Understanding the Proposals to Legalise Assisted Dying in the UK

The debate over assisted dying has been a contentious issue in the UK for many years. Recently, new proposals have been put forward to legalise assisted dying in England and Wales.

On 11 November 2024, the Terminally Ill Adults (End of Life) Bill was published. This bill makes provision for a person who is terminally ill and meets the eligibility criteria to choose to request and lawfully be provided with assistance to end their own life.

This blog aims to break down the key elements of these proposals to provide a clear understanding of what they entail.

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What is Assisted Dying?

Assisted dying refers to the practice where a person with a terminal illness or incurable condition is provided with the means to end their own life, typically through prescribed medication. This is distinct from euthanasia, where a third party actively ends the person’s life.

Who would be eligible for assisted dying?

Under the bill, there are four criteria that must be met before a terminally ill person can be assisted to end their own life. The person must:

1. Have capacity “to make a decision to end their own life” (with capacity to be determined in accordance with the Mental Capacity Act 2005);
2. Be aged 18 or over;
3. Be ordinarily resident in England and Wales, and have been ordinarily resident there for at least 12 months
4. Be registered as a patient with a GP practice in England or Wales.

What is the process?

1. Voluntary Decision: The individual must make a voluntary, clear, and settled intention to end their life, free from any external pressure or coercion. This safeguard is crucial to protect vulnerable individuals from being influenced or coerced into making such a decision.
2. Medical Confirmation: Two independent doctors must confirm the diagnosis and prognosis of the terminal illness. This double-check system is designed to prevent errors and ensure that the diagnosis is accurate. There must be a period of at least seven days between the first and second assessments.
3. Court Approval: At the second stage, after the individual has made an initial declaration and obtained two medical statements, they may apply to the High Court for approval of assisted dying. The court must then determine whether the requirements of the bill have been satisfied in relation to the initial declaration.
4. Waiting Period/Second Declaration: A mandatory waiting period is required between the initial request and the provision of the means to end life. This 14 day period allows the individual time to reflect on their decision and ensures that it is well-considered and not made impulsively. This second declaration must be in the presence of a witness and the co-ordinating doctor.

Ethical and Legal Considerations

The proposals have sparked significant debate, with strong arguments on both sides. One side of the argument is that legalising assisted dying provides a compassionate option for those suffering from terminal illnesses, allowing them to die with dignity and on their own terms. They emphasise the importance of personal autonomy and the right to choose.

Opponents, however, raise concerns about the potential for abuse and the moral implications of allowing assisted dying. They worry about the pressure it might place on vulnerable individuals and the possible erosion of trust in the medical profession. Some fear that legalising assisted dying could lead to a slippery slope, where the criteria for eligibility might gradually expand, potentially endangering more lives.

Looking at other countries where assisted dying is legal can provide valuable insights. Stats from the BBC revealed the following:

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 and its Dignitas facility began operating in 1998.

The organisation accepts foreign patients as well as Swiss nationals, and said it had 1,900 UK members in 2023, a 24% rise on the previous year.

Between 1998 and 2023?Dignitas helped 571 Britons to die,?external .

Assisted suicide is also legal in?Austria.

In the?US, 11 states - Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC - allow "physician-assisted dying".

It permits doctors to prescribe lethal 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.

It is also legal in?Spain?and?Colombia, both of which also permit assisted suicide.

Assisted dying is legal in some parts of Australia but the law differs across states. It is not permitted in either the Northern or Australian Capital territories.

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.

Final Thoughts

The proposed bill to legalise assisted dying in England and Wales would be a significant shift in the approach to end-of-life care. Whilst it has the potential to provide a compassionate option for those suffering from terminal illnesses, it is crucial government proceed with caution. I do feel that there is a huge amount of criticism for this bill and we cannot ignore the critics who argue that more time is needed to thoroughly examine the potential implications and to ensure that all voices, including those of vulnerable groups and healthcare professionals, are heard.

I am also concerned that we have both a failing health and social care system and can either cope with something new like this in the mix.

The goal must be to create a law that is both compassionate and robust to ensure we provide dignity and choice whilst protecting the most vulnerable members of society.

Do you support the assisted dying bill?

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