Assisted Dying – is the UK ready for assisted dying to become a real option of choice?

The debate surrounding assisted dying in the UK has gained momentum over the last few months following the introduction of two bills in both the House of Lords and the House of Commons, Kim Leadbeater’s Terminally Ill Adults (End of Life) Bill having been published this week. Assisted dying has been a topic of debate for many years, could legislative change be on the horizon?

Previous bills have failed

The courts have consistently held that the right to die is a matter for Parliament to decide. Lord Falconer introduced the Assisted Dying Bill to the House of Lords in 2014. Although it advanced to the Committee Stage, time ran out before it could be fully debated.  Lord Falconer’s bill was introduced in the House of Commons in 2015 by Labour MP Rob Marris, having, like Kim Leadbeater, chosen to bring the bill forward after being drawn first in the Private Members’ Bills ballot, marking the first debate on the issue since 1997. The bill failed at its Second Reading vote, with 330 against and only 118 in favour.

In 2021, Baroness Meacher introduced a further bill on assisted dying to the House of Lords, proposing more stringent safeguards. This bill would allow terminally ill adults, confirmed by two independent doctors and a High Court judge to be mentally competent and fully committed to their decision, to obtain life-ending medication which could then be taken at a time and place of their choice. This bill again passed the Committee Stage, but the parliamentary session ended before it could progress further.

Renewed cross-parliamentary approach

As explained earlier, the Terminally Ill Adults (End of Life) Bill is a private members’ bill introduced in the Commons by Labour MP Kim Leadbeater, which had its First Reading on 16 October 2024, with its Second Reading scheduled on 29 November 2024. Lord Falconer’s third bill on assisted dying, the Assisted Dying for Terminally Ill Adults Bill, introduced in the Lords in July 2024, is scheduled for its Second Reading on the same day.

The two bills are broadly similar sharing the same core eligibility criteria, choosing to maintain strict safeguards:

• Must be 18 or over
• Must be a resident of England and Wales and registered with a GP for at least 12 months
• Must have the mental capacity to make an informed decision
• Must be diagnosed with a terminal illness and expected to die within six months
• Must make two separate declarations, witnessed and signed about their wish to die
• Requires approval from two independent doctors and a High Court judge

The Assisted Dying for Terminally Ill Adults (Scotland) Bill, introduced to the Scottish Parliament in March 2024 by Liam McArthur of the Scottish Liberal Democrats, is at the evidence gathering phase of Stage 1 in the Scottish legislative process.  The Scottish bill is similar to those before Westminster with two notable distinctions:

• Eligibility age requirement of 16 and over
• Requires approval from two independent doctors only

Could legislative change be on the horizon?

Previous bills have faced substantial resistance around issues of safeguarding and public trust in the medical profession, with concerns about coercion, moral implications, and the potential weakening of palliative care systems. While ethical opposition remains, the new bills aim to address safeguarding concerns felt to have been inadequately addressed by their predecessors. Bills before Westminster and Holyrood include a “Review” section, which did not appear in bills previously considered, allowing for continuous assessment and potential refinement of the law over time, demonstrating an effort to address previous concerns more comprehensively. Ms Leadbeater has emphasised that her bill “will not undermine calls for improvements to palliative care” and includes “the strictest safeguards anywhere in the world”.

Assisted dying has already been legalised in 27 jurisdictions, including Canada, the Netherlands and Belgium, and is reaching advanced stages of the legislative process in the Isle of Man and Jersey. The Isle of Man’s bill, which recently passed its Third Reading, includes protections such as independent assessments by multiple doctors, a 14-day reflection period, and self-administration of life-ending medication. If approved, the bill could be enacted by 2027.  In Jersey, an ethics board review and public consultation in 2023 sanctioned legislative drafting, with debate in the States Assembly anticipated by the end of 2025 and possible enactment by 2027. Jersey’s proposed law is notable for an “unbearable suffering” clause, extending eligibility beyond strictly terminal cases, accompanied by an 8-step assessment and consent process.

Since the adoption of assisted dying laws, many jurisdictions have gradually expanded eligibility to include people suffering from severe psychiatric conditions. Countries like Belgium and the Netherlands have also extended eligibility to minors, albeit under strict circumstances. In most jurisdictions, the overall number of assisted deaths has risen over time since the introduction of new laws, particularly in Canada^[1]. Ms Leadbeater’s bill has sought to address concerns seen in the effect of laws in other jurisdictions which may make the Second Reading vote a lot closer than in 2015. However, with the NHS already under significant pressure with long waiting lists and underfunding, the comments this week from the Secretary of State for Health and Social Care raising concerns about the cost of providing an assisted dying service and the “choices and trade-offs” may prove to be influential. 

We will monitor the upcoming parliamentary sessions as they unfold, and our team are on hand to assist with your regulatory queries.

Co-authored by Areesha Qureshi
 

^[1] Assisted Dying/Assisted Suicide - Health and Social Care Committee