Assisted Dying In England & Wales – How did we get here?

The Assisted Dying Bill

As the Isle of Man becomes the first place in the British Isles to approve the right to die, and the UK Bill’s third reading in Parliament takes place on 25 April, this Insight provides a stocktake on how we got here, and other jurisdictions

Our focus, as before, on this divisive issue, is to consider the legal process, practicalities and ramifications, rather than the ethics.

Assisted Dying In England & Wales – How did we get here? 

1. Section 2 of the Suicide Act 1961 – encouraging or assisting a suicide - is a crime with a 14 year prison sentence. Suicide stopped being a crime in 1961.
2. In 2002, the case of Diane Pretty established that Article 8 of the European Convention of Human Rights (ECHR) does not confer a right to decide when or how to die.
3. In 2008/2009, Debbie Purdy campaigned for the “right to die”, leading to a judgment in which the Court encouraged the Director of Public Prosecutions to issue guidance on his approach to prosecution of potential offences of assisting suicide.
4. In 2010, the DPP (Kier Starmer, as the time, as it happens) published that guidance (Suicide: Policy for Prosecutors in Respect of Cases of Encouraging or Assisting Suicide | The Crown Prosecution Service). It sets out the public interest factors for and against prosecution to be considered by the Director of Public Prosecutions under s.2 of the Suicide Act. The guidance confirms that a prosecution is less likely in circumstances where the suspect was ‘wholly motivated by compassion’, their acts were only of ‘minor’ encouragement and/or they sought to dissuade the individual beforehand.
5. In 2014:
   1. The Assisted Dying Bill was introduced by Lord Falconer, Privy Councillor, KC and labour politician, but failed due to the general election interrupting progress.
   2. Revised CPS guidance gave the CPS discretion whether to prosecute assisted suicides.
   3. Mr Tony Nicklinson sought a declaration that the law of assisted suicide was incompatible with his right to a private life under Article 8 of the ECHR (R (on the Application of Nicklinson and another) v Ministry of Justice). The Supreme Court did not make a declaration of incompatibility. 
6. In 2015:
   1. A further Assisted Dying Bill failed having been proposed by Rob Marris, Labour MP, based on Lord Falconer’s earlier attempt.
   2. Mrs Nicklinson (Mr Nicklinson having died) and Mr Paul Lamb applied to change the law to allow individuals to end their lives with assistance without those assisting them being at risk of prosecution. The European Court of Human Rights (ECtHR) refused to consider the applications and underscored that regulation of assisted dying is a matter for national legislatures rather than the judiciary.
7. In 2018, the court decided in the case of Noel Conway that it would be institutionally inappropriate for the court to declare that s2 of the Suicide Act was incompatible with the right to privacy under Article 8 of the ECHR.
8. In 2020, another attempt, this time by a Phil Newby, failed.
9. In 2021, a further attempt, by Baroness Meacher, a British life peer, to introduce an Assisted Dying Bill failed.
10. In 2023, the House of Commons’ Health and Social Care Committee launched an inquiry into assisted dying: MPs launch new inquiry on assisted dying/assisted suicide - Committees - UK Parliament. This reported in 2024: MPs publish report on Assisted Dying/Assisted Suicide - Committees - UK Parliament (see also discussions section below). 
11. In 2024:
    1. Those willing to assist their loved ones travel abroad for assistance had to be prepared to be arrested on their return, a concern which was widely highlighted by Rebecca Wilcox, daughter of prominent assisted dying campaigner Esther Rantzen.
    2. In July 2024 the first reading of the Assisted Dying for Terminally Ill Adults Bill was introduced by Lord Falconer:
       • This would allow terminally ill adults with six months or less to live to get medical help to end their own lives provided they are mentally able to make the decision, the choice is approved by two doctors, and by the High Court, and the medicine must be self-administered.
       • Given the lack of success in private members’ bills becoming law, Lord Falconer hoped a backbench MP might introduce a similar bill to the House of Commons.
    3. In October 2024, this came to fruition, with the first reading of the Assisted Dying Bill, introduced by Labour MP, Kim Leadbeater.
       • The Bill would allow terminally ill adults with six months or less to live to get medical help to end their own lives with broadly the same safeguards as in Lord Falconer’s Bill: ie they are mentally able to make the decision, the choice is approved by two doctors, and by the High Court, and the medicine must be self-administered.
       • The Bill amends the Suicide Act by providing an exemption to the offence of encouraging or assisting suicide for those who comply with the terms of the Bill or can prove that they reasonably believed they were acting in accordance with the terms of the Bill, took all reasonable precautions and exercised all due diligence to avoid the commission of an offence. The Bill also makes clear that provision of assistance in accordance with the terms of the Bill will not give rise to any civil liability.
       • No registered medical practitioner or health professional is obliged to provide assistance in accordance with the Bill. Those who choose not to participate are to be protected from discrimination.
       • See Assisted Dying – The Legal Process and Practicalities | Weightmans for more detail on what the Bill proposed.
    4. In November 2024, Parliament voted in favour of the Bill at its first reading.
12. Current position: 
    • There were almost daily developments to the Bill as it successfully passed through Committee stage.
    • In February 2025, the latest amendment that was passed replaced the scrutiny of a High Court Judge with a panel of legal, mental health and social work staff.  This panel will include a psychiatrist, social workers and be chaired by a senior legal figure. This change aims to address concerns about the practicality and capacity of the High Court to handle these cases.
    • MPs are expected to vote on further amendments at Report stage on 25 April and then it could pass to the final stage in the House of Commons, the third reading, before going to the House of Lords for further scrutiny.
    • The implementation period has been doubled to a maximum of four years should the Bill be passed into law.
    • An impact assessment is expected to be published before the Bill returns to the Commons. This will review social, economic and environmental impacts, risks and costs and benefits. 

Other Jurisdictions

The Isle of Man

1. In October 2023, the Isle of Man’s Parliament voted by a 70% majority to pass an Assisted Dying Bill.
2. The Bill allowed for the provision of assisted dying for adults (over aged 18) who are terminally ill (i.e. those with less than a year to live) with capacity and a “clear and settled intention” to end their own lives. They must have lived on the Isle for 12 months.
3. By May 2024, members of the Isle of Man Parliament began debating the clauses of the Assisted Dying Bill. Controversial clauses included whether a doctor should administer a lethal injection or whether the patient should self-administer it.
4. On 25 March 2025, the draft Bill was passed by the Isle of Man Parliament making it the first jurisdiction in the British Isles to legalise assisted dying. If Royal Assent is received in 2025, the first assisted death could come as soon as 2027.

Guernsey

The parliamentary debate on assisted dying started in 2018 but draft legislation failed.

After the UK’s supportive vote in November 2024, however, it is thought that a request to make assisted dying legal could be made in early 2025, with more than half Guernsey States members supporting it.

Jersey

Jersey was set to vote on proposals in May 2024, although it had yet to introduce a bill, with plans to legalise assisted dying by 2025.

Scotland

A proposed Assisted Dying for Terminally Ill Adults (End of Life) (Scotland) Bill was lodged in September 2022. It was published in March 2024. This will be the third time the Scottish Parliament has considered the issue. The Bill will potentially be voted on in Spring 2025. 

The rest of the world

1. Assisted dying remains illegal in most countries but it is thought that around 300 million people live in countries where it is now legal.
2. Switzerland created a “right to die” when it made assisted suicide legal in 1942. It is best known for its Dignitas facility in Zurich, attracting people from around the world.  
3. The Netherlands and Belgium both legalised assisted dying more than 20 years ago for patients experiencing unbearable suffering from an incurable illness, including mental health issues. They are the only European countries to have extended this to children.
4. Canada, Australia, New Zealand, Spain and Austria have had assisted dying laws since 2015, some allowing assisted death for those that are not terminally ill.
5. Assisted dying is legal in 11 US states (and is known as physician-assisted dying).

Discussion

Slippery slope?

Op/ponents of assisted dying argue that the qualifying criteria of laws enacted in Belgium and Canada have loosened over time, leading to a sharp rise in assisted deaths and those models should not be followed in the UK. For example:

• In 2021, Canada’s Medical assisted in dying (introduced in 2016) was extended in 2021 to those experiencing “unbearable suffering” rather than only an irreversible illness or disability.
• In 2023, Quebec passed provincial law mandating that medical assistance in dying be available in all hospices which some see as a warning that, down the line, hospices could lose any state funding that they receive if they are not willing to evolve into a completely different service.

Kim Leadbeater MP says the Canadian system is not what is being debated for England and Wales, where eligibility would be restricted to the terminally ill.

Hospice funding

The UK Bill has prompted debate over end of life hospice and palliative care funding. In 2024, a report by the All-Party Parliamentary Group on Hospice and End of Life Care found that many hospices are already in funding famine. The Health and Care Act 2022 legally requires Integrated Care Boards—ICBs—to commission sufficient palliative and end-of life care for their population. However, the report found that the funding that hospices receive from ICBs still varies significantly across the country.

Palliative care

Also in 2024, the House of Commons Health and Social Care Committee published its report setting out its findings on Assisted Dying/ Assisted Suicide. As to Palliative Care, it found that despite the UK being a leader in palliative and end-of-life care, it identified inconsistencies in access and provision. It recommended ensuring universal coverage of palliative care services, including hospice care at home, and increasing the number of specialists in palliative care.  

The Bill continues to be a topic of intense debate, controversy and interest with wide-ranging discussions including ethical considerations, potential safeguards and the impact on the healthcare system.

Click here to follow the progress of the UK Bill through Parliament.