Warning: This briefing discusses issues around suicide which some readers may find distressing.
On 16 October 2024, Kim Leadbeater (Labour) presented the Terminally Ill Adults (End of Life) Bill 2024-25 to Parliament, having been drawn highest in the private members’ bill ballot for the 2024-25 session.
The bill’s long title states it would “allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life”.
The bill’s second reading is scheduled for Friday 29 November 2024. In a letter to ministers, the Cabinet Secretary Simon Case confirmed that “the Prime Minister has decided to set aside collective responsibility on the merits of this bill” and that the government would “therefore remain neutral on the passage of the Bill and on the matter of assisted dying”. Members of Parliament, including government ministers, will therefore have a free vote on whether to give the bill a second reading and allow it to proceed to the next stage.
Terminology
There is no consensus on which terminology to use when debating the issue of whether people should be legally permitted to seek assistance with ending their own lives. Consequently, a range of terms are used, principally ‘assisted suicide’ and ‘assisted dying’, and the choice of term often reflects underlying views on the debate.
This Library briefing paper uses a range of terms, which have been chosen to reflect the wording of the bill (and the explanatory notes), the existing criminal law, and the terminology used by people and organisations who have commented on the debate. The choice of terminology is not intended to endorse or reflect any stance on the debate about changing the law.
The existing criminal law
Suicide and attempted suicide are not in themselves criminal offences. However, under section 2(1) of the Suicide Act 1961 it is an offence (in England and Wales) for a person to intentionally encourage or assist the suicide (or attempted suicide) of another.
A prosecution for an offence under section 2(1) can only be brought by or with the consent of the Director of Public Prosecutions.
When deciding whether to start or continue a prosecution under section 2(1), prosecutors should consider both the Code for Crown Prosecutors and an offence-specific prosecution policy issued by the Director of Public Prosecutions. These require prosecutors to consider whether there is sufficient evidence against the defendant and whether it is in the public interest to prosecute.
The bill
The broad aim of the Terminally Ill Adults (End of Life) Bill is to allow adults aged 18 and over, who have mental capacity, are terminally ill and are in the final six months of their life, to request assistance from a doctor to end their life.
The applicant must be resident in either England or Wales. Two doctors must assess each request, at least seven days apart, to ensure that the person meets the eligibility criteria. The eligibility criteria include that the person has a “clear, settled and informed wish to end their own life” and that they have reached this decision voluntarily, without coercion or pressure. If both doctors state, independently of one another, that the eligibility criteria have been met, the person may apply to the High Court for approval of their request.
If the High Court decided that the applicant met the requirements of the bill, there would then be a 14-day reflection period (this would be shortened to 48 hours if death is imminent). After this time, the applicant may make a second declaration to request assistance to end their life. If the doctor continues to be satisfied that the person meets the eligibility criteria set out in the bill, a life-ending “approved substance”, to be self-administered, would be prescribed.
A person who provides assistance to another in accordance with the bill would not face any criminal (or civil) liability, and the Suicide Act 1961 would be amended accordingly. The section 2 offence would continue to apply to assistance falling outside the framework in the bill.
Parliamentary scrutiny
The bill is a private member’s bill, meaning it has been introduced by an MP who is not a government minister.
To become law, a private member’s bill must go through the same stages as a government bill, including second reading, committee stage, report and third reading in both the Commons and the Lords, followed by Royal Assent.
However, there are specific features of the process for scrutinising private members’ bills that have led some to question whether MPs will be able to properly scrutinise this particular bill. These include:
- the limited amount of time (13 Fridays in a session) generally available for the Commons to consider private members’ bills
- the risk of the bill being ‘talked out’ in the chamber at either second reading or report stage, either because of the number of MPs who wish to speak or because of MPs making deliberately long speeches
- the fact that a public bill committee considering a private member’s bill cannot call for oral or written evidence unless it is specifically authorised to do so by order of the House
Sir David Natzler, a former Clerk of the House, has suggested that one option to address concerns could be for the government to make clear to MPs that it will treat the vote at second reading as a vote on the general principle of whether to legislate to allow assisted dying/assisted suicide. If MPs were to vote in favour, the government could then “seek withdrawal or suspension of further proceedings on the bill in return for a public consultation on the issue”.
There have also been calls for the government to commit (before second reading) to making extra time available for the remaining stages of the bill. However, the government has so far declined to give such a commitment.
The last Commons debate and vote on the law was in 2015 when, on a free vote, the Commons voted against giving the Assisted Dying (No 2) Bill 2015 a second reading by 330 votes to 118. This was also a private member’s bill, introduced by Rob Marris MP, but this did not attract any notable criticism or concerns at the time.
Court approval
The inclusion of a judicial safeguard in the assisted dying process was first proposed in an amendment moved by Lord Pannick at the committee stage of Lord Falconer’s Assisted Dying Bill [HL], introduced in 2014.
Subsequent bills have included the condition that terminally ill people wishing to end their own life may be assisted to do so only with the consent of the Family Division of the High Court. The current bill would also provide for the involvement of the ‘High Court’ (the Family Division is not mentioned expressly). The High Court would have the power to make a declaration that the necessary requirements of the bill had been satisfied, thereby permitting assistance, or to refuse to make a declaration.
Views on judicial involvement in assisted dying have been mixed. They range from proposals for a complete, court-based model – under which a court would decide on the merits in each case – to questions over whether it is the proper function of judges to approve the administration of drugs intended to facilitate a person’s death.
There has been substantial commentary from retired members of the judiciary as to the efficacy of the proposed judicial safeguard in the current bill. Former President of the Family Division of the High Court, Sir James Munby, has expressed concern about the drafting of the clause relating to court approval. He suggested there are several omissions in the proposed scheme for judicial involvement in relation to matters such as the function of a judge (particularly in the context of testing evidence), the need for open justice, court process, and rights of appeal.
Human rights
Over the past two decades, the debate on assisted suicide and assisted dying in the UK has been driven in part by legal challenges to the current regime, brought by people suffering from terminal illness or catastrophic injury. They have argued that various aspects of the existing law constitute violations of their human rights, as protected by the European Convention on Human Rights (ECHR).
The domestic courts and the European Court of Human Rights (ECtHR) have recognised that end of life decisions and associated legal regimes engage the article 8 right to a private life. Other relevant rights are the right to life (article 2), right to freedom from inhuman and degrading treatment (article 3), and the right to freedom from discrimination in the enjoyment of Convention rights (article 14).
In 2014 the UK Supreme Court concluded that although it had the constitutional authority to make a declaration that the law on assisted suicide was incompatible with article 8, it would be institutionally inappropriate to do so before Parliament had had the opportunity to consider the issue.
The ECtHR has found that various forms of assisted dying may be compatible with the right to life, provided that there are sufficient safeguards against abuse. Given the lack of consensus in Europe on the issue, it has allowed states a wide ‘margin of appreciation’ on the issue: the latitude to decide how to balance the competing interests in personal autonomy and the sanctity of life.
Concerns have been raised that, by partially lifting the ban on assisted suicide, but only for a narrowly defined group of people, the bill may give rise to claims that it is discriminatory towards groups that are excluded from its scope. In doing so, it may open up a ‘slippery scope’ to expansion, according to some critics. Others have argued that confining the scope of the bill to terminally ill adults should allay concerns about expansion, and that the wide margin of appreciation allowed by the ECtHR makes it unlikely the court would rule against the UK if it did partially lift the ban.