No Divisions as Lords Weigh Assisted Dying Safeguards

High-Level Summary

The House of Lords continued Committee stage (13th day) on the Terminally Ill Adults (End of Life) Bill. Peers debated whether participation by health and care staff should be on an explicit opt‑in basis, the idea of a public register of participating clinicians, the scope of conscience protections (including for ancillary staff), and whether assisted dying should be classed as a medical treatment. A second debate examined transparency and timing of records, including how preliminary discussions are documented, what is shared with the commissioner, and whether cancellations must be recorded immediately. The sponsor argued existing clauses already give broad protections and tabled an amendment to embed an opt‑in to specialist training; Ministers raised legal and operational concerns about several proposals. No divisions were taken; key amendments were withdrawn or not moved, Clauses 5–7 were agreed, and the House adjourned for the Easter Recess.

Detailed Summary

Arrangement of Business – Announcement

Lord Kennedy of Southwark outlined sitting arrangements, thanked staff, and indicated an adjournment around mid‑afternoon. He said, “I will adjourn proceedings today at around 3 pm”, and wished everyone “a well‑deserved break over the Easter Recess”. He added the House would return “on Monday 13 April for the final day on Report of the English devolution Bill”.

Terminally Ill Adults (End of Life) Bill – Committee (13th Day), Clause 5: Opt‑in, registers, conscience protections and whether assisted dying is ‘medical treatment’

Baroness Fraser of Craigmaddie moved Amendment 189 to establish a publicly available register of clinicians willing to conduct preliminary discussions and to formalise an opt‑in model. She argued a register would “strengthen transparency” and make participation “a positive choice”, citing that “Some 45% of doctors in the BMA’s 2020 study indicated they would not be willing to participate”. Supporters, including Baroness Campbell of Surbiton, Baroness Finlay of Llandaff, Lord Carlile of Berriew, the Bishop of Southwark and Baroness O’Loan, pressed for explicit opt‑in across roles, broader conscience protections (including for non‑clinical staff), and for assisted dying not to be classed as medical treatment. Baroness Campbell said, “not one doctor, nurse or allied professional said yes”. Baroness Finlay stated, “assisting suicide is not a medical treatment” and backed a specialist register for trained doctors. Baroness Fox of Buckley said the aim was to “ensure that no medical professional or related staff are forced to participate”. Lord Stevens of Birmingham urged putting beyond doubt that assisted dying “is not to be regarded as medical treatment” to avoid professional‑duty conflicts.

Those cautioning against a public register included Baroness Gerada, who said, “I absolutely would not want my name on a publicly available register”. Baroness Andrews pointed to Clause 31, quoting, “No person is under any duty to participate in the provision of assistance in accordance with this Act”. The sponsor, Lord Falconer of Thoroton, said he had tabled Amendment 669A following discussions with the BMA so that “opt‑in should be in the Bill” via opt‑in to specialist training. He emphasised there is no duty on doctors to raise assisted dying—“No registered medical practitioner is under any duty to raise the subject”—and that “No person is under any duty to participate in the provision of assistance”. On ancillary roles, he said “there should not be a conscience clause in relation to, for example, a cleaner or somebody doing ordinary administrative tasks”. On institutions, he indicated he was working on protections so hospices suffer no detriment if they decline participation: “we should deal with it in the Bill” and he was “working on trying to do that”.

For the Government, Baroness Blake of Leeds raised legal and operational issues. On a public register, she warned publication “could expose those individuals to intrusion or a risk to personal safety” under Article 8 ECHR. She cautioned that specifying assisted dying is not a treatment “may impact the possible service models” by limiting Clause 41 regulation‑making, and that very broad opt‑outs could render the Bill unworkable. Outcome: Amendment 189 was withdrawn; other related amendments were not moved. The sponsor said hospice‑related provisions were being worked on.

Terminally Ill Adults (End of Life) Bill – Committee (13th Day), Clauses 5–7: Recording, transparency, GP input and timelines

Lord Shinkwin’s Amendment 193 proposed that any time a clinician or patient raises assisted dying, it “must be considered a preliminary discussion and the discussion must be recorded”, arguing “its sole purpose is to improve safety”. Baroness Hollins cautioned that making an extra preliminary step mandatory “adds an unnecessary layer of stress” and favoured a multidisciplinary assessment model. Baroness Grey‑Thompson sought greater precision and contemporaneous documentation, noting, “The words ‘as soon as possible’ appear eight times in this Bill”. Lord Rook and Lord Harper pressed for the commissioner to receive preliminary discussion records to enable evidence‑based oversight, warning, “A regulator who cannot scrutinise the record cannot regulate the system”. Baroness Keeley proposed a defined route for GPs to share relevant eligibility information with assessing doctors and, where necessary, the commissioner. Lord Wolfson of Tredegar urged that cancellations be recorded immediately, saying a decision to withdraw “should not be left hanging”.

Responding for the Government, Baroness Blake said imposing fixed deadlines could “result in a duty that is difficult or impossible to discharge” and increase legal risk for practitioners, but indicated that amendments to require immediate recording of cancellations “would not have major workability concerns”. The sponsor explained that Clause 5 already requires a formal preliminary discussion and record, and he was “not minded to accept” treating any conversation as a formal preliminary step. He preferred to retain “as soon as reasonably practicable” for recording, and pointed to Clause 44 powers enabling regulations that require notifications to the commissioner. He agreed to consider the proposal on immediate recording of cancellations: “I think I should consider that; it is an important amendment”. Outcome: Amendment 193 was withdrawn, Clauses 5–7 were agreed, and the House adjourned at 2.48 pm.