Assisted dying and the Terminally Ill Adults (End of Life) Bill
Overview
We don’t take a position on the principle of assisted dying or whether the bill should be passed.
We understand that the subject raises significant moral and ethical issues for our members and the public.
But if it is passed, as with any legislation, it must be clear, coherent and workable for those it affects.
The bill must have robust, accessible and independent safeguards, as well as strong independent monitoring and review mechanisms to uphold the rule of law.
The proposals
The Terminally Ill Adults (End of Life) Bill has passed the House of Commons and is being considered by the House of Lords.
It aims to allow terminally ill adults living in England and Wales who have six months to live to request assistance from medical professionals to end their lives.
The bill lays out steps for checking that the person has:
- a clear, settled and informed wish to end their own life
- the mental capacity to make such a decision, and
- made that decision voluntarily, without coercion or pressure
Our view
We are neutral on whether the bill should be passed.
However, informed by the expertise of our members, we’re briefing parliamentarians to make sure the bill, if passed, provides a legally sound and workable regime for those using it and working under it.
Below are our key recommendations on the bill.
Capacity
The law must be clear on how a person’s mental capacity is to be assessed.
The bill says capacity would be assessed using the existing test in the Mental Capacity Act 2005.
Parliament should consider whether this is the right test for this bill, or whether there should be a separate capacity test tailored for the bill.
We welcome bill amendments that require the secretary of state to issue codes of practice and provide mandatory doctors’ training on capacity.
This would help people assessing capacity to take into account complicated issues such as the effects of medication and symptoms of terminal illness.
Assisted Dying Review Panels
The bill was amended in the Commons to change the decision-making process from a judicial one to multi-disciplinary Assisted Dying Review Panels.
More detail is needed in the bill and/or in regulations on how these panels will work. There should be public consultation on this.
Parliament should also clarify how Assisted Dying Review Panels would deal with and decide cases, including:
- the role lawyers may play in the process (including as potential panel members)
- how panels assess a person’s eligibility for assisted dying
- the availability of second opinions
- whether panel hearings are held in public or private
- options for raising concerns or challenging a panel decision
- the availability of legal aid
Clarifying key terms
The bill contains some terms that are not clearly defined.
For example, what constitutes “pressure” needs to be clear in the bill and/or statutory guidance.
We also recommend that Parliament revisits the term “next of kin”.
Monitoring and review
Parliament should consider how best to ensure there are strong independent mechanisms for monitoring and reviewing the legislation if it is passed.Further consultation
Currently, the bill leaves many key aspects of the assisted dying process to be dealt with under regulations, codes of practice or guidance.
This leaves important questions about how the scheme would work unclear.
We strongly recommend that the required regulations, codes of practice and guidance are drafted and published as soon as possible, then consulted on as widely as possible before the bill fully commences.
Our briefings
Read our briefings to MPs and peers on the bill: