Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

[Lord Harper (Con)]

I am aware of that. I want to know whether it will contain detailed costings for the court process. Obviously, I do not know what the noble and learned Lord, Lord Falconer, is going to say, but one of the things discussed yesterday was whether he will accept any of the amendments that have been tabled. The point I am making is that, if he were minded to accept the amendments from the noble Lord, Lord Carlile, which obviously have a cost implication, there is a role for the Government in assessing those costs as well as a role for the sponsors. I am simply asking whether, if the noble and learned Lord were to accept them—he may not, of course—he would also provide the costs to the Committee. At that point, I draw my remarks to a conclusion.

[Lord Hamilton of Epsom (Con)]

My Lords, I will not detain the Committee for very long; the noble Baroness, Lady Hayter, can be reassured that I am not in the business of making a long speech.

I have in the past expressed my concerns to the noble Lord, Lord Carlile, as to whether judges are the best people to make these decisions and whether they can do so against the advice of the contracting doctor. The problem is that the doctor will be absolutely adamant that he is right in his case; I do not see why a judge should be able to overrule that, and I am not at all certain that a panel makes it much better. We should concentrate very much on the question of the contracting doctor; my forthcoming amendments will, I hope, address that point.

The problem is that doctors are sometimes malevolent. I accept that the doctors in this House are dedicated to looking after their patients and the public good, but that is not always the case. There are occasions—the noble Lord, Lord McCrea, referred to them—when doctors get it completely wrong.

I am very pleased that although Esther Rantzen was given six months to live, that was two and a half years ago. She wrote an article in the newspaper saying how much she has enjoyed the extra time that she has been given, although she is an advocate of this Bill. We must accept that doctors get these things wrong, and I think we should be concentrating on the contracting doctor rather than on the process of review.

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Lord Hamilton of Epsom (Con)]

Does the noble Baroness not share my concerns about the misdiagnosis of six months, when you think of all the people who live for much longer afterwards?

[Baroness Hayter of Kentish Town (Lab)]

While that is absolutely a legitimate thing to discuss, and I would always defer to doctors on that, it makes no difference to this part of the argument of whether we call it dying. The noble Lord may well want to raise the question of whether we can ever be sure that someone is dying, although I have to say that I cannot be the only one who has been with someone where it is jolly clear that they are not going to live till the end of the week. There are times when you absolutely know that someone is going to die. While he may well be right that there are other cases, that is not the issue of this word. This word in the Bill is to give to the public the understanding that we are talking about whether there is a way of helping either the final timing or the way of those final days. We are not talking about someone who just decides to commit suicide for some other reason; we are talking about people who are dying from some sort of terminal illness.

Terminally Ill Adults (End of Life) Bill

Lord Hamilton of Epsom Excerpts

Committee stage
Friday 23rd January 2026 Lords Chamber

[Lord Shinkwin (Con) [V]]

My Lords, I will speak to Amendment 44, so ably introduced by the noble Baroness, Lady Berger, and I thank her for tabling it. Today is an especially important day for me, because it marks exactly 30 years to the day since I had emergency neurosurgery in a desperate attempt to save my life following a terminal diagnosis of only six months. My neurosurgeon could not give me odds on survival, never mind recovery, so the outcome was definitely not a done deal.

The need for this amendment underlines why it is so important that no one assumes that this appallingly drafted Bill is a done deal, either. We keep being told by the Bill’s supporters that it is about people who are already dying. If that is the case, I assume that the amendment will meet with their enthusiastic support, given that it would make incontrovertibly clear in the Bill that a person’s motivation for seeking an assisted death is their terminal illness. Otherwise, as last Friday’s debate showed, we could be in the extremely dangerous situation of other motivations coming into play, such as feeling like a burden; living with a mental disorder, including depression; or living with a disability other than the terminal illness.

In her powerful speech of 12 December, the noble Baroness, Lady Gray of Tottenham, said:

“We do not live in a society where everyone is equally able to make decisions without being constrained by external influences, whether that is in the form of other people or simply follows from one’s own life circumstances”.—[Official Report, 12/12/25; col. 495.]


How right she was.

There was a time when I imagine the noble and learned Lord would have agreed with her, given that own his commission ruled that it was essential to ensure that a decision was not influenced by

“self-imposed pressures that could result from”

people

“feeling themselves to be a burden”.

It is worth asking the question of what has changed in that time. Well, the pressures on the NHS have increased, access to GPs has massively decreased and house prices have rocketed, making owning a home a distant dream for many young people and, thus, making the inheritance from granny even more valuable. Meanwhile, social care costs have gone through the roof, thereby devaluing granny’s legacy—and, of course, as your Lordships’ House highlighted only two days ago, the insidious impact of social media has had an alarming effect on society and, many would argue, on some of its values.

So will the noble and learned Lord agree in his closing remarks that, taken together, these factors only serve to make the case even more compelling for there being a specific requirement in the Bill that the sole reason people can seek an assisted death is their terminal illness? If he does not, let him say so. To his credit, in 2012, he was clear about the danger of someone feeling a burden, and I admire his honesty and clarity then. Will he take the opportunity today to be equally honest and clear and confirm that, in changing his mind, he has moved from viewing burden as a pressure to be safeguarded against to instead viewing it as a legitimate basis of a rational choice to be facilitated? Let me say to the noble and learned Lord that I may not agree with him, but I would applaud his determination to address the question directly.

The question posed by this amendment cannot be dodged, because it goes to the heart of the Bill. Indeed, failing to accept the amendment makes sense only if there is an ulterior motive in rejecting it. I would be grateful if the noble and learned Lord, when he comes to reply, could give the Committee a categorical assurance that there is absolutely no intention by the drafters and promoters of the Bill that anyone should ever be able to cite the Bill as the grounds for saying at a later stage, “On what logical basis would we deny that same choice—assisted dying—to people with depression or those who are chronically ill, for example?” Indeed, would the noble and learned Lord not agree that accepting this amendment would actually help him, at least in part, to dispel the fears of those who suspect that, if autonomy rather than motivation is the metric that really matters here, the Bill would contain the seeds for removing barriers to a Canada-style assisted-dying free-for-all in years to come? After all, if motivation is irrelevant, how could it not?

In conclusion, the noble Baroness does the Committee a great service, because her simple amendment hits the nail on the head. It also indirectly exposes a battle that is under way for the soul of her great party. Its values, not least its commitment to disability rights, for which I have so much respect, cannot simply be suspended for the duration of this Bill. There are hard choices to be made here and now. I hope very much that the noble and learned Lord will recognise the significance of this amendment and choose to accept it.

[Lord Hamilton of Epsom (Con)]

My Lords, I put my name to Amendment 313. My concern is the whole question of misdiagnosis. My noble friend Lord Shinkwin has addressed the fact that he was diagnosed with a terminal illness some time ago. One assumption running through this Bill and through the amendments—I apologise to my noble friends who put down these amendments—is that the medical diagnosis of somebody approaching death is faultless. We know from endless examples given by your Lordships in this Chamber that that is not actually the case. There are a large number of incidents when the medics get it completely wrong. I would like to address the question of them quite innocently getting it wrong. I will deal with more malicious misdiagnosis in later amendments.

The whole basis on which we are discussing this Bill is that there has been a medical diagnosis, which must hold as the whole basis on which assisted dying takes place. We know, however, that all too often people live on for quite a long time. The noble Lord, Lord McCrea, made the point that people have lived on with diagnoses that they were going to die after six months. My wife’s uncle, a distinguished diplomat, was given six months to live and died 18 months later. So much fault is the case here that we should be very worried about how much we are going to lean on medical diagnosis as a basis for judging that somebody should be allowed to die.

Earlier on in the debate, some weeks ago, my noble friend Lord Polak described how he was given six months to live. He is not with us, but I would not describe him as a delicate flower. I would also say that he is probably not prone to bouts of depression or that sort of thing either, but let us hypothesise—

[Lord Harper (Con)]

Just for the avoidance of doubt for anyone watching these proceedings, the noble Lord, Lord Polak, is no longer present in the Chamber, but he is very much still with us.

[Lord Hamilton of Epsom (Con)]

My noble friend Lord Harper is absolutely right: he is still with us, but he is absent for the moment. It might have been that, when he was given his diagnosis that he had six months to live, he was told that his final months would be very grim indeed and he would suffer terribly. He might, if this Bill had been in place, have made the decision to end his life. That was 32 years ago and my noble friend Lord Polak is actually pretty fit and doing a good job in your Lordships’ House. So we have to question medical diagnosis in this case.

I am very concerned and would like to hear from the noble and learned Lord, Lord Falconer, what he thinks about the problems of wrong diagnosis. I am old enough to remember that there was a time when we had capital punishment in this country. One of the reasons why it was abolished was because of the miscarriages of justice and the number of people who were hanged when they were innocent. That was a very serious lever used to get rid of capital punishment. What percentage of misdiagnosis of terminal illness would the noble and learned Lord, Lord Falconer, think would be right before he thought about whether the whole basis of this Bill was to be questioned? I do not think we have any statistics on misdiagnosis—maybe he has some—but it really undermines the whole basis of this Bill if we have doctors who quite innocently say that they think a person has only six months to live but then find that they have not and they live on much longer. This is a matter of tremendous concern to people in this country.

[Baroness Berger (Lab)]

I thank the noble Lord for giving way. It might be helpful, in the context of this conversation, for noble Lords to be aware that the data that the Department for Work and Pensions has on people who are in receipt of a benefit that comes during the six months towards the end of life shows that 23% of people who were given a six-month prognosis are still alive three years later.

[Lord Hamilton of Epsom (Con)]

If I understand the noble Baroness correctly, that is 23% of people who die well beyond the six-month sentence they have been given. That is an extraordinarily large figure, and I am grateful to her for it. I think that makes us question the whole basis of this Bill which is talking about medical diagnosis that gives people a limited life but turns out to be wrong. This could be very disturbing, if we are going to go ahead on the basis of information that could be wrong in quite as many cases as that.

[Baroness Finlay of Llandaff (CB)]

My Lords, the noble Lord asked about data. During the Select Committee that was held on Lord Joffe’s Bill on this subject, the Royal College of Pathologists told us in evidence that, at post-mortem, one in 20 people were found to have died from something different to what was written on the death certificate. That underlines the point that he makes: errors in diagnosis are the fundamental problem, happen quite often and result in the wrong treatment being given—not through malpractice, but just because medicine is a very inexact science.

[Lord Hamilton of Epsom (Con)]

I am very grateful to the noble Baroness. That just illustrates my point that misdiagnosis can very easily be done, and we are putting an enormous weight on it in this Bill and it can so often be wrong. We should be very disturbed and concerned about that because it means that we may be passing legislation which is based on faulty information.

[Lord Blencathra (Con)]

My Lords, this may be a convenient point to speak to two amendments in my name in this group. My Amendment 320ZA complements Amendments 39B and 39C, which I briefly touched on in the last debate, by making explicit that non-medical motivations cannot drive an assisted death. It draws a distinct line between medical suffering and social abandonment. International evidence shows that non-medical motivations dominate assisted dying requests. In Oregon, “being a burden” is cited by nearly half of all applicants. Parliament must decide whether it is comfortable legislating for that. This amendment ensures that England and Wales do not drift into a model in which existential distress, loneliness or, in the words of the noble and learned Lord, “sheer misery” or lack of care become accepted reasons for state-facilitated death. It also responds directly to the Equality and Human Rights Commission, which warned that subtle pressures from lack of services can drive people prematurely towards death. This amendment ensures those pressures are addressed, not endorsed.

My other Amendment 332AA operationalises the “ask why” concession. The noble and learned Lord, Lord Falconer, said he is “attracted” to requiring clinicians to ask why a person wants to die but unless the answer has consequences, the question is meaningless. This amendment ensures that when the answer is, “I am a burden” or “I cannot afford care,” or “I am alone”, “I am fed up” or “I am miserable”, the process pauses and support is provided. It reflects the evidence from the Royal College of Psychiatrists and British Geriatrics Society, both of which emphasise the need for holistic assessment. It ensures that treatable depression, unmet care needs or social pressures are addressed before an irreversible decision is made. This is safeguarding, not obstruction. It ensures that assisted death is not used as a substitute for care.

My amendments matter because, first, they protect genuine choice. A decision driven by lack of heating, housing or social care is not the same as one driven by intractable physical decline. These amendments stop the law becoming a backdoor response to social failure.

Secondly, I believe they are a practical safeguard, not a veto. This is not a blanket ban; it is a procedural pause to address fixable problems—social support, benefits, palliative referrals—before a final medical judgment is made. Thirdly, clinicians need clarity. Doctors must be able to ask why and act on the answer. These amendments would give them a clear statutory duty to do so, reducing moral and legal ambiguity. If the noble and learned Lord, Lord Falconer of Thoroton, truly believes this Bill is about free, informed choice, will he oppose leaving people to die because the state failed to provide basic support or will he back these modest, targeted safeguards?