Terminally Ill Adults (End of Life) Bill

Lord Sandhurst Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, I rise with some caution, because these are deep waters. I think we should err on the side of caution. I support the noble Baroness, Lady Berger, because this is an entirely new process. Assuming the Bill comes into force in some form, the age can always be lowered in the light of experience; by experience, I mean that of the human brain and how people are considering these things.

What has prompted me to say this in particular is the report in the Times on 25 November of the study by Cambridge’s MRC Cognition and Brain Sciences Unit, which compared the brains of 3,802 people aged between zero and 90 years, using datasets of MRI diffusion scans, which map neural connections by tracking how water molecules move through the brain tissues. Very simply, this study found that the topology of the childhood brain runs from birth until the turning point at the age of nine, and then it transitions into the adolescent phase, an era that it found—this is completely dispassionate—lasts right up to the age of 32 on average. Our early 30s see the brain’s neural wiring shift into the adult mode, and I emphasise that phrase: adult mode. This is the longest era and lasts over three decades. A third turning point, around the age of 66, marks the start of an early ageing phase and, for those of us who are a bit older, the late ageing brain takes shape at around 83 years old.

I conclude by reading from the report:

“While puberty offers a clear start, the end of adolescence is much harder to pin down scientifically. Based purely on neural architecture, we found that adolescent-like changes in brain structure end around the early thirties”.


If that is the architecture, at this stage in the Bill we should be looking at 25 and not a younger age.

[The Lord Bishop of Leicester]

My Lords, I too rise to support this amendment with some caution, noting that these are deep waters. I hope that noble Lords will forgive me for pointing out the blindingly obvious: as I look around your Lordships’ Committee, I do not see any 18 to 25 year-olds on these Benches, and the voices of children and young people are vital in such a debate.

The role of Children’s Commissioner was created to ensure that the voices of children and young people were heard within your Lordships’ House and the other place. Therefore, when the Children’s Commissioner, whom I know personally, who has visited my diocese and whom I have seen at work listening to children and young people—she and her staff are superbly skilled at that work—urges us to be cautious, I believe we should listen. I therefore urge consideration of that note of caution.

--- Later in debate ---

[Lord Sandhurst (Con)]

My Lords, I will be very brief. Having listened to this, I am more and more persuaded that we must have reasons, because there will be no coroner’s inquest. We know that some doctors have misbehaved in the past, but that does not always come out. One needs to have a paper trail so that, if concerns start to arise about Dr X, we can see what Dr Y has been saying, as well as Dr X.

[Lord Wolfson of Tredegar (Con)]

My Lords, I can be extremely brief, because of the confirmation given by the noble and learned Lord and also knowing that the substantive issues of domestic abuse, interpreters and various other matters will be dealt with in their appropriate place.

At the risk of underlining my reputation as a legal geek, I invite the noble and learned Lord’s attention to his Amendment 350, and in particular the Member’s Explanatory Statement. I understand the amendment, but I do not understand the statement. The amendment leaves out from “to” to end of the line and inserts “section 12(4) and (7)”, which are about “sharing of specialists’ opinions”. The Explanatory Statement says:

“This is a drafting change (consequential on subsection (4) being added to clause 12)”.


Now, Clause 12 already has a subsection (4), and the noble and learned Lord’s amendments to Clause 12 are to subsections (5) and (8). I do not know whether the Explanatory Statement has confused me and in fact the change is not consequential on a new subsection (4) being added but just stands in and of itself. It may be that I am confused unnecessarily, but if the noble and learned Lord could just clear up that minor point, I would be grateful.

Terminally Ill Adults (End of Life) Bill

Lord Sandhurst Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Hayter of Kentish Town (Lab)]

I hope that the right reverend Prelate is not going to push for a vote at Third Reading. The task for this House is scrutiny of the Bill both at this stage and on Report, and I hope that that is what we will do.

[Lord Sandhurst (Con)]

My Lords, I will not be long. I speak to Amendment 726, which, as those of you who get that far in the list of amendments will see from the explanatory statement, is one of a number of amendments that I have been prompted to put down by the Law Society. They are intended to make the Bill safer in operation.

I would also like the House to know that I speak free from religious belief, but I do speak as a world-weary lawyer with many years’ practice at the sharp end in both medical negligence matters and legal professional negligence matters. I am all too conscious of my own experience of having seen things go wrong even where the people concerned were decent, honest professionals. Some of them, of course, although professionals, were neither decent nor honest. I have also sat as a legal assessor for five years at the General Medical Council, and I appeared as counsel for a north-eastern NHS trust in a very messy inquiry about 20 years ago about the misdoings of a Doctor Neale, who had featured in a “Panorama” programme—some of you may know about that. I have seen things go wrong on the ground for the past 30 or 40 years of my life.

It is with that in mind that I put down, among others, Amendment 726 with the support of the Law Society. I stress that the Law Society is neutral in principle but has looked at this Bill with what can be described as lawyers’ eyes. Its amendment is designed to make the Bill safer and better in practice. This amendment would “require” and not just permit—that is the difference—the Secretary of State to issue a code of practice in connection with what we are concerned with today; that is, capacity and so on, and the absence of coercion. A code is necessary. In Clause 39 of the Bill, there is provision for other codes of practice to be made; this is simply to add an additional code.

I suggest that this is a perfectly safe, non-destructive amendment that would improve the Bill in respect of a very important practice. As we have heard, coercion—I use the word loosely to cover a wide range of subtle pressures—must be addressed, and it should come from the Secretary of State. The panels that will oversee all this will not be enough. This must come from the Government, looking at things carefully and putting down a code of practice which says: “This is how the panels must address this”. We cannot have a postcode lottery with a panel in one part of England adopting one approach and another adopting a much tougher approach. We need uniformity.

[Lord Hay of Ballyore (DUP)]

My Lords, I support Amendment 48 in the name of the noble Baroness, Lady Ritchie, which seeks to protect individuals from being pressurised into assisted death. As the Bill stands, references to coercion and pressure in Clause 1 are strictly related to coercion and pressure coming from “any other person”. Amendment 48 would remove these three words and broaden out the whole understanding of coercion to include more than just that which comes directly from other people.

Various forms of pressure and influence can arise very easily from various sources: institutions, the media and, of course, even oneself. Every week there are new headlines about hospices struggling for funding and the increasing costs of caring for an ageing society. The Pathfinders Neuromuscular Alliance shared a heartbreaking story in its written evidence to the Commons Bill Committee of a patient who was told by their GP:

“Have you got any idea how much you cost the NHS?”


What kind of influence will these stories have on someone who has the option of assisted death? There is currently no safeguard to protect patients from pressure to choose an assisted death because they feel like a burden on the NHS or their family, or are experiencing loneliness, depression and many other related issues.

This is not just my concern. Caroline Abrahams of Age UK said to the Select Committee:

“We worry about the lack of choice about whether you are going to get good social care or good end-of-life and palliative care … We worry about a sense that, over time, it can exacerbate a feeling that an older person’s life is not worth as much as a younger person’s”.


She spoke about

“how we could ensure that older people in particular do not feel under pressure to make a decision that is for reasons other than their own real choice”.

I remind the House that Dignity in Dying put pro-assisted suicide campaigning material in our Tube stations last year. While advertising for assisted dying will not be legal under this Bill, the promotion of this service by its supporters and its presence in our society, alongside all the problems that our NHS and hospices are facing, seriously risks sending a message to people at the end of their lives that our society is better off without them. If a patient was motivated towards assisted death for this reason, Amendment 48 would ensure that they were not eligible as a result.

I ask those supporting the Bill how they intend to safeguard those who feel like a burden, cannot access the palliative care they need and feel that they have no choice but to pursue an assisted death. What would we say to Professor Smith, who said in her evidence to the Select Committee that the key question was:

“Is the person trying to escape the abuse and feelings that they have been made to feel a burden or are they trying to escape the suffering of their illness? If we cannot answer that question, then we should be very concerned”?


If we start permitting assisted suicide because people feel that institutions and the media do not want them, leading them down a dark path in their heads towards that decision, we will have completely failed the most vulnerable in our community. I urge noble Lords to support Amendment 48, because we are dealing with a life and death situation.

Terminally Ill Adults (End of Life) Bill

Lord Sandhurst Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Pannick (CB)]

My Lords, we have had an hour and three-quarters on this amendment and perhaps we should move on.

[Lord Sandhurst (Con)]

My Lords, I shall be very brief. The definition at the beginning is a most important matter. I am quite clear, having heard noble Lords make a number of very sound observations, that “capacity” is an essential term. That is the first thing. However, it is not sufficient, and it has to be added to. I say that because the Mental Capacity Act states explicitly that a person is not treated as lacking capacity merely because they make an unwise decision. That is a very different situation from what we will be dealing with in many cases going forward. I urge the House, when this comes back on Report and preferably beforehand, and the promoters, to consider adding simply “and ability” so that it reads “capacity and ability” because they are different concepts, and they are necessary if this is to work properly in future.

[Baroness Berger (Lab)]

I wish to respond briefly to two points. I have every admiration for the noble Baroness, Lady Hayman, and I definitely concur that we have a responsibility in this House. I also gently remind this House that there were a number of Members of the other place who said, both in writing to their constituents and in their spoken contributions in the House, that they were essentially outsourcing the job to this place for us to ensure legislation that is fit for purpose. I regret that that is the case. I think there are many of us on all sides of the debate, on both sides of this House, who would wish to see a government Bill, which has been the case with previous Private Members’ Bills that have been adopted by the Government. We would have more time and opportunity to ensure that we have robust legislation.

In the absence of that, in the process that we find before us, I want to share with the Committee—I was going to bring it up in the next group but in light of the comments and the contributions that we have heard so far I think it is important to share on record—the comments that we heard in the Select Committee from the Royal College of Psychiatrists. It is a professional body that was called to give evidence on behalf of its members as one of the pillars of the process, as one of the pillars of the panel.

We heard from Dr Annabel Price, who is the lead for the Royal College of Psychiatrists on the Bill. She is an eminent expert in this space. She shared with us that the college had very carefully thought through its position and its views and that it had asked for a review of the Mental Capacity Act’s suitability because it believes that the Bill currently states that a person is eligible if they have the capacity to make a decision to end their own life, but this framework has not been tested for this particular decision. There are principles within the Mental Capacity Act that the college is not certain are compatible with this decision and need to be thought through more carefully.

I think we should heed that warning and listen very carefully to that college whose members will be responsible should this legislation go through. Therefore, in the context of the amendment moved by the noble Baroness, Lady Finlay, I think it is important for us to consider this in terms of how we inform our debate going forward, which is relevant to this group and to the group that follows.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

That is very well put and is exactly the question. Is it appropriate to bring the Mental Capacity Act into this Bill? I understand that whether you have an assisted death is an incredibly important decision. You cannot remove the word “capacity”, so you have to reject the amendment from the noble Baroness, Lady Finlay.

Her Amendment 115 effectively draws on how the Mental Capacity Act 2005 is currently drafted, except it adds two things. It removes the presumption of capacity and, separately, it requires the person making the decision to be aware of a variety of things that are connected with their illness. To summarise, the way the Mental Capacity Act operates at the moment is that if you are unable to understand information relevant to the decision, to retain that information, to use and weigh that information or to communicate your decision, you do not have capacity under the current Mental Capacity Act. The extent to which the things that the noble Baroness, Lady Finlay, has referred to in her amendment would be relevant would have to be weighed in the context of the decision that has to be made.

I am more than happy to debate whether we need to make the changes to the Mental Capacity Act that she is suggesting. For my part, I do not think we do. One thing that is absolutely clear is that the amendment proposed, as the noble Lord, Lord Sandhurst, identified, is completely ridiculous. You cannot remove the question of capacity from this choice. Putting aside some detail hurdles, there are two hurdles that need to be overcome in how this Bill is constructed. You have to be capable of making the decision, as the noble Lord, Lord Wolfson, said, and—completely separately—you have to make that decision completely voluntarily. It has to be your own decision, not the product of pressure.

We have had—and I say this with warmth and respect—a rambling debate going over a whole range of issues, miles away from the question of whether one should remove the word “capacity” and put in the word “ability”. If this House wants to make the law completely confused in this area, either put in the word “ability” or put in “capacity and ability”. I echo the speech of the noble Baroness, Lady Hayman, when she says we have to approach this in a grown-up manner, and to remove the word “capacity” is not a sensible way to deal with this.

I also echo those who have said that the idea of running two systems at the same time—the Mental Capacity Act system and the separate system proposed by the noble Baroness, Lady Finlay—is wrong and confusing. I congratulate the noble Baroness, Lady Fox, for spotting what the right decision is. Of course, under the Mental Capacity Act some unimportant decisions are taken, but a decision such as whether to have the ventilation removed from you if you have motor neurone disease, that will almost certainly lead to your death, is without a shimmer of a shadow of doubt a life and death decision.

The Chief Medical Officer of England and Wales, in evidence to the Lords Select Committee, said:

“it is far better to use systems that people are used to and that are tested both in practice and, where necessary, in law”.

He went on to say:

“I have a concern that you could have a conversation in one bed in a hospital where someone is talking about, for example, an operation where they might well lose their life, because they are frail and there is the operative risk, done under the Mental Capacity Act, and, in the next-door bed, someone is trying to do the same process of having a difficult conversation about someone who might die, or could definitely die, as a result of that decision, but using a different legal framework. The risks that that could lead to confusion are not trivial”.


I also echo what the noble Baroness, Lady Browning, who sadly is not in her place, said. There are problems about practically every aspect of how various parts of the health service work, but she was part of a process that considered how the Mental Capacity Act worked. The broad conclusion was that it was a good, workable Act, and we should not stray from it in this particular case. I invite the noble Baroness to withdraw her amendment.

[Lord Sandhurst (Con)]

Before the noble and learned Lord sits down, may I just make it absolutely plain that I said that capacity was necessary but not sufficient. I am not stuck with whether it should be “and ability”, but I was absolutely plain in my very short speech that capacity was necessary but not sufficient.

[Lord Falconer of Thoroton (Lab)]

I was picking up on the word necessary. What the noble Baroness, Lady Finlay, is suggesting is that we remove the word “capacity”. I do not know if I misunderstood the noble Lord, but that is what I thought he was saying.

[Lord Sandhurst (Con)]

I wanted to make it plain because some people listening to the noble and learned Lord might have thought I had not said that.

[Baroness Lawlor (Con)]

Before the noble and learned Lord finishes, can he clarify for the Committee that a person who can grasp only a diluted amount of information, or who cannot retain the information in any real sense that would be intelligible to us, can be deemed to have capacity for the purposes of the Mental Capacity Act, but for this Bill, which is designed to give people agency and allow an individual as much choice as possible to choose treatment or have agency over medical and palliative care decisions and so on, an entirely different threshold should, quite rightly, be expected for such a serious measure as this?

Complications from Abortions (Annual Report) Bill [HL]

Lord Sandhurst Excerpts

Committee stage
Friday 6th June 2025 Lords Chamber

[Baroness Boycott (CB)]

My Lords, I join this debate to follow up the powerful speech by the noble Baroness, Lady Barker. I have been involved in women’s rights for a very long time; I started a magazine called Spare Rib in 1972 and within that we campaigned all our lives for things such as abortions. I can honestly say that I think the life facing a young woman today is more frightening than the life that faced me as a young woman.

I look at what is happening online, where you can download a very simple app. I had a lunch for Laura Bates the other day, which many noble Lords came to. She explained that I could download an app, take a photograph of the noble Baroness, Lady Freeman, right beside me, press a button and have a photograph of the noble Baroness naked—not with Kate Moss’s body, but with the noble Baroness’s body. You can do this at 11 or 12. It is really threatening being a young woman today. There are many things that are out of our control. We, as older women who have had successful lives, have to fight fantastically hard to protect this next generation from a lot of the stuff that is coming down the pipe.

I very much listen to and know about the conspiracies and the power happening in America to try to alter fundamental rights such as abortion. I find it extremely distressing that measures such as this should come to the House of Lords and even be debated seriously, and that there should be a politicisation of women who face abortion. Frankly, nobody wants an abortion; I cannot think why people ever thought that. Nobody wants one. There are several things you do not say when you ask yourself, “What do I want to do in my life?” No one says, “I want to be an alcoholic”, or, “I want to have an abortion”, or, “I want to be a druggie”. You do not put those on your wish list. They happen and we should protect women and support them all the way through, as the noble Lord, Lord Patel, spoke about in his fantastic debate earlier. These are people who need our protection and our love. I really support the noble Baroness, Lady Thornton, in bringing this forward. I will take part in any further debate because this is vital, and we are vital to this. Our voices really matter here.

[Lord Sandhurst (Con)]

My Lords, I thank my noble friend Lord Moylan again for bringing to our attention the issue of the reliability of statistics on the complications of abortion. It is absolutely right that, in all healthcare, we have correct and accurate data that health service providers can use to understand the safety of procedures.

It is the usual practice for Committee to include discussion of the amendments that have been tabled to the Bill, but here, of course, there is only the proposition that the only substantive clause should not stand part. This, therefore, has necessitated a general discussion of the underlying principles behind the Bill in a restatement on this side of the Chamber of our positions.

At Second Reading, I said that our view was that the Bill performs “an important service” by highlighting

“the absence of accurate, comprehensive statistics in respect of abortions”,—[Official Report, 13/12/24; col. 1990.]

but I explained in the same speech that improved data collection and reporting does not require legislation for it to be delivered. In short, I do not depart from that view, but this Bill has allowed an informed debate to emerge about data in this field. It presents an opportunity to urge the Government to do more to rationalise data recording and collection, so that proper evidence-based medicine can be implemented. In this respect, I endorse what my noble friend Lady Finn said about data collection and statistics more generally.

In answer to a Written Question asked by my noble friend, the director-general of the Office for Statistics Regulation stated that that office—the OSR—had not completed a compliance check on the abortion statistics collected by the Office for Health Improvement and Disparities since as long ago as 2012. That raises important issues of data quality. I am glad to note that it has now been agreed that the OSR will carry out a long-overdue compliance check on those statistics, but only after the Department of Health and Social Care has been able to update the design of the abortion notification system. This seems, to me and to others on this side, the wrong way round. Surely it would make more sense to complete these compliance checks before making alterations to the ANS. That way, the department will be able better to understand any deficiencies in the system—and we know there are some. I hope the Minister will be able to comment on this and address it.

Overall, my noble friend has raised an important concern. I suggest that the Government must now take steps to ensure that the data are gathered on a more reliable and consistent basis.

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

My Lords, I thank the noble Lord, Lord Moylan, for tabling this Private Member’s Bill and my noble friend Lady Thornton for tabling an amendment. I very much appreciate the contributions made by a number of noble Lords.

The stated main purpose of the Bill is to impose a legal duty on the Secretary of State to

“publish and lay before Parliament an annual report on complications from the termination of pregnancy in England under the Abortion Act 1967”.

The purpose of such an annual report, as I understand it, would be

“to inform policy and safe practice regarding the termination of pregnancy”.

I know that noble Lords appreciate that this Government are entirely committed to the priority of patient safety.