Who would be eligible?
Only adults with a terminal illness that can reasonably be expected to cause their death within six months would be eligible under Labour MP Kim Leadbeater’s Bill.
Terminal illness is defined as an “inevitably progressive illness, disease or medical condition which cannot be reversed by treatment”.
The person must also be mentally competent, have lived in England and Wales for at least one year and be registered with a GP practice.
Mental health disorders or disabilities alone don’t qualify as terminal illnesses.
How would a terminally ill person access assisted dying?
Medical practitioners could raise assisted dying with their patients, but would be under no obligation to do so. If a person asked for help to end their life, they would have a preliminary discussion about the requirements.
This would be followed by signing a first declaration, witnessed by a coordinating doctor and another person. It could be signed by an authorised proxy if the patient cannot write their own name.
The coordinating doctor would carry out a first assessment to decide whether the patient meets the eligibility criteria. This would ensure they have “a clear, settled and informed wish to end their own life”, that their declaration was voluntary and that they hadn’t been coerced or pressured.
A second independent doctor would then carry out another assessment. Both doctors should discuss with the patient their prognosis, any available treatments, other options such as palliative or hospice care or psychological support, and how the substance used in the assisted dying process would bring about death.
They would also make clear that the patient can stop the process at any time and, where appropriate, advise them to discuss their request with loved ones.
If there was any doubt about the person’s mental capacity, they could be referred for a psychiatric assessment. If the second doctor rejected the application, the coordinating doctor could refer the patient for a second opinion.
If two doctors agreed that the patient should be eligible, the application would progress to the High Court, where a judge would check again that all criteria had been met. The court may question the person, doctors or anyone else they find appropriate.
The person would then make a second declaration. Both the first and second declaration could be cancelled at any time by the person telling – orally or in writing – their coordinating doctor or any registered medical practitioner from their GP practice that they no longer want to continue.
The Bill says that at least seven days must pass between the two doctor assessments and 14 days after the High Court finds the person eligible, before the patient could end their life, unless their death was likely to occur within that time.
How would the person end their life, if found eligible?
The coordinating doctor or an authorised medical practitioner would provide the patient with the life-ending medication. The drugs used would be specified in regulations by the Secretary of State.
The medics could prepare the substance for self-administration or prepare a device that will help them administer it, but the final act must be taken by the patient. Doctors would not be allowed to administer the drug.
The medical professional would remain with the person until they had died, it was determined that the procedure had failed, or the person changed their mind about ending their life.
If a person decided not to use the substance, it would immediately be removed.
Would healthcare staff be forced too help people die?
No medical practitioner would be required to discuss assisted dying with their patients. However, if they were unwilling to do so, they must refer the patient to another medical professional, if requested.
No healthcare professional would be under any duty to participate in the assisted dying process and the Bill specifies that employers must not penalise staff who choose not to be involved.
