The Terminally Ill Adults (End of Life) Bill: briefing note

Introduced to Parliament on 16 October 2024 by way of the Private Members’ Bill ballot, the Bill – extending to England and Wales only - was published on Monday 11 November 2024. There is no official government position on the Bill, however, Health Secretary, Wes Streeting has expressed his opposition to the Bill. MPs will have a free vote on the Bill.

The Explanatory Notes to the Bill provide that the “model of assisted dying proposed in this bill would give choice to terminally ill, mentally competent adults only.”  

Overview: key measures

The Explanatory Notes explain that the 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”.

Whilst the Bill (as introduced) has 43 sections, for the purpose of this briefing note we have not made reference to all elements of the Bill. Instead we provide a brief overview of the sections relating to eligibility requirements, initial discussions with registered medical practitioners and procedure, safeguards and protections.    

Eligibility requirements

Set out at sections 1 to 3 of the Bill, these include that the terminally ill person must be aged 18 or over, ordinarily resident in England and Wales and has been for a period of “at least 12 months ending with the date of the first declaration”. They must also be registered with a GP practice in England and Wales and must have capacity (clause 3) in accordance with the Mental Capacity Act 2005, to make an informed choice without pressure or coercion.

Section 2 (as introduced), provides that for the purposes of the legislation a person will be considered to be terminally ill if they have “an inevitably progressive illness, disease or medical condition which cannot be reversed by treatment”, and their “death in consequence of that illness, disease or medical condition can reasonably be expected within 6 months.”

Initial discussions

Section 4 of the Bill addresses ‘Initial discussions with registered medical practitioners’, with subsection 1 providing that there is no duty for a registered medical practitioner to raise “the subject of provision of assistance” in accordance with the legislation. Section 4(2) adding though that “nothing in subsection (1) prevents a registered medical practitioner exercising their professional judgement to decide if, and when, it is appropriate to discuss the matter with a person.”

Procedure, safeguards and protections

Sections 5 to 15 of the Bill address procedure, safeguards and protections. For the purposes of this briefing note we have not referred to the detail set out within the Bill, but instead make reference to several of the key areas addressed within these sections as follows:

• Requirements for the ‘first declaration’ that a person who is seeking to be provided with assistance must make.
• Assessment made by the first doctor – the coordinating doctor (section 7).
• Assessment made by the second doctor – an independent doctor (section 8).
• The Doctors’ assessments: further provision (section 9) – this relates to further provision about the assessment the coordinating doctor is required to carry out under section 7, including a requirement to discuss and explain what treatments may be possible, other care available (including palliative and hospice care) as well as other specific matters relating to the provision of assistance under the proposed legislation.
• A second opinion – by way of a further independent doctor – where required (section 10).
• Court approval (section 12).
• Confirmation of request for assistance: second declaration (section 13).
• Cancellation of declarations (section 14).
• Signing by proxy (section 15).

Other key matters addressed within the Bill include (but are not limited to):

• ‘Protections for health professionals’, in the context of criminal and civil liability for providing assistance (sections 23 to 25).
• ‘Offences’ – addressing the inducement of a person to make a first or second declaration, through “dishonesty, coercion or pressure” and the false and misleading production of documentation, and wilful concealment or destruction of documentation (sections 26 and 27).
• ‘Codes and guidance’ (sections 30 and 31).
• ‘Monitoring and review’ under which the operation of the legislation would be subject to monitoring by the Chief Medical Officer, and a review of the legislation by the Secretary of State (sections 33 to 35).

Timeline

With a second reading scheduled to take place on 29 November, members will soon start debating principles of the Bill in the House of Commons.

Related item:

• Assisted Dying Bill: an overview of the key provisions and proposed safeguards