Terminally Ill Adults (End of Life) Bill

Lord Moore of Etchingham Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I want to speak specifically to Amendment 22, about why prisoners should not be eligible for assisted dying. The amendments from the noble Lord, Lord Farmer, are also pertinent here.

The right reverend Prelate the Bishop of Gloucester raised the real and specific safeguard issues from the lack of medical records of prisoners, and I am sure we will hear more about the problems of medical care for prisoners. The terrible terminal diagnosis that one might get as a prisoner would be particularly frightening, I would think, because of the lack of medical care.

That is actually not my concern. Regardless of where one stands on assisted dying in general, I really hope that, when it comes to this Bill, noble Lords will consider the very particular circumstances of those incarcerated by the state. I hope the sponsors of the Bill will still be open to excluding prisoners and keeping them out of the Bill, on the basis, if nothing else, of their lack of autonomy.

I have to confess that I was rather taken aback when I heard Minister Stephen Kinnock in the other place state that excluding prisoners from this Bill would lead to a difference in treatment between prisoners and non-prisoners, an inequality, citing Article 8, private life, and Article 14, discrimination, of the ECHR. He noted that differential treatment would require objective and reasonable justification. It seems a bit shocking to me to have to explain this to a Minister, but my objective and reasonable justification is that, if you are in prison, you do not have the same rights as if you are not in prison. I did not make that up—although I know the Sentencing Bill has gone a bit liberal.

Actually, I think that, you know, you are deprived of your liberty. Many of the arguments made by the advocates of the Bill about autonomy and giving people choice towards the end of life, in particular circumstances —which I completely understand, philosophically and politically—are entirely appropriate for free people. But when you are not free and do not have autonomy, it brings with it a whole new range of ethical dilemmas.

The purpose of prison is, as I have said, to suspend certain rights from people to protect the public, to ensure deterrence and to uphold a sense of justice in society—I could go on. When the state has deprived an individual of so much autonomy, for all the criminal justice reasons we know, offering the option of an assisted death does not increase their autonomy in a meaningful way. It is saying, “Oh, well, we’re giving them choice”—but their real choice would be being able to leave. In other words, we have limited their choices.

Why does this matter? It is because, when the state decides to deprive somebody of their liberty, it is a very serious decision. For me, it is the worst possible punishment you could give: you are limited in being free, which I obviously consider to be very important. Prisoners, inevitably, are depressed: and often they are vulnerable in the first place. That is why they are prone to suicidal ideation.

Those of us who have had the privilege of doing some work with prisoners will know that we spend a lot of time tackling self-harm, with people hating themselves and the circumstances they are in. We do a lot of work on that. I and many others have worked on IPP prisoners, who are, ridiculously unfairly, still in prison indefinitely based on an abolished sentence, often for minor breaches of the law in the past. It is always shocking when you hear of another IPP prisoner who has taken their life. It is particularly horrible, as many noble Lords here have articulated far better than I can, because it is almost like it is on the state’s conscience. That is the reason why coroners make such a fuss about it. Those prisoners should not be there; they are in prison because the state made a mistake with the sentencing regime that it will not resolve and then they take their life. The state is somehow implicated in those suicides and we make a particular point of that.

Those of us who have worked in prisons will also know that suicide prevention is something we take very seriously. It does not matter how heinous the prisoner’s crime is. They could be a child abuser, a rapist or a murderer, but, if there is even a hint that they might commit suicide, there is suicide watch. We do all sorts of suicide prevention. The reason is that, as a humane society, we do not think that people should be allowed to take their own life, if at all possible. We have suicide watch in prison because the state has somebody incarcerated. Therefore, as a humane society, you take seriously not letting them kill themselves: otherwise, you could just say, “Carry on boys, it doesn’t matter”. We do not do that because we think that we have to protect those prisoners in the state’s care.

Right, I will finish. Letting prisoners have access to and be eligible for assisted death would be very close to reckless state abandonment of those prisoners to something very deeply dark. Philosophically, if a penal sentence in Britain ends up with the state effectively putting a prisoner to death via lethal drugs—I do not want to go on, but that is what would have to happen: they would be locked up in a prison, in the state’s care, the state would then make them eligible to ask for assisted dying, with limited autonomy, and would then hand them lethal drugs—that is far too like capital punishment, which I have long opposed and do not approve of. Therefore, even if you do not agree with me on the rest of the Bill being a completely difficult challenge to humanity, which I think it is, I none the less suggest that, if we pass it, we should absolutely exempt prisoners from it.

[Lord Moore of Etchingham (Non-Afl)]

My Lords, I support these amendments, particularly those relating to prisoners and, indeed, what the noble Baroness, Lady Fox, so eloquently expressed. Just before I do, I will also support something that the noble Lord, Lord Blencathra, who is now not in his place, said earlier, when he complained about some of the exterior noise around those of us who are debating this Bill.

I declare an interest as a general practitioner, not of medicine but of journalism. I know very well what happens and how to recognise when we are being pushed to do a story. In the past two weeks, all the British media have been pressed very hard by lobbyists in favour of this Bill to produce a series of highly contentious arguments that attack anybody who tries to debate the Bill fully. This is very much at odds with the spirit of legislation of this sort, and with what the noble and learned Lord, Lord Falconer, keeps trying to do. He says at the end of each group what a valuable debate it has been. He does not say, “What a waste of time this debate has been”; he says it has been valuable, which it has been. I have learned a lot today, for example, about GPs and their difficulties, and we are learning more about prisoners. There was a virulent article in the Times by Nicholas Boles, who was an informal—

--- Later in debate ---

[Lord Moore of Etchingham (Non-Afl)]

I am grateful to the noble Lord. As I said, I will come on to the amendment soon, but I want to emphasise this point because I think that it matters a lot in this debate and will matter in the coming weeks. A particularly virulent article in the Times, written by Nicholas Boles—he was, until recently, an informal adviser to the Prime Minister—put these arguments in a way that was quite inappropriate for the type of discussion on a conscience issue that we are having.

On prisoners, I want very much to pursue the point about autonomy, which is absolutely right. It goes to the heart of this Bill, because the Bill’s supporters are those who give precedence to autonomy over all other things. The people who are more questioning of the Bill do not necessarily do that—at least, they think that there are many qualifications to the right of autonomy.

As the noble Baroness, Lady Fox, pointed out so eloquently, this issue very much applies to prisoners, who have a double loss of autonomy in prisons. First, their autonomy has been taken away from them by the decision of the state, as expressed in the quaint phrase “at His Majesty’s pleasure”; it is not “at the prisoner’s pleasure” but “at His Majesty’s pleasure”, which is an expression of the power of the state and the prisoner’s loss of autonomy. Secondly, prisoners lose autonomy in another way because of their vulnerability and the situation they are in.

The point I wish to add to this argument is to do with the Government, rather than the movers of the Bill, although it affects them, of course. In evidence to the Select Committee, the relevant Minister at the Ministry of Justice, Sarah Sackman, said that, as far as the Government are concerned:

“The policy choice that the option of a voluntary assisted death be extended to those in prison is just that. It is a policy choice on which the Government are neutral”.


I do not understand how the Government can be neutral on a matter that is entirely within their purview, and I would like to hear what the Minister has to say about that.

[Baroness Berridge (Con)]

My Lords, I will speak to Amendments 30A and 119A in my name, which relate to children and young people who are under an EHCP. I offered to withdraw these two amendments in order to shorten proceedings; by putting that on the record, I will shorten the meeting offered by the noble and learned Lord, Lord Falconer, but not necessarily these proceedings.

I am grateful to my noble friend Lady Coffey for spotting a typo in Amendment 119A—ECHP instead of EHCP. Please may we not create any more quangos with that combination of letters?

The Select Committee heard from Dame Rachel de Souza, the Children’s Commissioner for England, about the basic policy reason behind some vulnerable adolescents and those with additional needs being under her jurisdiction until they are 25: they need the extra support to transition into adulthood. Amendment 30A would remove all young people under an EHCP from the Bill; Amendment 119A on this policy ground would mean them falling under the Act, but with additional conditions. Such an issue may be additional subject matter for the promised meeting. Would these be the right conditions, were we to accept Amendment 119A?

The Children’s Commissioner’s jurisdiction also covers anyone under the age of 25 who has ever been in care. She has a specific responsibility for children up to the age of 25 who have an EHCP. I note that, in law, it is not 18 for all purposes. You cannot adopt children until you are 21. So, at the moment, the Bill does not produce a cliff edge at the age of 18.

Some of the young people on EHCPs may lack capacity and are, therefore, outside the scope of the Bill. As the noble Baroness, Lady Hollins—she is no longer in her place—has often said, assessing the capacity of people with learning disabilities is a complex matter. However, many young people are on an EHCP because of other additional needs or considerable childhood traumas; they will have capacity and will, therefore, come under this Bill. It is again relevant to think of them at 18 years and one day old, and with a life-limiting condition. Sadly, due to the lack of the usual pre-legislative processes of consultation, a White Paper and scrutiny, we are without the data on these vulnerable groups showing how many in the EHCP or under High Court DoLS also have life-limiting conditions. That data would give us an idea as to the priority of conditions for different groups.

In the Select Committee, Ken Ross of the Down’s Syndrome Association stated that people with Down’s syndrome cannot always fully comprehend complex decisions and have very suggestible minds. This is why there are additional safeguards in the EHCP, but if they have capacity, they are under the Bill currently without any additional safeguards.

Again, due to the process of the Private Member’s Bill, it is not clear how this legislation sits with other legislation and safeguards. Has the Bill been considered by the Department for Education, which has responsibility for children under the 1989 Act? Has the noble and learned Lord met with those Ministers? For instance, just to give an array of possible problems, in many cases local authorities legally still have a role for those under an EHCP after the age of 18. How will that fit with the processes outlined for assisted dying? Will there be a clash of decision-making from the EHCP special educational needs panel and the TIA panel?

What legal authority does the local authority have on safeguarding grounds to intervene in the panel’s process for a young adult on an EHCP if it disagrees with the assessment by the panel that the young person is making the request for assisted dying due to peer pressure or, as Ken Ross suggested, an enhanced susceptibility to pressure from white coat syndrome for those with Down’s syndrome? Is it mandatory for the TIA panel to get information from the SEND panel? Can the SEND panel appeal the decision to grant assisted dying? It seems not, so the family and the local authority will be left with the expensive and difficult remedy of judicial review.

Has the noble and learned Lord considered the evidence from the British Association of Social Workers? It states that the panel needs the power to do its own safeguarding assessments, or the power to close a case a local authority is seized of under Section 42 of the Care Act 2014. Otherwise, assisted dying could be granted and there could still be an open safeguarding case at the local authority unless the panel has the power to investigate and close it. These issues would have been flagged on a government write-round or during proper pre-legislative scrutiny. I am disappointed at the lack of meetings so far, as we need a proper process to consider the position of many vulnerable 18 year-olds on the day after their 18th birthday.

Bearing in mind Amendment 22, which the noble Baroness, Lady Grey-Thompson, mentioned, I wonder whether she, the noble and learned Lord or the Minister are aware of whether the policy decisions made for pregnant women in other jurisdictions are based on policy alone or on clinical evidence. If there is clinical evidence that drugs can promote and induce labour, is that why other jurisdictions have taken pregnant women out? That is relevant, because I have amendments later in the Bill about warning relatives of complications, especially if there is going to be a person under 18 present while assisted dying is being given.

Finally, on the points raised at the start of the proceedings by the noble and learned Baroness, Lady Butler-Sloss, I did not have the benefit of listening to the “Today” programme, but we are dealing with so many groups of vulnerable people. That is because of the lack of pre-legislative steps that we usually have. Groups would have been consulted and there would have been a White Paper. I have been exchanging optimistic emails with the noble Lord, Lord Carlile, but for me personally it is an open question, bearing in mind the lack of pre-legislative scrutiny, whether the Private Member’s Bill process actually fix that.

I know that the noble and learned Baroness worked with the noble Baroness and that she is very fair-minded, but I have had cause to look at the evidence from the Jersey States Assembly, a small Parliament. It was drawn to our attention in the Select Committee by Alex Ruck Keene KC that some instructions went to 200 pages, so I asked the Library to do some research and the Jersey parliament’s process is gold-plated. Not only that, but its website is much easier to use than parliament.uk and one can look at the process and timetable from 2021. When the States Assembly approved what it was going to do, the Executive—the Minister for Health and Social Affairs—gave drafting instructions to parliamentary counsel. To write a piece of legislation fit for purpose, they ran to 201 pages. We say that we are the mother of Parliaments in the Commonwealth context, but that is the way to legislate. I keep open in my conscience whether this process can fix the problems with the Bill which are such that none of the royal colleges is currently supporting it.

Terminally Ill Adults (End of Life) Bill

Lord Moore of Etchingham Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Butler-Sloss (CB)]

My Lords, I understand very much the points made by the noble Lord, Lord Winston, and the noble Baroness, Lady Fox. I come to this issue from a rather different position. I used to try a lot of cases, some of terminally ill young people, generally from the ages of 15 up to 25 or more. There were a number of cases of those with terminal illness, undoubtedly with capacity, who were also suffering from depression, not very surprisingly, or were confused as to what they really wanted. They came before me for all sorts of reasons unconnected with whether they should live or die from their perspective. What I was looking at was the medical evidence as to the sort of support that they ought to have.

Despite the neuroscience issue, which is important, and despite 18—or down to 16 under the present Government—being the age at which you are able to vote, I just raise whether you are looking at how much you care about the future of this country and what you care about for yourself. Do you want to die because you are going to die in the next few months? The doctors may be right or wrong about six months; we know that many diagnoses are inaccurate. This may be the most important decision of all to make: life or death? Consequently, I am concerned about the age of 18 from my own experience. Whether it should be 21 or 25 is arguable, but I am worried if it sticks at 18.

[Lord Moore of Etchingham (Non-Afl)]

My Lords, I support the amendment from the noble Baroness, Lady Berger. It is reasonable to have these considerations about the different ways people think and feel at different times in their life. One of the big discussions we have more broadly about the Bill is about the cognitive capacities of old people, which are very important in their freedom of decision.

In a similar way, it is reasonable to talk about the cognitive capacities of very young people. In particular, one of the things that makes very young people different from older people is that they naturally have very little encounter with death; they are much less likely to have come across situations in which people die and people they know have died. They simply do not know what it involves. If it were banned throughout the world that anybody under the age of 25 would fight in a war, we would hardly have any wars. One reason why soldiers are prepared to fight in wars is that they do not understand death when they are very young. They are ready for anything.

There is often a very strong culture of suicide in young people, because it is a romantic idea. The poet Keats expressed it absolutely beautifully in his “Ode to a Nightingale” when he speaks about being

“half in love with easeful Death”,

and the joy of ceasing on the midnight with no pain. He knew of what he spoke, in a sense, because he was suffering from a terminal illness, and he died before he was 25.

As the noble Baroness, Lady Berger, and others have brought out, we need to think about the influences on young people who may go in that direction. If they suffer from a terminal illness, that becomes even more acute. Because of their lack of experience in these matters, they will be under greater pressure, quite possibly, to feel that suicide is the way out and is somehow a noble thing to do.

I remember, at school, there was a very brilliant boy who was 18 and wrote a very short poem that just said, “If I should die, think only this of me: ennui”. It was a very clever thing to write, and he subsequently committed suicide aged 19. I ask noble Lords to think about what it might be like in such a situation at such an age.

[Baroness Hayter of Kentish Town (Lab)]

My Lords, the people we are talking about are dying, in suffering and in pain. They are not being offered; they are going to be asking. I think of a 23 or 24 year-old in pain and about to die, possibly within weeks or months, and we turn around and say, “I am really sorry. You have had children, taken big decisions in your life, taken career decisions and seen whatever has happened to your parents, but you cannot be helped in your last few days, weeks or months because you are only 24”. I find that extraordinary. The age of 18 is probably the right one. Can we remember that these people are dying, and they are suffering? Those are the people who will be applying for this.

Terminally Ill Adults (End of Life) Bill

Lord Moore of Etchingham Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Moore of Etchingham (Non-Afl)]

My Lords, I could not possibly attempt to compete with the forensic skill of the noble and learned Baroness, Lady Butler-Sloss, which is so impressive. I simply want to add to this excellent debate one striking comparison which I hope may illuminate it.

Near my home in Sussex stands the beautiful cliff of Beachy Head, which is the most popular National Trust property, with 2.5 million visitors every year. Unfortunately, it is also the number one suicide spot in the world. Online suicide forums instruct people exactly how to get there and jump to their death. At least one such candidate arrives every single day. Also every day, however, a remarkable charity—the Beachy Head Chaplaincy Team—is there, based five minutes’ walk from the fatal cliff edge. The team’s purpose is the opposite of assisted suicide: they try to persuade those who have come to die to live. They are astonishingly successful. I have the latest figure from Gerry Howitt, the team’s CEO. So far this year, they have engaged with 271 people who have come to kill themselves. Of those, only four have jumped.

The chaplaincy team also works tirelessly with Sussex Police, the council, clinical mental health professionals, the local pub, the local taxi service and the National Trust at all practical measures of dissuasion. This means, for example, that lay-bys close to the cliff are blocked, pushing people to park nine minutes’ walk from the edge. Such preventive actions work. The total of those who arrive intending to jump has fallen by 32% since 2023.

As these potential suicides make that nine-minute walk, the chaplains, who are well trained in spotting symptoms and often carrying intelligence about individual arrivals, try to engage them in conversation. Their carefully honed technique starts by showing empathy and moves through establishing rapport to suggesting behavioural change and walking them down to the team’s building for a cup of tea.

Studies show that suicidal ideation, the overwhelming presence of thoughts of death and suicide, is never continuous for more than four hours, often for much less. Offered the right mixture of professionalism and human kindness, people change their minds. Of those 271 with whom the chaplaincy intervened this year, only 57 even reached the cliff. As I say, only four actually jumped.

I am sure your Lordships’ House will admire this moving example of co-operation between private charity and public services and this triumph for life itself. Indeed, the police intervene against suicide attempts under Article 2 of the European Convention on Human Rights—the right to life. Some may object that the sort of suicide being assisted by the Bill before us is very different from that being prevented on Beachy Head, and in some ways that is true. But I end by asking your Lordships to consider the following thought.

The Bill does not support the freedom to kill yourself: that, we already possess. It confers a right to kill yourself with the active assistance of the state and doctors, and at public expense. It also reverses the operation of that power of human persuasion which works such wonders on Beachy Head. Under this legislation, the professionals will, by definition, be people wishing to fulfil a person’s wish to die. No one will be present to advocate the choice of life.

I do not believe that our country, particularly our National Health Service, can successfully contain such a contradiction in public policy and morality. If the Bill is enacted, the same hospital whose professionals help rescue potential suicides will contain other professionals who give gravely sick people the substances to kill themselves.

On Beachy Head, the chaplains say, “Please don’t jump”. In regard to this Bill, my Lords, I say the same to you.