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What is assisted dying and how could the law change? How assisted dying laws across the UK could change
(about 2 months later)
Labour MP Kim Leadbeater says her bill includes "the strictest safeguards anywhere in the world" On Friday, MPs in Westminster have another chance to consider a bill which could legalise assisted dying in England and Wales.
MPs voted in support of a proposal to legalise assisted dying in England and Wales, in November 2024. In Scotland, a separate assisted dying bill has received the initial backing of MSPs and will now be looked at in more detail.
Months of detailed scrutiny and further votes in the Commons and Lords are required before the bill could become law.
At present, laws throughout the UK prevent people from asking for medical help to die.
However, proposed laws to give terminally ill adults the right to choose to end their life have been agreed in the Isle of Man, which is part of the British Isles.
What is the proposed law on assisted dying in England and Wales?What is the proposed law on assisted dying in England and Wales?
The Terminally Ill Adults (End of Life) Bill, external was introduced by backbench Labour MP Kim Leadbeater. The Terminally Ill Adults (End of Life) Bill, external was introduced by Labour MP Kim Leadbeater.
It proposes giving terminally ill people the right to choose to end their life. It proposes letting terminally ill people end their life if they:
It says that anyone who wants to end their life must: are over 18, live in England or Wales, and have been registered with a GP for at least 12 months
be over 18 and live in England and Wales, and have been registered with a GP for at least 12 months
have the mental capacity to make the choice and be deemed to have expressed a clear, settled and informed wish, free from coercion or pressurehave the mental capacity to make the choice and be deemed to have expressed a clear, settled and informed wish, free from coercion or pressure
be expected to die within six monthsbe expected to die within six months
make two separate declarations, witnessed and signed, about their wish to diemake two separate declarations, witnessed and signed, about their wish to die
satisfy two independent doctors that they are eligible - with at least seven days between each assessmentsatisfy two independent doctors that they are eligible - with at least seven days between each assessment
Once a patient's application has been approved, they would then have to wait 14 days before proceeding. Labour MP Kim Leadbeater says too many people "have a horrible, harrowing death" under the current system.
Once an application has been approved, the patient would have to wait 14 days before proceeding.
A doctor would prepare the substance being used to end the patient's life, but the person would take it themselves.A doctor would prepare the substance being used to end the patient's life, but the person would take it themselves.
The bill defines the co-ordinating doctor as a registered medical practitioner with "training, qualifications and experience" at a level to be specified by the health secretary. It does not say which drug would be used.The bill defines the co-ordinating doctor as a registered medical practitioner with "training, qualifications and experience" at a level to be specified by the health secretary. It does not say which drug would be used.
It would be illegal to use dishonesty, pressure, or to coerce someone into declaring they want to end their life, with a possible 14-year prison sentence. It would be illegal to coerce someone into declaring they want to end their life, with a possible 14-year prison sentence.
A majority of MPs backed the bill in November 2024.
How has the Leadbeater bill changed since MPs first voted?
A committee of 23 MPs - including 14 supporters and nine opponents - has gone through the proposed legislation line by line. It held public hearings and took evidence from experts.
Under the original proposals, a High Court judge would have to approve each request to end a life.Under the original proposals, a High Court judge would have to approve each request to end a life.
However, Leadbetter suggested a three-person panel comprising a senior legal figure, a psychiatrist and a social worker should oversee applications instead. However, the committee accepted Leadbeater's suggestion that a three-person panel comprising a senior legal figure, a psychiatrist and a social worker should oversee applications instead.
And the MPs reviewing the bill have agreed to adopt this approach. Other changes include:
The proposal followed concerns the High Court would not have capacity to rule on each individual case. doubling the maximum time between the bill being passed and the law coming into effect from two years to four, to allow training and finalising new systems
However, opponents say the move undermines the bill's safeguards. clarifying that doctors must set out palliative care options during initial discussions
Doctors must raise other options to assisted dying, MP says specifying the law wouldn't come into effect in Wales without Senedd approval
When could assisted dying become law? On Friday, MPs will have the chance to propose and vote on additional changes. There won't be a vote on whether to pass or reject the entire bill.
Many months of activity still lie ahead in the Commons and the Lords, and it is still possible that the bill could fall and not become law at all. The legislation will then be subject to further scrutiny in the Commons and the Lords, with further votes. The Commons is unlikely to vote to give the bill final approval until 13 June at the earliest.
There are 23 MPs on the committee scrutinising the proposed legislation line-by-line. They include 14 supporters - including two ministers - and nine opponents. The government has reduced its upper estimate for the number of assisted deaths in the first year from 787 to 647. It admitted errors in calculating how many people could take up the service if it becomes law.
The committee is holding public hearings and taking evidence from experts. It will then propose amendments to the bill. MPs to debate assisted dying bill again after major changes
It is hoped that the committee process will be finished in time for the bill to return to the House of Commons on 25 April.
At that stage, all MPs will have a chance to debate and vote on the changes proposed by the committee.
There would then be more scrutiny in the Commons and the Lords, and further voting.
Even if the bill cleared all its parliamentary hurdles, MPs had originally been told there would be a period of up to two years before any new law would be implemented.
However, Leadbeater has proposed doubling this to four years, to allow more time to set up training and systems for what would be an entirely new service.
If everything was ready more quickly, assisted dying could be in place ahead of the deadline, but the BBC understands that some ministers have expressed concern about the possible delay.
Who are the MPs who will scrutinise the assisted dying bill?
How did MPs vote on assisted dying?
The historic vote saw 330 MPs support the assisted dying bill, and 275 reject it.
MPs were given a free vote on the issue, which meant they could make their own decision rather than follow party instructions. The government is impartial on the issue.
Prime Minister Sir Keir Starmer was among those to vote in favour of the bill, as was Chancellor Rachel Reeves.
However, Deputy Prime Minister Angela Rayner, Foreign Secretary David Lammy, Health Secretary Wes Streeting and Justice Secretary Shabana Mahmood all voted against.
Most Conservative MPs rejected the bill, including party leader Kemi Badenoch. The former PM Rishi Sunak and former deputy PM Oliver Dowden were among the minority of Tory MPs who supported it.
When MPs last voted on the issue in 2015, they rejected different proposals by 330 votes to 118, external.
'Hardest decision of my career': MPs wrestle with assisted dying choice
Assisted dying: How did my MP vote?
How might the law change in Scotland?How might the law change in Scotland?
A separate bill is under discussion in Scotland. Lib Dem MSP Liam McArthur with campaigners outside the Scottish Parliament
Liberal Democrat MSP Liam McArthur drafted the Assisted Dying for Terminally Ill Adults (Scotland) Bill. The assisted dying bill being considered in the Scottish Parliament says that eligible applicants would have to:
If passed by MSPs, eligible applicants would have to:
be resident in Scotland for at least 12 monthsbe resident in Scotland for at least 12 months
be registered with a GP in Scotlandbe registered with a GP in Scotland
be terminally illbe terminally ill
have the mental capacity to make the requesthave the mental capacity to make the request
The bill is being considered by the health committee, external ahead of an initial vote by MSPs. The first stage of the committee's work is due to be completed by 23 May 2025. Liberal Democrat MSP Liam McArthur, who drafted the Assisted Dying for Terminally Ill Adults (Scotland) Bill, said he will raise the proposed minimum age from 16 to 18.
In October 2024, Scottish Health Secretary Neil Gray said the proposed legislation went beyond the limits of Holyrood's powers, and was a matter for Westminster. On 13 May, MSPs backed the "stage one vote" on the bill's general principles by 70 votes to 56, with one abstention.
However, McArthur said he was confident the UK and Scottish governments could find a solution if MSPs backed his bill. It was a free vote, which means MSPs could vote as they wish.
'Northern Ireland is being left behind on assisted dying' MSPs can now propose major amendments, ahead of a vote on the final draft.
How might the law change in the Isle of Man and Jersey? That process is expected to take several months, but needs to be completed before the next Holyrood elections in May 2026.
The Isle of Man and Jersey are both part of the British Isles but are able to set their own laws. They have each been considering different proposals to allow assisted dying. How could the assisted dying law work in Scotland?
The Isle of Man parliament passed its Assisted Dying Bill on 25 March. The bill will now be sent for Royal Assent, where King Charles will give formal approval for it to become law. How your MSP voted on the assisted dying bill
The scheme could be in place by 2027, and will cover adults who have lived on the island for five years and are expected to die within 12 months.
Jersey's politicians backed the principle of legalising assisted dying in 2021.
And in May 2024, they approved plans to allow assisted dying for those with a terminal illness "causing unbearable suffering".
Final legislation is currently being written, and once approved, an 18-month implementation period would begin, meaning new rules would take effect in summer 2027 at the earliest.
Guernsey: Request to make assisted dying legal could be made in 2025
Who opposes assisted dying?Who opposes assisted dying?
Opponents warn that people could be put under pressure to end their lives and want improvements to palliative care instead.
Paralympian and House of Lords crossbencher Baroness Grey-Thompson is a vocal critic.Paralympian and House of Lords crossbencher Baroness Grey-Thompson is a vocal critic.
She told the BBC she is worried about "the impact on vulnerable people, on disabled people, [the risk of] coercive control, and the ability of doctors to make a six-month diagnosis". She is worried that disabled and other vulnerable people could be put under pressure to end their lives - and that doctors may struggle to make accurate six-month diagnoses.
Baroness Grey-Thompson is a long-standing critic of legalising assisted dying Baroness Grey-Thompson (C) is a long-standing critic of legalising assisted dying.
Actor and disability-rights activist Liz Carr, who made BBC One documentary Better Off Dead?, also opposes changing the law. Actor and disability-rights activist Liz Carr, who made the BBC One documentary Better Off Dead?, also opposes the legislation.
"Some of us have very real fears based on our lived experience and based on what has happened in other countries where it's legal," she wrote on X."Some of us have very real fears based on our lived experience and based on what has happened in other countries where it's legal," she wrote on X.
Dr Gordon Macdonald, from campaign group Care Not Killing, said: "The safest law is the one we currently have. Dr Gordon Macdonald, from campaign group Care Not Killing, said the bill ignores the wider "deep-seated problems in the UK's broken and patchy palliative care system".
"This bill is being rushed with indecent haste and ignores the deep-seated problems in the UK's broken and patchy palliative care system." Labour MSP Pam Duncan-Glancy, the first permanent wheelchair user to be elected to Holyrood, said it could become "easier to access help to die than help to live".
The British Medical Association, external, which represents doctors, and the Royal College of Nursing, external are neutral on the issue.
More than 1,000 GPs responded to a BBC questionnaire on attitudes to changing the law, with about 500 saying they were opposed, and about 400 in favour.
‘People will make bad decisions because we don’t talk honestly about death’‘People will make bad decisions because we don’t talk honestly about death’
'Palliative care is not good enough - and there's no plan to fix it' 'Palliative care is not good enough - there's no plan to fix it'
Why do supporters want the law on assisted dying to change? Why do supporters want assisted dying legalised?
Leadbeater argues the law needs changing because some people "have a horrible, harrowing death", however good their end-of-life or palliative care is. Leadbeater argues that some people "have a horrible, harrowing death", however good their end-of-life care is.
Cancer patient Nathaniel Dye worked on the bill with Leadbeater. He said it would allow people a death which was "as kind and compassionate as possible". The Dignity in Dying campaign group said her bill provides the "most detailed, robust proposals" on the issue that "Westminster has ever considered".
The Dignity in Dying campaign group said the bill provides the "most detailed, robust proposals" on the issue that "Westminster has ever considered". Chief executive Sarah Wootton said that the fact that every year "up to 650 terminally ill people end their own lives, often in lonely and traumatic ways," proves the need for reform.
According to chief executive Sarah Wootton, the fact that every year "up to 650 terminally ill people end their own lives, often in lonely and traumatic ways," shows that the status quo is not working.
Dame Esther Rantzen, who has stage four lung cancer, has joined Dignitas in SwitzerlandDame Esther Rantzen, who has stage four lung cancer, has joined Dignitas in Switzerland
One of the highest-profile advocates for change is broadcaster Dame Esther Rantzen, who has stage-four lung cancer. Broadcaster Dame Esther Rantzen, who has stage-four lung cancer, is another long-standing campaigner for change. "All I'm asking for is that we be given the dignity of choice," she said.
"All I'm asking for is that we be given the dignity of choice," Dame Esther told BBC News. "If I decide that my own life is not worth living, please may I ask for help to die?" The NHS is spending a fortune giving people a death they don't want
Both the British Medical Association, external, which represents doctors, and the Royal College of Nursing, external are neutral on the issue. How might the law change in the Isle of Man and Jersey?
InDepth: The NHS is spending a fortune giving people a death they don't want The Isle of Man and Jersey are both part of the British Isles but are able to set their own laws.
The Isle of Man passed its Assisted Dying Bill in March, and the new system could be in place by 2027.
Jersey's politicians approved plans to allow assisted dying for those facing "unbearable suffering" in May 2024. The final legislation is being written. If approved, new rules could take effect from summer 2027.
What are assisted dying, assisted suicide and euthanasia?What are assisted dying, assisted suicide and euthanasia?
There is some debate over exactly what the various terms mean, external. There is some debate over exactly what the terms mean, external.
However, assisted dying generally refers to a person who is terminally ill receiving lethal drugs from a medical practitioner, which they administer themselves.However, assisted dying generally refers to a person who is terminally ill receiving lethal drugs from a medical practitioner, which they administer themselves.
Assisted suicide is intentionally helping another person to end their life, including someone who is not terminally ill. That could involve providing lethal medication or helping them travel to another jurisdiction to die.Assisted suicide is intentionally helping another person to end their life, including someone who is not terminally ill. That could involve providing lethal medication or helping them travel to another jurisdiction to die.
Euthanasia is the act of deliberately ending a person's life to relieve suffering in which a lethal drug is administered by a physician. Patients may not be terminally ill.Euthanasia is the act of deliberately ending a person's life to relieve suffering in which a lethal drug is administered by a physician. Patients may not be terminally ill.
There are two types: voluntary euthanasia, where a patient consents; and non-voluntary, where they cannot because, for example, they are in a coma.There are two types: voluntary euthanasia, where a patient consents; and non-voluntary, where they cannot because, for example, they are in a coma.
Where is euthanasia or assisted dying legal around the world?Where is euthanasia or assisted dying legal around the world?
The Dignity in Dying campaign group says more than 200 million people around the world have legal access to assisted dying, external. The Dignity in Dying campaign group says more than 200 million people around the world have legal access to some form of assisted dying, external.
Switzerland has allowed assisted suicide since 1942. Its Dignitas facility accepts foreign patients as well as Swiss nationals, and between 1998 and 2023 it helped 571 Britons to die, external.Switzerland has allowed assisted suicide since 1942. Its Dignitas facility accepts foreign patients as well as Swiss nationals, and between 1998 and 2023 it helped 571 Britons to die, external.
Assisted suicide is also legal in Austria.Assisted suicide is also legal in Austria.
In the US, 10 states - Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC - allow "physician-assisted dying". In the US, 10 states allow "physician-assisted dying" where doctors can prescribe lethal drugs for self-administration.
It permits doctors to prescribe lethal drugs for self-administration. In Canada, voluntary euthanasia or "medical assistance in dying" can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration.
Voluntary euthanasia is legal in Canada, where it is called medical assistance in dying. It can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration. Medically assisted dying accounted for 4.7% of deaths in Canada in 2023. Voluntary euthanasia and assisted suicide are also legal in Spain and Colombia.
It is also legal in Spain and Colombia, both of which also permit assisted suicide. Assisted dying is legal in some parts of Australia - though the law differs across states - and in New Zealand.
Assisted dying is legal in some parts of Australia, but the law differs across states. The Netherlands, Belgium and Luxembourg let people who are not terminally ill receive assistance to die.
New Zealand's End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.
Three countries have laws that allow people who are not terminally ill to receive assistance to die: The Netherlands, Belgium and Luxembourg.
How does assisted dying work in other countries?How does assisted dying work in other countries?
Update 3 January 2025: This piece has been updated to give further detail on the definition of a co-ordinating doctor.Update 3 January 2025: This piece has been updated to give further detail on the definition of a co-ordinating doctor.