Terminally Ill Adults (End of Life) Bill

Baroness Blackstone Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords, I have spoken in favour of assisted dying in previous debates in this House, and that is still my position. Therefore, I am grateful to Kim Leadbeater MP for her work in steering the Bill through the Commons. We must not forget that the elected House has supported it; our task is to scrutinise, not reject it.

Like my noble friend Lady Thornton, I was concerned at proposals last week for a Select Committee, which might undermine the agreed timetable for such scrutiny in Committee. After so many years considering assisted dying, whether in Select Committees or Private Members’ Bills, it is now important that we complete the process. Therefore, I am grateful that my noble friend Lady Berger has agreed to a committee that is limited in scope and time, allowing the Bill to go through all stages before this Session ends.

With a view to improving the Bill, I welcome the opportunity to look into procedures and safeguards, calling evidence from experts. I am impressed by many of the contributions made so far, including some speeches from those not in support of the Bill. However, I regret the language used sometimes, such as references to the “killing Bill” or the “assisted suicide Bill”. Because of my personal experience, I am affronted by this.

When my former husband, in hospice care, was dying of stomach cancer at the age of 44, in agonising pain, with terrible nausea, too, he desperately wanted it to “come to an end”, as he put it, and asked for my help. I tried to persuade his carers to speed up his death, but failed. Is this “killing”? Was his wish to die “suicide”? Surely not. He loved life and had not wanted to die, but he was dying and, when life became truly unbearable, he longed for death. Because of the law, I could not help him end his torture.

As legislators, we have a duty to consider public opinion. Rigorous surveys all report high support for the Bill, ranging from 73% to 80%. The Nuffield Council on Bioethics set up a citizens’ jury on assisted dying earlier this year. Support for law change actually grew over the eight weeks of deliberations, when participants heard views from all sides. There are also large majorities in favour of assisted dying among Christians and those of other faiths, as well as disabled people.

Some speeches have referred rightly to the inadequacies of the status quo. Prosecutions of people who admit to helping a close relative die usually end in juries refusing to convict. Laws should not remain on the statute books where this is the case. Currently, there is no safeguarding when people end their lives at Dignitas, nor when unregulated and drastic ways of ending life, such as starvation, take place. Those who oppose the Bill need to address the problems of the status quo. We need more palliative care, yes, but it cannot always end the horrors of agonising deaths.

I end with two pleas. First, allow our fellow human beings greater autonomy over how they die; it is for them to decide and not for others, whether for faith or other reasons, to impose their views. Secondly, be truly compassionate in sparing terrible suffering as death approaches, allowing those who choose to die sooner to do so.

Terminally Ill Adults (End of Life) Bill

Baroness Blackstone Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Markham (Con)]

My Lords, it is clear, I think, that we all want the same thing here. Whatever one’s feelings about it generally, if this Bill is passed, we want to make sure that the person is in the right position—I do not use either “capability” or “ability”—to make a decision on whether to take part in assisted dying.

We all want the same thing, so what we have to decide is whether we believe that the existing framework, the Mental Capacity Act, can work here. I have heard a body of evidence that says it can. I respect in particular the evidence from Sir Chris Whitty, who, as Chief Medical Officer, is probably our highest adviser in the land in the medical space. He believes that it can do it. I also respect the opinions of the psychiatrists who have written in and said that, in their professional opinion, they are able to use the Mental Capacity Act to assess whether a person is in the right position to take part in assisted dying. So, as the noble Baroness, Lady Andrews, and others have made out, we have a body of evidence and 20 years of experience showing that the Mental Capacity Act can work and is already acting in very similar situations.

One can argue whether these two things are exactly the same, but they are pretty similar: both involve life-and-death situations, such as “do not resuscitate” orders, people deciding not to eat or drink any more, and people with motor neurone disease asking to come off ventilators. These are all very similar situations that, today, are decided under the Mental Capacity Act. So we have a system that is being used and which our best adviser says works, and we are setting an unknown definition against that. If we set about asking, “What do we mean by ‘ability’?”, we would probably all come up with very different answers. This would be untried and tested; it may take years, if not decades, to find something, against something that exists today. It would be very confusing: when do you use the Mental Capacity Act and when do you use this new definition?

Again, we all want the same thing: for the person to be in the right position. Our highest expert in the land says that the Mental Capacity Act can do it, and a number of psychiatrists are also saying that they can make the assessment under it. To my mind, that is what we should be considering.

[Baroness Blackstone (Lab)]

My Lords, I agree entirely with what the noble Lord, Lord Markham, just said. We have a tried and tested way of measuring people’s capacity, but we do not have a single tried and tested way of measuring people’s ability. That is a very broad concept, and anybody who has worked in education at any level will say with absolute certainty that it would be unwise to replace what is currently in this Bill with “ability”. There is no definition of it—it can cover a vast variety of different kinds of ability—and finding an adequate test could take years.

[Baroness Berridge (Con)]

My Lords, I declare my interest: I received a personal donation from Dr Etherton to fund research support. Normally, I would agree with the noble Lord, Lord Pannick, in relation both to legal terms that are not defined and to moving to something that is ill defined; he will find, in the later groups of amendments with which I am involved, that this is a key concern that I have had.

The amendment in the name of the noble Baroness, Lady Finlay, talks about “ability”. I have struggled with that, for the same reasons as the noble Lord, Lord Pannick, but I have been persuaded that there is something in this. I served on your Lordships’ Select Committee. One of the benefits of serving on those Select Committees is that you sometimes get to meet your hero. Professor Sir Chris Whitty sat in front of us as the highest expert in the land, but when he gave evidence to the Commons Select Committee he had to write afterwards because he had misunderstood something and had to clarify it. It was after the Third Reading vote, I think. His letter was put in our pack and made public; I thank the noble and learned Lord, Lord Falconer, for nodding. One has to consider the fact that even he got it wrong.

We also heard from Professor Alex Ruck Keene, who is an honorary KC, who trains practitioners in how to apply this test. We heard that, although it might be common and used up and down the land, there is a considerable body of evidence that practitioners are struggling to apply it in what he calls the 15% of cases that are complex. I think this is the kind of case outlined by the noble and learned Baroness, Lady Butler-Sloss.

The committee’s time constraints meant that I was not able to put that evidence to Professor Sir Chris Whitty, as Members’ questions are limited, but I put the following to him because it is sometimes helpful for us to think about the practical realities. The MCA would bring with it its other parts, not just the capacity test. There is a presumption if, for example, an 18 and a half year-old who has had a life-limiting condition all their life is being assessed and the doctor doubts whether that young person has capacity that they have capacity—as far as I understand Professor Ruck Keene. We have to take that evidence into account. There has been some discussion about the royal colleges, but as political parties we know that some people will peel off from the corporate view. We need to take seriously that the royal colleges are not supportive of the Bill. While Professor Sir Chris Whitty might—

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as chair of the Royal College of Obstetricians and Gynaecologists. I have followed what the different royal colleges are saying and it is not true to say that they are opposed to the Bill in general. Most of them are neutral, one or two are in favour and one or two are against.

[Baroness Berridge (Con)]

As people around me are saying, I do not think I said that. They are neutral. The royal colleges have said that they have problems with the Bill, but they have been neutral on the principle, save for the Royal College of General Practitioners. I am sorry; I stand corrected on that. They are neutral, as is the Association for Palliative Medicine, which is not a royal college.

When one looks at the evidence that we took, of course individuals from within that group would come along whom we had to call. It was right that we did that, but one looks at a corporate view. I enormously respect Professor Sir Chris Whitty, but I heard his evidence on this and he was not the highest expert in the land. He was humble enough to write to correct himself, as he had misunderstood the Mental Capacity Act when he gave evidence in the Commons.

Terminally Ill Adults (End of Life) Bill

Baroness Blackstone Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Lord Dodds of Duncairn (DUP)]

Some noble Lords are becoming exasperated or resentful about the time that we are taking to consider these important amendments today. I say gently that, had some of these issues been dealt with in a different way in the other place, we would not have to spend the time we are spending in this House dealing with them. When we consider the number of days in Committee that we spend on important Bills that come before us—sometimes 11 or 12 days in Committee and another three, four or five days on Report—it is not unreasonable that we spend at least a few hours to consider matters of life and death.

These amendments relating to coercion are at the heart of some of the concerns that many people have about the Bill. Coercion is central to the concerns. We have heard about financial and emotional abuse, about external influences, people feeling a burden and wanting to relieve themselves of that burden. These are critical issues—they are real issues. Those of us who have served as Members of Parliament, who have worked in the community and who have dealt with real people in real communities understand and know the reality of what we are talking about.

It can be easy to dismiss these issues sometimes. We sometimes see people speak on television who are very strong and confident, with lots of family support and resources around them. But I was struck today by the words of the noble Lord, Lord Deben: we must speak up for the vulnerable. I came across many vulnerable people in my work as an MP in one of the most deprived areas of Belfast, and they suffered in great loneliness and financially straitened circumstances. They felt pressure in today’s environment, where suicide is something that people undergo. In this situation, will the safeguards being introduced be stronger than what we have today?

A new regime is being set up whereby, for the first time, the state and all its resources will be made available to assist another person to end their life. That is a very different set of circumstances. All the pressures and influences that vulnerable people come under today will be massively increased and amplified when this new law comes into place—if it does.

It is very important that we take the time to consider these matters. I support the amendments in this group, to a greater or lesser extent, and very much agree with the sentiments argued by the noble Baroness, Lady Fox, about encouragement. That is something that needs to be in the Bill if we are to provide all the necessary safeguards. Whether you are for the Bill or against it in principle, surely we need the most robust and strongest possible safeguards against coercion, pressure, encouragement or otherwise.

[Baroness Blackstone (Lab)]

My Lords—

[Lord Shinkwin (Con)]

My Lords—

[Baroness Blackstone (Lab)]

We have given an enormous amount of time to looking at safeguards. The noble Lord just totally denied that and said that we have to begin all over again. We do not. This debate has regrettably been characterised by too few of the speakers giving any consideration at all to the important, tough safeguards already decided in the House of Commons. I will not go through them now, in the interests of time, because I that know my noble and learned friend Lord Falconer will, when he responds to this debate.

[Lord Shinkwin (Con)]

My Lords—