressure on a group of people or on individuals and that makes them do it—this is putting it crudely, but if an organisation says, “Do have an assisted death; it is the right thing for everybody or for you”—that should be covered by the Bill. The noble Baroness adverted to how “person” can generally include both corporate person and human person, but I can talk to her separately about that to make sure that it is covered.

[Baroness Fox of Buckley (Non-Afl)]

Some clarification is needed in relation to a number of points that you have made. How does anybody know, how does the doctor know, whether any of these scenarios have happened? Is there anything in the Bill that makes the doctor ask and explore? The word I proposed was “encouragement”—that you would ask not just “Were you coerced or pressurised?” but “Were you encouraged?”—because it would develop a richer conversation. Is there anywhere in the Bill where all the things that you have just said—apologies; I should not have said “you” but “the noble and learned Lord”—can be fleshed out, discussed and teased out?

Maybe I have got this wrong, but at the moment as I understand it, you fill your form in, somebody might even ask “Were you coerced?” and you say no, and that is that, out the window and then, Bob’s your uncle, you are eligible and off you go. It does not matter how often that process happens. The noble and learned Lord spoke about “first doctor, second doctor”, but if they do not all explore it, how will we know whether it was anything other than a yes/no? The noble and learned Lord has given a very rich explanation of what could have happened, but the Bill does not allow us to find out whether any of that will have occurred before the assisted death is enacted.

[Lord Falconer of Thoroton (Lab)]

I do not feel insulted by being called “you”, but I do not think that the noble Baroness, Lady Fox, properly understands how the Bill operates. The two doctors and the panel have to be satisfied that the person is reaching a voluntary decision of their own, uncoerced and unpressured. Codes of practice will determine how that is done and, what is more, the panel with the three experts on it also has to be satisfied. The noble Baroness, Lady Fox, is saying that that is a tick-box exercise. With respect, no: this is obviously a very serious matter. I expect the doctors and the panel doing it to take it seriously.

[Lord Mawson (CB)]

My Lords, as the noble and learned Lord knows, I have spent a lot of my life working with people in housing estates in the East End of London. Research we did some years ago discovered that virtually every nation on earth is represented in the housing estates where I worked. I have spent a lot of my time, nearly 40 years, working with Bengali families. We know each other quite well, but do I really know what is going on in the minds of that community or with that single mother, trapped in a house, who does not speak English after all these years? The truth is that I do not. It is really difficult to know. In the same way, I find it difficult, as a Yorkshireman, to help southerners understand what is really going on in Yorkshire. Even though I have tried it many times, the quality of their fish and chips really does not cut it.

One of my problems with this overcertainty is that it feels like a very white, English conversation, when actually this country is a global community, with people from many different cultures, all over the world. What concerns me is the practicality of much of the discussion that I have listened to today, and I have no idea how you actually understand coercion or encouragement—I think that is a really important word—in practice. Having spent many years of my life with these people, I would not pretend to know what I was really hearing, at such a point, and what it meant for their life in practice.

[Lord Falconer of Thoroton (Lab)]

I completely agree that the noble Lord and I might well not understand what people from different cultures would say, but the two doctors and a panel would have to understand that sufficiently to reach a conclusion. If they do not, they cannot provide the satisfaction that is required by the Bill. The idea that the people who will make the Bill work are all from a particular class, demography and education is, with respect, wrong.

[Lord Mawson (CB)]

Will we have enough people from these different cultures with the skills and knowledge to enter into that kind of understanding, whether they are doctors or on the panels? It is really difficult to understand how that practical proposition will work in the real world—in the East End of London.

[Lord Falconer of Thoroton (Lab)]

That will very much depend upon the number of people who apply from particular groups, and I think one can be pretty sure, on the basis of the impact assessment, that there will be sufficient numbers.

[Lord Harper (Con)]

My Lords—

[Lord Falconer of Thoroton (Lab)]

I think it would probably be sensible, unless the noble Lord has something to raise that we have not already dealt with, for me to make a bit of progress.

[Lord Harper (Con)]

It is directly relevant to the amendment that we are discussing, if the noble and learned Lord will forgive me. I am coming back to what the noble Lord, Lord Carlile, said about the point of the debate. I absolutely get that the noble and learned Lord is very certain about the quality of the Bill. He has set that out in his usual eloquent way. However, if he followed my injunction from the words of the right reverend Prelate the Bishop of Chester yesterday and if he has listened to this debate, he must recognise that that certainty is not shared by many Members of this Committee.

I hope the noble and learned Lord will forgive me if he was coming to this on later amendments, but he has in effect said that he is not persuaded by most of the amendments. If he does not accept that many noble Lords have concerns about the Bill and thinks it is basically fine as it is, I fear that—picking up the point made by the noble Baroness, Lady Hayter—many noble Lords who might have been persuaded to support it had it been improved will not now be persuaded. Is he prepared to listen and amend the Bill in any way at all?

[Lord Falconer of Thoroton (Lab)]

My Lords, first, I am sure that I will not be able to reach the high standard of the right reverend Prelate the Bishop of Chester, but I will try.

Secondly, I do not think I am rejecting the principle of many of the amendments. I am saying that—for example, in relation to an independent decision and to encouragement—the protection is there in practice. I also say to the noble Baroness, Lady Coffey, that her reference to organisations is something we could discuss. I think it may already be covered but let us discuss it.

The noble Lord, Lord Harper, is right: I am saying no to quite a lot of the amendments because, in my opinion, I do not think they are necessary and there is adequate protection. It does not mean I am not listening; but painful as it is, because I respect so many people who disagree with me, I do disagree with some people.

I am very conscious as well of what the Chief Medical Officer, Sir Chris Whitty, said, which is not to over-engineer this and make it a thicket people cannot get through. If you are serious about assisted dying, make sure it is genuinely accessible to people. I am trying to strike that balance.

[Baroness Scotland of Asthal (Lab)]

My Lords, I wonder if I might help my noble and learned friend on the concerns that clearly have been expressed. A number of noble Lords have been talking about what evidence there is. The concern was expressed in the last debate last Friday that if you are not going to have someone who has been intimately involved with the family or the person who is making the request, that becomes more difficult.

A number of suggestions have been made. For example, would it be possible to have a multidisciplinary assessment of need and coercion early, so that you could have the information? My noble and learned friend will know that when we make these multidisciplinary assessments, usually you hear from everyone—the social worker, the housing officer—just as we do for the multiagency risk assessment for domestic violence; and those domestic violence cases are really important. Will my noble and learned friend look again at how the Bill could make sure that the evidence upon which these decisions are going to be made is there?

Secondly, I will deal with the amendment from the noble Baroness, Lady Fox, on encouragement. My noble and learned friend will know—I disclosed this to the House, because, of course, I was the Attorney-General when the DPP’s guidelines were put out— that the whole purpose of looking at and assessing encouragement was to make sure that no one else had applied pressure. The word “encouragement” very much comes from the DPP’s guidelines, which has meant that since they came in, only four prosecutions have been made. They were made in relation to people who were identified as having participated in something which might have been homicide or manslaughter, and others were not prosecuted. I know that my noble and learned friend would think that entirely proper.

Will my noble and learned friend think again about looking at those issues to make sure, perhaps through regulations, that we can have that clarity, which might give reassurance to those who are desperately concerned about these issues?

[Lord Falconer of Thoroton (Lab)]

In relation to the multidisciplinary team, Amendment 222 from the noble Baroness, Lady Hollins, is a bit close to that but not quite there. On the question of encouragement, of course, the reason why the DPP’s guidelines refer to encouragement is that the criminal offence at the moment is encouraging suicide, and that deals with a completely different concept.

May I go on into Amendment 50—

[Lord Ashcombe (Con)]

I would like to go back to our noble colleague from Yorkshire—I am afraid I do not know the noble Lord’s name and I apologise. He talked about working in the communities in the East End. We are short of GPs as it is, and most of our GPs come from an Anglo-Saxon background still. The noble Lord referred to the fact that, having worked with this community for a very long time, he still could not necessarily read the situation. I wonder how we deal with that, because the GPs in that community may not have had the length of time that he had to assess these situations.

[Lord Falconer of Thoroton (Lab)]

I think I answered that; the noble Lord may not have been satisfied with my answer, but I did answer it by saying that people have to be satisfied that the decision is voluntary and without coercion. If they do not know, because they cannot read adequately the community, they could not be satisfied.

[Baroness Coffey (Con)]

The noble and learned Lord has just made a point about the risk of coercion and referred to a psychiatrist. It would be very helpful to understand what clause in the Bill he is referring to, because Clause 12(6)(b) is only about the capacity of the person; it is not talking about coercion. I am also conscious that capacity is on the balance of probabilities anyway. It would be useful to understand which clause he believes referral would be in, on the grounds of coercion.

[Lord Falconer of Thoroton (Lab)]

I will come to that in a moment, because I have to get through the amendments—we have to make progress a bit. However, I completely understand the question.

Amendment 50 is from the noble Lord, Lord Evans. He basically said that when anybody tries to behave badly, trying to coerce or pressure somebody into making the decision to have an assisted death, that should be sufficient to bar it for ever, even if it had no impact whatever in relation to it. I see the force of that; I think it would be a wrong amendment, for the following reasons. Somebody—a doctor—might go over the line, but it is absolutely clear that the person definitely wants an assisted death. I do not think they should be barred from doing that because they are concerned about what might happen to the doctor or to the person they love if it is absolutely clear that they have not been coerced or pressured into it.

On Amendment 52 from the noble Baroness, Lady Grey-Thompson, she is saying that somebody should not be subject to or at risk of coercive control. Everybody agrees that the person who is adopting the assisted death should not be subject to coercive control. If they are at risk, I would expect the two doctors and the panel to investigate that fully and, if they are not satisfied that the person is reaching a decision of their own, plainly an assisted death cannot go ahead. But I think we are all on the same page in that the risk has to be properly investigated and a conclusion reached.

Amendment 57A in the name of the noble Baroness, Lady Lawlor, says you should not be allowed to have an assisted death if someone has been

“prompted to consider ending their own life”—

presumably in the context of assisted death—by any professional person. Clause 5 leaves it to the judgment of the doctor as to whether they raise the question with the patient. If they raise it, they have to raise it under Clause 5 in the context of the treatment available to the patient and all other options available, including palliative care. I do not think that if a doctor, or indeed any other professional person, makes a judgment that it would be sensible to raise it, that should thereby debar the person from having an assisted death. The noble Baroness wants to intervene. By all means let us prolong the debate if it is a new point.

[Baroness Lawlor (Con)]

It is about the level of authority which the professional person, who is in a way a public servant, and the trust which one endows in one’s GP or family doctor. As we have heard today from other people who are medically qualified, that has great weight with the patient—I speak as someone who comes from a medical family. They constantly agonise about their prescriptions for patients and their emotional condition, and all that. But if one raises assisted dying with somebody who is terminally ill, the professional—the doctor, say—is planting the idea.

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[Lord Falconer of Thoroton (Lab)]

I completely appreciate what the noble Baroness is saying. She is, in effect, repeating what she said with such force and articulateness before. My answer to that is that there will be some professional people, and Clause 5 recognises this, who think the person is saying, “I just can’t bear this, I want this to end”. Would it be inappropriate in those circumstances for a professional person, in the context of all the other options, to raise it? In my view, it would not be, and in my view, it would be completely wrong to say that if you did raise it in those circumstances, that person, the patient, would be barred from ever having an assisted death.

On Amendment 58, the lead amender—not every other amender—said that coercion or pressure should include

“intentional or indirect structural disadvantage including poverty or lack of care”.

We are all agreed that coercion and pressure on an individual by another individual is not to be allowed. Where the reason that you want an assisted death is because in your mind you are influenced by your circumstances—for example, because you are poor—should you be barred from having an assisted death because of your poverty? In my view, you should not be. What the two doctors on the panel have to be satisfied about is that it is your own decision.

[Baroness Grey-Thompson (CB)]

This partly follows on from the comments of the noble Baroness, Lady Fox. The noble and learned Lord mentioned in his previous answer to one of my amendments that the doctors would be able to investigate. I think many of us still do not understand how that investigation would take place. In terms of understanding the standard of proof, Minister Sarah Sackman in another place said it would be on a civil standard. So, in terms of balance of probability, is the noble and learned Lord saying that the doctor has to be only 51% certain that there is no coercion for the panel to carry on and for an assisted death to be granted?

[Lord Falconer of Thoroton (Lab)]

They have to be satisfied that the person is not being coerced. That means that they have to do the appropriate inquiries. If, for example, as the noble Lord was saying, they do not understand the community, then they cannot be satisfied. If, for example, they do not know enough about it, they cannot be satisfied. Every case will depend upon its individual circumstances. They will have to do what is required in relation to it.

Amendment 118, in the name of the noble Lord, Lord Hunt, proposes that if you have a close relative who has been convicted of fraud or you are living with somebody who has been convicted of fraud, there has to be an independent financial assessment. That means that if your child, grown up by this time, has committed a fraud, there has to be an independent financial assessment of your circumstances before you can have an assisted death. I am strongly against the idea that if a relative of yours committed such an offence, that would mean there would have to be a yet further layer that you have to go through. There are still all those protections.

[Lord Hunt of Kings Heath (Lab)]

My Lords—

[Lord Falconer of Thoroton (Lab)]

This is a new practice that every answer one gives, the person then responds by repeating their speech. So, if it is new, yes—

[Lord Hunt of Kings Heath (Lab)]

The Companion states that in Committee we are entitled to speak more than once, and I think it is more helpful to do it this way. I am the 11th amendment in this group that the noble and learned Lord has so eloquently dismissed so far, but I think he has about another 10 to go.

I want to make two points. First, does the noble and learned Lord not reflect, on all the concerns that have been expressed, that the Bill might have had a smoother passage if he had shown any disposition whatever to take any of these issues away and reflect on them before coming back on Report? Secondly, I mentioned the Human Tissue Authority legislation that provides some protection and investigation to make sure that a donor is not getting a financial reward. Will he at least look at that to see whether there is any way in which we could reflect that in this legislation?

[Lord Falconer of Thoroton (Lab)]

On my noble friend’s first question, I have not dismissed all the amendments; I have accepted that we should look at some of them, and very many of the ones I am not accepting are because they are already covered in the Bill. I am rejecting some of them on the basis that I do not think they are practical. When my noble friend talked about the donor, I think he was talking about, for example, somebody who may benefit from the will of the patient. Indeed, that was a point raised by the noble Lord, Lord Farmer. Very often, the person who most supports you in relation to this is the person you love most and who is going to benefit under your will. So, very frequently the person who has taken a loved one to Switzerland is the person who is then going to inherit under their will. That does not make them bad, and I would most certainly not exclude people who benefit from the will of the person who dies because they have helped them in this respect. It seems to me to not properly recognise the importance of human relations in relation to this.

I have dealt with the point of the noble Lord, Lord Farmer, about the will. His second point was that, if you had a friend who was convicted of a criminal offence involving financial fraud of some sort, you should not be able to have an assisted death unless there is an investigation of your financial position. Well, if I reject the point from my noble friend Lord Hunt in relation to a close relative or the person you speak with, then I think, for the reasons I have given, it also does not apply in relation to a friend.

In Amendment 181, the noble Baroness, Lady Grey-Thompson, proposes that the doctor must ask why and seek specific confirmation that a decision is not coerced. There is no specific requirement for that in the Bill: it is for the two doctors to determine what they think the right course is. If they felt that they could not reach a decision without asking why, or without asking, “Are you being coerced?”, they would have to ask that. But there is no prohibition. It is, as the noble Lord, Lord Pannick, said, a decision for the two doctors and the panel to decide, in each case, what is the best way to reach a conclusion as to whether this person is being coerced. That is the question that all these things are addressing.

[Baroness Grey-Thompson (CB)]

So, the two doctors could ask an entirely different set of questions to each person who is requesting to end their life?

[Lord Falconer of Thoroton (Lab)]

It will depend on the circumstances. If, for example, the doctor had a very severe doubt about whether somebody was being coerced, I would expect them to ask very many questions about their domestic circumstances. Suppose, however, it was somebody who was clearly not, on the face of it, at the slightest risk of coercion—a person of 60 in the full flush of his or her pomp, as it were—and who had said, right from the outset, “I can’t bear the thought of this illness”, and the idea that this person has been coerced is not really plausible, then I would expect the doctor to be asking different questions from the sorts of questions that they would be asking if the circumstances of somebody’s home life were completely different. It would obviously depend on what you knew as the doctor, or had found out as the panel, about the circumstances of the individual.

[Baroness Royall of Blaisdon (Lab)]

I apologise for interrupting my noble and learned friend, but I just point out that the BMA itself is very clear that the doctors should be able to make their own judgment in all these cases.

[Lord Falconer of Thoroton (Lab)]

As I understand it, Amendment 222, in the name of the noble Baroness, Lady Hollins, would establish a specialist service to provide psychological assessment and support and then bereavement support for those seeking an assisted death. My noble friend Lady Merron has indicated the difficulties in relation to that. On the question of a psychological assessment, the position is that some work has been done abroad in relation to this. California introduced, in addition to what was required by the law in a particular part of California, a psychiatric assessment for everyone who wanted an assisted death but concluded that that was not necessary because the numbers of psychiatric assessments were producing nothing. It was only where special requirements were required that suggested it was a good thing. So I respect the suggestion but I do not think it is necessary.

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[Baroness O’Loan (CB)]

I have a very quick question. I cannot find in the Bill the powers that would allow the doctors to carry out the investigation to which the noble and learned Lord has repeatedly referred. If people do not co-operate, that is it.

[Lord Falconer of Thoroton (Lab)]

With the greatest respect, the noble Baroness has missed the point. If, for example, a person says to the doctor, “I’m not telling you things”, the doctor can never be satisfied. That is the protection.

[Baroness Coffey (Con)]

Would the noble and learned Lord write to me with the answer to the question I asked earlier?

[Lord Falconer of Thoroton (Lab)]

Of course, and I apologise for not answering it.

[Lord Watts (Lab)]

Can we perhaps shoot just one fox? There was a suggestion that there are not enough non-Anglo-Saxon GPs available to do this. I have just looked at the facts: 46% of GPs were born outside the UK and 25% of them are from Asia.

[Lord Falconer of Thoroton (Lab)]

I am very grateful to my noble friend for mentioning that, because that is what was being whispered to me but I did not have the statistics. I am very grateful to him for providing them.

[Baroness Finlay of Llandaff (CB)]

My Lords, this has clearly been a long debate, and I think for good reason. As one noble Lord said, coercion and pressure are a major concern for many people about the way the Bill is written. I will very briefly respond. I am well aware of the time, but a lot of points have been made. Noble Lords will all be relieved to know that I am not going to go through them all.

First, the word “encouragement” is taken from the Director of Public Prosecutions guidelines, and for good reason, because the Director of Public Prosecutions recognised the power of a person in authority over a person who is vulnerable. That is why it tends towards the prosecution of assistance coming from a person in authority. I would include doctors in that, but it was also thought to include prison staff, nurses and others employed in that role.