Revisions still in progress: Assisted dying bill faces a wave of amendments

Momentum surrounding the Terminally Ill Adults (End of Life) Bill (“the Bill”), which seeks to legalise assisted dying in England and Wales, has notably shifted in recent months. With the final voting of the Report Stage due to go ahead tomorrow, 20 June, there is a risk that the parliamentary session may end before the Bill is able to progress further, as was the case in 2021.

The Bill, currently at Report Stage, has been subjected to increased scrutiny, with over 500 amendments proposed—only one-third of which have been accepted by Labour MP and sponsor, Kim Leadbeater. The first debate at Report Stage took place on 16 May, and after four hours of intense debate, only one of several tabled amendments was voted on. A closure motion was agreed, and proceedings were adjourned until 13 June, where further amendments were debated and voted on. Despite more than 90 hours of debate on the Bill to date—highlighting growing parliamentary and public concern—many amendments are yet to be discussed or voted on, and the Report Stage has once again been adjourned.

Progress against proposed amendments

Acknowledging personal beliefs

A significant development in the current draft of the Bill is the adoption of a new clause which confirms that there is no obligation on “any person” to participate in the assisted dying process. The new clause safeguards against any person, including health and social care professionals, being compelled to act contrary to their beliefs or professional codes, mandating that participation in the process is voluntary. This clause has garnered substantial parliamentary support, and MPs overwhelmingly voted in favour of its inclusion in the Bill at the first Report Stage vote on 16 May 2025. Furthermore, in the June proceedings, the process for replacing doctors unwilling to participate in assisted dying was also agreed.

Confirming when assisted dying can be discussed with a patient

Another amendment, proposed by MP Meg Hillier, voted into the Bill states that doctors cannot discuss assisted dying with anyone under the age of 18, addressing concerns that the legislation may eventually be extended to include children, as has been the case in other jurisdictions that have legalised assisted dying.  However, Ms Hillier’s other proposed amendment, seeking to stop health professionals initiating conversations about assisted dying unless the patient raised the topic first, was defeated. While some argued that informed consent requires full awareness of all end-of-life options, others cautioned that this could lead to undue influence, particularly given the power dynamics of the clinical setting.

Ban on advertising

The Report Stage also saw an amendment proposed by Ms Leadbeater voted in by MPs which creates a ban on advertising assisted dying services and imposes a duty on ministers to block advertising. Exemptions would be permitted in some cases, such as providing information to users of particular services. Labour MP Paul Waugh, however, called for tighter restrictions, proposing that the legislation should not allow exemptions to be made. His amendment was voted down. 

No automatic Coroner referral

Other amendments accepted include a measure to ensure assisted deaths carried out under the Bill would not be deemed unnatural and therefore, would not automatically be referred to and investigated by a coroner. Supporters of the amendment stated that, without this provision, assisted deaths would be “the most scrutinised deaths”, while critics argued that investigations by coroners would be necessary to identify coercion or abuse of assisted dying services.  MPs also voted in favour of an amendment stating there must be a report from a doctor where there is concern about a proposed assisted death.

Growing Concerns

Despite the large number of amendments tabled, MPs have only had the opportunity to vote on 12 of 133 amendments and key issues on fundamental aspects of the Bill remain to be determined by MPs. Former Lib Dem leader, Tim Farron criticised the sheer volume of amendments by Ms Leadbeater herself, characterising the process as “shambolic” and indicative of Ms Leadbeater’s own waning confidence in the Bill’s robustness.

Eligibility

A key topic that was discussed at various points during the debate in May, was limiting  the eligibility of those who can access assisted dying services, particularly, those who may fit the eligibility criteria solely due to voluntary starvation or due to physical manifestations of mental disorders, such as anorexia. Although Ms Leadbeater had previously indicated support for the amendment, proposed by MP Naz Shah, there was no opportunity to vote on this during the last proceedings. Similarly, amendments addressing the vulnerability of disabled individuals and the elderly within the Bill’s framework were also not voted on.

In a significant development, the Royal College of Psychiatrists (“RCP”) has withdrawn its support for the Bill in its current form, stating:

"It's integral to a psychiatrist's role to consider how people's unmet needs affect their desire to live. The Bill, as proposed, does not honour this role, or require other clinicians involved in the process to consider whether someone's decision to die might change with better support."

Their concerns highlight the possibility that decisions to end life may stem from treatable depression or unmet palliative needs—all of which could change with adequate intervention.

During the debate, the RCP’s comments were used to argue in favour of various amendments. As discussed in our earlier article Assisted Dying Bill – progress amidst ongoing controversy, a Voluntary Assisted Dying Review Panel, made up of a senior legal figure, social worker and practising psychiatrist, would be responsible for ensuring individuals seeking assisted dying meet the eligibility criteria and are not being coerced. However, during the debate, critics highlighted that the RCP does not believe there are enough sufficiently trained psychiatrists for the role, although Ms Leadbeater argued that the initial number of those seeking assisted dying will be very small, and in conjunction with the training period, this would therefore, not be an issue.

Coercion

During May proceedings, James Cleverly also raised concerns that women and ethnic minorities, who may experience familial or cultural coercion, could be particularly at risk. Critics argue these groups often lack the full social autonomy assumed by the Bill’s framework. This was recently backed by Labour MP Rupa Huq, who expressed concerns that the cost-of-living crisis could make assisted dying “quite attractive” for those struggling financially, suggesting that some might be coerced into an assisted death to save on care costs. As highlighted in our previous article One step closer: what's next as the Assisted Dying Bill clears Second Reading, coercion has remained an ongoing concern throughout the progression of the Bill.

Shifting focus

Rebecca Paul MP notably critiqued the shifting philosophical basis of the Bill—from ending unrelievable pain to prioritising personal autonomy. She argued that this change risks undermining protections for vulnerable individuals, especially where social and economic conditions (such as inadequate hospice funding) might subtly incentivise assisted dying. As explored in our previous article, during the earlier stages of the Bill, key concerns revolved around patient safety and support, as well as workable logistics, and while these areas are still relevant considerations, the debate has arguably shifted to concerns around who can access assisted dying and the freedom of choice, fuelling calls for further scrutiny of the Bill.

Next Steps

The debate is set to continue on 20 June, where the remaining amendments will be debated and voted on.

However, the Prime Minister, Sir Keir Starmer, has come under pressure from his own MPs to postpone the final voting this Friday. A group of over 50 Labour MPs have written to the Leader of the House, Lucy Powell, asking for intervention to allow the necessary time to discuss and scrutinise a bill which will “alter the foundations of [the] NHS”. However, supporters of the Bill have criticised delaying tactics used by opponents. As tension grows, it remains to be seen whether Starmer will respond to internal party pressure and call for a delay. If the Bill progresses - depending on how MPs vote on Friday - a Third Reading will follow thereafter, determining the Bill’s forward trajectory.

With significant debate still ongoing, the Assisted Dying Bill remains a work in progress, risking its further progression. We will continue to monitor the development of the Bill, and our team are on hand to assist with your regulatory queries.

Co-authored by Areesha Qureshi, Solicitor Apprentice