Assisted Dying: Everything it is advisable to know from legislation change to jail time

The Labour MP who has put forward historic proposals to legalise assisted dying has told MPs they have a “duty to fix things that aren’t right”.

Kim Leadbeater said “even with the best palliative care” people were having “harrowing, horrible deaths” or were taking their own lives because their needs can’t be met. She spoke about vulnerable people being interrogated by police after a loved one had taken their own life as she explained how current laws are “not fit for purpose”.

She made the plea to MPs as the full text of her legislation was published. She said: “Most people come into politics, come in here, to change things and to try to change things for the better.

“This is potentially one of the biggest things we will do as members of parliament in our careers. It’s an opportunity for Parliament to show it at its best, working often on a cross-party basis and on an issue of huge social significance and importance.”

Music teacher Nathaniel Dye, who is dying of cancer, told Ms Leadbeater’s event in Parliament that an assisted dying law would offer people a choice “at their darkest hour”. He said: “Imagine I am dying and palliative care hasn’t improved. Well, I have no choice whatsoever: I die in pain or I die in pain.

“I see this as a chance just to act with kindness and a choice for people at their darkest hour. I am not a doctor, I am not a lawyer, but I would just implore MPs and peers to really carefully consider these safeguards because I think it is the best phrase I have got: my very death depends on it.”

But the bill is incredibly complex and while it is getting a lot of support it is also facing opposition. Here’s everything you need to know about the proposed legislation.

What is the law now?

Assisted suicide is banned in England, Wales and Northern Ireland, with a maximum prison sentence of 14 years. In Scotland, it is not a specific criminal offence but assisting the death of someone can leave a person open to being charged with murder or other offences.

Sir Max Hill, who was Director of Public Prosecutions (DPP) until October last year, said the law has been “essentially unchanged” since the passing of the Suicide Act in 1961. He said the Bill has safeguards “all over it” and is a “once-in-a-lifetime opportunity for Parliament” to change what is currently a “pitiful situation” with the current law.

Sir Max said the status quo is a two-tier system where the wealthy can travel to Dignitas in Switzerland while others have to consider assisting their loved ones to die and facing possible prosecution as a result. He said there is “an unanswerable argument that the law at the moment provides no safeguards, no rails, no guidance and leaves the vulnerable in a pitiful situation”.

Former Attorney General Charlie Falconer said the current law is “completely broken” and “desperately needs to change”. “I believe what very many of the public would expect parliament to do is to produce a change in the law, a properly safeguarded change in the law… and now we have the opportunity.”

Tory MP and former Cabinet minister Kit Malthouse, who is chair of the Choice at the End of Life parliamentary group, said people are currently experiencing a “horror show”. He said: “We’re not inserting something new into what is an otherwise benign situation. In the last 10 years, I’ve spent a lot of time with dying and bereaved people and heard some stories that will never leave me.”

He pointed to the case of Mavis Eccleston, who was accused of the murder and manslaughter of her husband Dennis in 2019 after the pair made a suicide pact following his terminal bowel cancer diagnosis but she survived. She was cleared of the crime and her daughter has since called for a change to laws on assisted dying.

How could it change?

The law would be changed to allow mentally competent terminally ill adults with six months or less to live to end their lives. The dying person must take the medication themselves. No doctor or anyone else can give the medication to the terminally ill person.

Ms Leadbeater said how people will die will be “fleshed out” at later stages. It is understood the Chief Medical Officer would develop a code of practice on this, while secondary legislation would be introduced by the Health Secretary in consultation with the medical profession. Different models to assist death are used around the world but they can include drinking medication, administering the drug by IV or pressing a button.

Ms Leadbeater said fewer than 1,000 people a year in England and Wales are expected to choose an assisted death if it became law.

When will it become law?

MPs are expected to vote on the bill on November 29. But it is not guaranteed the bill will be voted on. Bills such as this are known as private members’ bills (PMBs) and are considered during Friday sittings. The time available to consider them is from 9.30am until 2.30pm. If the debate is still ongoing at 2.30pm then it is adjourned and the Bill falls to the bottom of the list, which means it is highly unlikely to make any further progress.

On the other hand, if it passes at its second reading, the bill will be then go on to be scrutinised by a committee and MPs will be able to amend the legislation. If it passes the next stage, it will go to the House of Lords.

If the legislation does end up being passed, Ms Leadbeater has suggested a new law would not take effect for another two to three years, with “even more consultation to make sure we get it right”.

What are the safeguards?

Speaking to reporters at a briefing in Parliament, Ms Leadbeater emphasised that her bill has strict provisions. Her Bill has “three layers of scrutiny” in the form of a sign-off by two doctors and a High Court judge, and would make coercion an offence with a possible punishment of 14 years in jail.

To be eligible, a person must be over 18, resident in England and Wales and registered with a GP for at least 12 months, and have the mental capacity to make a choice about the end of their life. They must, at every stage of the process, express a “clear, settled and informed” wish, free from coercion or pressure. They must make two separate declarations of their wishes, which must be witnessed and signed, and can change their mind at any time.

Two independent doctors must be satisfied that the person is eligible and must, if necessary, consult a specialist in their condition and receive an assessment from an expert in mental capacity. The application then goes before a High Court judge who must hear from at least one of the doctors and may hear from and question the person making the application and anybody else they consider appropriate.

There must be at least seven days between the two doctors making their assessments and a further 14 days after the judge has made a ruling, for the person to have a period of reflection on their decision. For someone whose death is expected imminently, the 14-day period could be reduced to 48 hours.

Do we know how MPs will vote?

A debate on Ms Leadbeater’s bill on November 29 will mark the first time MPs have debated the issue since 2015, when 330 MPs opposed changing the law and 118 MPs voted in favour. MPs have been given a free vote, meaning they will not be told by their party how to vote.

Some high profile Cabinet ministers have said they plan to vote against the bill. They include Health Secretary Wes Streeting who voiced his fears about coercion and people feeling a “duty to die”, and Justice Secretary Shabana Mahmood has previously stated she will oppose it due to her “unshakeable belief in the sanctity and value of human life”. On the other hand Energy Secretary is in favour of a changing “cruel” laws.

Keir Starmer suggested he is yet to make up his mind on whether he’ll vote in favour of a change in the law on assisted dying. Ahead of the first Commons vote on the highly sensitive issue in almost a decade, the PM stressed he will not be putting “any pressure whatsoever”. The Prime Minister said “a lot will depend on the detail” of the legislation.

“When I was chief prosecutor I was involved in drawing up guidelines, we had a massive consultation exercise and I saw first-hand the depth and the strength of the arguments on both sides,” Mr Starmer told reporters at Cop29 in Baku. “That is why this will be a free vote and it will be a free vote where every MP can decide for themselves what position they want to take on the Bill.

“I will not be putting pressure on any MP to vote one way or the other. I personally will study the details of the Bill which has now been published today because safeguards have always been extremely important to me and were an essential part of the guidelines that I drew up when I was chief prosecutor.” In 2015 Mr Starmer, a former DPP, voted to change the law and gave a passionate speech in the Commons about his experience in dealing with cases in the justice system.

What is the opposition to it?

Opposition campaigners have raised fears of coercion and a slippery slope to wider legislation taking in more people.

Right To Life UK branded the proposed legislation “a disaster in waiting”, and described the proposed measures as a “monumental change to our laws”. Campaign group Our Duty Of Care, representing doctors and nurses, has sent a letter to the Prime Minister arguing it is “impossible for any government to draft assisted suicide laws which include protection from coercion and future expansion”.

Critics also say the Bill is being “rushed with indecent haste”, but Ms Leadbeater said almost three weeks is “plenty of time to look at the Bill” before the vote and is normal within parliamentary timeframes. She added that the general conversation around assisted dying has been ongoing for years.