Everything you need to know about the Assisted Dying Bill
What is the Assisted Dying Bill?
The Assisted Dying Bill, or to give it its official title the Terminally Ill Adults (End of Life) Bill 2024-25, is a private members bill being brought to the Commons by Kim Leadbeater, the Labour MP for Spen Valley. Should it become law, it would give terminally ill people in the final six months of their life the right to request assistance from a doctor to end their life.
How did we get here?
In the months before the general election, the Labour party had an internal debate about starting a ‘national conversation’ on the issue, on which supporters have been campaigning for years. Keir Starmer had promised Dame Esther Ranzten, who has terminal cancer, that if elected he would hold a vote on it; the now health secretary Wes Streeting argued it might be time to start a wider debate.
So here we are - with Streeting now openly saying he will vote against the bill, and Starmer saying silent on his own leanings. Like it or not, should the bill pass, it will likely be the most significant thing this government will be remembered for - and a momentous step into a new moral territory. Small wonder it has provoked intense debate, reams of column inches and has divided MPs on new and very different lines.
This is not the first time parliamentarians have had to consider whether to legally help people to end their own life. The last Commons debate and vote on the law was in 2015, when on a free vote, MPs voted against a second reading of another private members bill, the Assisted Dying (No 2) Bill 2015, by 330 votes to 118. But voluntary euthanasia legislation in England and Wales was proposed as far back as 1931. The British Voluntary Euthanasia Society (now known as Dignity in Dying) was founded in 1935. Bills have been introduced and attempted in both the Commons and Lords on the issue multiple times, but thwarted or dropped each time.
What does the public think?
MPs are thought to be divided on the issue, with the final decision on something of a knife edge. Polling suggests the country at large supports a change in the law, with 65 per cent backing the legislation. Good Housekeeping readers are likewise broadly in favour - an online survey of 1,256 people found that 71 per cent think healthcare professionals should be allowed to help someone end their life if asked to assist, with 21 per cent against and 16 per cent undecided. Sixty four per cent of readers think assisted dying is humane in the right circumstances and 41 per cent think a change to legislation is long overdue - although 34 per cent worry it is open to abuse.
Why is the bill controversial?
The restrictions used in the bill are, arguably, open to interpretation. Under its terms, a terminally ill adult given less than six months to live will legally be able to take their own life if sanctioned by two independent doctors and a High Court judge. Those opting for assisted dying would have to make two separate declarations of a voluntary desire to die, and the decision would have to be confirmed by a judge. There would then be a 14-day reflection period (shortened to 48 hours if death is imminent).
But some of the wording is ambiguous. Doctors are not under any duty to raise the issue with a patient, but the bill does allow for them to ‘discuss the matter with a person’ when it is in line with their professional judgement. Patients may give their consent to assisted suicide by electing a ‘proxy’ who can sign forms on the patient’s behalf if they are ‘unable to sign their name (for any reason).’ If all eligibility criteria is met, a life-ending (although unspecified) ‘approved substance’, to be self-administered, would be prescribed - although Clause 18 (6) allows a coordinating doctor to aid the person by assisting them ‘to ingest or otherwise self-administer the substance’. And although it would become a criminal offence, punishable with up to 14 years in prison, for anyone to persuade someone to agree to assisted suicide, a person who provides assistance to another in accordance with the bill would not face any criminal liability.
What are the arguments against?
Those against the bill (even some who are in favour of the principle of assisted dying) are uncomfortable about this ambiguity. They don’t like the fact that the bill would not allow a doctor to refuse to have any part in facilitating an assisted suicide on the grounds of conscience - because even if a doctor objects to approving a patient’s death, he must recommend another physician who might. They point out that accurately predicting how long a patient has left to live is very difficult, which makes the six month guideline both impractical, and potentially a slippery slope to encouraging elderly relatives to end their lives. They point to the impracticality of involving family judges in the High Court, of which there are just 19. Better, say those against the bill, to invest more money in proper palliative care for those at the end of their life. At the very least, they argue, such an enormous decision should be given more time for debate rather than the five hours it will get in the Commons as a private members bill.
And the arguments for?
Those in favour of the bill argue that the principle is one of liberty: that people should have the right to choose the manner of their own death, especially those enduring unbearable suffering. They argue that the safeguards are the strictest in the world; that crucially the involvement of a judge means it cannot be abused. The latest advocate for the bill, former prime minister David Cameron (who was previously against the legislation) says the bill is not about ending life, but shortening death, and that its robust safeguards will protect the most vulnerable.
What happens in other countries?
Campaigners on both sides point to the example of other countries - those who are pro say the legislation is closest to that found in the Australian state of Victoria, where a fifth of those given the life-ending medication never take it, and that the slippery slope argument is disproved by the state of Oregon, in the US, which has had an assisted dying law for longest and where it remains restricted to terminally ill adults. Those who are against look to the examples of Holland, Belgium and Canada, where access to restricted dying has been widened over the years - pointing to a 29-year-old Dutch woman who was granted euthanasia this year on the grounds of mental suffering. In Canada, there’s no longer a need for a terminal diagnosis while in Belgium, it is legal to euthanise children, with no age restrictions - albeit on the grounds of terminal or incurable disease, at their request and if they are in chronic pain or near death.
What happens next?
If it goes ahead at all (and a group of cross-party MPs is attempting to block it even coming to the Commons in a so-called ‘wrecking amendment’), it depends on the results. Sir David Natzler, a former Clerk of the House, has suggested that one option for the government to address concerns would be to make the result a vote for the general principle of legislation, and that if MPs were to vote in favour, there could then be a public consultation.
Whatever happens, the decision will be a monumental one.
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