By Christine Rayner
An Assisted Dying Bill for England and Wales is to be introduced in the Commons on 16 October 2024. The bill and issues it raises have been discussed by a panel in a Religion Media Centre briefing – links are here.
What does ‘assisted dying’ mean?
Assisted dying is generally used to describe where someone who is terminally ill seeks medical help to obtain lethal drugs which they administer themselves. The term “assisted suicide” is sometimes used to indicate a person has chosen to die. It is also used in the context of someone who is not terminally ill. Providing someone with a lethal dose of sedatives, or helping them go to Switzerland – where the law is different – can be regarded as assisted suicide in law.
What is the law in the UK at the moment?
Assisted dying is illegal in all parts of the UK, under the Suicide Act 1961, but there are changes in the air. Euthanasia (where a medical professional administers a lethal drug, with the consent of the individual) is also illegal in the whole of the UK under the Homicide Act 1957, with a maximum penalty of life imprisonment.
In Northern Ireland, assisting or encouraging suicide is illegal under the Criminal Justice (Northern Ireland) Act 1966 and is punishable by up to 14 years in prison. This offence applies even if the assistance takes place in Northern Ireland, but the suicide takes place elsewhere.
Assisted dying is also illegal in Scotland, but in March this year a Bill was introduced in the Scottish Parliament. The Assisted Dying for Terminally Ill Adults (Scotland) Bill would allow terminally ill adults to request assisted dying if they meet certain eligibility criteria, including being at least 16 years old and a resident of Scotland for at least 12 months. Two doctors would need to assess the patient and confirm that they are acting voluntarily.
A similar Bill was introduced in the Parliament of the Isle of Man last summer. The Assisted Dying Bill 2023 would allow terminally ill adults who have been residents of the Isle of Man for at least a year to request assistance in ending their life. The bill would include safeguards, such as two doctors independently assessing the patient’s mental state and a reflection period for the patient to change their mind. The bill passed its second reading in the Tynwald, the Isle of Man’s Parliament, on October 31, 2023, with 17 votes to 7. It passed a key vote in the House of Keys on May 14, 2024, and is expected to receive a third reading in the summer. If it passes, it could be available to residents from 2027.
In Jersey, the States Assembly approved proposals for assisted dying, on 21 May 2024. Legislation is now being drawn up, which could be enacted in 2025.
The States of Guernsey rejected proposals for assisted dying in 2018. But an opinion poll in March 24, commissioned by Dignity in Dying, showed only 15 per cent opposed, and three-quarters of respondents wanted the States to debate assisted dying again. The poll was of 3,500 people. Deputy Gavin St Pier said he would prompt a vote on the issue in the next year.
The Welsh Senedd will debate assisted dying on 23 October, however the issue is governed by criminal law made at Westminster. The motion calls on UK parliament to introduce a compassionate assisted dying law.
How does assisted dying work in practice?
If the criteria are met, a health professional provides the patient with an approved substance to end their life. The patient then administers the substance themselves.
What would happen to someone who helped a terminally ill person to die in UK now?
Section 2 of the Suicide Act of 1961 makes it illegal to encourage or assist someone to commit suicide or attempt suicide. Anyone prosecuted under the existing law can be jailed for up to 14 years.
Euthanasia is illegal under English law and is considered manslaughter or murder. The maximum penalty is life imprisonment.
Who would decide whether to prosecute?
The Director of Public Prosecutions (DPP) must agree to prosecute someone for assisting or encouraging a suicide.
Are there any exceptions to prosecution?
Guidelines drawn up by the DPP and Crown Prosecution Service (CPS) advise against prosecution if the victim made a clear, voluntary, and informed decision to commit suicide and the person assisting was motivated by compassion.
It is legal to administer terminal sedation to a dying patient in the UK if the intent is to treat their suffering, even though it will hasten their death.
How many times has this been debated in Parliament?
Attempts to bring in a law to allow assisted dying have been introduced several times in the past 20+ years. Lord Joffe’s Patient (Assisted Dying) Bill was introduced in 2002-03, but blocked by the House of Lords.
Lord Falconer has tried several times to change the law, introducing Assisted Dying Bills in 2013-2014, 2014-2015, 2015-2016, 2019-2021, 2021-2022 and July 2024. His latest attempt is expected to be pulled, if the Commons debate goes ahead.
Former Labour MP for Wolverhampton South West Rob Marris (2001-2010, then 2015-2017) introduced a second Assisted Dying Bill in 2015, but was defeated in a free vote by 330 votes to 118.
Another Assisted Dying Bill was introduced by Baroness Meacher in May, 2021, but did not proceed after the end of the session.
The issue has been debated many times in the House of Lords and was last voted on in the Commons in 2015.
In February, 2024, the Health and Social Care Select Committee published a report on assisted dying. It was intended as a basis for future debate, rather than offering solutions. It included examples of the law being challenged in the case of disabled, or terminally ill people who are unable to end their own lives without someone’s help. The issue got as far as the Supreme Court in June 2014, where applicants claimed the law was incompatible with their right to a private life, under Article 8 of the European Convention on Human Rights. The court decided against making such a declaration, by a majority of seven to two, ruling that the issue should be returned to the Houses of Parliament for a decision over changing the law.
What is the prime minister’s view on the subject?
Although it is widely believed Sir Keir Starmer privately believes the law should be changed, publicly he has said the subject should be decided by a free vote of MPs, to respect “strong views” on both sides. A phone call in March 2024 between Sir Keir and Dame Esther Rantzen (a prominent campaigner for assisted dying to be made legal) was filmed by ITV News. During the conversation, Sir Keir said if Labour won the general election and he became prime minister he would make Parliamentary time available for the debate and vote.
Why is it in the news again?
Next week, Labour MP Kim Leadbeater is putting forward a bill to allow assisted dying. Details have not yet been published, but the wording is expected to be similar to a bill before the Lords which would allow terminally ill adults with six months or fewer to live, to end their own lives. The issue came back into public focus after Dame Esther Rantzen, who has stage four lung cancer, appealed for a change in the law. The bill is expected to be presented next Wednesday (16 October), with a debate and vote before Christmas.
Where is assisted dying legal?
In Belgium, Luxemborg and the Netherlands a doctor can adminster life-ending drugs to a patient who has given consent.
In Canada, voluntary euthanasia and assisted dying is allowed for people whose death is “reasonably foreseen”.
Australia allows assisted dying in some states, as does the US.
Spain allows assisted dying for “serious, chronic and incapacitating illnesses” and those causing “intolerable suffering”.
Switzerland has allowed assisted suicide since 1942
What is public opinion in the UK over the subject?
A YouGov survey was commissioned by Dignity in Dying on 26 and 27 July 2023, with a sample size of 1,844 adults in England and Wales. The results suggested that 78 per cent support assisted dying if taken to mean “when a terminally ill adult of sound mind can legally seek assistance to end their life via life-ending medication, following the approval of two doctors.”.
