Terminally Ill Adults (End of Life) Bill

Debate between Lord Deben and Lord Sandhurst

Committee stage
Friday 6th February 2026 Lords Chamber

[Lord Deben (Con)]

My Lords, I am hoping that I am going to help the noble and learned Lord, Lord Falconer, and I am sure he will be pleased with that help. We have been discussing some fundamental issues of interest to the people who are going to have to carry this Bill through. Therefore, I recommend three very simple things to the noble and learned Lord.

First, the sooner we know what the noble and learned Lord’s amendments are going to be, the very much better it will be. It would allow some of us to help—certainly not me, but the experts—to make sure they are adequate. Secondly, I support the noble and learned Baroness, Lady Butler-Sloss, in her demand that we should know as much as possible in advance. Thirdly—and the gravamen of my points—if you talk to people outside, many of them have no idea about the details of the Bill and have a general view either in favour or against it. However, when you talk to people who have some real understanding of the Bill, the issues which concern them most are those where they feel there is not adequate clarity, especially for the medics and others who are going to be involved.

This debate has been different, if I may say to the noble and learned Lord, from previous debates on this area. It has concentrated on the lack of clarity around what we really mean by competence. We have made the distinction between the competence that is satisfactory to make important but immediate decisions that can be reversed and the competence necessary to make fundamental decisions, where a person needs a longer-term ability.

It therefore seems to me that it would be advantageous to the noble and learned Lord’s whole cause if he could take this very seriously. If he can find a proper answer, which satisfies the sensible things that have been said, it will go very much further—this is a rather delicate sentence, which I hope the noble and learned Lord will not take amiss—to repair the impression that every amendment is shoved off. These are not amendments to treat with anything but the very greatest of care.

[Lord Sandhurst (Con)]

My Lords, I will speak to Amendment 581A. It reads:

“In the event that the assisting professional has doubts as to the person’s capacity for the purposes of subsection (5)(a), the assisting professional … must take steps to assess the person’s capacity, including (if they are not a person meeting the requirements under section 12(6)(b)) seeking the advice of such a person, and … may not proceed further until, with the benefit of such advice as is received under paragraph (a), they have satisfied themselves that the person has capacity to make the decision to end their own life”.


This is aimed at the very moment when the applicant, if I can use that neutral term, is about to be provided with the substance with which life will be ended. It is the very end of the process. The assisting professional is there. The amendment would require that, if they had doubts as to that individual’s capacity, they sought advice from a practising, registered psychiatrist. What could be objectionable about that? Why would it not be necessary, if the assisting professional had doubts? Should it not be mandatory? We know that people’s capacity can fluctuate if they have certain conditions. I see the noble and learned Lord nod as I say that. In this situation, when the final decision of whether to end life is being made, it is critical that the assisting professional has confidence, based on proper knowledge, that the applicant has the necessary capacity.

This amendment, together with a fair number of others that I have put forward, was put to me by CLADD, the Complex Life and Death Decisions group at King’s College London. Others have mentioned the group today, but I think it necessary, because I shall refer to it again, to explain who it is and what it does. The group has substantial expertise in a range of relevant disciplines. It is concerned that any Bill such as this is drafted in the best way to ensure that it operates in practice without avoidable dangers.

Because this is the first of its suggested amendments, I will say a little more about them. The group comprises psychiatrists, psychologists, lawyers and social scientists. They are serious academics who come at this without side; they are simply anxious that those involved at the sharp end have the best framework in which to operate. Its chair is Professor Bobby Duffy, professor of public policy and director of the Policy Institute. Other members include: Professor Gareth Owen, professor of psychological medicine, ethics and law and an honorary consultant psychiatrist at the prestigious South London and Maudsley hospital; Alexandra Pollitt, its director of research who specialises in mental health policy and public health; Professor Ruck Keene, an honorary King’s Counsel based in the Institute of Psychiatry, Psychology and Neuroscience at the Dickson Poon School of Law and a Wellcome research fellow researching mental capacity law, mental health law and disability law; Professor Katherine Sleeman, the Laing Galazka Chair in Palliative Care based at the Cicely Saunders Institute at KCL; a director of engagement, Suzanne Hall; and an NIHR doctoral fellow, Dr Liam Gabb.

They are therefore a range of absolutely top-class professionals who know about the detail. They have real, practical experience and academic expertise, and it is really important that their concerns, which I shall express on this occasion and elsewhere, are registered as being serious. They are not from people who are saying, “Don’t have such a Bill at all”; they are saying, and this is really important, “If we are going to embark on this course of helping people to die with medical assistance”—I will not use pejorative terms—“then it must be done properly”.