Terminally Ill Adults (End of Life) Bill

Lord Jackson of Peterborough Excerpts

Friday 27th March 2026 Lords Chamber

[Baroness Lawlor (Con)]

My Lords, I will speak to my amendments in this group. They aim to tighten the recording rules in Clause 7 and would make them even tighter than the seven-day limit proposed by the noble Baroness—to whom I am very grateful for her remarks. I propose that, where the discussion is with a practitioner in the patient’s own GP practice, the record of the relevant discussions and assessment is written and saved online on the same day; and that, in other cases, the practitioner must submit the record to the patient’s medical practice, and the commissioner, within a week. My amendments would also require the practice to include this in the patient’s online records. My amendments would impose similarly tight time limits for the submission of the co-ordinating doctor’s assessment.

Speed in recording discussions is of the essence. My experience as a historian, often working with hundreds of documents over a period of a week or even a day in history, suggests speed is important. These are government documents or the private records of officials and politicians. My work suggests that every hour that passes between a conversation and the recording of it brings a loss in accuracy and nuance. In the matter of deciding to take your own life, it is particularly important that the record is as accurate and precise as possible. The same-day requirement should make for greater accuracy, including details that might otherwise be lost if more time elapses. Even insignificant details can turn out to be important.

By contrast, allowing a period of time—the Bill says “as soon as practicable”—will tend to mean that details can be blurred into a general pattern that a doctor may form as a result of having seen a number of patients seeking an assisted death. The individual nature of the case may be lost. A report written up and submitted on the same day is less likely to be affected by hindsight or a desire to tailor the report to ensure that the practitioner will not be held responsible should a breach occur. These amendments in my name leave the medical practitioner the choice of writing a handwritten note at the time or just after the appointment, or keying it later that day into the computer. Although it may be argued that a doctor needs a longer period to see to the paperwork or that the medical practitioner should be allowed more individual choice about how they handle the recording, the obligation for speed and a formal process is imposed by these amendments and is justified, since a person’s life is at stake.

[Lord Jackson of Peterborough (Con)]

My Lords, I support the amendment in the name of my noble friend Lord Shinkwin and the amendments of my other noble friends, and others. “Verba volant, scripta manent” means “Spoken words fly away, written words remain”. There is a reason that other noble Lords have pressed the issue about the collection of data and how specific it should be. I am going to make a broad reference to the experience in other jurisdictions because, without a record, the preliminary discussion will always be regarded as having been conducted properly, making it impossible to regulate the process.

In Australia, we have already seen VAD documentation failures serious enough to trigger disciplinary action and official findings of non-compliance, including unsigned and backdated declarations in Victoria, witnessing errors, late submission of mandatory forms and hundreds of timeliness-related form issues identified in Western Australia. In Victoria specifically, non-compliant cases included witnessing and late-form problems. In the last annual report, Victoria said one case was non-compliant because of an error in witnessing the contact person appointment form. Six more cases were non-compliant because forms were submitted late, including first assessment, consulting assessment and practitioner administration forms. The board also said a data audit had to identify historic cases where first assessment forms had been started but never submitted specifically to improve data integrity and reporting.

The issues and problems are even more significant and egregious in Canada. There was poor documentation. There are reports of,

“incomplete assessments … recurrent and excessive delays in reporting …frequent errors”

and “missing information”. There has been a lack of evidence on safeguards, Dr Jaro Kotalik, a Canadian academic, noted that, despite federal regulations mandating data collection, there is

“no publicly accessible evidence that the eligibility criteria and safeguards prescribed by law were respected”.

Refusals were also not being tracked. The Canadian system does not require doctors to formally document their refusals, making it difficult to assess patterns of approval bias or doctor shopping.

Back in Australia, former Attorney-General for Victoria Robert Clark described the oversight structure as

“hear no evil, see no evil, speak no evil”.

He testified that the regulator simply checks whether paperwork is signed rather than auditing actual compliance. In one case where a doctor falsely certified a patient’s signature, the regulator merely asked for the missing signature instead of investigating the breach. I am not saying that that is likely to happen, but it is much less likely to happen—even the noble and learned Lord the sponsor will agree—if we have tight wording in the Bill, which is contained in these amendments. For those reasons, I strongly support the amendment of my noble friend Lord Shinkwin and others.