Assisted dying Bill introduced to the House of Lords
The issue of assisted dying remains one of the most ethically and legally complex debates in England and Wales.
Under the current law, the Suicide Act 1961 prohibits ‘encouraging or assisting the suicide, or attempted suicide, of another person’, treating it as a criminal offence punishable by up to 14 years in prison.
Assisted dying could include accompanying a relative to an assisted dying clinic in Switzerland, such as Dignitas. To add salt to the wounds, the Forfeiture Act 1982 prevents anyone who has assisted someone in a suicide, or attempted suicide, from benefitting from that person’s estate. Therefore not only could a well-meaning child potentially face imprisonment for assisting a suffering parent, but they could also lose their entire inheritance.
Assisted dying is a term generally used to describe the situation where a terminally ill patient seeks medical help to obtain lethal drugs to end their life.
Proponents of assisted dying argue that a regulated system with robust safeguards could better protect patients, families, and healthcare professionals while respecting individual dignity and autonomy, alleviating suffering in certain cases where palliative care may be ineffective. While assisted dying has been legal in Switzerland since 1942, jurisdictions closer to home, including Scotland, Jersey and the Isle of Man are currently considering proposals.
The campaign for legalising assisted dying in England and Wales has been gaining momentum over recent years. In the landmark case of R (on the application of Nicklinson and another) v Ministry of Justice 2014, the Supreme Court upheld the illegality of assisted suicide while acknowledging that the time had come for Parliament to consider reform.
Several Private Members Bills in both the Commons and the Lords have (unsuccessfully), sought to legalise assisted dying since 2014.
In February this year, the Health and Social Care Select Committee published a report on Assisted Dying/Assisted Suicide, and while it did not attempt to resolve the debate, it said that the purpose of the report was to provide a basis for discussion and debate in future parliaments. In April, MPs debated the issue after a petition backed by Dame Esther Rantzen, who has herself said (on Radio 4) that if her current treatment for stage four lung cancer does not work she might ‘buzz off to Zurich’.
Lord Falconer then introduced the latest Private Member’s Bill on assisted dying to the House of Lords in July this year, having first introduced a Bill to Parliament on the subject in 2014, which was based on the Oregon Death and Dignity Act (which enabled assisted dying in Oregon as far back as 1997). Lord Falconer’s 2024 Bill would only apply to terminally ill patients who have been advised that they only have six months left to live and who have the mental capacity to make the decision.
If enacted, the Bill would enable a medically qualified professional to prescribe drugs to end the patient’s life. Two doctors and, crucially the High Court, would have to approve an application. While Lord Falconer recognises that Private Members’ Bills rarely become law, he hopes a backbencher will introduce a similar bill to the Commons, where it will have a greater chance of success.
One of the critical challenges in this area of law is designing a framework that adequately addresses the potential risks and concerns. Key considerations include:
- Establishing clear eligibility criteria based on factors such as terminal illness, mental capacity, residency requirements, and minimum age.
- Implementing oversight processes, such as mandatory reporting, review committees, and possible cooling-off periods, to ensure that decisions are well-informed and free from coercion or undue influence.
- Allowing for conscientious objection by healthcare staff who may have ethical or religious objections to participating in assisted dying.
- Defining the scope of the legislation, including whether it would cover both euthanasia (where a doctor administers a lethal dose) and assisted dying (where the patient self-administers the lethal dose).
- Ensuring that the legalisation of assisted dying does not undermine investment in and access to high-quality palliative care services.
Ultimately, any legal framework for assisted dying would need to strike a delicate balance between respecting individual autonomy and dignity, while protecting vulnerable individuals from potential abuse or coercion. Robust safeguards, clear protocols, and ongoing monitoring would be essential to mitigate the risks and ensure that the system operates ethically and effectively.
