Terminally Ill Adults (End of Life) Bill

Lord Sandhurst Excerpts

Friday 12th September 2025 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, I believe in choice and personal autonomy, but, if this Bill is passed, it will change how we treat each other as humans, and not for the better. Hard cases make bad law and the Bill is defective in too many respects. I say that despite the imperfect state of the current law.

The reports of the Delegated Powers Committee and the Constitution Committee cannot be brushed aside. The Bill is at once long but incomplete. There is insufficient detail or principle evident for proper scrutiny of the important powers to be delegated. We should, for example, have had draft regulations regarding the co-ordinating doctors, who are to have a central role and will make the most important assessments—namely, whether the person seeking assistance has sufficient mental capacity, a clear, settled and informed wish to end their own life and seeks assistance voluntarily, without coercion or pressure from another.

How will this be done and from what knowledge base? My noble friend Lord Murray has explained that. How will the panel then test the process? How long will the panel devote? How will it be resourced, so that it is not, as it must not be, a tick-box exercise? We all know that subtle family pressures are real.

Until now, doctors have been obliged to protect against suicide. The Bill goes against that. Death by poison is not treatment. It brings huge ethical challenges and changes for doctors.

What sort of people will be the independent advocates? What skills will they have? How will the vulnerable be identified? Qualifying vulnerable persons are those with a learning disability, mental disorder, or autism, which is often not diagnosed—people who may experience substantial difficulty in understanding the processes or information relevant to those processes, or in communicating their views, wishes or feelings. But there is no requirement to involve the independent advocate before a doctor decides to initiate a conversation on assisted dying with people in that precious cohort. The independent advocate will only be appointed once someone is on the path.

Who will consider family coercion—subtle family coercion or just the old person who thinks, “I’m probably a bit of a burden”—and with what resources? I am aware of the head of safeguarding in a London hospital who has recently said that there are already issues with families who want to clear the decks. The noble Lord, Lord Grabiner, explained all that.

The overloaded NHS is not always safe. Remember the Bristol Children’s Hospital and Stafford Hospital scandals. My chambers were involved in dealing with the aftermath of those and many other medical disasters. Mistakes happen and practitioners are, I am afraid, known to change the notes after the event. I have personal experience of that in matters in which I have been involved. How will we know whether the system is working properly? Cover-ups will happen. Yet, we are not to have coronial inquest. Why on earth not?

Giving responsibility to the NHS will create a stark financial conflict. It will likely damage the delivery of palliative care: the noble Lord, Lord Stevens, addressed that in detail. Palliative care should be our focus. This Bill cannot be put into acceptable shape. We shall be left with a national death service—and a poor one at that. We should have had a royal commission and proper legislation.