A 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.
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This is not the latest version of the Bill
Available Versions
| Date | Debate |
|---|---|
| Friday 20th June 2025 | Report stage |
| Friday 13th June 2025 | Report stage |
| Friday 16th May 2025 | Report stage |
Relevant Documents
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|---|---|
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Page 1
Eligibility to be provided with lawful assistance to voluntarily end own life
Source Bill 012 EN 2024-25
Clause 1 sets out the circumstances in which assistance can be provided to a person to end their own life.
The person must:
Under the general law, the place where a person is “ordinarily resident” is the place where they reside in the ordinary course of their day to day life.
The assistance must be provided in accordance with clauses 5 to 22. Those clauses, amongst other things, require steps to be take to ensure that the person-
Source Bill 012 EN 2024-25
Subsection (1) defines when a person is “terminally ill” for the purposes of the Bill. The person must have an inevitably progressive illness, disease or medical condition that cannot be reversed by treatment. The person must also be expected to die within 6 months.
Subsection (2) makes it clear that a person is not to be regarded as terminally ill by reason of them being mentally ill or having a disability.
Page 2
Source Bill 012 EN 2024-25
Clause 3 provides that the test of whether a person has capacity to make a decision to end their own life is to be determined in accordance with the Mental Capacity Act 2005. Sections 1 and 2 of that Act establish the principles and criteria for assessing a person's capacity to make decisions.
Section 2 of that Act provides that a person lacks capacity in relation to a particular matter if the person is unable to make a decision for themselves in relation to that matter because of an impairment of, or a disturbance in the functioning of, the mind or brain. Section 3 of that Act defines what it means to lack capacity. Section 3 provides that a person lacks capacity if they are unable to:
Initial discussions
Source Bill 012 EN 2024-25
Subsection (1) makes clear that no doctor is under a duty to raise the subject of the provision of assistance under the Bill with a patient. But that does not prevent a doctor exercising their professional judgement to discuss the matter with a patient (see subsection (2)).
Subsection (3) provides that, where a patient indicates to a doctor that they wish to seek assistance end their own life in accordance with the Bill, the doctor may (but is not required to) discuss the matter with the patient.
If the discussion takes place, subsection (4) provides that it must cover, amongst other things, the available palliative, hospice or other care.
If the doctor is unwilling or unable to conduct the discussion, subsection (5) requires them to refer the patient to another doctor who is willing and able to conduct the discussion.
Page 3
Source Bill 012 EN 2024-25
Clauses 5 to 15 set out steps that must be taken, and safeguards and protections that operate, when a person decides to seek assistance to end their own life in accordance with the Bill. In summary, assistance can only be provided if:
Procedure, safeguards and protections
Source Bill 012 EN 2024-25
A person who wishes to be provided with assistance to end their own life must make a declaration under this clause (a "first declaration"). The form of the declaration is set out in Schedule 1. The person must sign the declaration. Where the person is unable to sign, clause 15 enables it to be signed by a proxy.
The declaration must also be witnessed by the coordinating doctor and another independent person.
The coordinating doctor is a registered medical practitioner who meets the requirements set out in subsection (3). In particular, the Secretary of State can set out in regulations the training, qualifications and experience that are required by any coordinating doctor.
Subsection (3) and clause 36 ensure that neither the coordinating doctor nor the independent witness can be a relative of the person seeking the assistance nor can they know or believe that they are a beneficiary under that person's will or may otherwise benefit from the person's death.
Source Bill 012 EN 2024-25
This clause requires a person making a first declaration under clause 5 to provide both the coordinating doctor and the independent witness with two forms of proof of identity. The Secretary of State can set out in regulations what forms of proof of identity can be used.
Page 4
Source Bill 012 EN 2024-25
Where a first declaration is made by a person, the coordinating doctor who witnessed the first declaration must carry out an assessment of the person. The purpose of the assessment is to establish whether the person:
If the coordinating doctor is satisfied that all those requirements are met, they must make a statement in the form set out in Schedule 2. They must also refer the person for a second assessment by another registered medical practitioner (referred to in the Bill as "the independent doctor").
Clause 9 makes further provision about first assessments.
Source Bill 012 EN 2024-25
This clause applies where the coordinating doctor refers the person under clause 7(3)(c) for a second assessment by the independent doctor. The purpose of the second assessment of the person carried out by the independent doctor is to establish whether the person:
The second assessment must take place after "the first period for reflection". This period begins with the day the coordinating doctor makes their statement under clause 7 and lasts for 7 days.
The independent doctor must carry out the second assessment independently of the coordinating doctor.
If the independent doctor is satisfied that all the requirements are met, they must make a statement in the form set out in Schedule 3.
A registered medical practitioner can only act as the independent doctor if they meet the requirements set out in subsection (6). In particular, the Secretary of State may set out in regulations the training, qualifications and experience which the practitioner must have. To ensure independence, the practitioner must not have provided the person with treatment or care in relation to their terminal illness and must not be in the same medical practice or clinical team as the coordinating doctor. The independent doctor must also not know or believe that they are a beneficiary under the person's will or may otherwise benefit from that person's death.
Clause 9 makes further provision about second assessments.
Page 5
Source Bill 012 EN 2024-25
This clause makes provision about the assessment by the coordinating doctor under clause 7 and the assessment by the independent doctor under clause 8.
In particular, subsection (2) sets out things the doctor carrying out the assessment must do. These include a requirement to explain to and discuss with the person the possible treatments, the palliative, hospice and other care available and the nature of the substance that might be provided to assist the person to end their own life (including how it will bring about death). The doctor must also explain the further steps that would need to be taken if the person wished to be provided with assistance to end their own life and that those steps may be cancelled by the person at any time. The doctor is also to advise the person to inform their GP and, so far as the doctor considers it appropriate, advise the person to discuss the request with their next of kin and other people they are close to.
If the doctor carrying out the assessment has a doubt as to whether the person being assessed is terminally ill, the doctor must obtain an opinion from a specialist in the illness, disease or condition in question. If the doctor carrying out the assessment has doubt as to the capacity of the person being assessed, they may refer the person for assessment by a psychiatrist or other suitably qualified person but are not required to do so. This is because there may be circumstances in which the doctor making the assessment does not require a specialist opinion to determine that the person does not have the necessary capacity.
Page 6
Source Bill 012 EN 2024-25
If the independent doctor carries out the second assessment of the person and is not satisfied of the matters set out in clause 8(2), this clause enables the person to request a second opinion from another independent doctor. The provisions of clauses 8 and 9 also apply to this assessment.
Subsection (3) provides that only one referral for a second opinion can be made under this clause.
Page 7
Source Bill 012 EN 2024-25
The coordinating doctor who witnesses the first declaration under clause 5 has a variety of functions under the Bill. This clause enables the Secretary of State to make regulations providing for cases where the original coordinating doctor becomes unable or unwilling to continue to carry out these functions part way through the process. This will ensure continuity of care for the person who made the first declaration.
Equivalent provision is not needed for the independent doctor, as their functions are confined to the second assessment under clause 8. If they become unable or unwilling to continue to act before the second assessment is completed, a new referral could be made to an independent doctor for a second assessment.
Source Bill 012 EN 2024-25
This clause applies where a person has made a first declaration (and it has not been cancelled), the coordinating doctor has made the statement in Schedule 2 and the independent doctor has made the statement in Schedule 3.
The person may apply to the High Court for a declaration that the requirements of the Bill have been met in relation to the first declaration.
The High Court must make the declaration if, and only if, it is satisfied that-
The court may hear from and question the person, and must hear from the coordinating doctor or the independent doctor (or both). For the purposes of determining if it is satisfied that the person has a clear, settled and informed wish to end their own life and that they have made the first declaration and court application voluntarily and have not been coerced or pressured, the court may also hear from and question any other person or ask a person to report to the court on any relevant matter.
If the High Court refuses to make the declaration, the person can appeal to the Court of the Appeal. The Court of Appeal can confirm the decision of the High Court or make the declaration. There is no appeal against a decision of the High Court to make the declaration.
Page 8
Page 9
Source Bill 012 EN 2024-25
Where a person who wishes to be provided with assistance to end their own life has obtained a court declaration under clause 12, they may then make a further declaration under this clause ("the second declaration"). But the second declaration cannot be made until “the second period for reflection" has ended. The second period for reflection begins on the day the court declaration is made and last for 14 days. But, if the coordinating doctor is of the opinion that the person is likely to die within one month of the court declaration, the period for reflection is reduced to 48 hours.
The second declaration must be in the form set out in Schedule 4. It must be witnessed by the coordinating doctor and by an independent witness. The coordinating doctor may only witness the second declaration if they are still satisfied that the person making the declaration-
The coordinating doctor must sign a statement in the form set out in Schedule 5 confirming all those things and that must be witnessed by the same independent witness as witnessed the second declaration. Neither the coordinating doctor (see clause 5(3)) nor the independent witness (see clause 34) may be a relative of the person signing the second declaration, and neither must know or believe they are a beneficiary under their will or may otherwise benefit from that person's death.
Page 10
Source Bill 012 EN 2024-25
This clause enables a person who has made a first or second declaration to cancel the declaration by giving notice to the coordinating doctor or to a doctor at their GP's practice. Notice may be given orally or in writing, or the cancellation indicated by a means of communication known to be used by the person concerned. A cancellation takes effect as soon as the notice or indication is given, and no further steps are then taken in reliance on the declaration.
Source Bill 012 EN 2024-25
This clause makes provision for cases where the person intending to make a first declaration or a second declaration is unable to sign their own name. They can authorise another person to sign the declaration on their behalf. That other person may be someone they have known personally for at least 2 years or someone they consider to be of good standing in the community.
Clause 36 provides that a proxy:
Page 11
Information in medical records
Source Bill 012 EN 2024-25
This clause provides for the making of declarations and statements made under the Bill to be recorded in the person's medical records. The original statement or declaration is to be included as part of that record.
Source Bill 012 EN 2024-25
This clause provides for a cancellation of a first or second declaration to be recorded in the person's medical records.
Page 12
Provision of assistance to end life
Source Bill 012 EN 2024-25
This clause applies where the High Court or Court of Appeal has made a declaration under clause 12, the second period for reflection (see clause 13) has ended and the person has made a second declaration (which has not been cancelled). It governs the provision of assistance in the form of an approved substance (see clause 21) with which the person may end their own life.
Subsection (3) provides that the approved substance must be provided directly, and in person, by the coordinating doctor.
Subsection (4) provides that at the time the approved substance is provided the coordinating doctor must be satisfied that the person:
Subsection (6) provides the coordinating doctor may:
But subsections (7) and (8) make clear that the decision to self-administer the approved substance and the final act of doing so must be taken by the person themselves not by the coordinating doctor. Subsection (6) does not authorise the coordinating doctor to administer an approved substance to another person with the intention of causing that person's death.
Subsections (9) and (10) provide that the coordinating doctor must remain with the person after the approved substance has been provided, although they need not be in the same room.
Subsection (11) ensures that if the person decides not to take the approved substance it is removed by the coordinating doctor.
Page 13
Source Bill 012 EN 2024-25
Subsection (1) provides that the coordinating doctor may authorise another named registered medical practitioner to exercise the coordinating doctor's functions under clause 18 in connection with the provision of assistance to a person. The authorisation must be in writing.
An authorisation can only be made with the consent, in writing, of the person who wishes to be provided with assistance. The Secretary of State can also set out in regulations the training, qualification and experience which the practitioner would require before they could be authorised under subsection.
Source Bill 012 EN 2024-25
Subsection (1) requires the Secretary of State to make regulations specifying drugs or other substances for the purposes of the Bill.
Page 14
Source Bill 012 EN 2024-25
Where a person has been provided with assistance to end their own life and the person has died as a result, this clause requires the coordinating doctor to make a statement in the form set out in Schedule 6. The making of the declaration must be recorded in the person's medical records, and the original statement included as part of that record.
Source Bill 012 EN 2024-25
This clause ensures that, where a person decides not to take an approved substance provided under clause 18 or the procedure fails for any reason, appropriate records are made in the person's medical record.
Page 15
Protections for health professionals
Source Bill 012 EN 2024-25
Subsection (1) ensures that no registered medical practitioner or other health professional (defined in clause 37(1)) is required to participate in the provision of assistance under the Bill.
Subsection (2) provides that an employee cannot be discriminated against because they choose not to participate in the provision of assistance under the Bill or because they choose not to participate in the provision of that assistance.
Source Bill 012 EN 2024-25
Subsection (1) makes it clear that a person is not guilty of an offence by virtue of providing assistance in accordance with the Bill.
Accordingly, subsection (3) amends the Suicide Act 1961 to ensure that the provision of assistance to a person in accordance with this Act is not an act which constitutes an offence under section 2 of that Act (criminal liability for complicity in another person's suicide).
The offence under section 2 of the Suicide Act 1961 will continue to operate for other cases where assistance is provided. But the amendment made by subsection (3) to that Act also provides a defence to a charge under section 2 of the Suicide Act 1961 where the person proves that they:
Source Bill 012 EN 2024-25
This clause ensures that providing assistance to a person to end their own life in accordance with the Bill does not give rise to any civil liability.
Page 16
Offences
Source Bill 012 EN 2024-25
This clause creates two new criminal offences.
Firstly, subsection (1) provides a person commits an offence if, by dishonesty, coercion or pressure, they induce another person to make a first or second declaration under the Bill, or to not cancel a first or second declaration.
Secondly, subsection (2) provides a person commits an offence if, by dishonesty, coercion or pressure, they induce another person to self-administer an approved substance provided in accordance with the Bill.
Source Bill 012 EN 2024-25
This clause creates three new criminal offences relating to documentation in connection with the provision of assistance under the Bill.
Subsection (1) makes it an offence to make or knowingly use a false instrument which purports to be a first or second declaration or a court declaration under clause 12, or to wilfully conceal or destroy a first or second declaration made by another person.
Subsection (2) makes it an offence to knowingly or recklessly provide, in relation to a person who has made a first declaration, a medical or other professional opinion which is false or misleading in a material particular.
Subsection (3) makes it offence to wilfully ignore or otherwise conceal knowledge of a cancellation of a first or second declaration.
Page 17
Regulatory regime for approved substances
Source Bill 012 EN 2024-25
The clause enable the Secretary of State to make regulations regulating the prescribing, dispensing, transportation, handling and disposal of approved substances.
Investigation and registration of deaths
Source Bill 012 EN 2024-25
Subsection (1) provides that the duty to investigate a death under section 1(2)(a) or (b) of the Coroners and Justice Act 2009 does not arise just because the person died as a consequence of the provision of assistance in accordance with the Bill. Section 1(2)(a) of that Act covers where the deceased died a violent or unnatural death, and section 1(2)(b) covers where the cause of death is unknown.
Subsection (2) amends the Births and Deaths Registration Act 1953 to enable the Secretary of State to make regulations to modify the operation of that Act in relation to deaths which arise from the provision of assistance in accordance with the Bill. For example, the regulations may modify the information that needs to be provided in relation to these deaths, or the form and manner in which the cause of such deaths is to be certified. The regulations must provide for the cause of death to be recorded as "assisted death" along with a record of the person's terminal illness by reason of which they were entitled to be provided with assistance to end their own life..
Subsection (3) requires the Registrar General to report annually to Parliament with a statistical analysis of deaths which have arisen from the provision of assistance in accordance with this Act.
Page 18
Codes and guidance
Source Bill 012 EN 2024-25
This clause authorises the Secretary of State to issue codes of practice in relation to various matters relating to the operation of the Act, such as assessment of whether a person has a clear and settled intention to end their own life and the assistance which a person may be given to ingest or self-administer an approved substance.
A code of practice cannot come into force until it has been laid before Parliament and the regulations bringing it into force have been approved by a resolution of each House of Parliament.
Page 19
Source Bill 012 EN 2024-25
The Chief Medical Officer for England and the Chief Medical Officer for Wales are required to provide guidance relating to the operation of the Bill. In particular, they must have regard to the need to provide practical and accessible information about the operation of the Bill, advice and guidance to persons considering requesting assistance under the Bill, their families, and the general public.
Provision through NHS etc
Source Bill 012 EN 2024-25
This clause enables the Secretary of State to secure that arrangements are in place for assistance to be provided in accordance with the Bill, including arrangements for the funding of any provision made. This would enable the Secretary of State to provide for services to be provided through the health service or by a separate service.
Monitoring and review
Source Bill 012 EN 2024-25
This clause enables the Secretary of State to make regulations to ensure the Chief Medical Officers are notified of steps taken under the Bill. The information will enable the Chief Medical Officers to monitor and report on the operation of the Bill under clause 34.
Page 20
Source Bill 012 EN 2024-25
Under subsection (1), the Chief Medical Officer for England and the Chief Medical Officer for Wales are required to:
Subsection (2) sets out matters the annual report must deal with, including information about cases where the High Court or Court of Appeal has refused to make a declaration under the Bill.
Subsection (3) provides the Chief Medical Officers may produce a combined annual report.
Subsection (4) provides the annual reports must be published and laid before Parliament or, as the case may be, Senedd Cymru.
Subsection (5) requires the Secretary of State to publish a written response to any report of a Chief Medical Officer under this clause, and to lay it before Parliament. If the response is to a report made by the Chief Medical Officer for Wales, the Secretary of State's response is also sent to the Welsh Ministers who must lay it before Senedd Cymru.
Page 21
Source Bill 012 EN 2024-25
This clause provides that the Secretary of State must review the operation of the Bill. The review must take place at least 5, but not more than 6, years after the passing of the Bill. The report of the review must be laid before Parliament.
The report must, in particular, set out:
Page 22
General and final
Source Bill 012 EN 2024-25
This clause makes provision for disqualifying persons from being witnesses or proxies under the Bill. It prevents a person (A) acting as a witness or proxy for a person (B) making a first or second declaration under the Bill if:
Source Bill 012 EN 2024-25
This clause confers power on the Secretary of State, by regulations, to amend the forms set out in the Schedules of the Bill.
Page 23
Page 24
Source Bill 012 EN 2024-25
Subsection (1) lists the provisions that come into force as soon as the Bill is passed.
Subsection (2) provides that the other provisions come into force on the day (or days) specified by the Secretary of State by regulations.
But, if any provision has not been brought fully into force at the end of the period of 2 years beginning with the day the Bill is passed, it automatically comes fully into force at the end of that 2 year period.
Page 25
Schedules
Form of the first declaration
No amendments available.