The Terminally Ill Adults End of Life Bill currently before Parliament would legalise assisted dying for terminally ill adults from the age of 18 who have a prognosis of six months or less. Giving evidence to the Lords select committee scrutinising the bill, Dame Rachel suggested the minimum age should be raised to 25, arguing that younger adults remain vulnerable and that brain development is not complete at 18.
Dame Rachel warned that the bill is moving through the parliamentary process so quickly that it could produce unintended consequences. When asked whether it was right to allow assisted dying from 18, she told peers that for many health professionals 18 is not viewed as a firm dividing line. She pointed out that statutory protections for vulnerable young people often extend to 25 through education health and care plans or EHCPs.
“I would far rather err on the side of caution and protect those who have had terrible lives, terrible experiences, have been abused, have been turned out by their families, and are suffering from severe mental illness,” she said.
She urged extra safeguards for people with special education needs and disabilities and for young people with eating disorders who may be moving into adulthood.
Dame Rachel said that, in her view, anyone considered for the bill who had come from childhood and needed protections would likely have had an EHCP. “Those children are protected in law to 25 and I think we are missing a trick by thinking somehow 18 is the cut off,” she added.
She recounted worries she has heard from young people about the bill. “I have one young person who told me, I am in care, I have disabilities, the government will pay for me to die under this bill but it will not pay for me to live,” she said. “There are deep concerns from children and I think we need to hear them and answer them.”
Baroness Hayter of Kentish Town pressed Dame Rachel on whether she would deny a terminally ill 18 year old who would not reach 19 access to a doctor assisted death. Dame Rachel replied that exercising caution now is different from creating a framework that could be extended in ways people may not want. She said she feared rapid passage of the bill could affect how decisions are made and how support is provided, potentially worsening the final months of life for some young people.
Dame Rachel urged lawmakers to consider child rights and child experience carefully and to ensure any changes protect young people from unintended harm.
