Assisted dying bill: What is the controversial legislation and what might it mean for patients?
The assisted dying bill returns to the House of Commons on Friday where every MP will get the chance to speak and vote on amendments.
The bill has undergone significant changes since it succeeded in an initial vote in the Commons in November, as more than 150 amendments were made at the bill’s committee stage.
The High Court approval has been dropped and replaced by multidisciplinary “Assisted Dying Review Panels”, while the implementation period has been doubled to four years for an assisted dying service to be implemented, if the bill passes into law.
Mentally competent adults with a life expectancy of six months or less – who have a settled wish to die that has been approved by two doctors and a panel with a senior legal figure, psychiatrist and social worker – would be able to do so under the proposed legislation for England and Wales.
However, Kim Leadbeater has said it is now “safer, fairer and more workable” after undergoing weeks of scrutiny by a committee.
It has been suggested that the changes to the High Court safeguard might sway MPs to vote against the bill.
In October 2024, Labour MP Ms Leadbeater introduced her new law to legalise assisted dying for some terminally ill adults in England and Wales.
Ahead of its initial publication, Ms Leadbeater insisted her private member’s bill would offer the “safest choice” for mentally competent adults at the end of their lives.
She said the Terminally Ill Adults (End of Life) Bill would make it illegal for someone to persuade a person through dishonesty, coercion or pressure to declare they wanted to end their life or to induce someone to self-administer drugs to die. Anyone found guilty of doing so would face a maximum prison sentence of 14 years.
Here, we take a look at the details of the bill as it goes to its final vote.
What is assisted dying?
This, and the language used, varies depending on who you ask.
Pro-change campaigners Dignity in Dying say that assisted dying allows a person with a terminal condition the choice to control their death if they decide their suffering is unbearable.
They argue that, along with good care, dying people who are terminally ill and mentally competent adults deserve the choice to control the timing and manner of their death.
But the campaign group Care Not Killing uses the terms “assisted suicide” and “euthanasia”, and argues that the focus should be on “promoting more and better palliative care” rather than any law change.
They say legalising assisted dying could “place pressure on vulnerable people to end their lives for fear of being a financial, emotional or care burden upon others” and argue the disabled, elderly, sick or depressed could be especially at risk.
What is the current law?
Assisted suicide is banned in England, Wales and Northern Ireland, with a maximum prison sentence of 14 years.
In Scotland, it is not a specific criminal offence but assisting the death of someone can leave a person open to being charged with murder or other offences.
What is happening at Westminster?
Ms Leadbeater formally introduced her bill to give a choice at the end of life for the terminally ill in October.
A debate and first vote took place on 29 November, where MPs voted 330 to 275 for the bill to be considered by Parliament.
As the bill has passed the first stage in the Commons, it went to the committee stage where MPs tabled amendments, one-third of which were agreed.
It will now face further scrutiny and votes in both the House of Commons and the House of Lords, meaning any change in the law would not be agreed until next year at the earliest.
Ms Leadbeater’s bill would apply only to England and Wales.
What is in the bill?
There are several requirements for someone to be eligible under the proposed law.
The person must be an adult – aged 18 or older – and be resident in England and Wales and registered with a GP for at least 12 months.
They must have the mental capacity to make a choice about the end of their life and be deemed to have expressed a clear, settled and informed wish – free from coercion or pressure – to end their life.
They must be terminally ill and be expected to die within six months.
They must make two separate declarations, witnessed and signed, about their wish to die.
The process must involve two independent doctors being satisfied a person is eligible and the medics can consult a specialist in the person’s condition and get an assessment from an expert in mental capacity if deemed necessary.
In an amendment to the initial proposal, a multi-disciplinary panel of experts, including a senior lawyer (which could be a High Court Judge), a consultant psychiatrist and a social worker, must then approve the request.
There must be at least seven days between the two doctors making their assessments and a further 14 days after the judge has made a ruling, unless the person’s death is expected imminently.
What safeguards are there?
It would be illegal for someone to pressure, coerce or use dishonesty to get someone to make a declaration that they wish to end their life or to induce someone to self-administer an approved substance.
If someone is found guilty of either of these actions, they could face a jail sentence of up to 14 years.
While patients may elect a ‘proxy’ to give their consent, a proxy cannot be a family member, a beneficiary under a will, someone who may otherwise benefit financially or a health professional who has provided treatment or care for their terminal illness.
Would doctors have to take part in the service of assisted dying?
No. Doctors would not be under any obligation to take part.
Doctors who do would have to be satisfied the person making their declaration to die has made it voluntarily and not been coerced or pressured by anyone else.
They would also be required to ensure the person is making an informed choice, including being made aware of their other treatment options such as palliative and hospice care.
Who would administer the medication?
The dying person must take the medication themselves.
No doctor or anyone else can give the medication to the terminally ill person.
Will there be any scrutiny of how the new law operates?
The chief medical officers in England and Wales and the Health Secretary would be required to monitor and report on the operation of the law.
The health secretary would also be required to report on the availability, quality and distribution of appropriate health services to people with palliative care needs, including pain and symptom management, psychological support for those people and their families, and information about palliative care and how to access it.
Has the issue been voted on at Westminster before?
Until last year, not for almost a decade. An Assisted Dying Bill, which would have allowed some terminally ill adults to ask for medical help to end their life, went before the Commons in 2015 and was rejected by MPs.
There was also a bill proposed in the House of Lords during the 2021/2022 session which reached a second reading in the chamber, while a Westminster Hall debate on assisted dying took place in July 2022.
