UK
Assisted dying bill enters parliament – how likely is it to become law?
Daniel Gover, Senior Lecturer in British Politics, Queen Mary University of London
Wed 16 October 2024
Labour backbench MP Kim Leadbeater has introduced a bill in the House of Commons that aims to legalise assisted dying in England and Wales.
Leadbeater is not a member of the government, but has been able to introduce the terminally ill adults (end of life) bill after topping this session’s private members’ bill ballot in September.
It’s almost a decade since MPs last voted on assisted dying. Back then, the Conservatives had a majority. Now, the tables have turned and Labour has a large majority. However, it’s not yet clear whether the current cohort of MPs would back this momentous change.
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Leadbeater’s bill faces additional procedural challenges. Private members’ bills – legislation sponsored by individual MPs rather than the government – face a precarious route onto the statute book. They are highly vulnerable to objections, even if only from a small number of MPs.
While private members’ bills go through the same basic process to become law as government-sponsored legislation, they are awarded only limited parliamentary time. There are only 13 Fridays per session (typically a year) when these bills are discussed in the House of Commons.
A House of Commons staffer draws lots in the private members’ bill ballot in September. UK Parliament/Flickr, CC BY-NC-ND
Challenge 1: second reading
The first major test for this bill will be its second reading stage, due on November 29. For backbench bills, and especially those that are contentious, this stage can be tricky.
Private members’ bills aren’t “programmed” like government bills, which means there is no mechanism for allocating more time to their discussion if needed. So, it only takes a small numbers of MPs to frustrate a bill’s progress by talking at length to run down the clock.
To prevent this, supporters can attempt to move the “closure” – a motion to end the debate and make a decision. This, however, requires at least 100 MPs to vote in support – a difficult feat on Fridays, when most MPs are in their constituencies. This problem was illustrated earlier this year on a bill to outlaw conversion therapy. However, on a bill of this profile, there is a good chance of passing the closure.
For Leadbeater’s bill, simply getting a vote at this stage would be an important accomplishment. It would mean that for the first time since 2015 – also on a backbench bill – the opinion of the Commons could be tested on assisted dying.
Challenge 2: public evidence?
Assuming the assisted dying bill passes the second reading stage, it would then be sent to a public bill committee for detailed consideration.
Some major social changes have come about over the years because of backbench bills. Flickr/UK Parliament, CC BY-NC-ND
Unlike for government bills, this committee cannot, by default, hold public evidence sessions on backbench bills. For a reform of this significance, though, we should expect pressure from some MPs for an exception to be made to allow outside bodies – such as campaign groups, religious organisations and medical professionals – to submit evidence. This would delay the bill’s passage a little, though this need not be lengthy.
Challenge 3: report stage
The bill’s biggest test is likely to be at report stage – most likely on April 25 next year. This is when the bill returns to the House of Commons chamber.
Conventional wisdom is that this stage is often fatal for contentious backbench bills, since opponents can propose large numbers of amendments to the legislation, requiring many separate decisions to be made and time to be drained. Even if supporters attempt to move the closure, with enough amendments they may still run out of time. Something like this nearly happened on an EU referendum bill in 2013.
Yet, this conventional wisdom may be outdated. The speaker of the house routinely groups report-stage amendments together, reducing the number of separate decisions – and in recent years the norm has been a single group. Since 2019, there has never been more than one group of amendments up for consideration on any private member’s bill. If the speaker follows this recent practice, it may be easier to get the bill through report stage.
Challenge 4: out of time?
It is quite possible the assisted dying bill could overcome all these procedural hurdles. But if not, ministers may need to step in to set aside some of the government’s own parliamentary time to discuss the bill further.
Government time for backbench bills has been rare in recent years, although it did occur in 2019 during the passage of a bill to strengthen the laws around female genital mutilation. But there are some striking historical precedents.
In the 1960s, private members’ bills were used to pass major social reforms on the laws around homosexuality and abortion, and to abolish the death penalty. In all three cases, the government stepped in to dedicate extra time in the face of attempts to slow these bills’ progress.
Challenge 5: up to the Lords
If the bill makes it past these stages, then it also has a good chance of completing its final House of Commons (third reading) stage. But it would then need to complete a similar process in the House of Lords. While there are not quite the same time pressures in this chamber – notably, it does not have the same system of 13 Fridays – there is also no programming for any bills.
It is hard to predict exactly how the Lords would respond to an assisted dying bill. There have been multiple previous attempts to legislate on this matter over the years. The last time one reached committee stage, in 2015, it got bogged down with amendments and made it no further.
Leadbeater’s bill will be helped by another bill on assisted dying, started in the House of Lords by Labour peer Charlie Falconer. This is scheduled for debate in the coming months and may help identify and resolve some of the detailed points of contention – though this is not guaranteed.
It would be unusual, though not impossible, for the Lords to fail to pass a private member’s bill agreed by the House of Commons. Since 2010, there appear to have been only two that were actively held up in the Lords – as opposed to just running out of time. Even so, a small number of determined opponents to assisted dying could make life difficult.
Were this to happen – at this point an extreme hypothetical – one option available to MPs would be to re-introduce the bill in the subsequent session, perhaps from the new crop of ballot bills. Under the provisions of the Parliament Act(s), this bill might then be eligible to become law without the assent of the Lords. Such a situation very nearly occurred this year on another backbench bill, on hunting trophies, though the timing of the general election intervened.
Despite these procedural hurdles, the assisted dying bill has a reasonably good chance of passing into law. In the end, much will depend on whether MPs are willing to back this change, and how determined they are to do so.
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Vulnerable people not at risk from proposed assisted dying law, says MP
Robert Booth Social affairs correspondent
Wed 16 October 2024
Kim Leadbeater said the law would only apply to ‘people who are already dying’.
Photograph: Parliament TV
The lives of disabled and vulnerable people will not be at risk from a proposed assisted dying law because it will only apply to terminally ill adults, and each case is likely to be ruled on by two doctors and a judge, the MP sponsoring it has said.
Kim Leadbeater said her historic “choice at the end of life” bill will include “stringent” criteria and a cooling-off period in what is likely to be one of the most controversial pieces of legislation to go before parliament in years.
But people who are facing intolerable suffering but are not dying will still be denied medical assistance to end their lives, under the likely terms of the bill to be introduced on Wednesday.
That decision will prompt debate over whether the threshold for medical assistance to die should relate to suffering rather than time left to live.
Some campaigners argue people whose conditions mean they can be trapped and suffering in their bodies long before they meet a narrow definition of terminal illness will be left out.
A major poll has suggested most of the public support an assisted dying law in every constituency of Great Britain apart from Bradford West.
It found 74% agreed that adults “who are intolerably suffering from an incurable condition and who wish to end their lives” should be allowed medical help to do so. More than 7,000 adults were canvassed this month in an MRP poll by Electoral Calculus for Humanists UK, a campaign group that supports assisted dying.
A separate poll for King’s College London last week found 66% support for a bill becoming law restricted to people with six months or less to live, but about half of respondents said they would probably change their mind if it turned out someone had been put under pressure (55%) or ended their life because they were denied the care they needed (48%).
Opponents of the bill, which would become law in England and Wales only, are planning to protest outside parliament on Wednesday, where supporters will also rally. Gordon MacDonald, the chief executive of Care Not Killing, claimed the bill amounted to “state-sanctioned killing”.
“This bill sends a dog-whistle message to the terminally ill, vulnerable, elderly and disabled people, especially those on low or fixed incomes, that their lives are worth less than others,” he said on Tuesday.
But campaigners in favour of an assisted dying law welcomed the first reading of the bill as a “historic day”.
“This bill gives dying people hope that they will live the rest of their lives with the comfort of knowing they will have a say in how they die,” said Sarah Wootton, chief executive of Dignity in Dying.
The broadcaster Jonathan Dimbleby, who alongside Esther Rantzen is one of several high-profile backers of a law change, said: “My brother Nicholas was required to die from motor neurone disease and he wanted that right [to choose assisted dying] … he fervently wanted the choice … he would have welcomed the fact that this bill is going before the Commons.”
Dimbleby also accused “the leadership of some parts of the church” of “scaremongering” by warning of a “slippery slope” towards assisted dying for people who are not terminally ill. He called for the debate to be “measured and balanced and not overwhelmed by emotive assertions”.
Speaking to the Guardian, Leadbeater confirmed the bill will require adults to have a prognosis of being no more than a fixed number of months from death, with options including six, nine and 12 months all still under consideration.
“My concern about the conversation around people with disabilities is that issue … has been conflated with this piece of legislation, which is actually about people who are already dying – shortening their deaths because of terminal illness,” she said. “So I will be the loudest voice in the room shouting for the rights of people with disabilities.”
Concerns were expressed to a recent parliamentary inquiry into assisted dying that people living with a disability, and elderly people, may worry about being a burden on their family and may pursue assisted dying for that reason.
“I get a bit worried there’s a panic and potentially some scaremongering about people having to do this,” Leadbeater said.
“No one has to do anything. This is about finding a choice for people. The two other really important words that will be on the face of the bill tomorrow are ‘safeguards’ and ‘protections’.”
She insisted there would be “no slippery” slope towards wider interpretation of the bill. The Catholic church this week launched a letter-writing campaign targeting MPs and encouraging the faithful to oppose the bill, warning “a right to die can become a duty to die”.
Leadbeater added: “[The bill] will send a very clear message to people that this is not about disabled people. It’s not about people with mental health conditions. It is about terminally ill adults.”
The proposed law will be closer to those already in use in Oregon in the US, Australia and New Zealand than more widely drawn laws in Canada and the Netherlands where illness need not be terminal. In the Netherlands some children are included in a law that allows assisted dying where a doctor agrees suffering is “lasting and unbearable”.
Leadbeater will publish the detail of the bill in the coming weeks before a first Commons debate in late November.
“We need law that is robust and clear and by having really strict, stringent criteria, [we] will create a much better situation than we have currently got,” she said.
However, Dr Graham Winyard, a former medical director of NHS England, warned that the proposal would not end “death tourism” to Switzerland.
About 40 people travelled from the UK to Dignitas last year to end their lives and Winyard’s research found that less than half of UK residents who have obtained an assisted death in Switzerland in recent years would have been spared the journey by a law limited to terminal illness with a six-month prognosis.
Writing to the Guardian, he urged Leadbeater to “ensure that those who are incurably suffering – as well as the terminally ill – are provided with the comfort of choice. It is our strong belief that a bill which encompasses both the terminally ill and the incurably suffering would best reflect the values of compassion and dignity that we all strive for in end-of-life care.”
The lives of disabled and vulnerable people will not be at risk from a proposed assisted dying law because it will only apply to terminally ill adults, and each case is likely to be ruled on by two doctors and a judge, the MP sponsoring it has said.
Kim Leadbeater said her historic “choice at the end of life” bill will include “stringent” criteria and a cooling-off period in what is likely to be one of the most controversial pieces of legislation to go before parliament in years.
But people who are facing intolerable suffering but are not dying will still be denied medical assistance to end their lives, under the likely terms of the bill to be introduced on Wednesday.
That decision will prompt debate over whether the threshold for medical assistance to die should relate to suffering rather than time left to live.
Some campaigners argue people whose conditions mean they can be trapped and suffering in their bodies long before they meet a narrow definition of terminal illness will be left out.
A major poll has suggested most of the public support an assisted dying law in every constituency of Great Britain apart from Bradford West.
It found 74% agreed that adults “who are intolerably suffering from an incurable condition and who wish to end their lives” should be allowed medical help to do so. More than 7,000 adults were canvassed this month in an MRP poll by Electoral Calculus for Humanists UK, a campaign group that supports assisted dying.
A separate poll for King’s College London last week found 66% support for a bill becoming law restricted to people with six months or less to live, but about half of respondents said they would probably change their mind if it turned out someone had been put under pressure (55%) or ended their life because they were denied the care they needed (48%).
Opponents of the bill, which would become law in England and Wales only, are planning to protest outside parliament on Wednesday, where supporters will also rally. Gordon MacDonald, the chief executive of Care Not Killing, claimed the bill amounted to “state-sanctioned killing”.
“This bill sends a dog-whistle message to the terminally ill, vulnerable, elderly and disabled people, especially those on low or fixed incomes, that their lives are worth less than others,” he said on Tuesday.
But campaigners in favour of an assisted dying law welcomed the first reading of the bill as a “historic day”.
“This bill gives dying people hope that they will live the rest of their lives with the comfort of knowing they will have a say in how they die,” said Sarah Wootton, chief executive of Dignity in Dying.
The broadcaster Jonathan Dimbleby, who alongside Esther Rantzen is one of several high-profile backers of a law change, said: “My brother Nicholas was required to die from motor neurone disease and he wanted that right [to choose assisted dying] … he fervently wanted the choice … he would have welcomed the fact that this bill is going before the Commons.”
Dimbleby also accused “the leadership of some parts of the church” of “scaremongering” by warning of a “slippery slope” towards assisted dying for people who are not terminally ill. He called for the debate to be “measured and balanced and not overwhelmed by emotive assertions”.
Speaking to the Guardian, Leadbeater confirmed the bill will require adults to have a prognosis of being no more than a fixed number of months from death, with options including six, nine and 12 months all still under consideration.
“My concern about the conversation around people with disabilities is that issue … has been conflated with this piece of legislation, which is actually about people who are already dying – shortening their deaths because of terminal illness,” she said. “So I will be the loudest voice in the room shouting for the rights of people with disabilities.”
Concerns were expressed to a recent parliamentary inquiry into assisted dying that people living with a disability, and elderly people, may worry about being a burden on their family and may pursue assisted dying for that reason.
“I get a bit worried there’s a panic and potentially some scaremongering about people having to do this,” Leadbeater said.
“No one has to do anything. This is about finding a choice for people. The two other really important words that will be on the face of the bill tomorrow are ‘safeguards’ and ‘protections’.”
She insisted there would be “no slippery” slope towards wider interpretation of the bill. The Catholic church this week launched a letter-writing campaign targeting MPs and encouraging the faithful to oppose the bill, warning “a right to die can become a duty to die”.
Leadbeater added: “[The bill] will send a very clear message to people that this is not about disabled people. It’s not about people with mental health conditions. It is about terminally ill adults.”
The proposed law will be closer to those already in use in Oregon in the US, Australia and New Zealand than more widely drawn laws in Canada and the Netherlands where illness need not be terminal. In the Netherlands some children are included in a law that allows assisted dying where a doctor agrees suffering is “lasting and unbearable”.
Leadbeater will publish the detail of the bill in the coming weeks before a first Commons debate in late November.
“We need law that is robust and clear and by having really strict, stringent criteria, [we] will create a much better situation than we have currently got,” she said.
However, Dr Graham Winyard, a former medical director of NHS England, warned that the proposal would not end “death tourism” to Switzerland.
About 40 people travelled from the UK to Dignitas last year to end their lives and Winyard’s research found that less than half of UK residents who have obtained an assisted death in Switzerland in recent years would have been spared the journey by a law limited to terminal illness with a six-month prognosis.
Writing to the Guardian, he urged Leadbeater to “ensure that those who are incurably suffering – as well as the terminally ill – are provided with the comfort of choice. It is our strong belief that a bill which encompasses both the terminally ill and the incurably suffering would best reflect the values of compassion and dignity that we all strive for in end-of-life care.”
Aine Fox and Caitlin Doherty, PA
Wed 16 October 2024
Wed 16 October 2024
A potential assisted dying law for England and Wales would have “clear criteria, safeguards and protections”, the MP behind a new Bill has insisted in the face of concerns about a so-called “slippery slope” to take in people who are at risk of feeling pressured to end their lives.
Only those who are terminally ill would be eligible under the Bill, it has been confirmed, amid calls from some campaigners for those enduring unbearable suffering to come within the scope of a new law.
The formal short title of Labour MP Kim Leadbeater’s legislation for choice at the end of life is the Terminally Ill Adults (End of Life) Bill.
Only those who are terminally ill would be eligible under the Bill, it has been confirmed, amid calls from some campaigners for those enduring unbearable suffering to come within the scope of a new law.
The formal short title of Labour MP Kim Leadbeater’s legislation for choice at the end of life is the Terminally Ill Adults (End of Life) Bill.
Dignity in Dying campaigners gathered in Parliament Square in support of the new Bill (Lucy North/PA)
She will formally introduce her Bill in the House of Commons on Wednesday, and it is expected to be debated and face a first vote on November 29.
The detail of the proposed legislation is unlikely to be set out until closer to that debate, with Ms Leadbeater saying she is speaking to doctors and lawyers as well as campaigners on all sides to “make sure we get this right”.
Archbishop of Canterbury Justin Welby has warned of his concerns around introducing any form of legislation for assisted dying.
He told the BBC: “I think this approach is both dangerous and sets us in a direction which is even more dangerous, and in every other place where it’s been done, has led to a slippery slope.”
The Archbishop of Canterbury Justin Welby has warned of his concerns around legislation for assisted dying (Doug Peters/PA)
But Ms Leadbeater has rejected this argument.
She told ITV’s Good Morning Britain she would not have such concerns so long as “we get this legislation right”, adding: “That’s why the next six weeks and the debates that will come in the following months are really important.
“We’ve got the benefit in this country of looking at what other countries have done. And I’m very clear, based on what I’ve seen so far and the research that I’ve done is, if we get this right from the start, which some places have done, places like Oregon and certain states in Australia, we have very strict criteria, then those jurisdictions do not broaden out the criteria.
“So we have to get it right from the start with very clear criteria, safeguards and protections.
“And I’m not looking at the model that is going on in Canada. I’m looking at those other jurisdictions where this is done well and in some cases it’s been done for a long time, very well, and the criteria have never been extended.”
The Canadian model is open to people experiencing intolerable suffering caused by their medical condition, whereas in Oregon it is limited to those who are terminally ill.
The long title of the proposed legislation, which would apply to England and Wales, is a “Bill to allow adults who are terminally ill, subject to safeguards and protections, to request and be provided with assistance to end their own life”.
If the Bill clears its first hurdle at the end of November, it will face line-by-line examination in committee and further Commons votes before being sent to the Lords where the process begins again, meaning any change in the law would not be agreed until next year at the earliest.
Thanks to @kimleadbeater for joining us outside Parliament this morning.
Today Westminster takes a historic first step towards a more compassionate law.#AssistedDying #YesToDignity pic.twitter.com/qLMBJySV0D
— Dignity in Dying (@dignityindying) October 16, 2024
It is possible that MPs could vote against it on November 29, as they did last time changes to the law were considered in 2015, preventing it going any further.
Ms Leadbeater has indicated she would like to see a “time frame” on the diagnosis of patients, and she told BBC’s Newsnight there must be both medical and judicial safeguarding when it was put to her that the Bill could require two medical professionals and a judge to agree.
High-profile supporters of legalising assisted dying include Dame Esther Rantzen who is terminally ill and has pleaded with the public to write to their MPs to ask for “the right to choose, not to shorten our lives, but to shorten our deaths”.
MPs will have a free vote in Parliament, deciding according to their conscience rather than along party lines.
Prime Minister Sir Keir Starmer has previously supported assisted dying and made a personal promise to Dame Esther to make time for a debate and vote on the issue.
Members of Distant Voices, Christian Concern, the Christian Medical Fellowship and SPUC gathered in Westminster to protest against the proposed legislation (Lucy North/PA)
Trevor Moore, chairman of campaign group My Death, My Decision, said he had hoped the new Bill would “represent the first step in a profound and compassionate shift in how we provide the dignity of choice for people who are intolerably suffering”.
Actor and disability campaigner Liz Carr, speaking before the Bill’s formal title was announced, said limiting the legislation to the terminally ill would not lessen her fears about its potential consequences for vulnerable people.
She told the PA news agency: “Neither (the Bill being limited to terminally ill or being wider) allay my fears, neither make me feel less worried.
“Because I know this is such a concerted campaign and such a push, and there are huge lobbyists nationally, internationally to change these laws that I just don’t feel reassured because they want what they want, and what they want is to legalise assisted suicide.”
Campaigners both for and against the proposed new law gathered outside Parliament on Wednesday.
Terminally ill people in England and Wales could soon have the right to choose to end their lives
The bill is being introduced by Labour MP Kim Ledbeater and she says there will be really strict limits on who would be eligible.
A judge and two doctors would have to agree that terminally ill patients can be helped to end their lives under a proposed new law that’s just been introduced in Parliament.
A separate bill is already under discussion in Scotland, and politicians in both Jersey and the Isle of Man have voted to approve plans that could allow assisted dying in future.
Jenny Carruthers was diagnosed with incurable breast cancer in 2020. She wants the right to die, and believes terminally ill people deserve a voice. Her partner died of liver cancer in 2013 and she saw firsthand what it’s like to die a painful death.
“Our law as it stands is unsafe; it doesn’t allow any choice.”
“The law as it stands means that either I’ve got to suffer that or I’ve got to break the law, wave goodbye to my children on the airport steps if I’ve got enough money to go to Switzerland… if they come with me they’d be open to prosecution.”
The bill is being introduced by Labour MP Kim Ledbeater and she says there will be really strict limits on who would be eligible.
She says only terminally ill people who have 6 to 12 months left to live, and are able to decide for themselves, will be eligible, which is similar to laws in 11 states of America.
This is different to assisted suicide which can involve people who are not terminally ill – assisted suicide is legal in Switzerland.
But there is fierce opposition to this bill from religious groups who believe in the sanctity of life, to disability campaigners who say it’s a slippery slope.
Miro Griffiths is an academic and disability rights activist who fears this bill will devalue lives like his.
“The communities that will be most affected by the bill are facing systemic injustices, they’re facing discrimination in terms of the places where they live, the resources and services they’re trying to access and the quality of life that they have currently. Those things will play into the choices people make about the value of their life.”
The law may start with assisted dying, they argue, but over time laws can change, and a few years from now this could evolve to assisted suicide.
The academic told Channel 4 News “there are many voices who want assisted dying who wouldn’t be eligible for the criteria that’s being proposed so what you’ll have is a continuation of campaigning and as we’ve seen in other countries the criteria then expands.”
The last time this came up in Parliament was in 2015, and MPs voted against, but the mood has moved on since then.
Opinion polls over recent years have regularly shown support in the UK for assisted dying, with as much as 60-75% in favour.
Crucially though the Prime Minister is making this a free vote so Labour MPs can vote with their conscience, not with their party.
For 6 weeks now MPs will fiercely debate this issue but it is one that all main parties are likely to be split on.
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