Everything you need to know about the assisted dying Bill due to be debated by MPs
by Aine Fox and Richard Wheeler PA · ChronicleLiveA proposed law could legalise assisted dying in England and Wales.
MPs are due to vote on the first stage of the proposed legislation on Friday, November 28.
The issue has split parliamentarians at all levels of government, with several members of Keir Starmer's ruling cabinet at odds over plans put forward by Spen Valley MP Kim Leadbeater.
Here, ChronicleLive examines the key points to know before the Terminally Ill Adults (End of Life) Bill reaches the floor of the House of Commons.
Who would be eligible?
Only terminally ill adults who are expected to die within six months, have been 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.
How would the process work?
The terminally ill person must make two separate declarations, witnessed and signed, about their wish to die. The process must involve two independent doctors being satisfied the 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.
A High Court judge must hear from at least one of the doctors regarding the application and can also question the dying person as well as anyone else they consider appropriate. How long would it take?
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, for the person to have a period of reflection on their decision.
For someone whose death is expected imminently, the 14-day period could be reduced to 48 hours.
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.
How soon could an assisted dying service be running?
Ms Leadbeater has suggested an assisted dying service would not be up and running for around another two years from the point the law was passed, with "even more consultation to make sure we get it right" at that stage.
Would doctors be forced to take part?
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. Doctors would not be under a duty to raise the option of assisted dying with a patient.
The Bill states that there is nothing to stop them "exercising their professional judgment to decide if, and when, it is appropriate to discuss the matter with a person".
What about judges?
It is not thought judges would have the same right to decide whether or not to take part in the process.
Ms Leadbeater commented on the novel responsibilities this legislation might place on judges, saying they are "used to making these difficult and complex decisions and being part of this process", pointing out the parallels with decisions concerning life support cessation for critically ill patients. In advocacy of the Bill, former director of public prosecutions Sir Max Hill noted that High Court hearings on such matters could be conducted in an open court setting.
Who would administer the medication?
The individual facing the terminal condition would have to self-administer the medication; no physician or any other person would be permitted to do so. It's been proposed that in some situations, a terminally ill patient could administer the medication by pressing a button.
How many people are predicted to use a new assisted dying service?
As for the potential scope of use, Ms Leadbeater cited international examples where assisted dying is legal, indicating that it comprises about 0.5 to 3% of all mortalities. The expectation is that cases in England and Wales would likely number in the hundreds, not thousands.
How would a new law be monitored or reviewed?
In terms of oversight, Ms Leadbeater indicated that the chief medical officers in both England and Wales, alongside the Health Secretary, would take responsibility for monitoring and reporting on how the new legislative process was functioning.
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. This includes pain and symptom management, psychological support for those people and their families, and information about palliative care and how to access it.
When was the last time MPs debated assisted dying?
The issue hasn't been voted on at Westminster for nearly a decade. An Assisted Dying Bill was presented before the Commons in 2015 but was rejected by MPs.
A Bill was also proposed in the House of Lords during the 2021/2022 session which reached a second reading in the chamber. Debates on assisted dying took place in Westminster Hall in July 2022 and April 2024.
What happens next?
If the Bill passes the first stage in the Commons on Friday, it will go to committee stage where MPs can table amendments. It will then face further scrutiny and votes in both the House of Commons and the House of Lords.
This means any change in the law wouldn't be agreed until next year at the earliest. MPs are not guaranteed a vote on the Bill on Friday.
Bills such as this are known as private members’ bills (PMBs) and are considered during Friday sittings. The time available to consider them is from 9.30am until 2.30pm.
If the debate is still ongoing at 2.30pm then it is adjourned and the Bill falls to the bottom of the list, making it highly unlikely to make any further progress.
A closure motion, which can be moved at any point during proceedings to end the debate and force a vote, is typically proposed around 1pm on Friday sittings by an MP. If approved, the House then votes on whether or not to give the Bill a second reading.
If rejected, the debate resumes and the Bill is unlikely to progress.
What happens if any changes are suggested?
An amendment has already been tabled by a group of six cross-party MPs to halt the Bill. This amendment proposes to "decline" to give a second reading to the Bill, arguing that a PMB does not allow for sufficient debate and scrutiny on a matter of this importance.
The decision to debate the amendment rests with the Speaker of the House of Commons, Sir Lindsay Hoyle. If chosen, the amendment will be debated as part of the main Bill discussion.
If the amendment is selected and receives majority support from MPs, it signifies the House's disapproval for the Bill's progression. .
This effectively changes the question initially posed to MPs – from asking if they want it to progress at second reading to asking them if they want to reject it. If the amendment is not selected by the Speaker, the debate will focus on whether or not to approve the Bill at second reading in a straight yes or no vote.
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