Lords Weigh Assisted Dying Oversight And Palliative Safeguards

High-Level Summary

The House of Lords sat in Committee for the Terminally Ill Adults (End of Life) Bill (5th day), after a reminder from the Government Chief Whip on self‑regulation and decorum, and a restatement of Government neutrality. Peers then debated for over three hours whether authorisation for assisted dying should lie with the courts or with a new multidisciplinary panel. The Government maintained neutrality but said they would work with the judiciary to resource a court‑based route if Parliament chose it. A later debate examined whether specialist palliative care assessments should be mandatory before any assisted dying application proceeds. The lead amendments in both major groups were withdrawn, with further consideration signalled ahead of Report, and the Government confirmed an interim palliative care framework in spring and a final framework in autumn.

Detailed Summary

Arrangement of Business and process planning

Lord Kennedy of Southwark reminded Members of the House’s self‑regulating nature and procedures: “First, we are a self-regulating House” [ref: a1427.1/2]; “there are no points of order in this Chamber” [ref: a1427.1/2]; and “we do not accept interventions on interventions” [ref: a1427.1/4]. He reiterated that “The Government remain neutral on the Bill, and that position is not going to change” [ref: a1427.1/7], and indicated expected timings: “I expect the House to rise at a convenient point around 3 pm” [ref: a1427.1/9].

The Bill sponsor, Lord Falconer of Thoroton, sought agreement through the usual channels on a process to reach conclusions on key issues, noting, “We now need a process that brings us to a conclusion” [ref: a1428.0/1]. He indicated possible amendments, including on those “aged 18 to 25” and Court of Protection cases, and a place for multidisciplinary teams [ref: a1428.0/3]. Committee papers also recorded, “Scottish legislative consent correspondence published, Northern Ireland and Welsh legislative consent sought” [ref: a1429.1/1].

Committee: Court sign‑off versus panel oversight (Amendments 25, 120 and linked)

Lord Carlile of Berriew proposed replacing the Bill’s assisted dying review panel with a court‑based process (key Amendment 120), framing the choice as “whether permission for assisted suicide should be given by the court or via a panel” [ref: a1429.5/6]. He argued judges should decide such authorisations, expanding capacity by including “more than 40 designated family judges” [ref: a1429.5/8], and warned about “undue influence, often financially motivated” [ref: a1429.5/14]. Supporting judicial oversight, Baroness Hollins and the noble and right reverend Lord Harries of Pentregarth cited public trust in the judiciary, with Harries noting “there is one exception: the judiciary” [ref: a1441.0/2]. Former President of the Family Division, Baroness Butler‑Sloss, said that in urgent life‑and‑death matters “the judges will do it” if Parliament so directs [ref: a1442.0/4].

Concerns about practicality and capacity were raised. Speaking remotely, Lord Shinkwin cautioned that routing cases to court was a “recipe for overwhelming a system that already shows grave signs of being overloaded” [ref: a1432.1/2]. Baroness Berridge queried introducing “undue influence” into capacity tests and highlighted that the Bill’s offence “is completed where there is pressure” [ref: a1436.0/5]. In contrast, Lord Pannick defended the panel model, emphasising that a certificate of eligibility effectively requires unanimity because “The panel is to be treated as having decided to refuse to grant a certificate of eligibility” where a member votes against or abstains [ref: a1439.1/2], and cautioning that court delays could undermine a regime applying “only to those with six months or less to live” [ref: a1440.4/3].

For the Government, Baroness Levitt (Family Justice Minister) remained neutral on policy but said that if Parliament chose a court‑based route, “we will work with the judiciary to make sure that we have the resources in place to deliver what Parliament has decided” [ref: a1466.0/3]. When pressed on whether those would be additional resources, she stated, “I am not going further than I have gone” [ref: a1467.3/1]. Lord Falconer opposed replacing the panel, arguing “you are much better off having a multidisciplinary approach to somebody making an assisted death decision” [ref: a1473.1/2], and noted panels must give reasons in writing [ref: a1474.1/4]. After extensive debate, Amendment 25 was withdrawn [ref: a1479.2/11].

Committee: Palliative care assessment and access (Amendment 26 and linked)

Baroness Finlay of Llandaff moved Amendment 26 to require that anyone seeking assisted dying first be fully assessed by a specialist multiprofessional palliative care team to ensure informed autonomy. She stressed the amendments “do not block access to an assisted death” but ensure applicants have “accurate information” [ref: a1481.3/1-2], and that they “do not force a patient to be looked after by a palliative care team, and they do not stop a patient from proceeding” [ref: a1481.3/3]. Peers including Lord Carter of Haslemere and Baroness Brown of Silvertown backed mandatory specialist input, with Brown underlining that such discussions “have to be conducted by somebody properly trained and experienced” [ref: a1485.0/5]. Baroness Hollins proposed embedding specialist assessments and fast‑track Continuing Healthcare as a first stage, so no one proceeds until needs are “fully assessed and understood” [ref: a1486.0/2].

Responding for the Government, Baroness Levitt noted an existing statutory duty: “the provision of palliative care is a statutory requirement” under the NHS Act 2006 [ref: a1502.0/2], but warned that mandating referrals and additional hurdles could be unworkable or “could give rise to legal challenge” under the European Convention on Human Rights [ref: a1502.0/4–a1504.3/5]. She also confirmed the timetable for the modern service framework: “an interim report in the spring and a final modern service framework by the autumn” [ref: a1505.0/2]. Lord Falconer said the Bill already requires information and offers of referral at three points—preliminary discussion and both doctors’ assessments [ref: a1505.1/3; a1505.1/6]—and opposed compulsory assessments and preferential palliative provision for applicants, stating “you should not get a special advantage if you apply for an assisted death” [ref: a1505.1/10]. Amendment 26 was withdrawn, with Baroness Finlay indicating an intention to return to the matter on Report: “we must… come back to this on Report” [ref: a1507.0/1–2]. The House adjourned at 3.13 pm [ref: a1507.0/4].