Terminally Ill Adults (End of Life) Bill

Terminally Ill Adults (End of Life) Bill is a private members' bill (PMB) which legalises assisted dying for terminally ill adults in England and Wales. The bill was introduced by Labour backbench MP Kim Leadbeater in October 2024 after she was chosen first by ballot for PMBs. The Labour government and political parties in Parliament have given MPs a free vote on the bill.

Terminally Ill Adults (End of Life) Bill
Act of Parliament
Long titleA Bill to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life; and for connected purposes.
Introduced byKim Leadbeater
Territorial extent England and Wales

Background and campaign

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Assisted dying is the ending of one's own life with the assistance of another and is illegal under English law under the Suicide Act 1961 which can be lead to a maximum of 14 years' imprisonment.[1] This is distinct from euthanasia which is intentionally ending another person's life to relieve suffering, which is also illegal under English law.[1] In 2015, a private member's bill (PMB) called Assisted Dying (No 2) Bill was introduced by Labour's Rob Marris, which was a free vote for MPs.[2] However, it was defeated at its second reading by 330–118.[2] In May 2021, another PMB was introduced on assisted dying by Molly Meacher, Baroness Meacher, and received its second reading in the House of Lords but did not progress.[3]

 
Dame Esther Rantzen is a high-profile campaigner in support of the bill.

On 19 December 2023, journalist and television presenter Dame Esther Rantzen, who has terminal lung cancer, said she joined the assisted suicide clinic Dignitas in Switzerland where it is legal and permits foreigners to use the service.[4][5] This caused party leaders in Parliament to say they would facilitate parliamentary time for a bill.[4] On 21 December, then Leader of the Opposition and Labour leader Keir Starmer said there were "grounds for changing the law" on the issue; Starmer previously voted in support Assisted Dying (No 2) Bill 2015 as a backbencher.[6]

On 29 February 2024, the Health and Social Care Select Committee published a report on assisted dying with chair Steve Brine (Conservative) saying that: "The inquiry on assisted dying and assisted suicide raised the most complex issues that we as a committee have faced, with strong feelings and opinions in the evidence we heard."[7]

On 13 March, Starmer pledged to give MPs a vote on assisted suicide if Labour won the 2024 general election.[8] He phoned pro-assisted suicide campaigner Esther Rantzen and said to her: "I'm personally in favour of changing the law. I think we need to make time. We will make the commitment. Esther, I can give you that commitment right now... For people who are going through this or are likely to go through it in the next few months or years, this matters hugely and delay just prolongs the agony."[8] The UK July 2024 general election resulted with a Labour victory with Starmer becoming prime minister.

On 29 April 2024, MPs debated assisted suicide after a petition on UK Parliament petitions website after it reached the 100,000 signature threshold.[9][10][11] By the time of the debate it had reached over 200,000 signatures.[10][11] Before the debate, the government responded to the petiton stating: "It remains the government's view that any change to the law in this sensitive area is a matter for Parliament to decide and an issue of conscience for individual parliamentarians rather than one for government policy. If the will of Parliament is that the law on assisting suicide should change, the government would not stand in its way, but would seek to ensure that the law could be enforced in the way that Parliament intended".[10][11] Campaigner Esther Rantzen pleaded to MPs to attend the debate.[10][11]

On 16 June, then prime minister Rishi Sunak said that in principle that he was not opposed to legalising assisted suicide and stated that "It's just a question of having the safeguards in place and that's where people have had questions in the past".[12] He added that the issue was a matter of conscience.[12]

 
Backbench Labour MP Kim Leadbeater introduced the bill.

In September 2024, Kim Leadbeater, Labour MP for Spen Valley, was drawn first in the ballot for private members' bills.[13] She announced on 3 October 2024 that she would introduce a bill on assisted dying,[14][15] and on 16 October 2024, the bill was introduced to the House of Commons.[16] The full text of the bill (as presented for second reading) was published on 11 November 2024.[17]

Summary of the Bill

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The bill legalises terminally ill adults aged 18 or older to die by assisted suicide given that they meet these requirements:[18][19]

  • Must be a resident of England and Wales and be registered with a GP for at least a year
  • Mental capacity to make an informed decision free from coercion
  • Expected to die within six months
  • Make two independent declarations about their desire to die, which must be witnessed and signed
  • Two doctors must be satisfied the person is eligible; with a gap of a week between their assessments
  • A High Court judge must hear from one of the doctors and may question the dying person or anyone else involved as they see fit. There is another two week gap after the judge has made their ruling

Doctors are the only ones allowed to give out the substance that makes the person die. It can be prepared by a doctor, but the person dying must be one to physically take it.

Parliamentary Passage

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House of Commons

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First reading

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The Bill received its First Reading on 16 October 2024.[20]

Second reading

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The second reading with a debate and votes from MPs occurred on 29 November. It was passed with 330 in favour to 275 against.[21]

Debate

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The Labour government led by prime minister Keir Starmer announced it would be a free vote as it was an issue of conscience.[22] Secretary of State for Energy and Climate Change Ed Miliband said he supported the bill.[23] However, Secretary of State for Justice Shabana Mahmood and Secretary of State for Health and Social Care Wes Streeting oppose the bill with the latter arguing people feel an obligation to die.[23] Starmer did not publicly announce his voting intention prior to the second reading,[24] and voted in favour of the bill.[25]

Leader of the Liberal Democrats Ed Davey said it would be a free vote for Liberal Democrat MPs however that he personally opposed the bill.[26] He argues that the terminally ill can have a good standard of living and that elderly people may feel pressure from family members to commit assisted suicide.[26] Davey said that there should be more investment in palliative care.[26][27] His opposition is in contrast to a majority of Liberal Democrat MPs who support the bill.[26]

Mother of the House Diane Abbott of Labour and Father of the House Edward Leigh of the Conservatives wrote a joint op-ed in The Guardian opposing the bill.[28][29] They argued the Assisted Dying (No 2) Bill 2015 was published seven weeks before MPs voted on it however this bill was published 18 days ahead of its second reading.[29] They say that this, along with this Parliament introducing a significantly above average of new MPs, makes the process flawed and is not having proper scrutiny.[29] They go on to argue, that unlike wealthy individuals who have stable finances and good palliative care in cases of terminal illness, that poor people who may struggle to pay for social care may feel obliged to die to maintain finances for their family.[29] Or that they may feel unintended pressure to proceed with assisted dying as they are taking up a valuable bed in the hospital.[29] They conclude saying that health and social care needs improvement, in particular palliative care.[29]

Former prime ministers Gordon Brown, Theresa May, Boris Johnson, and Liz Truss all argued against the bill. Brown said: "An assisted dying law, however well intended, would alter society’s attitude towards elderly, seriously ill and disabled people, even if only subliminally".[30] In contrast, David Cameron, who previously opposed the 2015 bill, supported the bill and stated that it was "not about ending life, it is about shortening death" and that the bill has "sufficient safeguards" protecting vulnerable people,[31] and Rishi Sunak voted in favour of the bill,[25] writing that he belives it to be "a compassionate change to the law".[32]

Philosopher A. C. Grayling argued in favour of the bill and stated "there is no ground for restricting the kind of suffering that society is going to allow people to escape" and is a patron of the charity Dignity in Dying.[33]

Public opinion

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In March 2024, a poll of over 10,000 people found that 75 per cent of respondents supported legalising assisted suicide versus 14 per cent who opposed.[34] Muslims were the only demographic in which the majority opposed.[34] Another poll by Ipsos found that 66 per cent of people supported allowing a doctor to assist a terminally ill patient commit suicide with 16 per cent opposing.[4]

References

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  1. ^ a b "Euthanasia and assisted suicide". NHS. 12 July 2023. Archived from the original on 16 July 2017. Retrieved 20 November 2024.
  2. ^ a b "The Terminally Ill Adults (End of Life) Bill 2024-25". UK Parliament. 24 October 2024. Retrieved 20 November 2024.
  3. ^ Sherwood, Harriet (2022-12-05). "MPs to revisit assisted dying with an inquiry next year". The Guardian. ISSN 0261-3077. Retrieved 2024-11-28.
  4. ^ a b c Sherwood, Harriet (2024-10-16). "What is the background to the MPs' vote on assisted dying?". The Guardian. ISSN 0261-3077. Retrieved 2024-11-20.
  5. ^ Howard, Jacqueline (2023-12-19). "Esther Rantzen says she's joined assisted dying clinic". Retrieved 2024-11-21.
  6. ^ Francis, Sam (2023-12-21). "Sir Keir Starmer supports assisted dying law change". Retrieved 2024-11-21.
  7. ^ "MPs publish report on Assisted Dying/Assisted Suicide". UK Parliament. 29 February 2024. Retrieved 20 November 2024.
  8. ^ a b Riley-Smith, Ben (2024-03-13). "Starmer promises vote on legalising assisted dying". The Daily Telegraph. ISSN 0307-1235. Retrieved 2024-11-21.
  9. ^ "Hold a parliamentary vote on assisted dying". UK Parliament petitions website. 22 February 2024. Retrieved 20 November 2024.
  10. ^ a b c d "Esther Rantzen begs MPs to attend assisted dying debate". BBC News. 2024-04-29. Retrieved 2024-11-21.
  11. ^ a b c d "MPs to debate assisted dying after campaign backed by Dame Esther Rantzen". Sky News. Retrieved 2024-11-21.
  12. ^ a b Courea, Eleni (2024-06-16). "Rishi Sunak says he is not opposed to assisted dying". The Guardian. ISSN 0261-3077. Retrieved 2024-11-21.
  13. ^ "Conservatives lose out in lottery to bring in new laws". BBC News. 5 September 2024. Retrieved 4 October 2024.
  14. ^ Leadbeater, Kim (3 October 2024). "Too many people have been condemned to die in misery and pain. My assisted dying bill can change that". The Guardian. Retrieved 4 October 2024.
  15. ^ "Labour MP in fresh bid to change law on assisted dying". BBC News. 3 October 2024. Retrieved 4 October 2024.
  16. ^ Sherwood, Harriet (2024-10-16). "England and Wales assisted dying bill formally launched in House of Commons". The Guardian. ISSN 0261-3077. Retrieved 2024-10-16.
  17. ^ "Terminally Ill Adults (End of Life) Bill". UK Parliament. 12 November 2024. Retrieved 20 November 2024.
  18. ^ "Terminally Ill Adults (End of Life) Bill" (PDF). UK Parliament. 12 November 2024. Retrieved 20 November 2024.
  19. ^ "Assisted dying bill: What is in the proposed law?". BBC News. Retrieved 2024-11-28.
  20. ^ "Bills Presented". Hansard. 16 October 2024. Retrieved 20 November 2024.
  21. ^ https://votes.parliament.uk/votes/commons/division/1877
  22. ^ "Cabinet Secretary Letter to UK Government Ministers". GOV.UK. Retrieved 2024-11-20.
  23. ^ a b "Ed Davey reveals moving personal reason he opposes assisted dying". The Independent. 2024-11-12. Retrieved 2024-11-20.
  24. ^ "How did your MP vote on the assisted dying bill?". Sky News. 2024-11-29. Retrieved 2024-11-29.
  25. ^ a b Brown, Faye (2024-11-29). "Assisted dying bill backed by MPs after emotional Commons debate". Sky News. Retrieved 2024-11-29.
  26. ^ a b c d "Lib Dem MPs could clash with their own leader on issue of assisted dying". Sky News. Retrieved 2024-11-20.
  27. ^ "Ed Davey 'minded' to vote against assisted dying bill". BBC News. Retrieved 2024-11-20.
  28. ^ Elgot, Jessica; Walker, Peter (2024-11-20). "UK's longest-serving MPs issue joint plea for Commons to reject assisted dying bill". The Guardian. ISSN 0261-3077. Retrieved 2024-11-20.
  29. ^ a b c d e f Abbott, Diane; Leigh, Edward (2024-11-20). "Our politics could not be more different – but we're united against this dangerous assisted dying bill". The Guardian. ISSN 0261-3077. Retrieved 2024-11-20.
  30. ^ "Gordon Brown declares opposition to assisted dying". BBC News. Retrieved 2024-11-28.
  31. ^ "Ex-prime minister David Cameron backs assisted dying bill". BBC News. Retrieved 2024-11-28.
  32. ^ Sunak, Rishi (2024-11-29). "Rishi Sunak on assisted dying bill: Why I believe this is a compassionate change". Darlington and Stockton Times. Retrieved 2024-11-29.
  33. ^ Eastham, Janet (2024-11-21). "The depressed should be allowed to end their life, says AC Grayling". The Daily Telegraph. ISSN 0307-1235. Retrieved 2024-11-22.
  34. ^ a b Brand, Paul (11 March 2024). "Overwhelming majority support assisted dying, largest ever poll says". ITV News. Retrieved 2024-11-20.