Key takeaways
Safeguards must be legally robust
Concerns over coercion and vulnerable groups drive calls for judicial review and clearer regulation.
Life expectancy alone may not be enough
Lords propose adding “intolerable suffering” to ensure fair and compassionate access.
Respecting dignity while managing system pressures
Debate highlights ethical complexity and the need for well-resourced care pathways.
The House of Lords debated the Bill on 5th and 19th September. Key legal concerns raised include:
Definition of terminal illness
The Bill defines terminal illness as an “inevitably progressive disease” with a life expectancy of under six months. The Lords questioned the reliability of medical prognoses and proposed adding a test of “intolerable suffering” to avoid eligibility based solely on life expectancy.
Safeguards against coercion
Concerns were raised about detecting coercion, especially from family or societal pressure. Robust mental capacity assessments were deemed essential to ensure decisions are informed and voluntary.
Oversight and judicial review
The Bill proposes a review panel (psychiatrist, social worker, legal expert) instead of High Court approval. The Lords argued this weakens legal safeguards and called for stronger oversight.
Protection of vulnerable groups
Debate focused on risks to those with, for example, disabilities or mental health conditions, including eating disorders. The Lords questioned whether the proposed legal safeguards would be sufficient to protect vulnerable groups.
Palliative care
Some Lords advocated mandatory referral to palliative care before proceeding with assisted dying, to ensure all options are explored.
Regulation
Uncertainty remains over who would regulate the drugs and equipment required in an assisted death. The Bill allows medical professionals to opt out, but concerns persist about panel independence and regulatory clarity.
Human rights
The Bill raises complex legal questions around balancing the right to life with autonomy and dignity. Peers warned of a potential “slippery slope” if criteria expanded over time.
Funding
Hospices and care providers highlighted financial pressures and the need for resources to support training, regulation, and safeguarding.
Current status
The Bill passed its Second Reading in the Lords.
It will now be reviewed by a Select Committee gathering evidence from stakeholders.
The Lords are calling for amendments to strengthen safeguards