MPs backed a proposal to legalise assisted dying in England and Wales in a historic vote last year.
But months of detailed scrutiny and further votes are now required before the Terminally Ill Adults (End of Life) Bill can become law.
What is in the bill?
The purpose of the bill is to allow adults aged 18 and over, who have mental capacity, are terminally ill and are in the final six months of their life, to request assistance from a doctor to die.
This is subject to “safeguards and protections” which include:
• They must have a “clear, settled and informed wish to end their own life” and have reached this decision voluntarily, without coercion or pressure;
• They must have lived in England or Wales for 12 months and be registered with a GP;
• Two independent doctors must be satisfied the person meets the criteria, and there must be at least seven days between the doctors making the assessments;
• If both doctors state the person is eligible, then they must apply to the High Court for approval of their request (however, this requirement may be changed);
• If the High Court decides the applicant meets the bill’s requirements, then there is a 14-day reflection period (or 48 hours if death is imminent);
• After this, the person must make a second declaration, which would have to be signed and witnessed by one doctor and another person.
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Will a High Court judge need to approve?
After hearing concerns about people being coerced into assisted dying during expert evidence in January, MP Kim Leadbeater, who brought the bill to parliament, proposed replacing the need for approval by a High Court judge with an expert panel.
She proposed a “judge plus” system where a High Court judge – or a senior former judge – would lead a Voluntary Assisted Dying Commission alongside a psychiatrist and a social worker.
The panel would be “wholly independent” and must be satisfied a dying person had not been coerced into the decision.
What happens if the eligibility criteria is met?
If a person meets all these eligibility criteria, a life-ending “approved substance” would be prescribed.
This would be self-administered, so the individual wishing to die must take it themselves.
This is sometimes called physician-assisted dying and is different from voluntary euthanasia – when a health professional administers the drugs.
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As well as all the conditions set out above, the bill would make it illegal to pressure or coerce someone to make a declaration that they wish to end their life, or take the medicine.
These offences will be punishable by a maximum 14-year prison sentence.
How is this different from the current law?
Suicide and attempted suicide are not in themselves criminal offences.
However, under section 2(1) of the Suicide Act 1961, it is an offence in England and Wales for a person to encourage or assist the suicide (or attempted suicide) of another.
There has long been calls for a change of the law, with campaigners arguing it would stop people dying in pain or having to travel to other countries for help to end their lives
Assisted dying has been legal in Switzerland since 1942, with the Dignitas group becoming well-known as it allows non-Swiss people to use its clinics.
There is no government-held data on the number of Britons travelling abroad for assisted dying, but other countries where a form of this is legal include the Netherlands, Belgium, Spain, Luxembourg, Canada, New Zealand, Australia and some US states.
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Why is it being debated now in England?
The issue gained renewed attention due to campaigning by broadcaster Dame Esther Rantzen. The 84-year-old Childline founder has stage-four lung cancer and revealed in December 2023 that she had signed up to Dignitas.
Over the past two decades, the debate has largely been driven by legal challenges to the current regime, brought by people who are suffering and say the current laws violate their human rights.
Parliament previously considered the issue in 2015, when MPs voted down assisted dying by 330 votes to 118 at the first hurdle.
Following July’s general election, Labour backbencher Kim Leadbeater used a private member’s bill to bring the issue to the fore again – with MPs voting in favour of her proposal by 330 to 275 in November – a majority 55.
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Like the first time, MPs were given a free vote – meaning they could vote with their conscience and not along party lines.
What happens next?
The next stage under parliamentary procedure is the scrutiny committee. This is made up of 23 MPs, including 14 opponents of the bill, who will review the legislation line-by-line and suggest amendments. It is expected to last weeks.
The committee will hold public hearings and take evidence from experts before proposing any changes, which will be voted on by MPs later down the line.
If the bill passes its third reading in the Commons, it will go to the Lords for scrutiny, and once both houses agree it will receive royal assent and become law.
But even if the bill clears all its parliamentary hurdles, Ms Leadbeater has suggested it could be two years before the service becomes operational.
What are the main arguments for and against?
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Ms Leadbeater has claimed her legislation has the most robust safeguards of any assisted dying laws in the world – and people who are dying in pain should be given a choice over when to end their lives.
Lots of campaigners support her position. The Campaign for Dignity in Dying says it will give people who are facing unbearable suffering control, so they can have a peaceful death.
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They do not support a wider law, unlike My Death, My Decision, who want the bill to apply to people who are suffering with an incurable condition, even if it is not terminal.
However some people oppose any change to the current position. This can be for a variety of reasons, but one of the main arguments is the risk of a “slippery slope” – that the eligibility criteria would widen over time.
Others say good end-of-life care needs to be prioritised, and fear some people will feel pressured to opt for assisted dying if they feel like a burden to society.
