Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Friday 20th March 2026 Lords Chamber

[Lord Shinkwin (Con) [V]]

My Lords, I shall speak to Amendment 167 in the name of my noble friend Lady Fraser of Craigmaddie. In doing so, I should make it clear that I support the other amendments in this group, and I join other noble Lords in saying how good it is to see my noble and learned friend Lady Prentis of Banbury back in her place.

My noble friend Lady Fraser outlined how comprehension and communication can be a real challenge for some people because of their disability. The amendment invites us to think differently—to view the need for clarity from their perspective, not ours. That means our accepting that what may appear to many to be an unnecessary clarification will, to others, be essential.

Whatever position one takes on either the principle of assisted dying or indeed the Bill, surely the case for making the language in the Bill as clear as possible, for both the many and the few, is overwhelming. Doing so is ultimately about meeting the anticipatory duty to make a reasonable adjustment on account of disability. It was your Lordships’ House which helped to write that duty into law when it passed the Disability Discrimination Acts of 1995 and 2005 and the Equality Act 2010. Amendment 167 therefore gives us an important opportunity to show that we, as a law-making body, honour the duty to make reasonable adjustments, just as we require by law others to abide by that duty.

I hope the noble and learned Lord will recognise our responsibility to be seen to lead by example and to ensure that the wording of the Bill is in keeping with that duty, clearly and unambiguously. I hope he will consider my noble friend’s remarks very carefully, because she speaks with considerable professional experience and authority, which should not be ignored. I hope that he will accept her amendment.

[Baroness Berridge (Con)]

My Lords, Amendment 174 is in my name, and I am grateful to the noble and learned Lord for the meeting on this issue. This amendment states:

“Any interpreter provided under subsection (4) must be aged 18 … or over”.


It is a probing amendment.

If you put two lawyers in a room and give them wording from the NHS guidance saying that it is “inappropriate” to use children, you would have a fascinating discussion about discretionary versus mandatory, and that is the point behind this amendment. It might be that a different age, say 16, is appropriate, but since meeting with the noble and learned Lord, I have looked at certain guidance from particular NHS hospital trusts. Leicestershire Partnership NHS Trust states that you “must not” use children. The Milton Keynes University Hospital trust says that children “should not” be used as interpreters. So we have overall NHS guidance using the word “inappropriate”, which seems to imply discretion, but then we have certain hospitals—I obviously have not checked them all—using mandatory language. It is important that we consider whether, in this scenario, there should be any discretion to use children, whether they are under 18 or, as I say, under 16.

The TIA process should be mandatory, because it is a substantial process. This is the communication of a profound state of affairs. It includes numerous complicated stages, from a preliminary discussion to different co-ordinating doctors. It involves a Mental Capacity Act assessment and could involve the discussion of quite sensitive information about the administration of lethal substances and their potential complications. It is a serious and, as we have said, irrevocable decision.

My submission to the Minister is that it should not be an option that interpreting lies in the hands of a child, but that we should provide for qualified, skilled adults to be present and to provide that service, so that any relative, including children, can sit, support and have their own potential needs met. Is the noble and learned Lord satisfied that this should be a service provided by the National Register of Public Service Interpreters?

This is not a small problem. The census in 2021 shows that around 7.1% of people in the UK speak English as a second language and around 5% do not speak English well at all. The NHS website states that there are 1 million people who do not speak English well at all, who will need assistance with communication. If we do not provide this within the Bill, it might be that relatives, particularly children, are used in situations where the interpretation services are underfunded in that area—it is local commissioning that provides interpretation services.

I acknowledge that noble Lords may want the lower limit of 16, which some hospitals use, but I find it interesting to note that the limit may in the past have been too low. The former Member of the other place, Sajid Javid, talked about this. He said of his mum:

“I used to go to the doctor’s surgery with her—not because I was ill, but because I had to interpret for her. I was six or seven and an interpreter”.


I believe we should make sure that children in our jurisdiction are not placed in that situation.

From the evidence that was given to the Commons Public Bill Committee by Dr Jamilla Hussain, who is a palliative care specialist, we know that this issue disproportionately affects ethnic-minority communities, though not solely, of course. There are numerous reports of poor communication and interpretation that lead to adverse health effects and life-threatening illnesses being more prevalent in those communities. It would be the safest way possible if we put something mandatory into the Bill that does not allow for the possibility of situations where a young person feels they cannot say something, having been alongside their parent or guardian for many years. Putting something mandatory can actually protect those young people.

In relation to other clauses in the Bill, we have spoken about the profound effect on young people’s brains and development—I believe this is relevant and not repetition—of traumatic events such as the death of a close family member. That casts a new light on the possible neurological impact that interpretation by a child for a relative seeking assisted dying could have; it could give rise to further health conditions as they develop. Reports state that, if a child’s hypothalamic-pituitary-adrenal axis is faced with traumatic stress—in this instance the loss of the primary carer—it can lead to long-term functional and structural changes in key areas of the brain’s development. This can contribute to various psychopathologies, obviously including PTSD. Putting something mandatory into the Bill, so that children cannot be placed in this situation, is important to make it clear for all NHS hospitals which may have to deliver this.

It goes to a conceptual point, raised when I met the noble and learned Lord, about autonomy and choice. There are circumstances in which we limit autonomy and choice, particularly with children; we say that it is better for us all, as the legislature, to have taken a decision to protect those children. It should be mandatory that those under the age of 16 in this context are not taking part in the process of interpretation. It may be that, as we discuss this, there are situations and circumstances, such as terminal illness and advice about treatment, where it should be mandated that children are not involved as interpreters.