How assisted dying laws across the UK could change

On Friday, MPs in Westminster have another chance to consider a bill which could legalise assisted dying in England and Wales.

In Scotland, a separate assisted dying bill has received the initial backing of MSPs and will now be looked at in more detail.

The Terminally Ill Adults (End of Life) Bill was introduced by Labour MP Kim Leadbeater.

It proposes letting terminally ill people end their life if they:

• are over 18, live in England or Wales, and have been registered with a GP for at least 12 months
• have the mental capacity to make the choice and be deemed to have expressed a clear, settled and informed wish, free from coercion or pressure
• be expected to die within six months
• make two separate declarations, witnessed and signed, about their wish to die
• satisfy two independent doctors that they are eligible - with at least seven days between each assessment

Once an application has been approved, the patient would have to wait 14 days before proceeding.

A doctor would prepare the substance being used to end the patient's life, but the person would take it themselves.

The bill defines the co-ordinating doctor as a registered medical practitioner with "training, qualifications and experience" at a level to be specified by the health secretary. It does not say which drug would be used.

It would be illegal to coerce someone into declaring they want to end their life, with a possible 14-year prison sentence.

A majority of MPs backed the bill in November 2024.

A committee of 23 MPs - including 14 supporters and nine opponents - has gone through the proposed legislation line by line. It held public hearings and took evidence from experts.

Under the original proposals, a High Court judge would have to approve each request to end a life.

However, the committee accepted Leadbeater's suggestion that a three-person panel comprising a senior legal figure, a psychiatrist and a social worker should oversee applications instead.

Other changes include:

• doubling the maximum time between the bill being passed and the law coming into effect from two years to four, to allow training and finalising new systems
• clarifying that doctors must set out palliative care options during initial discussions
• specifying the law wouldn't come into effect in Wales without Senedd approval

On Friday, MPs will have the chance to propose and vote on additional changes. There won't be a vote on whether to pass or reject the entire bill.

The legislation will then be subject to further scrutiny in the Commons and the Lords, with further votes. The Commons is unlikely to vote to give the bill final approval until 13 June at the earliest.

The government has reduced its upper estimate for the number of assisted deaths in the first year from 787 to 647. It admitted errors in calculating how many people could take up the service if it becomes law.

• MPs to debate assisted dying bill again after major changes

The assisted dying bill being considered in the Scottish Parliament says that eligible applicants would have to:

• be resident in Scotland for at least 12 months
• be registered with a GP in Scotland
• be terminally ill
• have the mental capacity to make the request

Liberal Democrat MSP Liam McArthur, who drafted the Assisted Dying for Terminally Ill Adults (Scotland) Bill, said he will raise the proposed minimum age from 16 to 18.

On 13 May, MSPs backed the "stage one vote" on the bill's general principles by 70 votes to 56, with one abstention.

It was a free vote, which means MSPs could vote as they wish.

MSPs can now propose major amendments, ahead of a vote on the final draft.

That process is expected to take several months, but needs to be completed before the next Holyrood elections in May 2026.

• How could the assisted dying law work in Scotland?
• How your MSP voted on the assisted dying bill

Paralympian and House of Lords crossbencher Baroness Grey-Thompson is a vocal critic.

She is worried that disabled and other vulnerable people could be put under pressure to end their lives - and that doctors may struggle to make accurate six-month diagnoses.

Actor and disability-rights activist Liz Carr, who made the BBC One documentary Better Off Dead?, also opposes the legislation.

"Some of us have very real fears based on our lived experience and based on what has happened in other countries where it's legal," she wrote on X.

Dr Gordon Macdonald, from campaign group Care Not Killing, said the bill ignores the wider "deep-seated problems in the UK's broken and patchy palliative care system".

Labour MSP Pam Duncan-Glancy, the first permanent wheelchair user to be elected to Holyrood, said it could become "easier to access help to die than help to live".

The British Medical Association, which represents doctors, and the Royal College of Nursing are neutral on the issue.

More than 1,000 GPs responded to a BBC questionnaire on attitudes to changing the law, with about 500 saying they were opposed, and about 400 in favour.

• ‘People will make bad decisions because we don’t talk honestly about death’
• 'Palliative care is not good enough - there's no plan to fix it'

Leadbeater argues that some people "have a horrible, harrowing death", however good their end-of-life care is.

The Dignity in Dying campaign group said her bill provides the "most detailed, robust proposals" on the issue that "Westminster has ever considered".

Chief executive Sarah Wootton said that the fact that every year "up to 650 terminally ill people end their own lives, often in lonely and traumatic ways," proves the need for reform.

Broadcaster Dame Esther Rantzen, who has stage-four lung cancer, is another long-standing campaigner for change. "All I'm asking for is that we be given the dignity of choice," she said.

• The NHS is spending a fortune giving people a death they don't want

The Isle of Man and Jersey are both part of the British Isles but are able to set their own laws.

The Isle of Man passed its Assisted Dying Bill in March, and the new system could be in place by 2027.

Jersey's politicians approved plans to allow assisted dying for those facing "unbearable suffering" in May 2024. The final legislation is being written. If approved, new rules could take effect from summer 2027.

There is some debate over exactly what the terms mean.

However, assisted dying generally refers to a person who is terminally ill receiving lethal drugs from a medical practitioner, which they administer themselves.

Assisted suicide is intentionally helping another person to end their life, including someone who is not terminally ill. That could involve providing lethal medication or helping them travel to another jurisdiction to die.

Euthanasia is the act of deliberately ending a person's life to relieve suffering in which a lethal drug is administered by a physician. Patients may not be terminally ill.

There are two types: voluntary euthanasia, where a patient consents; and non-voluntary, where they cannot because, for example, they are in a coma.

The Dignity in Dying campaign group says more than 200 million people around the world have legal access to some form of assisted dying.

Switzerland has allowed assisted suicide since 1942. Its Dignitas facility accepts foreign patients as well as Swiss nationals, and between 1998 and 2023 it helped 571 Britons to die.

Assisted suicide is also legal in Austria.

In the US, 10 states allow "physician-assisted dying" where doctors can prescribe lethal drugs for self-administration.

In Canada, voluntary euthanasia or "medical assistance in dying" can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration.

Voluntary euthanasia and assisted suicide are also legal in Spain and Colombia.

Assisted dying is legal in some parts of Australia - though the law differs across states - and in New Zealand.

The Netherlands, Belgium and Luxembourg let people who are not terminally ill receive assistance to die.

• How does assisted dying work in other countries?

Update 3 January 2025: This piece has been updated to give further detail on the definition of a co-ordinating doctor.