Lord in Waiting/Government Whip (Lord Katz) (Lab)

My Lords, I thank noble Lords for the insightful debate today. As they know, the Government remain neutral on the principle of assisted dying and on the passage of this Bill. Whether and how the law in this area should change is, of course, a matter for Parliament. The Government have no major workability concerns about any amendment in this group, but these amendments introduce concepts that largely duplicate what is already in the Bill. I speak first to Amendment 39A, tabled by the noble Lord, Lord Blencathra. This amends only Clause 1, so it introduces inconsistency with later clauses in the Bill that relate to the doctor’s assessment. Furthermore, it is currently unclear who would be responsible for determining whether the individual has the required understanding of their diagnosis and the other matters specified. Amendments 188A and 553G, tabled by the noble Baroness, Lady Coffey, and noble Lord, Lord Blencathra, would require registered medical practitioners to apply the principles from the Supreme Court case of Montgomery v Lanarkshire when discussing “material risks” with someone in a preliminary discussion. These amendments would have limited effect, although I note that it is not usual drafting practice to refer to specific cases in legislation, because doing so could mean that those references become outdated when case law is further developed or modified. I hope that addresses the question raised in the contribution from the noble Lord, Lord Harper. For my part, I love being surrounded by lawyers—but then of course I am a north London Jew. Amendments 43, 312 and 340, tabled by the noble Baroness, Lady Coffey, seek to require that the person requesting an assisted death has a “clear, settled and demonstrably informed wish to end their own life”. There is no definition of “demonstrably” within the Bill. Therefore, it will likely be given its natural meaning, and this may result in little or no practical change to doctors’ consideration of the eligibility requirements. Noble Lords may wish to note that these amendments apply to the doctors’ assessments in Clauses 10 and 11, but not to the panel’s determination of eligibility in Clause 17. The amendments in the name of the noble Baroness, Lady Lawlor, seek to place a greater emphasis on the person’s understanding of the physiological effects of the substance used to end their life, and any possible side-effects. While they present no major workability concerns, the current drafting could lead to some ambiguity. For example, the amendments introduce language that is inconsistent with language elsewhere in the Bill: for example, “lethal drugs” instead of “approved substances”. These amendments could be seen as duplicative, given the existing requirements in Clause 12(2)(c)(iv) that the “assessing doctor must … explain to and discuss with the person … the nature of the substance that is to be provided … (including how it will bring about death and how it will be administered)”. The noble Lord, Lord Empey, raised issues under Amendment 180, which is tabled in his name and that of the noble Lord, Lord Taylor of Holbeach. This amendment would require the assessing doctor, as part of the preliminary discussion, to explain to and discuss with the person the approved substances, the risks, complication and failure rates, and any possible contraindications in the person’s specific case. This may be seen as duplicative, as paragraphs (c)(iv) and (d) of Clause 12(2) already require the assessing doctors, as part of both the first and second assessments, to explain and discuss the nature of the approved substance and “discuss with the person their wishes in the event of complications”. This amendment would also mean that the discussion takes place at the preliminary stage, which is earlier than the Bill currently provides for. As noted during the exchanges on this amendment, we can look forward to a longer discussion on approved substances and their regulation at what I believe will be group 49, as things currently stand, containing Amendment 537. We look forward to that. The noble Baroness, Lady Hollins, made some contributions on impact assessments. The impact assessment considers a range of scenarios and presents potential future impacts based on available evidence and international comparisons. It is clear that this does not represent a policy position from the Government. The impact assessment was developed to inform parliamentary debate and sets out what we knew based on the Bill at the time. Should the Bill receive Royal Assent, it would allow for the Secretary of State to develop a robust regulatory framework for approved substances and devices used for assisted dying. On the points from the noble Lord, Lord Wolfson, about preparing a process for ensuring consent and on questions of malpractice, this is an issue of policy, so these questions are rightly more for the Bill’s sponsor than for the Government. However, if the Bill gets Royal Assent, the Government will obviously ensure the safe and effective delivery of service. The last point that the noble Lord, Lord Wolfson, made was about doctors’ current duties to patients and whether they should be stated in the Bill. Again, what is in the Bill is a choice for Parliament. The noble Lord raised a number of comments, so I will commit to taking them away, reviewing Hansard and trying to address them from the Government’s perspective. I will write to the noble Lord if I have missed anything in my response. Having said all that, as noble Lords will be aware, these amendments have not had technical drafting support from officials. As such, I am unable to confirm whether the drafting is fully workable, effective or enforceable.