MPs will on Friday have to make one of the biggest decisions of their careers – whether or not to back assisted dying.
The proposed law would make it legal for over-18s who are terminally ill to be given medical assistance to end their own life in England and Wales.
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The bill – called the Terminally Ill Adults (End of Life) Bill – sets out detailed requirements in order to be eligible.
The Labour MP proposing it, Kim Leadbeater, says the safeguards are the “most robust” in the world, but others argue it is a “slippery slope towards death on demand”.
What is in the bill?
The purpose of the 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 die.
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This is subject to “safeguards and protections” which include:
• They must have a “clear, settled and informed wish to end their own life” and have reached this decision voluntarily, without coercion or pressure;
• They must have lived in England or Wales for 12 months and be registered with a GP;
• Two independent doctors must be satisfied the person meets the criteria and there must be at least seven days between the doctors making the assessments;
• If both doctors state the person is eligible, then they must apply to the High Court for approval of their request;
• If the High Court decides that the applicant meets the bill’s requirements, then there is a 14-day reflection period (or 48 hours if death is imminent);
• After this, the person must make a second declaration, which would have to be signed and witnessed by one doctor and another person.
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What happens if the eligibility criteria is met?
If a person meets all this eligibility criteria, a life-ending “approved substance” would be prescribed.
This would be self-administered, so the individual wishing to die must take it themselves.
This is sometimes called physician-assisted dying and is different from voluntary euthanasia, when a health professional would administer the drugs.
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As well as all the conditions set out above, the bill would make it illegal to pressure or coerce someone to make a declaration that they wish to end their life, or take the medicine.
These offences will be punishable by a maximum 14-year prison sentence.
How is this different from the current 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 encourage or assist the suicide (or attempted suicide) of another.
Ms Leadbeater says the current framework is “not fit for purpose”, as people who are terminally ill and in pain only have three options – “suicide, suffering or Switzerland”.
Assisted dying has been legal in Switzerland since 1942, with the Dignitas group becoming well-known as it allows non-Swiss people to use its clinics.
There is no government-held data on the number of Britons travelling abroad for assisted dying, but other countries where a form of this is legal include the Netherlands, Belgium, Spain, Luxembourg, Canada, New Zealand, Australia and some US states.
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Why is it being debated now in England?
The issue has gained renewed attention recently due to campaigning by broadcaster Dame Esther Rantzen. The 84-year-old Childline founder has stage-four lung cancer and revealed last year that she had signed up to Dignitas.
Over the past two decades, the debate has largely been driven by legal challenges to the current regime, brought by people who are suffering and say the current laws violate their human rights.
Parliament last considered the issue in 2015, when MPs voted down assisted dying by 330 votes to 118.
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Ms Leadbeater has brought the issue to the fore through a private members bill, meaning it has been introduced by an MP who is not a government minister.
She wants to give people who are terminally ill and in pain a choice, insisting the bill is about “shortening death rather than ending life”.
What are the main arguments for and against?
Lots of campaigners support Ms Leadbeater’s position. The Campaign for Dignity in Dying says it will give people who are facing unbearable suffering control, so they can have a peaceful death.
They do not support a wider law, unlike My Death, My Decision, who want the bill to apply to people who are suffering with an incurable condition, even if it is not terminal.
However some people oppose any change to the current position. This can be for a variety of reasons, but one of the main arguments is the risk of a “slippery slope” – that the eligibility criteria would widen over time.
Others say good end-of-life care needs to be prioritised, and fear some people will feel pressured to opt for assisted dying if they feel like a burden to society.
Read More:
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How will the bill be scrutinised?
MPs will debate and vote on this bill on Friday 29 November.
It is a free vote, meaning MPs can side with their conscience and not party lines.
The government is taking a neutral position, though individual cabinet ministers have come out both strongly for and against the proposal.
If passed on Friday, the bill will have to pass many more parliamentary hurdles before it becomes law.
MPs will get a chance to debate the bill again in greater depth during its committee stage and peers will also have ample opportunity to express their views on the legislation in the House of Lords.
