The Assisted Dying Bill Has Politicians in the UK Divided

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It is emotional. It is controversial. But it can soon become law. A bill to legalise assisted dying, external for terminally ill adults in England and Wales has been formally introduced in the House of Commons.

It will be an open vote and MPs are due to debate it in Parliament on 29 November. It is highly likely there will be further debates and votes will be needed before the Terminally Ill Adults (End of Life) Bill can become law.

As of now, assisted dying is illegal in England, Wales, and Northern Ireland, and carries a maximum prison sentence of 14 years for anyone helping someone to die.

Being a free vote, MPs can vote according to their conscience rather than along party lines. As of now, even the Health Secretary Wes Streeting has not said which way he will vote, as he is “conflicted” on the issue. Prime Minister Sir Keir Starmer, who has said he is “personally in favour of changing the law” on assisted dying, has committed to giving MPs a free vote on the issue.

This bill has been in the pipeline for several years now. The last time MPs voted on whether to legalise assisted dying was in 2015 when it was rejected 330 to 118. However, the atmosphere this time seems to be different, and the vote is expected to be much closer.

If it passes, it will move to the committee stage, in which it will be scrutinised and probably amended. Further votes in both the Commons and the Lords are needed before it can become law.

What the Bill Says

Supporters of the bill say it offers the ‘strictest safeguards’, as it is for those who are terminally ill with six months or less to live and that it offers greater legal protections than any other legislation of its kind in the world.

Labour MP Kim Leadbeater, who published the bill, said she had undertaken a “thorough and robust process” to determine the shape of the legislation, including wide consultations with medical and legal experts. 

She said, “I don’t underestimate the seriousness of the issue. For my part, I have looked closely at the evidence from other jurisdictions, and I believe this bill not only offers protections to people nearing the end of their lives that they don’t have at present, but also provides for the strictest safeguards anywhere in the world.” 

The law would apply to England and Wales. A separate bill is already under discussion in Scotland. Meanwhile, politicians in Jersey and the Isle of Man have already backed plans to introduce assisted dying and the process to bring in legislation is underway.

Many of those who are against the bill becoming law have raised questions over the capacity of the courts to handle assisted dying cases. They believe that the judicial system is already struggling with huge backlogs, which can lead to hearings being delayed for months, or even years.

Assisted dying is a universal issue and it is a personal one for most people. The devil lies in the detail.

Eligibility is the first question. According to the bill, only adults with a terminal illness who are expected to die within six months will be eligible for an assisted death. The person must have the mental capacity to make a choice about the end of their life and must express a “clear, settled and informed” wish, free from coercion or pressure.

Only permanent residents of England and Wales registered with a GP for at least a year will be eligible. The bill excludes disability and mental illness as eligibility criteria.

The applicants have to make two separate declarations, witnessed and signed, about their wish to die. Following that, two independent doctors must be satisfied the person is eligible with a gap of at least seven days between the doctors’ assessments.

A High Court judge must hear from at least one of the doctors and can also question the dying person, or anyone else they consider appropriate. There must be a further 14 days after the judge has made the ruling.

The bill states that a doctor could prepare the substance, but the person themselves must take it, which is called physician-assisted suicide. No doctor or anyone else would be allowed to administer the medication to the terminally ill person.

Doctors would also not be under any obligation to take part in the assisted dying process. The British Medical Association has called for assisted dying services to be organised separately from normal NHS care. They have also called for an opt-in service in the legislation for NHS staff, as opposed to opt-out.

Furthermore, the bill would make it 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 any of these actions, they could face a jail sentence of up to 14 years.

Leadbeater believes less than 1,000 patients a year in England and Wales are expected to choose assisted dying should the law pass.

Will it Pass?

It does not seem that the bill will be easy to pass. Some MPs have raised serious doubts that the legislation would even pass the first parliamentary stage on 29 November.

Dr Peter Prinsley, a Labour MP who is also a consultant, said he believed some of the new, younger MPs were wavering. “I’m not as confident of this thing passing as I was before I started having these conversations,” he said in a TV interview.

“If you’re maybe a bit younger and you haven’t encountered people who die in horrible circumstances or take their own lives or whatever, maybe you’re a little bit removed from it. Anybody I speak to who has experienced things as they are now cannot understand why we’ve not made this change,” he added.

Prinsley also feared many MPs would abstain and urged them to vote – whatever they decide. “I don’t think that abstaining, which people may be tempted to do, is a neutral act. I think that people need to make a decision about this, and that’s what I’m encouraging people to do,” he said.

Labour peer Charlie Falconer said there was no legal risk of its scope being widened by the courts on human rights grounds, because of the strictly limited definitions in the bill and the failure of previous challenges in British and European courts.

“The English courts and the European Court of Human Rights in Strasbourg have said time and time and time again that assisted dying is not something prescribed by the convention. It is for legislatures to decide … they recognise there are spiritual, religious, and ethical approaches that differ from one country to another. Any such application would be hopeless,” he said.

Comparing the bill to the law elsewhere in the world, The Guardian noted, “The proposals most closely align with the law in Oregon, the US state that legalised assisted dying for terminally ill, mentally competent adults with a prognosis of six months or less in 1997. The Oregon law has not been extended beyond terminally ill adults.”

It is difficult to predict how this will play out in Parliament but a 2023 survey by the Royal College of Surgeons found 53 percent of respondents in favour of assisted dying and 25 percent opposed as compared to 2019 when a Royal College of Physicians survey found 31 percent in favour and 43 percent opposed. A Royal College of GPs survey the same year found 40 percent in favour and 47 percent opposed. A British Medical Association survey in 2020 found that 50 percent backed assisted dying and 39 percent opposed it.

(Nabanita Sircar is a senior journalist based in London. She tweets at @sircarnabanita. This is an opinion piece and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for the same.)