Assisted Dying Bill: What you need to know

MPs have voted in favour of the ‘Terminally Ill Adults (End of Life) Bill’ (the “Bill”) following its third reading on 20 June in the House of Commons. The Bill passed by 23 votes, meaning that it will now move in to the House of Lords to face further scrutiny. The vote was held on a free basis, enabling MPs to vote with their conscience rather than being confined to vote with their party whip. 

The discussion around assisted dying is inevitably highly polarising and emotive, with both those in support and in opposition of change to the status quo as equally vocal and steadfast in their viewpoints as the others. Successive UK governments have erred on the side of caution, reluctant to make changes, with the last time the matter was formally debated by Parliament being in 2015. The first major hurdle has now been overcome, but the Bill still faces a tough battle in gaining Royal Assent.

The Assisted Dying Bill

If the Bill becomes law, to be eligible for an assisted death a person must:

• be 18 or over
• be ordinarily resident in England or Wales and have been so for at least 12 months
• be registered with a GP in England or Wales
• have the capacity to make the choice under the Mental Capacity Act 2005; and
• be reasonably expected to die within six months.

A person who meets the initial grounds of eligibility must undergo a three stage process:

1. The first declaration:

1. 1. The person must make various declarations, including that they are eligible and understand that they can withdraw at any time either orally or in writing. This must be witnessed by a co-ordinating doctor who must also be satisfied that the person is eligible and that they have made an informed and free choice.
   2. The person is then given a seven day reflection period before being assessed by a second doctor (independent doctor).
      
      
2. Multidisciplinary panel
   1. The first declaration and both doctor’s reports will then be sent to the Voluntary Assisted Dying Commissioner – who is appointed by the Prime Minister and does not sit as a judge -  who will then refer the case to a multidisciplinary panel to determine if the person is eligible.
   2. Evidence must be heard from at least one of the doctors and the person may also provide evidence alongside any other individuals as may be required.
   3. Where the request is rejected, the person may challenge this on the basis that the decision involved an error of law, was irrational or was procedurally unfair. If the Commissioner agrees, the case must be referred to a second panel.
      
      
3. The second declaration:

1. 1. If the request is approved, the person will be given a certificate of eligibility
   2. There is then a fourteen day period of reflection before the person makes a second declaration, which must be witnessed by the co-ordinating doctor and an independent witness
   3. The doctor must then provide a statement confirming that the person is eligible and notify the Commissioner of this

Timeline so far

1. Kim Leadbeater MP introduced the Terminally Ill Adults (End of Life) Bill into the House of Commons on 16 October 2024 and the Bill received its first reading.
2. The Bill underwent its second reading on 29 November 2024 where MPs voted, via an unwhipped vote, 330 to 275 in favour of the Bill.
3. The Bill was then sent to the Public Bill Committee to undergo further scrutiny.
4. The Bill entered the House of Commons for the report stage on 16 May 2025. There was insufficient time to consider all the amendments and the debate was continued on 13 June, where several amendments were passed.
5. On 20 June 2025, the report stage was completed along with the third reading, with MPs voting – again unwhipped - 314 to 291 in favour of the Bill.
6. The Bill will now pass on to its first reading in the House of Lords.

Why do people want the law on assisted dying to change?

Whilst most agree that everyone should have the autonomy to make choices about their own bodies and healthcare, the key question is whether this freedom should stop short of the right to access life-ending medications, even where this is in a highly controlled and regulated manner and environment.

The main argument in favour of legalising assisted dying is to give people who are suffering the choice to die in a more dignified and comfortable manner than the current systems allow. The current best option for terminally ill patients is to rely upon palliative medicine; the aim of which is to help very sick people to be as comfortable as possible towards the end of their lives without hastening (or postponing), their death. In the words of Kim Leadbeater MP, the current law is ‘failing people’.

Why are people opposed to the Assisted Dying Bill?

Primarily, people are concerned that legalising assisted dying opens up new possibilities for abuse and exploitation of sick and elderly people who are some of the most vulnerable in our society. Though the Bill contains safeguards against people being coerced and pressured into opting to end their lives prematurely, there will inevitably be cases which slip through the net. This is of particular concern because the plans as currently outlined place so much weight on the determinations of doctors and judges who, though experts in their respective fields, are of course not immune from making human errors. And in the context of ending a life, there’s no coming back from any mistake. 

There are also questions around how pressure and coercion might be identified and assessed. Encouraging a relative with a poor quality of life to consider assisted dying may be well meaning and in their apparent best interests, but at what point does suggestion become pressure? Additionally, how can the needs of the individual be safeguarded against relatives with concerns about increasing care costs eroding potential inheritance or the “burden” of providing physical care is becoming too much for them? With so many potential “risk” scenarios, this deceptively straightforward issue takes on a different complexion.  

What’s more, there have been questions raised about how equitable the proposals are as it is likely that those who cannot access good health and social care are more likely to turn to assisted dying, when compared with those who have the resources to afford to explore the alternatives.

From a procedural perspective, prominent political figures, such as Labour MP Dianne Abbott and Conservative MP Sir Edward Leigh have expressed concerns over the pace at which the Bill has moved from initial publication to its second reading, as they believe that it has not given adequate time for scrutiny and debate. Additionally, they are uneasy at the experience-levels of the MPs who will carry the responsibility for making this landmark decision. There are more new MPs in the Commons than ever before, many who have been in their new roles only a matter of months. This is also the first private members bill of the current parliamentary session, meaning that many MPs are engaging with this process for the first time.

Assisted dying globally

As the first country to permit any kind of assisted dying, Switzerland is frequently cited as the example of how this can work in practice.

Assisted suicide has been legal in Switzerland since 1941 and the country is home to Dignitas, a non-profit organisation which provides physician-assisted dying, including for non-Swiss nationals visiting the country specifically to end their life.

The US state Oregon has had legal assisted dying since 1997, whilst various other states have subsequently brought in law based on Oregon’s model including Washington in 2008 and California in 2015. More recently Canada, Australia and New Zealand have all legalised assisted dying.