Lord Falconer of Thoroton (Lab)

My Lords, I thank everybody who has taken part in this interesting and important debate. The amendments fall into four categories, all of which overlap. The first category is the amendments from the noble Lord, Lord Blencathra, which say that the patient has to have demonstrably understood the information about diagnosis, prognosis, treatment and the drugs that will be prescribed. The noble Baroness, Lady Coffey, says that “demonstrably” should be put before “informed”. She also seeks to insert into the Bill what is regarded as the Montgomery v Lancashire test from the Supreme Court—that is the third one. The fourth is that a number of noble Baronesses and noble Lords have indicated that they want to be absolutely clear that the patient is properly informed of the effect of the drugs, any side-effects, any complications and what is going to happen. I have thought very carefully, listening to the debate, whether one needs to make any changes to the Bill in order properly to reflect that the patient has to be properly informed before they make their decision. There is absolutely no doubt on anybody’s part in the course of this debate that, before any decision is made, the person has to be properly informed, and that means they have to be properly informed on prognosis, diagnosis, palliative care options and what the effect will be of the drug being administered, including side-effects, complications and what may happen in relation to complications. As far as the Bill is concerned at the moment, Clause 1(2) says that steps need “to be taken to establish that the person … has a clear, settled and informed wish to end their own life”. “Informed” there plainly has a meaning well acquainted to the law: that they know enough material to be able to take the decision. Enough material to take the decision in relation to prognosis and diagnosis would need to involve knowing what the level of certainty of the diagnosis is, what possible steps could be taken to alleviate the position and the various risks in relation to that, the effect of the drugs on me physiologically—the lethal drugs, if I choose to have an assisted death—what the risk of complications is and what would happen if I got complications. Without that material, it would not be “informed”. That reference to “clear, settled and informed” is then repeated four times, significantly, throughout the Bill. First of all, in Clause 10(2), the first doctor has to be satisfied that the person has a clear, settled and informed wish to end their life. Secondly, the second doctor has to be satisfied that the patient has a clear, settled and informed wish. Thirdly, the panel has to be satisfied that the person has a clear, settled and informed wish. Fourthly, at the point that the assistance is given, the provider of the assistance, the co-ordinating doctor, must be satisfied at the time the approved substance is provided that the person has a clear, settled and informed wish to end their own life.