Parliament to Introduce Proposals for Assisted Dying in England and Wales
On Wednesday, proposals aimed at granting terminally ill individuals in England and Wales the right to choose to end their lives will be presented in Parliament. Meanwhile, a separate bill is currently under consideration in Scotland.
Opponents of these proposals have voiced concerns about the potential for vulnerable individuals to feel pressured into making the decision to end their lives. The campaign group Care Not Killing has argued that the government should prioritize enhancing palliative care services instead.
Understanding Assisted Dying, Assisted Suicide, and Euthanasia
The terminology surrounding end-of-life choices can be confusing, with various interpretations of the terms involved.
Generally, assisted dying refers to a situation where a terminally ill individual receives lethal medication from a healthcare professional and is responsible for administering it themselves. Assisted suicide involves intentionally aiding another person in ending their life, which can include providing them with lethal substances or facilitating their travel to jurisdictions where they can legally die. Euthanasia, on the other hand, is the deliberate act of ending another person’s life to alleviate suffering, typically administered by a doctor, and does not require the patient to be terminally ill. This can be categorized into two types: voluntary euthanasia, where the patient consents, and non-voluntary euthanasia, where the patient cannot give consent, such as in cases of coma.
Legal Status of Assisted Dying in the UK
Currently, UK laws prohibit individuals from seeking medical assistance to end their lives. Euthanasia is illegal under English law, classified as either manslaughter or murder, with penalties potentially leading to life imprisonment. The Suicide Act of 1961 also criminalizes encouraging or assisting suicide in England and Wales, carrying a maximum penalty of 14 years imprisonment for those convicted. Similar legislation is in place in Northern Ireland, while in Scotland, assisting a person to die could be prosecuted under laws such as culpable homicide.
In March 2024, the Health and Social Care Committee raised concerns about the ambiguity surrounding the regulations governing UK doctors when patients seek to die abroad. The British Medical Association (BMA) has advised its members against issuing medical reports for patients intending to pursue assisted suicide in other countries, such as the Dignitas facility in Switzerland.
Potential Changes to Assisted Dying Law in England and Wales
Labour MP Kim Leadbeater is set to introduce a bill aimed at allowing terminally ill individuals in England and Wales the right to choose to end their lives. This bill is expected to align closely with a proposal previously introduced in the House of Lords in July 2024, which would enable terminally ill adults with six months or less to live to receive medical assistance in ending their lives.
Debate on Leadbeater’s bill is anticipated in the House of Commons on Friday, November 29. She expressed to BBC News that “now is the time” for a renewed discussion on assisted dying, asserting that the current framework lacks safety and does not provide the choice that individuals deserve.
The bill must pass through both the House of Commons and the House of Lords before becoming law. Prime Minister Sir Keir Starmer has previously indicated support for a free vote among Labour MPs on the issue, expressing personal backing for changes to the law. The last attempt to pass a bill concerning this topic was rejected by MPs in 2015.
Prospective Changes to the Law in Scotland
In Scotland, Liberal Democrat MSP Liam McArthur has proposed the Assisted Dying for Terminally Ill Adults (Scotland) Bill. If approved by the Scottish Parliament, this legislation would allow terminally ill adults to request assistance in ending their lives. Eligibility criteria would include being a resident in Scotland for at least 12 months, being registered with a GP in Scotland, and possessing the mental capacity to make such a request.
Scottish Health Secretary Neil Gray indicated in October 2024 that the proposed legislation might exceed the powers of the Scottish Parliament and should be addressed at Westminster. However, McArthur expressed confidence that collaboration between the UK and Scottish governments could facilitate the bill’s passage if it receives MSP support. Previous attempts to pass similar legislation in 2010 and 2013, led by the late MSP Margo MacDonald, were unsuccessful.
Advocates for Change in Assisted Dying Legislation
The British Medical Association (BMA) and the Royal College of Nursing maintain neutral stances on assisted dying. Nonetheless, various advocacy groups representing individuals with terminal and life-limiting conditions have made concerted efforts to reform the law in recent years.
A prominent advocate for change is broadcaster Dame Esther Rantzen, who initiated a petition supporting assisted dying in December 2023, gathering over 200,000 signatures and prompting a parliamentary debate on April 29. Rantzen emphasized the importance of providing individuals with the dignity of choice, stating, “If I decide that my own life is not worth living, please may I ask for help to die?”
Opposition to Assisted Dying
Some prominent figures, including Paralympian and House of Lords crossbencher Baroness Grey-Thompson, oppose any changes to the current law. She raised concerns about the implications for vulnerable populations, particularly disabled individuals, and the risk of coercive control, questioning the reliability of doctors’ six-month prognosis.
Public health expert Dr. Lucy Thomas referred to assisted dying as a last resort, cautioning against viewing the choice to end one’s life as a straightforward consumer decision. Liz Carr, an actor and disability-rights advocate, also opposes legal reform, citing fears rooted in her experiences and those observed in countries where assisted dying is permitted.
The Archbishop of Canterbury, Justin Welby, warned that legalizing assisted dying could create a “slippery slope,” leading to increased pressure on individuals to opt for medical assistance in dying. Dr. Gordon Macdonald, the chief executive of Care Not Killing, expressed disappointment over Leadbeater’s bill, urging the government to prioritize reforms to the palliative care system, which currently leaves many individuals without access to necessary support.
Despite the opposition, Leadbeater contends that her bill “will not undermine calls for improvements to palliative care.”
Global Perspective on Assisted Dying Legislation
The Dignity in Dying campaign group reports that over 200 million individuals worldwide have access to some form of assisted dying legislation. Switzerland has permitted assisted suicide since 1942, with the Dignitas facility opening its doors in 1998 and serving both Swiss nationals and international patients. By 2023, Dignitas had assisted 571 Britons in dying.
Assisted suicide is also legal in Austria. In the United States, eleven states—including Oregon, California, and New Jersey—allow for “physician-assisted dying,” enabling doctors to prescribe lethal medications for self-administration. Canada has legalized voluntary euthanasia, known as medical assistance in dying, which can be administered by a physician or nurse practitioner.
Spain and Colombia have similarly enacted laws allowing both assisted dying and assisted suicide. Parts of Australia also recognize assisted dying, although regulations vary by state, with it remaining illegal in Northern Territory and the Australian Capital Territory. New Zealand’s End of Life Choice Act allows adults nearing the end of their lives to request assistance from healthcare professionals.
The Netherlands, Belgium, and Luxembourg are three nations where individuals who are not terminally ill may receive assistance in dying.
