Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

2nd reading
Friday 12th September 2025 Lords Chamber

Moved by

[Lord Carlile of Berriew]

As an amendment to the amendment in the name of Lord Forsyth of Drumlean, to leave out “and to provide full support at ministerial and official level to the peer in charge of the bill for its remaining stages in the House of Lords”.

[Lord Carlile of Berriew (CB)]

My Lords, I should make it clear at the outset that I am opposed to this Bill in principle but, above all, I am opposed to it because it is not an adequate Bill to deal with all the issues raised and does not provide anything like sufficient protection for those vulnerable people who might be persuaded, against their real will, to accept assisted suicide.

I agree with the words in the amendment tabled by the noble Lord, Lord Forsyth, apart from his bold bid that, in effect, this Private Member’s Bill should be treated as a government Bill. That was not what the noble and learned Lord, Lord Falconer, said was happening; I am sure that he would confirm that civil servants are insisting on their neutrality being maintained, even when they are looking at the feasibility of the Bill—I see him nodding in agreement. The noble Lord, Lord Forsyth, asks for

“full support at ministerial and official level to the peer in charge of the bill”.

That would put the noble and learned Lord in the position of a Minister. Such support is inappropriate for a Private Member’s Bill of this kind. It does not pretend for one second to be neutral or even-handed.

If the last 27 words of the amendment tabled by the noble Lord, Lord Forsyth, were removed, I would agree with it completely, but he seeks to take the steps that I have just described. Indeed, despite the large resources supporting the purposes of this Bill and the involvement of many experts, including the noble and learned Lord, Lord Falconer, one of our most respected and knowledgeable legislators, this Bill earns a D-minus for its draftsmanship, even after all those committee meetings in the other place. It needs to be dismantled if it is to be an effective and proper Bill, to give it what I would, as a shortcut, call legislative legitimacy.

What evidence is there for the propositions that I make? I will cite two pieces of evidence that emerged from your Lordships in the last two days. First, the Delegated Powers and Regulatory Reform Committee, chaired by the noble Baroness, Lady Ramsey of Wall Heath, produced a report a couple of days ago which there is no time to read out. I will simply summarise that, by the calm standards of that committee, its criticism is excoriating. I was on that committee for a considerable period, and I never saw any Bill criticised to that extent. It says that the Bill is simply not fit for purpose, breaking several standard rules of draftsmanship. It is incompetently drafted, after all the time that has been spent on it, with the steersmanship of the noble and learned Lord, Lord Falconer. Then yesterday, the Constitution Committee reported and endorsed the views expressed by the other committee, saying, in effect, that the Bill was not fit for purpose.

We must remember that this Bill would allow a citizen deliberately to perform acts which are intended to cause the death of another citizen. Since the end of capital punishment, no such act is allowed in our law to any citizen other than in war. That is the weight of the change which this Bill seeks to make. We must be given time, the space and the methods to amend the Bill if that can possibly be done, hence my support in due course for the amendment tabled by the noble Baroness, Lady Berger, which would allow a Select Committee to hear evidence which the Commons committee chose not to hear and would have been very persuasive. I beg to move.

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[Lord Pannick (CB)]

My Lords, I will focus on the content of existing law relating to end-of-life issues. I do so to make the point that the current law recognises the fundamental importance of autonomy. It rejects the absolute sanctity of life, about which we have heard much from the Bishops’ Benches and noble Lords, and the Bill will introduce greater dignity and greater safeguards than currently exist.

There are two basic legal principles. The first is that you have a legal right to end your life. Since the enactment of the Suicide Act 1961, attempted suicide is no longer a crime. You do not need to satisfy a panel of doctors or psychiatrists. There is no special protection against your relatives. If you are a competent adult, the doctors cannot require you to eat, to have a blood transfusion or chemotherapy, and they cannot stop you going to Dignitas. Why is that? Because the law recognises that it is your life, and so it is your decision, and because the law rejects the absolute sanctity of life.

There is a second legal principle that follows from this, and it is that the health system has a legal duty in some circumstances to take positive steps to implement your wish to end your life. I will give noble Lords an example: the case of Re B (Adult, refusal of medical treatment) [2002] 2 All ER 449. This was an adult woman who was paralysed from the neck down. She was dependent on an artificial ventilation machine to breathe. She wanted the machine turned off: she wanted to die because of the poor quality of her life. Her doctors declined to do so, so she applied to the courts for an order that they do so. The noble and learned Baroness, Lady Baroness Butler-Sloss, then the president of the Family Division, granted that order. She said the woman was an adult; she was of sound mind; it was her decision whether to live or die.

Parliament has intervened in this area. We made provision by the Mental Capacity Act 2005, Sections 24 to 26, to allow an adult of sound mind to make an “advance decision” refusing treatment to prolong their life, should the occasion ever arise, and should the person at that time lack the capacity to indicate their wishes.

I have one other example. When Tony Bland, a victim of the 1989 Hillsborough football stadium tragedy, was in a persistent vegetative state with no prospect of recovery and could not express a view about whether to live or die, the Appellate Committee of this House decided in 1993 that because he had no quality of life, there was a legal duty on the health authority to end his life support—to pull the plug. That is what the doctors did, and there have sadly been many similar tragic cases since.

For this Bill to authorise doctors to assist a person to end their life by providing a drug so they can die with dignity is entirely consistent with well-established legal principles which respect autonomy on end-of-life decisions. The Bill contains many more safeguards than already exist. It enables terminally ill people to end their life in a less painful and more humane manner than starving themselves to death or otherwise committing suicide, or travelling to Switzerland.

[Lord Carlile of Berriew (CB)]

My Lords—

[Lord Pannick (CB)]

I cannot take questions.

[Lord Carlile of Berriew (CB)]

Why not?

[Lord Pannick (CB)]

Because we are restricted to four minutes.

I support the Bill. I look forward to debate—including debate with the noble Lord, Lord Carlile—in Committee. Thank you.

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[Lord Carlile of Berriew (CB)]

Before the noble Lord sits down—

[Noble Lords]

No.

Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Forsyth of Drumlean (Con)]

My Lords, I do not know if I am alone in being frequently asked by people, from time to time, “What is the point of an unelected House of Lords?” I now have the absolutely mind-blowing answer, which is to refer them to these two days of debate on this really difficult subject and the range of expertise which we have heard.

I am speaking because I tabled an amendment. That was last Friday, so some noble Lords may have actually forgotten what it said. It called

“upon His Majesty’s Government, in the light of the 32nd Report from the Delegated Powers and Regulatory Reform Committee, to ensure sufficient time is available for consideration of amending stages of this bill, and to provide full support at ministerial and official level to the peer in charge of the bill for its remaining stages in the House of Lords”.

Despite the differences that we have heard in these two days of debate, there is a clear and absolute consensus across the House that the Bill is in need of amendment and further scrutiny.

I listened very carefully to the speech of the noble Baroness, Lady Berger, and I see her amendment. I am a little doubtful about how a Select Committee—which is not really a Select Committee because it is not going to produce a report; it is simply going to hear evidence—is going to change or alter the noble Baroness’s opinion on this matter, or indeed anyone else’s. However, it means we cannot actually start that task until 7 November, so we have lost some time.

As many speeches pointed out, none of us knows when and how we are going to die; none of us even knows when the end of the Session is going to be. So, between 7 November and the end of the Session, having listened to all the speeches and thinking of the number of issues that are going to have to be addressed, I venture to suggest that four Fridays for private Members’ legislation, unless we are going to completely destroy the prospects of other people with Private Member’s Bills, are not going to be sufficient time. It therefore seems essential that the Government provide time.

I understand why they do not want to do that: if I were in government and in the Prime Minister’s Office, I would be saying, “But that means we won’t have time for this, that or the other”. But this is an absolutely life-and-death issue and it is important that it is considered properly and put on the statute book, if it is to be put on the statute book, in a way that will satisfy my noble friend Lord Wolfson of Tredegar in his brilliant speech. He showed that what we are doing here is making legislation and we should put legislation on the statute book that has been properly thought through, which means that there has to be government time.

I happen to know that the Cabinet Secretary advised the Government that this should be treated in the way that all Private Members’ Bills dealing with matters of conscience are. Abortion, the death penalty and the decriminalisation of homosexuality were Private Members’ Bills that the Government took on board in order to ensure that they had proper time and were properly supported, and I do not—I was going to say “for the life of me”—understand why that should not apply to this Bill, having listened to these two days of debate. I suspect it might be because the Health Secretary and the Justice Secretary were opposed to the Bill—but we are told that the Government are neutral, and therefore I do not see why they should not provide that time in order to satisfy those people who have written to us on both sides of the debate.

I say to the right reverend Prelate the Archbishop of York, who threatened to vote down the Bill at Third Reading, that I hope he will think again about that. The expectations are sky high and to vote down a Bill that had not been properly considered or given enough time would put this House in a very awkward position, for no good reason. Our duty is to scrutinise the Bill, send it back to the House of Commons and ensure that we have the time to do a proper job.

[Lord Carlile of Berriew (CB)]

My Lords, noble Lords may recall—but I will remind them in case they have forgotten—that I tabled an amendment to amend the amendment from the noble Lord, Lord Forsyth, because it seemed to me that the noble Lord wanted to turn this Bill into a government Bill and give it all the authority of a government Bill, with a Minister in charge, or by putting the noble and learned Lord in the position of being a Minister. However, I have listened to the noble and learned Lord and he has said—absolutely rightly, and I totally agree with him and the noble Lord, Lord Wolfson—that this absolutely should be, and should remain, a Private Member’s Bill.

I have also looked at the potential effect of the amendment to the commitment Motion from the noble Baroness, Lady Berger, who I think has approached the Bill with great energy, superb intelligence and good judgment, and has done great credit to the House. Having considered that and the state of play as it is now, I think it is right that I should withdraw my amendment so that we can move quickly on to other, more substantive matters. I beg leave to withdraw the amendment.

Amendment (to the amendment) withdrawn.

Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Berridge (Con)]

I will just reply to the noble Baroness, then, that within the Bill that is not necessary. I have outlined Clause 10. This applies to the people who are verifying in the process, not to the individual. It was not in the Motion your Lordships’ House approved that that evidence should be taken.

To continue, Dr Annabel Price said:

“Pressure has a broader definition of perhaps strong encouragement, expectation or the worry of letting somebody down”.


The noble Lord, Lord Patel, joined in this mini focus group and asked:

“If I were to use the word ‘pressure’ and if I were to use the word ‘coercion’, how would you interpret the two?”


Professor Mumtaz Patel from the Royal College of Physicians—again opposed to the Bill—said, “It is grey”.

Amendment 846 also reflects the view of the Law Society, which is neutral on assisted dying but opposed to the Bill. Kirsty Stuart said:

“I think it is really difficult because there is not a definition at the moment … in the Bill”.


That is why Amendment 846 is based on the statutory guidance principle from the offence of coercion under the Serious Crime Act. I note that the Home Office has recently had to issue 91 pages of statutory guidance on that offence. It seems the courts are struggling with it.

Even if Thomas Teague is right that you look at the dictionary, are we talking about economic pressure, emotional pressure, financial pressure, spiritual pressure, reputational pressure, internalised or externalised pressure, or pressure of circumstances—for instance, no one provides you with a hospice bed? As Dr Suzanne Kite, from the Association for Palliative Medicine, said:

“We know that there are pressures of, ‘Can we afford the electricity for the oxygen supply?’ … Yes, these are issues”


that people face “on a daily basis”. The Bill is silent as to what kind of pressure is meant.

To move from individual sources of pressure, there can also be group sources of pressure. Alasdair Henderson, from the Equality and Human Rights Commission, spoke to the Select Committee about

“this wider issue of coercion or pressure at a societal level or an attitudinal level”

and

“the broader trends or cultural issues”.

He said that

“pressure is not always applied directly by another individual, but can result from attitudinal barriers, particularly around disability, and lack of services and support in society as a whole”.

Could pressure come from NICE refusing you, on value-for-money grounds, the drug that you think will wipe out your metastasised cancer? Indeed, the pressure could emanate from the Chancellor of the Exchequer in her Budget, or from the Secretary of State for Health and Social Care, to encourage vulnerable people to take assisted dying, a matter I put to the Government Minister, Stephen Kinnock.

Caroline Abrahams of Age UK said:

“The context again for this is a system in which adult safeguarding is under acute pressure because local government is under such acute pressure”.


The British Association of Social Workers also said that unless these statutory services

“are adequately resourced, that may bend people’s decision a certain way … much of social care is self-funded now. If you are poor and you cannot have access to those personal resources, even more pressure is applied to you”.

I look to the noble Lord, Lord Pannick: how does a medical practitioner sign to say that this kind of pressure—from culture, society or attitudes, or lack of statutory services—is not being put on the individual?

There was unanimity in the Select Committee when we started asking the professionals about training. I said that pressure

“is not defined in the Bill, so I am afraid I cannot help you. We have no definition in the Bill. You are going to need training, though, in pressure. Has any of you received any training like that?”

Professor Nicola Ranger from the Royal College of Nursing, Professor Mumtaz Patel of the Royal College of Physicians and Dr Michael Mulholland from the Royal College of GPs all said no. So we now have additional costs added to the Bill, because we have to devise training in pressure and deliver it to a whole raft of professionals, care staff, et cetera, so that they understand it, in particular bearing in mind the vulnerability to criminal prosecution that exists in Clause 34.

I am going to give the noble and learned Lord, Lord Falconer, this opportunity to shorten Committee proceedings. Deleting “pressure” from the Bill, when it has not been consulted on and has not been subject to pre-legislative scrutiny, would aid the Committee in evaluating the Bill.

[Lord Carlile of Berriew (CB)]

My Lords, in a group such as this, which has so many conceptual, linguistic and semantic alternatives on offer, it is very difficult to see how a Committee stage such as this is going to help very much in determining a final solution to the matters under consideration. Therefore, it could become very tempting to enter into the nice and easy solution suggested by my noble friend Lord Pannick, to the effect that the Bill is quite enough and provides sufficient protection. It is right to say that the Bill certainly seeks to provide sufficient protection, and I do not in any way attribute anything other than good motives to those who sponsor the Bill, in particular the noble and learned Lord, Lord Falconer.

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[Baroness Hayter of Kentish Town (Lab)]

If I could just finish. It has been a long time in this debate without hearing from my side—I want to come on to something that the noble Lord, Lord Deben, said anyway.

The amendments to this Bill are about coercion or pressure. As stated by the noble Lord, Lord Pannick, the situation at the moment is that people can go to Dignitas without even proving to a doctor that they are dying, and without any check as to whether there is coercion or pressure, or whether someone is going to inherit their house. They can go, and that is the way they end their life, and they feel it is not worth living any longer. On the definition of coercion, are we really content with continuing the status quo where there is absolutely no check—from a psychiatrist, a social worker, a lawyer, or anyone else—on whether they have been coerced? That is the alternative: allowing the status quo to continue with no checks whatever.

We have to ask, therefore, whether these discussions about definition are really about that, or whether they are about trying to stop the Bill. Perhaps we could discuss whether those who want the wording changed would then support the Bill. If they would, let us get down to discussing that, but if they are never going to, they are wasting the time of those who want it to go through.

[Lord Carlile of Berriew (CB)]

My Lords—

[Noble Lords]

Order!

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[Baroness Hayter of Kentish Town (Lab)]

I was not suggesting wasting time. I was asking whether, if these changes were agreed, people would then allow the Bill to proceed.

[Lord Carlile of Berriew (CB)]

Before the noble Baroness sits down, I have great admiration for her, but I and many others resent her waving her hands at us. The reason we wish to have the sorts of discussions that I was mentioning was so that, believe it or not, we can make a judgment as to whether we are prepared to support the Bill, or to be silent on whether we support the Bill, or to oppose it at Third Reading. It is unworthy of the noble Baroness to allege that all of us here who are expressing concerns are wasting time. It is not true, and it is what she said.

[Baroness Hayter of Kentish Town (Lab)]

I never said that about wasting time. The words did not come; I did not say them. I was asking whether the people who want a better definition will then be able to support the Bill.

Terminally Ill Adults (End of Life) Bill

Lord Carlile of Berriew Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Lawlor (Con)]

I thank the noble Baroness for her question, and I certainly will consider it, but I think it is important that we have a discussion about what I regard as a compromise Motion, which may be useful in the discussions noble Lords have with the sponsor or those who wish to proceed in that way.

[Lord Carlile of Berriew (CB)]

Would the noble Baroness, for whom I have a great deal of respect, consider whether she is really adding anything at all to the debate by continuing? We can read her amendments; we know the difference between 18, 21 and 25. I and the noble and learned Lord, with whom I do not disagree on the fundamental principle behind the Bill, are both of the view that we should have proper discussion on it and get through Committee in the way that is expected of us as the House of Lords, so when the noble and learned Lord intervenes and says he is willing to hold meaningful discussions, we should do that and move on to the next business.

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The noble Baroness, Lady Coffey, commended a test of domicile. Domicile is one of the most complex legal concepts that we have. There is domicile of origin, domicile of choice and domicile of operation of the law. In my opinion it would be disastrous for us to incorporate such a concept into this legislation, not least because I can have domicile in this country simply because it was the domicile of my parents when I was born. I could have lived my entire life in the United States, France or wherever, but would be able to come back to this country to benefit as a health tourist and take advantage of this Bill if enacted. That is exactly what we all want to avoid. Domicile should be ruled out. I hope that the noble and learned Lord, when he responds, will confirm that.

[Lord Carlile of Berriew (CB)]

My Lords, I agree with my noble friend Lord Pannick. The concept of residence is clearly understood. I recommend to the noble Lord, Lord Moylan, that he might need a criminal lawyer just in case he was prosecuted for doing something wrong. I would be very happy to act for him, of course.

I recommend that all of us who are considering this matter should have a good look, as I have, at the National Health Service ordinary residence tool, which was revised in March this year. It gives a very clear outline of all the possibilities and where they fall in the ordinary residence judgment. What concerns me about the example that the noble Lord, Lord Moylan, gave, which we will come to on another group, possibly even today, is that if somebody has been living in Spain and wants to come back to their former country of ordinary residence for an assisted dying, if this Bill becomes law, it will prove extremely difficult to detect where there has been undue influence, particularly within a family. It would be extraordinarily difficult to investigate that evidence, whether it was done by a court or by a panel. I would be opposed to it on those grounds.

[Baroness Butler-Sloss (CB)]

I also entirely support, including the word “disastrous”, the points that the noble Lord, Lord Pannick, made. As he said, domicile is complex. You would end up in court dealing with the issue of domicile. It really is not a good idea.

Under Clause 1(1)(c), there are two requirements. One is “ordinarily resident”. I say to the noble Lord, Lord Moylan, that if I was trying the case I would have no problem at all. If it says “ordinarily resident”, that is what I would accept, so long as there was the evidence to support it. I do not think we need to be caught up in the Human Rights Act in dealing with such an issue. What worry me are the two requirements,

“ordinarily resident … and has been so resident for at least 12 months ending with the date of the first declaration”.

That seems to be a complete bar for someone who is in an embassy. It is very difficult if they are not ordinarily resident. It looks as though the noble Lord, Lord Carlile, does not agree.

[Lord Carlile of Berriew (CB)]

I hesitate to interrupt my noble and learned friend, whom I regard as being of almost biblical correctness in almost everything. If she were to take a look at the NHS tool that I referred to, which sets out all the requirements to prove ordinary residence, she would find that people who work in embassies, for example, are excluded because they are given fixed-term contracts for a certain time, even though that contract may be extended at some time. It also specifically refers to people who work for charities and who go to work abroad for a temporary period fixed by a contract. I do not think the issue that she has raised is very worrying.

[Baroness Butler-Sloss (CB)]

I am delighted to hear it in relation to embassies and charities, but the other example given was the person living in Spain who wants to come back to die here. It seems to me that needing to be resident in this country for the last 12 months would not allow that person to do so. The noble and learned Lord might just look again at that particular element of residence.