SAFEGUARDS in a backbench Bill that seeks to legalise assisted dying have been tightened after members of the House of Lords said that the Family Division of the High Court would have to give consent before a patient could call upon the provisions of the Bill.

Lord Falconer's Assisted Dying Bill, if passed into law, would allow people with terminal illness and less than six months to live, to be "provided with assistance to end their own life" (News, 25 July). The Bill entered the committee stage in the House of Lords last Friday.

"On the assumption that this Bill is passed, it seems to me critical and essential that the court should have an input," the former President of the Family Division, Baroness Butler-Sloss, said. "The judge would have the power to require, for instance, a psychiatrist or other medical opinion, if the judge was not satisfied that the patient - we are talking about the rights of the patient - had the full capacity necessary to make this absolutely crucial decision."

She said that her experience demonstrated that requiring the consent of the High Court would not unduly delay an assisted death from taking place: "In my day, I was able to try cases on the day that the problem came before the High Court, and it was able to go to the Court of Appeal on the same day if it was sufficiently urgent.

"I would expect the President of the Family Division to treat all these cases with the utmost seriousness, and would see it as crucial that they be heard as quickly as possible."

During the debate, many people spoke of the pressure that terminally ill patients might face from family members and others to end their lives.

The former Paralympian Baroness Grey-Thompson warned of the dangers of "gentle suggestion" and "the constant drip-drip of 'You're not worth it'".

She said that, in a recent conversation, somebody "looked at me and sort of waved at the wheelchair and said, 'Well, you must have considered killing yourself hundreds of times.'

"No, I have not, actually, and I think that it was a bit of a surprise to him. It is that sort of tone, where 'You're brave. You're marvellous.' People do not realise that they are being demeaning. I think that they genuinely think that they are being empathetic, sympathetic, and kind, but, actually, you are constantly being knocked down and told that you have no value and no worth."

The Bishop of Bristol, the Rt Revd Mike Hill, emphasised the need to ensure that the patient wanted to end his or her life not only when they began the process of seeking consent, but also before any life-ending drugs were administered.

He wanted "at least to give the opportunity to the person, as they come to the moment when they will actually have the drugs administered, to return to that decision to make sure it is robust. . . Each decision ought to be subject to some level of scrutiny. Clearly, the first one needs to be subject to a very high degree of scrutiny, but we need to give some attention as to whether the second decision also needs a degree of scrutiny."

It would be "necessary to confirm that the decision to accept assistance is free from pressure, coercion, or duress from others, or from a sense of duty or obligation to others, and that there exists a level of capacity commensurate with the decision", he said.

Clause One of the Bill completed its Committee Stage on Friday. The remaining 12 clauses must wait until additional time is given to the Bill. As a backbench Bill, it is not given priority when time is allocated.