Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Shinkwin (Con) [V]]

My Lords, it was a day much like any other when I was diagnosed. A busy day at the office was followed by a hospital appointment to find out why, within months, my face had, in effect, shut down on the left side. Nothing prepared me for what came next: an MRI scan showed that a succession of mini-strokes was killing me, and I had six months left to live. The only hope was neurosurgery.

I asked the neurosurgeon my odds on making a full recovery. Her reply was direct. She said, “I can’t give you odds on survival”. What she did not say was, “I can help you to die”. This Bill would fundamentally alter the conversation that a patient has with the doctor whom they trust to do no harm, as the noble Lord, Lord Truscott, and others have highlighted.

Notwithstanding an excruciating and painful long recovery, the surgery was a success, although I have to speak slowly to be understood, and I am grateful for noble Lords’ patience and understanding. Ironically, my shock then and my shock subsequently at becoming, 20 years later, a Member of your Lordships’ House have something in common: they were both unforeseen.

That brings me to some wise words from Hansard on 12 March 2007:

“Our role in scrutiny is vital … we are a legislative Chamber … There will no doubt be … unforeseen consequences, but they would all need to be considered”.—[Official Report, 12/3/07; cols. 451-56.]


I thank the noble and learned Lord, Lord Falconer of Thoroton, as the words are his. It is indeed our duty to scrutinise the Bill and consider all its unforeseen consequences, for they are legion.

I wonder whether we have any idea of the Pandora’s box that the Bill will prise open. Many noble Lords have referred to jurisdictions where assisted dying has already been introduced. The precedents that those jurisdictions provide clearly show the chain of events that the Bill would set off, not just for disabled people but for older people, young people with mental health issues, and young women with eating disorders. It is the stuff of nightmares.

My noble friend Lady May of Maidenhead told us how her friend referred to the Bill as a “licence to kill Bill”. She is right: it gives the state a licence to kill the wrong type of people. I am the wrong type. As the noble and learned Lord, Lord Falconer, pointed out in his speech, there are savings to be made should assisted dying be introduced. This Bill effectively puts a price on my head. Indeed, should it become law and precedents set elsewhere apply in the UK over time, I face the realistic possibility, as a severely disabled person, of being killed as a result of legislation passed by this House. As my noble friend Lord Harper reminded us, no organisation of or for disabled people supports the Bill.

I close with a plea that we do not allow anything to deter us from doing our duty and subjecting this Bill, with all its unforeseen and irreversible consequences, to the scrutiny it not only deserves but so desperately needs. I support the Motion in the name of the noble Baroness, Lady Berger.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord Falconer of Thoroton]

That the House do now resolve itself into Committee.

[Lord Shinkwin (Con)]

My Lords, I apologise, but I rise to raise a procedural issue crucial to the reputation of your Lordships’ House. When I blocked out my diary for the Fridays scheduled for Committee on this Bill, I did so in good faith. I assumed not only that your Lordships’ House would recognise the value of the views of Members with lifelong lived experience of disability, but that steps would be taken to ensure that those views were heard on an equal and non-discriminatory basis. That would be entirely in keeping with the Equality Act 2010, which placed on organisations a legal duty to make reasonable adjustments on account of disability in, among other things, the way in which they work.

In the belief that your Lordships’ House and the Government will appreciate the crucial importance of our being seen to set an example and uphold the law, which we passed and which we expect others to abide by, I emailed the Government Chief Whip and wrote to the Prime Minister to explain that, because of my disability, I need to leave by 3 pm in order to catch my flight home. I requested an assurance that the House would not sit beyond 3 pm, which is of course the time by when the House normally rises on a sitting Friday. Regrettably, I have been given no such assurance. Instead, the Government are using a procedural technicality as a feeble fig leaf for discrimination against me as one of the House’s Members—one of its few Members—with lifelong disability. I do not believe it is beyond the wit or the will of the Government, or indeed your Lordships’ House, to ensure that we rise by 3 pm so that I can participate today and on other sitting Fridays on an equal and non-discriminatory basis. Given that not one organisation of or for disabled people supports this Bill, surely it is right that all of us—every one of us—are enabled to do our duty of subjecting this monumentally significant Bill to the forensic scrutiny it requires.

In conclusion, do we really want to send the message to those who are following our proceedings today, “Do as we say, not as we do”? That would be shameful and it would be unworthy of your Lordships’ House. For our own sake, I urge the House not to discriminate against me as one of the very few Members born disabled. I therefore ask that the House rises by 3pm.

[Lord Polak (Con)]

My Lords, I have every sympathy with the noble Lord, but I would like to thank the Chief Whip, the noble Lord, Lord Kennedy, for his willingness to listen and to be flexible, especially when I, together with a number of colleagues, asked for the Second Reading to be split into two days. In the Chief Whip’s remarks yesterday, he talked about convention and tradition, and so we are to rise at 3 pm or thereabouts. I place on record that, as a modern Orthodox Jewish Member of your Lordships’ House, sitting on Fridays in the winter is deeply problematic. Shabbat begins today at 3.54 pm; on 5 December, it will begin at 3.35 pm and on 12 December at 3.33 pm. Your Lordships will know that, by 3.54 pm today, I and others will need to be ready for Shabbat, and I will be in synagogue.

Keeping with my tradition, as the House will follow its tradition, there will be times, therefore, over the coming weeks that I and some others will be absent— I hope that that does not occur when I have an amendment in my name to speak to. I am grateful for the indulgence of the House, but I felt it really important to place this matter on the record as we begin Committee, which will take place only on Fridays.

--- Later in debate ---

[Baroness Andrews (Lab)]

The noble Baroness is quite right, and it is a very important part of mental capacity decisions that the families are involved, supportive and completely understand the implications of what it means to have either incomplete capacity or capacity that varies from time to time. There is no reason— I will leave my noble and learned friend Lord Falconer to answer this point—why this should not be a better Bill, and maybe it can be better if we address these particular questions.

[Lord Shinkwin (Con)]

My Lords, I thank the noble Baroness, Lady Finlay of Llandaff, for her amazing dedication to her patients. That is beyond question. I hope we are united as a House in paying due respect to that fact and also to the fact that her professional experience is a tremendous asset to this House.

The noble Baroness, Lady Finlay, spoke of her professional experience, and I will speak very briefly of my lived experience on the other side of the table—or the bedside—as a patient. She mentioned Dame Cicely Saunders and the reference to total pain. I simply say that I have been there. My disability has taken me there far more times than I would like to remember. It is awful. The bottom falls out of your world, and your capacity to think clearly, rationally and normally evaporates. So I simply say that it is crucial that patients have the ability to choose: the choice between assisted death and specialist palliative care—a choice that they do not currently have.

I simply finish on this point. Other noble Lords have mentioned the Royal College of Psychiatrists. I ask the Committee to take note of the fact that the Royal College of Psychiatrists states that applying the Mental Capacity Act to the decision to end one’s life is an entirely novel test—in “uncharted territory”, with “no experience or precedent”.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, earlier on in the debate, there was a discussion concerning members of the committee, on who was or was not called, or who was denied the right to be called to it. I suggest that the straitjacket of the time this House allocated probably did not allow the relevant committee the appropriate time to call everyone that it thought was appropriate. It ought to have been given more time, but it seems that it had to be rushed.

Concerning the Mental Capacity Act, Margaret Flynn, chair of the National Mental Capacity Forum, said it was designed to protect us

“when others start to make decisions about our lives … Assisted dying was not on the table during the Law Commission’s consultation which resulted in the MCA”.

Therefore, the suitability of the Mental Capacity Act 2005 as a test for a decision to end one’s life is a major source of debate. I believe the many experts and professionals arguing that it is insufficient for this specific irreversible decision.

The MCA was not designed for assisted dying. It was created to safeguard people who lack capacity in decisions about their care, treatment or finances. Assisted dying was not on the table during the Law Commission’s consultation. The Royal College of Physicians, as the noble Lord said a moment ago, said that applying the MCA to the decision to end one’s life is an entirely novel test in uncharted territory with no experience or precedent. It is a very low threshold. The Royal College of Physicians argues that assessing a person’s mental capacity to decide to end their life is an entirely different and more complex determination, requiring a higher level of understanding than assessing capacity for treatment decisions.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 21st November 2025 Lords Chamber

[Baroness Blackstone (Lab)]

My Lords—

[Lord Shinkwin (Con)]

My Lords—

[Baroness Blackstone (Lab)]

We have given an enormous amount of time to looking at safeguards. The noble Lord just totally denied that and said that we have to begin all over again. We do not. This debate has regrettably been characterised by too few of the speakers giving any consideration at all to the important, tough safeguards already decided in the House of Commons. I will not go through them now, in the interests of time, because I that know my noble and learned friend Lord Falconer will, when he responds to this debate.

[Lord Shinkwin (Con)]

My Lords—

[Baroness Cass (CB)]

My Lords—

[Captain of the King’s Bodyguard of the Yeomen of the Guard and Deputy Chief Whip (Baroness Wheeler) (Lab)]

My Lords, we will hear from the noble Lord, Lord Shinkwin, and then the noble Baroness, Lady Cass.

[Lord Shinkwin (Con)]

My Lords, an enormous amount of time was given in the other place to blocking safeguards. I support the vital amendments in this group and thank all those who tabled them. It is a pleasure to follow the noble Lord, Lord Dodds of Duncairn, who made some incredibly important points about vulnerability. Some of us have been there. This is proper scrutiny; it is the House of Lords at its best. On whichever side of the divide we find ourselves on this Bill, we should all be very proud of that.

As someone who speaks from one patient’s perspective, I would never presume to know exactly how the pain another person experiences might feel to them as an individual. But I think that the sense of incredible loneliness, compounded by a sense of disorientation, are both parts of total pain, as defined by the pioneer of specialist palliative care, whom the noble Baroness, Lady Finlay of Llandaff, mentioned—Dame Cicely Saunders. That makes these amendments dealing with coercion and pressure crucial.

When I have been drowning in a pool of pain, the sides of which, in that moment, seemed so steep and slippery, I would have clutched at almost anything in an attempt to pull myself out. I appreciate how coercion and pressure are so nuanced and subtle and how much each of us in this House, at some point in our lives, may need to be protected from them. My noble friend Lady Coffey is absolutely right, in speaking to her Amendment 47, to mention the Royal College of Psychiatrists and, in her explanatory notes, its reference to the sense of being a burden as an internal coercion. I can testify from personal experience that in some cases the sense of being a burden, or the burden of pain, whether physical and or emotional, can be simply too great to bear on your own. This can be the most powerful and damaging form of coercion and perhaps the one from which we most need protection. We need to recognise that in the Bill.

I note that the Bill does not require any questions to be asked about why a person may wish to die. It is because Rebecca Paul’s Amendment 468 on precisely this issue was rejected in Committee in the other place that Amendment 3, moved by the noble Baroness, Lady Finlay of Llandaff, and Amendment 181, in the names of the noble Baronesses, Lady Grey-Thompson and Lady O’Loan, are so important. As the noble Baroness, Lady Ritchie, and the other sponsors of Amendment 48 have argued, we cannot divorce this internal coercion from the circumstances in which, for example, a disabled or older person might find themselves. We have to factor those in. It is not just coercion or pressure by any other person that may prove the tipping point.

I hope that your Lordships’ House will give very careful consideration to the amendments on financial pressures, such as Amendment 462, which I thank the noble Lord, Lord Hunt of Kings Heath, for tabling so ably. As we know, these pressures are exacerbated when a person is living with a disability.

In closing, I particularly welcome Amendment 846, tabled by my noble friend Lady Berridge, and Amendment 58, tabled by the noble Baroness, Lady Grey-Thompson, because the subtlety of pressure, particularly as it relates to disability, can definitely stem from cultural attitudes, whether institutional—for example, in terms of access to appropriate care—or societal. I give one example. I was laughed at in the street outside my home as recently as last weekend because of how I look as a result of my disability. That is not good for morale, to put it mildly.

It could be argued that mockery goes with the territory of being disabled, particularly when the anonymised vitriol on social media encourages teenagers, for example, to view disabled people as fair game. My question in relation to the Bill, and specifically Amendment 58, is, how can being subject to such prejudice not affect a person’s mental well-being or their sense of self-worth? How could such a structural disadvantage, in terms of the cumulative effect of being constantly exposed to such negative and discriminatory attitudes, not affect a person in a vulnerable situation who is considering assisted dying? It is inevitable, but how many non-disabled people factor that in?

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 5th December 2025 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I will speak briefly to Amendment 405 because the Equality Act is relevant to it. It provides a legal duty to provide reasonable adjustments for disabled people, which is defined quite broadly and I think would include a person who was terminally ill. The amendment is currently worded that the doctor must

“take all reasonable steps to ensure that there is effective communication”.

Will the noble and learned Lord consider changing his drafting to say that the doctor must “ensure reasonable adjustments are provided to ensure effective communication”?

[Lord Shinkwin (Con)]

My Lords, I rise to speak on Amendment 405. It is a pleasure to follow the noble Baroness, Lady Hollins, and to echo some of the points she touched on. I clarify that of course the amendment is in the name of the noble and learned Lord, Lord Falconer of Thoroton. I do so because, as a disabled person who was on the National Disability Council in the late 1990s developing codes of practice and advising the then Government on the importance of language—a point that the noble Baroness has just mentioned—I fail to see how changing the Bill’s wording from

“must first ensure the provision of adjustments for language and literacy barriers”,

which was the language of the amendment adopted by the other place, to “take all reasonable steps” can do anything other than weaken this Bill.

The noble and learned Lord would have us believe that this is just a drafting change; indeed, he said in his opening remarks that it makes it “clearer”. I contend that this is no drafting change because, yes, it changes the sense of meaning. The amendment would take us backwards because it would fundamentally weaken one of the Bill’s safeguards, such as they are, which was inserted as a result of Jack Abbott’s Committee amendment in the other place, and which the Bill’s sponsor in the other place described as “very sensible”—she was happy to support it.

I have a few questions for the noble and learned Lord that I would be grateful if he could answer in his closing remarks. Is this Committee being asked to believe that today the Bill’s sponsor in the other place is happy for the noble and learned Lord, in effect, to overrule her? Can he confirm in his closing remarks that she and Mr Abbott have been consulted, or is it that, together, the noble and learned Lord and Ms Leadbeater have decided to water down one of the few safeguards in the Bill because, well, it is only the House of Lords so no one is going to notice? The whole point of the Bill is to make it as easy as possible for people to have assisted dying, so let us minimise the constraints.

I began my career at the Royal National Institute for Deaf People during the first Blair Government. It was an exciting time. To the credit of Tony Blair and the noble Lord, Lord Hutton, who was Health Secretary, digital hearing aids were introduced on the NHS. The RNID, when I worked there, was listened to, and it should be now. So could the noble and learned Lord explain why this amendment implicitly ignores the finding made this year by the RNID and SignHealth in their report that some patients did not understand their diagnosis or treatment?

As a disabled person, I thank our Labour colleagues most sincerely. I know that I owe a debt to the Labour Party’s long-standing and noble—in the true sense of the word—commitment to advancing disability rights. However, this amendment underlines an inescapable but painful truth. The Bill makes a mockery of that fine, noble and honourable tradition. It shreds a tradition that deserves to be preserved, not sacrificed in such a profoundly cynical and misleading way as to make out, as the amendment does, that this is somehow only a drafting change.

There is a reason why not one organisation of or for disabled people supports the Bill; they know that disabled people need the Bill like a hole in the head. I marvel that the noble and learned Lord does not seem to realise that the Bill is dangerous enough already without the removal of provisions that would at least acknowledge the obligation to first ensure that communication adjustments were made; for example, for people with learning disabilities or users of British Sign Language.

The last thing that we as a House should be doing is endorsing an attempt to make the Bill an even poorer piece of proposed legislation than it already is. Noble Lords could be forgiven for thinking that that was not possible, but, as the noble and learned Lord’s Amendment 405 clearly states, he is perfectly capable of making his poorly drafted Bill even worse.

[Baroness O’Loan (CB)]

My Lords, could the noble and learned Lord, Lord Falconer, clarify for me the impact of Amendment 290 and whether it deals with matters of coercive control and economic abuse effectively for the purposes of the legislation? I ask this because Amendment 290 would remove

“including coercive control and financial abuse”

from the Bill. The same principle applies to Amendment 366, while Amendment 931 would remove the requirement for members of a panel to receive training on coercive control and financial abuse.

Even taking into account the Domestic Abuse Act, which I will come back to in a moment, there is a difference between coercion and pressure and coercive control and abuse. It is for that reason that I support the comments previously made about, for example, Kim Leadbeater in the Commons being pleased to support mandated training on domestic abuse, including coercive control and financial abuse, and the Health Minister in the Commons Committee noting that the amendment would require training regulations to include

“mandatory training relating to domestic abuse, including coercive control and financial abuse”,—[Official Report, Commons, 18/3/25; col. 1212.]

which clearly would ramp up the requirement.

However, the definition of domestic abuse in Section 1 of the Domestic Abuse Act 2021 refers to behaviour in the context of personal relationships—persons who are connected—and there is a list of the persons who are connected. Section 1(4) of the Act does not cover those who are not personally connected but who may be capable of having enormous influence upon people on behalf of those who are. I think, for example, of financial advisers, lawyers and even doctors, people like that, who may be able to put pressure on people, and we have seen situations in which such pressure has been brought to bear. Does the noble and learned Lord consider that the situations in which pressure may be brought to bear by someone not personally connected should be otherwise provided for?

This group also contains amendments to Clauses 10 and 13, the provisions in relation to the situation in which a doctor is unable or unwilling to act as the independent doctor. There are provisions in Amendments 332, 418 and 419 for a further referral if a doctor is unable or unwilling to continue. His reasons for unwillingness could include ethical concerns or suspicions of undue influence on the patient. Despite the fact that there is a provision that he can seek specialist advice on this issue, there may be a situation in which the doctor will simply withdraw from the process. The single additional referral was approved in the other place to protect the patient, but these amendments would enable doctor shopping to occur. We will come back to that in group 44. Moreover, if a doctor withdraws from completing the process because of suspicions of possible or undue influence, the reason must surely be recorded.

Amendment 405 would remove from the Bill the requirement to have regard to “language and literacy barriers”, replacing it with the new more general requirement to

“take all reasonable steps to ensure … effective communication”.

The noble Baroness, Lady Hollins, explained during the previous debate the extent to which people with a disability have complex needs, which must be satisfied to enable understanding. The inclusion of “all reasonable steps” et cetera introduces a far less specific test, and consideration must be given to setting standards for the level of communication which is required. I have to ask the noble and learned Lord: does this amendment inadvertently disadvantage those with specific learning difficulties and similar vulnerable groups?

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

I do not accept that it is not a drafting point, but that may be dancing on the head of a pin. The point that both the noble Baroness, Lady Fox, and the noble Lord, Lord Deben, are making concerns making sure that if you are leaving for a reason that will give rise to problems, it is properly recorded. I completely accept that and we will make sure that that is the position, because it is a valid point.

In relation to Amendment 405, the noble Lord, Lord Shinkwin, said that it is a watering down. It is not a watering down at all, with respect. The current draft says:

“When carrying out an assessment in accordance with subsection (2), the assessing doctor must first ensure the provision of adjustments for language and literacy barriers, including the use of interpreters”.


The new draft says that the relevant doctor must

“take all reasonable steps to ensure that there is effective communication between the assessing doctor and the person being assessed (including, where appropriate, using an interpreter)”.

The noble Lord, Lord Shinkwin, is shaking his head; I am more than happy to talk to him about how that could be a change, and if there is some change that he would like in relation to it, let us put it in. But it is, in legal terms, to my eye, wider. It covers a much wider ambit without providing any inadequate protection. Maybe the right course is for me and the noble Lord, Lord Shinkwin, to sit down and for him to identify the changes that he would like. At the moment, I cannot see them.

[Lord Shinkwin (Con)]

I thank the noble and learned Lord, and I will be very brief. Would he consider withdrawing his amendment? The change I would simply write, and I imagine the House would find acceptable, is what the sponsor of the Bill in the other place also found acceptable, which is to accept Mr Abbott’s amendments.

[Lord Falconer of Thoroton (Lab)]

I do not need to withdraw the amendment, because if the noble Lord objects to it, I will not press it in Committee. It depends on what we get to when we get to Report. What I am saying is that, at the moment, I cannot see the difference. I am more than happy to talk to him before Report. If there are valid points, let us put them in. However, at the moment, it looks to me to offer just as good, if not better, protection.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I rise to speak to Amendments 17 and 309A in the name of the noble Lord, Lord Beith, which I have supported. The noble Lord sends his sincere apologies that he cannot be here today. I will also speak to Amendment 62 in my name. I thank the noble and learned Lord, Lord Falconer, for his discussions with both the noble Lord and me on how this Bill affects Scotland.

These are probing amendments. They seek to establish the scope of the Bill, firstly with regard to residents of England who may find themselves availing of Scottish health services. Amendments 17 and 309A remove an anomaly in the Bill under which some residents in England close to the Scottish border will be excluded from its scope because they are registered with a Scottish GP. This is relatively common in border areas, as it may be that a Scottish GP is closer than the nearest English practice, or it may reflect a desire to stay with the same practice after moving house. The BMA has identified cross-jurisdiction protection for doctors supporting their patients in shared-care arrangements across borders as a gap in this Bill that it would like to see addressed in Committee. The Scottish Ambulance Service has also requested further clarity on what paramedics should do or not do across border areas. How does the noble and learned Lord plan to address these issues?

My Amendment 62 is about whether the remit of the Bill extends, perhaps unwittingly, to Scottish doctors, as it probes whether any Scottish GP, whether or not you are registered with them, can undertake preliminary discussions. The Amendment refers to Clause 3, referred to on page 1 of the Bill, and the steps taken under Clauses 8, 10, 11 and 19. Clause 8 refers to the preliminary discussion, the initial request for assistance and the first declaration that is done by the terminally ill person who, under subsection (3)(a), must be in England and Wales, but Clauses 10 and 11 are about the role of doctors. My reading of Clause 1(3), which was inserted in the other place, is that the steps in Clauses 8, 10, 11 and 19 must be taken when the terminally ill person is in England or Wales, but the steps in Clauses 10 and 11 are to be taken only by doctors in England and Wales—not Clause 8, the initial request for assistance, or Clause 19, the confirmation of the request for assistance, or second declaration. They could be undertaken by any GP and, as such, the Bill as it stands would permit discussions to be undertaken by GPs in Scotland even though they would not be regulated under the Bill. Is this what the sponsors of the Bill intended?

I believe there would be a number of consequential issues that might need to be addressed, depending on the territorial extent of the Bill. For example, can the noble and learned Lord say whether the recording required of the preliminary discussion in Clause 7 would work for Scottish GPs? Given the very separate record keeping of NHS Scotland and NHS England, which he and I have discussed, the considerable challenges of cross-border data sharing in the context of health, particularly in primary care, and the separate Scottish legal context, where does that leave the offence of destruction of documentation in Clauses 35 and 36 if the preliminary discussion is undertaken by a Scottish GP? If the intention is that Scottish GPs can undertake these discussions, can I ask the sponsors to clarify this for the record? If this is not the intention, can the noble and learned Lord consider whether the territorial extent needs to be clarified in other areas of the Bill? If it is not the intention, does the noble and learned Lord consider that further amendments need to be tabled to ensure that this loophole is closed? Perhaps he could take us through the provisions relating to Scotland in this response and clarify.

I believe that, when parts of the Bill were extended to Scotland on Report, the sponsor did not have time to explain why they were needed or what they did. The honourable Member for Glasgow West asked whether the Bill’s sponsors had had any conversations with Scotland’s Lord Advocate and the Scottish Government, and the honourable Member for Spen Valley was only able to confirm that she had taken legal advice from government officials to ensure that devolution is respected. She stated that conversations had already started and would continue where legislation that affects other jurisdictions needs to be amended. Could the Minister confirm for us what guidance the Government have provided regarding the provisions relating to Scotland and their necessity?

As this House is well aware, the Scottish Parliament is currently going through its own stages on an assisted dying Private Member’s Bill in Holyrood, so we are facing the very real possibility of a two-tier system in Britain, which the former Prime Minister Gordon Brown has highlighted as being extremely concerning. There is currently a sharp divide between what has been proposed for Scotland and what we have before us here. The amendments in this group do not affect in any way what happens in Scotland, but, like the former Prime Minister, I am very concerned that we could find ourselves in a situation where people are moving between the two jurisdictions. At the very least, I would have expected there to be intensive consultation between the two Parliaments.

The Scottish Cabinet Secretary for Health has written a number of letters to the lead committee on assisted dying in the Scottish Parliament, in which he acknowledges that the Scottish and UK Government officials must continue to hold discussions on the legislative competence issues. Is the Minister able to say more about these discussions? Are they confined to legislative competence or do they extend to issues such as delivery timescales, the regulatory framework of medical practitioners across the UK and the intention to give Scottish Ministers the authority to determine approved substances to use, all of which Mr Gray has highlighted as concerns and are indicative of the problems of having potentially different systems north and south of the border?

In conclusion, it seems to me that matters are moving and changing at pace, both with additions to this Bill and the Scottish Bill. If things are done piecemeal or with haste, we are in danger of assisted dying becoming another deposit return scheme—although you cannot return from being dead. The deposit return scheme was an example of the two Parliaments wanting to implement something that needed careful consultation and co-operation across the UK, legislating separately, both totally within their devolved areas but, in the case of Scotland, ending up with a Bill that could not be implemented because of the cross-border issues that had not been fully acknowledged and addressed. Addressing these issues and getting clear answers from the Bill’s sponsors and the Minister are what this group of amendments is about, and I believe they are essential. I beg to move.

[Lord Shinkwin (Con)]

My Lords, I rise to speak to Amendment 17, particularly in relation to the Scottish Ambulance Service, which my noble friend Lady Fraser of Craigmaddie mentioned briefly in her speech. I do so as someone who can remember just about all my journeys in ambulances—some in agony after a fracture, some with the blue light flashing, others more sedate. What marked them all was a sense that, however much pain I was in, I was none the less safe. The ambulance crew were in control of the situation, caring, competent and consistently professional. That is my abiding memory based on first-hand experience.

I am concerned, as I understand the Scottish Ambulance Service is, that there is currently no guidance on this specific issue even though its absence has significant practical implications. Simply put, from a frequent ambulance traveller’s perspective, without this amendment ambulance crews and other healthcare professionals might well not feel fully in control of the situation. That is just not where you want to be as a potential patient needing urgent emergency care.

Surely, emergency services operating across the Scotland-England boundary not only need but deserve clear guidance. For example, what exactly is a paramedic meant to do if they are called out because an assisted death has gone badly wrong, leaving the individual seriously injured but very much alive, which of course can happen and indeed has happened on occasion in other jurisdictions where such legislation has been implemented? It does happen, yet the Bill, as far as I can see, is silent on this point, which is not much use to a paramedic desperately wanting to provide care when an emergency response is requested due to complications such as choking or vomiting.

I am not aware of this having been covered in the impact assessment, or of John Grady having received an answer when he raised this very issue on Report in the other place. So, I would be very grateful if the Minister could share with the House in her closing remarks what work has been done by the Government to evaluate and address such an important cross-border issue.

[The Lord Bishop of Norwich]

My Lords, I support Amendments 17 and 309A, proposed by the noble Lord, Lord Beith, and so ably explained by the noble Baroness, Lady Fraser. I declare an interest, in that my wife is a GP and a medical examiner—so the Bill has had much discussion at home.

Having spent 10 years living in Northumberland, and having friends who live along the Scottish border, I know that many of those living sufficiently close to the border have chosen very deliberately to be registered with a Scottish GP because they then receive free prescriptions. This raises a number of questions for the noble and learned Lord.

Let us say that you live on the English side of the border, at Cornhill-on-Tweed, and your GP is in Coldstream. The sense of continuity of care that GPs give to their patients is vital to that GP-patient relationship. Indeed, this House was reminded of that yesterday in the excellent maiden speech of the noble Baroness, Lady Gerada:

“That continuity, seeing lives unfold across time, gives general practice its unique moral and social power. It allows us to see people as whole human beings, not as isolated organs or diagnoses”.—[Official Report, 11/12/25; col. 370.]


In supporting this probing amendment, I am interested to discover more about how that continuity of care that is so essential in primary health care can be continued.

--- Later in debate ---

[Baroness Butler-Sloss (CB)]

My Lords, I want to make a practical point. It is obvious that this will be the first Act in relation to assisted dying. Clearly, it is unjust because it does not deal with people with motor neurone disease and so on. Why does the House not accept that the issue of prisoners should be in the next Bill and not the present one?

[Lord Shinkwin (Con)]

My Lords, I will keep my remarks very brief. I rise to speak in support of Amendments 30A and 119A in the name of my noble friend Lady Berridge. I thank her most sincerely for tabling them and thank my noble friend Lady Monckton for her supportive remarks. Disabled people and people with Down’s syndrome should know that this House would never treat them as bottom of the heap.

Given the evidence provided to the Select Committee by the National Down Syndrome Policy Group, the question to my mind is not so much why we would want, but why would we not want to support the provisions in these amendments? We are talking about vulnerable young adults who deserve and need extra protection on account of their disability. I say that as a disabled person who has been involved in championing disability rights for almost 30 years. Such protection as would be afforded by these amendments is neither patronising nor discriminatory. On the contrary, it is our duty to strike the correct balance between rights and protection. I believe these amendments do so.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 9th January 2026 Lords Chamber

[The Deputy Chairman of Committees (Lord Geddes) (Con)]

My Lords, the noble Lord, Lord Shinkwin, is taking part remotely. I invite him to speak.

[Lord Shinkwin (Con) [V]]

My Lords, I will speak to Amendment 120 and the amendments consequential to it. I should explain at the outset that my remarks incorporate the concerns of my noble friend Lord Farmer, who regrets that he is unable to be here. We are both worried, as I know are many other noble Lords, about current capacity and other pressures on the family courts. We are particularly concerned that these amendments would increase capacity pressures still further by placing decision-making and sign-off for applications for assisted dying orders into the Family Division of the High Court.

The noble Lord, Lord Carlile, mentioned safety. Notwithstanding his reference to 40-plus circuit judges and a cohort of recorders, I fear that what is before us is a recipe for overwhelming a system that already shows grave signs of being overloaded. Noble Lords will know that, for some considerable time, my noble friend Lord Farmer has been pressing this and previous Governments to cite early legal advice and support in family hubs when families separate, to ease pressure precisely because of existing capacity issues.

Moreover, the National Audit Office recently said of the family justice system:

“The government … does not have an overall assessment of the main drivers of delays or the capacity required to manage the system efficiently and reduce delay. MoJ, DfE and others have carried out several reviews … to identify causes of delay in family justice, identifying more than 25 different contributing factors … but most of the reviews could not quantify the scale and impact of each issue on overall performance, or the resources required to deal with these causes efficiently, due to data limitations”.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[The Deputy Chairman of Committees (Baroness Kennedy of Cradley) (Lab)]

My Lords, the noble Lord, Lord Shinkwin, is taking part remotely. I invite the noble Lord to speak.

[Lord Shinkwin (Con) [V]]

My Lords, I will speak to Amendment 30 in the name of the noble Baroness, Lady Foster of Aghadrumsee, and the noble Lord, Lord Weir of Ballyholme. I also support the other amendments in this group.

I first put on record that while I like and respect the Government Chief Whip, as I know do so many Members of your Lordships’ House, I am deeply disappointed that without consultation and despite my having written to the Prime Minister, it has effectively been decided that, as a severely disabled Member who has to leave the House by 3 pm on a Friday in order catch my flight home, I should not be enabled to contribute on an equal and non-discriminatory basis to scrutiny of a Bill that would have a devastating impact on disabled people if it became law. Instead, I have had to fly home at very short notice so that I can contribute, but unequally, without the ability to intervene in this debate remotely. The Prime Minister never replied to my letter, so I assume this decision is his response. It does not reflect well on him or his great party in my respect. His great party deserves better than being saddled with what everyone knows is ultimately the Prime Minister’s Bill.

Returning to Amendment 30, I hope we can assume that all noble Lords accept the motivations listed in the noble Baroness’s amendment and that they apply. On the basis that the noble and learned Lord is not contesting that fact, I do not understand why anyone would not want a doctor to rule these surely vital motivations out at the start and for the Bill to make it absolutely clear that they must do so. I would be very grateful if, in his closing remarks, the noble and learned Lord could make it absolutely clear that he accepts not only the existence of these motivations but that the Bill should ensure they are addressed, as set out in Amendment 30.

I completely understand why it is difficult for us, as an overwhelmingly non-disabled group of people, and thus a privileged and hugely unrepresentative body, to appreciate the extent to which these motivations go with the territory of being disabled in the UK in 2026. Let us consider the motivation in this amendment of feeling like a burden. Personal experience has taught me that society continues to view disabled people such as me as a burden, rather than as a contributor with equal rights. Such a perspective colours societal attitudes, which in turn inform our continued exclusion by default from employment—just look at the 30% disability employment gap—access to goods and services, such as shops, pubs, bars and restaurants, which any non-disabled person assumes and takes for granted, and, of course, from the policy-making process here in Parliament.

In case anyone would query that, I invite noble Lords in the Chamber to cast their eyes around the Chamber and count how many Members of your Lordships’ House with lifelong lived experience of disability are present today. Even if every Member with such lived experience were present, it would still be the case that no more than 1% of the House of Lords could speak on the basis of such experience. Yet, as a shamefully disproportionately non-disabled lawmaking body, we presume through this Bill that we have a right, effectively, to pronounce on the fate of disabled people, who, the evidence from other jurisdictions shows, will be disproportionately affected by it.

I thank the noble Baroness for tabling Amendment 30 because it gives us an opportunity, following Rebecca Paul’s blocked attempt to introduce a similar amendment on Report in the other place, at least to ensure that disability and other motivations are taken into account. I completely agree with those who argue that the reputation of your Lordships’ House is at stake. It is, but not for the reasons some would have us believe. I believe that our reputation will be irretrievably damaged if we are seen to put completing the process of scrutiny of this life and death Bill ahead of our overriding duty to ensure it is scrutinised forensically. The two are quite distinct.

Let us not be deceived that the time spent blocking amendment after amendment—including Rebecca Paul’s, which I have just mentioned, which mirrored this amendment in the other place—somehow amounts to evidence that the Bill was subject to effective scrutiny before it came to us. It does not. The very fact that the noble Baroness, Lady Foster, has had to table this amendment is proof that the Bill is only now receiving proper scrutiny for the very first time, here in your Lordships’ House.

--- Later in debate ---

[Viscount Stansgate (Lab)]

I point out to the Committee that if Amendment 34 were to be accepted, it would pre-empt Amendment 35, which leads the next group.

The noble Lord, Lord Shinkwin, is taking part remotely, and I now invite the noble Lord to address us.

[Lord Shinkwin (Con) [V]]

My Lords, I begin by quickly welcoming back the noble Baroness, Lady Campbell of Surbiton, and thank her for reminding us so eloquently why we have missed her contributions.

I rise to speak to Amendment 34, and I thank my noble friend Lord Frost for tabling it and for his excellent speech. I also thank the noble and learned Lord, Lord Falconer of Thoroton, for his past commitment to ensuring the law is communicated as clearly as possible by removing the Latin names of the prerogative writs through the Civil Procedure (Modification of Supreme Court Act 1981) Order 2004. Can he explain in his closing remarks why, 22 years later, he appears to have changed his mind on the guiding principle, which I assume informed his earlier decision, that the law should be accessible and unambiguous? Perhaps, and maybe he could clarify this in his closing remarks, he now believes it should be accessible only to some, and that for others it is fine for it to be clouded—or shrouded might be more appropriate, given the fatal consequences of an ill-informed decision on assisted death—in euphemism, nuance and even deceit.

After all, those with a learning disability or Down’s syndrome, for example, are only disabled people, are they not? What does it matter if their disability means they cannot quite grasp the enormity, finality and irreversibility of the decision to seek, as my noble friend’s amendment states,

“help to commit suicide by provision of lethal drugs”?

We know that language matters, but do we know how much it matters to those whose disabilities make them understand less or make comprehension challenging, and, in the case of Down’s syndrome, those whose innate desire to please makes them more prone to agreeing with the question, especially when its implications are not fully grasped?

I hope the noble and learned Lord will accept this amendment and thereby protect not only those whose disabilities make full comprehension difficult but the reputation of your Lordships’ House. Let it never be thought that we do not care if those whose disability-related need for the clarity provided in my noble friend’s amendment are somehow misled to death because of nuance. I hope the noble and learned Lord will show, by accepting this amendment, that those whose disabilities make them particularly vulnerable to ambiguity must not be treated as unfortunate collateral damage.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I signed the amendments from the noble Lord, Lord Frost, which seek to probe the ways that we can make this Bill more transparent to the public. That is my main driver—I believe in plain speaking. The public deserve to know what this Bill involves.

As it happens, I think the noble Lord’s wording would add clarity. His proposal is to replace

“assistance to end their own life”

with

“medical help to commit suicide by provision of lethal drugs”.

That wording is factually accurate, even if it makes you gulp. The reason it makes one gulp is because it is factually accurate, and we do not often recognise what is being advocated here. There is a danger that the Bill’s terminology creates ambiguity rather than clarity, and it is important that we are frank and open.

Why use the word “suicide”? As has already been explained, the Bill needs to amend the Suicide Act precisely to carve out the legal space to allow this type of assisted suicide, as mentioned in the Bill, to be within the law. That is accurate. But I am wary of having a culture war over the word “suicide”—I use the term “assisted dying” all the time, so I do not want to be called out for hypocrisy here—because I am aware of the fact that suicide as an issue is far too serious and tragic to be glib about or to have verbal ping-pong over.

On the other hand, I am worried that avoiding the word “suicide” in this debate, and making it verboten, might desensitise public debate. Let us be honest, language choice can influence opinion. “Assisted dying” sounds softer, palatable and more sympathetic. It is interesting that evidence shows that support for assisted dying changes if you call it “assisted suicide”; it drops significantly when the terms are plainly defined.

Some may flinch at the proposed words used by the noble Lord, Lord Frost—

“medical help to commit suicide by … lethal drugs”.

As I have said, it is hard to accept that. It makes you think. Is there going to be a complete change in the way medicine is operated, so that medics could hand you poison and lethal drugs? The answer is yes. When people hear that phrase, it might hit them what a fundamental shift this will be for medical professionals and so on. That is exactly why a number of us are not prepared to nod this Bill through. It is perfectly reasonable to completely disagree with what I have just said, but I want everyone to know what the Bill is about and why it is a very big change in our society, causing all sorts of ethical discussions. The public deserve to know that, and therefore we should be as clear as possible.

I recall that, on the first day in Committee—and subsequently, but particularly on the first day—there was a lot of tut-tutting and reprimands, with a lot of people being shouted at when Peers used the term “assisted suicide”. A lot of people stood up, saying, “You can’t say that. You’re just being emotional, manipulative and so on”. But clear language promotes public and patient understanding. In a way, I advocate a patient-centric approach rather than a euphemistic approach, which could, arguably, be seen as an act of misinformation in some instances.

Terminally Ill Adults (End of Life) Bill

Lord Shinkwin Excerpts

Committee stage
Friday 23rd January 2026 Lords Chamber

I have spoken often in this House and beyond about the importance of mental health and the need to treat mental illness with the same seriousness and urgency as physical illness. This amendment is consistent with that principle. I am not sure that there could be any more important set of words in the Bill than those that define the purpose for which we would allow such a change to a law that has existed for centuries. I urge your Lordships to support my amendments, to make the Bill true to its purpose and bring dignity to those whose lives are ending. I commend these amendments to the Committee.

[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—