UK Commons Passes Assisted Dying Bill, Marking Major Step Towards Legalisation

The UK House of Commons voted 314 to 291 on 20 June to pass the third reading of the Terminally Ill Adults (End of Life) Bill, a private member’s bill introduced by Labour MP Kim Leadbeater. The legislation aims to allow terminally ill adults in England and Wales with less than six months to live to legally request assisted dying under strict conditions. The bill now moves to the House of Lords for further scrutiny, with implementation potentially beginning as early as 2029 if approved.

Bill Details and Safeguards

The bill stipulates that only adults aged 18 or over, with full mental capacity and a clear, voluntary request, may apply for assisted dying. Applicants must be permanent residents of England or Wales and registered with a local GP for at least 12 months. The application process requires:

• Two independent declarations of intent, signed by witnesses.
• Assessment by two independent doctors, with at least a seven-day interval between evaluations.
• Final approval by a panel comprising a senior legal professional, a psychiatrist, and a social worker, replacing an earlier requirement for High Court judge approval.

The bill explicitly prohibits coercion or pressure to influence a person’s decision, with offenders facing up to 14 years in prison. Healthcare professionals may opt out of participating, and applicants can withdraw their request at any time. The legislation focuses on “assisted dying” via self-administered medication, distinct from “euthanasia” involving direct administration by a doctor.

Kim Leadbeater stated: “This bill offers choice and dignity to terminally ill patients, allowing them to decide their final moments.” She highlighted that the safeguards, modelled on Oregon’s system in the US, are among the world’s strictest, noting Oregon’s 1997 law has not led to scope creep.

Controversy and Opposition

The bill sparked heated debate in the Commons. Opponents, including the “Not Dead Yet UK” campaign, argue it lacks sufficient protections for vulnerable groups, fearing patients might feel pressured to choose death amid strained NHS resources. Former Prime Minister Gordon Brown warned the bill could shift societal attitudes towards the elderly, gravely ill, or disabled, risking harm to vulnerable communities.

The Royal College of Psychiatrists opposed the bill, citing concerns that patients with treatable mental health conditions might be wrongly approved for assisted dying and noting terminal illness as a suicide risk factor. Some MPs criticised the rushed 18-day review period before the second reading, compared to seven weeks for a similar 2015 bill.

Supporters counter that the bill’s narrow scope—limited to terminally ill adults with six months or less to live, excluding disabled or mentally ill individuals—ensures robust protections. Public opinion polls show approximately 73% of Britons back the bill, reflecting widespread support for legalising assisted dying.

Global Assisted Dying Laws

The UK’s bill aligns with assisted dying or euthanasia laws in other countries but differs in key aspects. Below is an overview of select nations’ legislation:

• Oregon, USA: Since 1997, the Death with Dignity Act has allowed terminally ill patients with six months or less to live to request assisted dying, subject to two doctors’ approval. Cited as a model for the UK bill, Oregon’s law remains narrowly focused, with about 0.4% of deaths annually involving assisted dying as of 2023.
• Netherlands: Legalised euthanasia and assisted dying in 2002 for patients with “unbearable suffering” and no prospect of improvement, including non-terminal and mental health conditions. In 2023, the Netherlands extended euthanasia to terminally ill children aged 1–12 under strict conditions. The UK bill is far narrower, restricted to terminally ill adults.
• Canada: The 2016 Medical Assistance in Dying (MAID) law initially applied to those with a “reasonably foreseeable” death, expanding in 2021 to include non-terminal patients with serious illnesses or disabilities. Canada’s broader scope has sparked ethical debates, contrasting with the UK’s restrictive approach.
• Switzerland: Assisted suicide has been legal since 1942, available to citizens and foreigners at clinics like Dignitas, with no terminal illness requirement. The UK bill excludes non-residents and limits eligibility to terminally ill patients.
• Isle of Man: In March 2025, the Isle of Man became the first British Isle to approve assisted dying for terminally ill residents with 12 months or less to live, with implementation expected by 2027. Proposed by local doctor and MHK Alex Allinson, it is broader than the UK bill but similarly restrictive.

Next Steps and Outlook

The bill now faces rigorous scrutiny in the House of Lords, where opponents hold significant influence and may propose amendments or delay progress due to limited parliamentary time. If passed, the bill requires agreement between both Houses and Royal Assent to become law. Implementation, including drug protocols and staff training, is expected to take several years.

The UK’s legislative progress marks a significant shift in societal values, echoing developments in Switzerland, the Netherlands, and Canada. However, opponents stress that NHS underfunding and legalised assisted dying could exacerbate pressures on vulnerable groups, urging investment in palliative care as an alternative.

With over 300 million people globally living in jurisdictions permitting assisted dying, the UK’s decision could further fuel international debates. While countries like Japan have yet to legalise, recent discussions on platforms like X suggest growing public interest in addressing ageing populations and medical challenges through such reforms.