On 29 November 2024, the House of Commons voted by a majority of 330 to 275 in favour of legalised assisted dying in England and Wales. The historic vote followed the second reading of the Terminally Ill Adults (End of Life) Bill, a private member's bill introduced by Labour MP Kim Leadbeater that proposes to legalise assisted suicide for terminally ill adults in England and Wales.
Under the current law, it remains illegal in the UK to encourage or assist someone else to commit suicide or to 'intentionally help another person to end their own life'. Euthanasia, which is the act of deliberately ending someone's life to relieve suffering, is also unlawful, although here there are various well-established exceptions.
There have been previous unsuccessful attempts to legalise assisted dying. Recently, there has been a steady increase in public support for a re-evaluation of assisted dying laws. High-profile cases intensified public and legal scrutiny. Most recently, the case for legalisation has been championed by campaigning journalist Dame Esther Rantzen.
The key elements of the Bill are as follows:
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Eligibility
- The individual must be a resident of England or Wales and have been registered with a GP for at least a year.
- They must possess the mental capacity to make an informed decision without coercion.
- They must have been diagnosed with a terminal illness with a prognosis indicating a life expectancy of six months or less.
- They must make two independent declarations of their wish to die, both of which must be witnessed and signed.
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Medical Oversight
- There must be approval from two independent doctors to confirm the patient's eligibility.
- Additional specialist consultation is mandated if there are doubts about mental capacity or diagnosis.
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Judicial Oversight
- It appears likely that the final version of the bill will replace the proposed High Court judge with an expert panel comprising a legal chair, a psychiatrist and a social worker.
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Safeguards
- The Bill creates new offences to protect against coercion and abuses of the system.
- All stages of the process are to be regulated and documented.
The introduction of assisted dying legislation presents a range of medico-legal risks particularly regarding informed consent. Concerns persist that vulnerable individuals may feel subtle pressure to pursue assisted dying to avoid being perceived as a burden. The inherent uncertainties of medical prognoses further complicate this issue. Assessing a patient's psychological state adds another layer of complexity.
Critics also warn of a 'slippery slope,' suggesting that what begins as a provision for terminally ill patients could expand to include non-terminal conditions or psychological suffering. Legal and ethical accountability is likely to remain a pressing concern, necessitating an overhaul of the current regulatory approach for professionals operating in this field.
If enacted, the Assisted Dying Bill could have far-reaching implications for indemnity insurance policy wordings. Insurers will need to reassess their policy terms to ensure clarity and compliance with the new legal framework.
For healthcare professionals, indemnity insurance policies will need to explicitly define coverage for assisted dying procedures with particular attention to the policy treatment of deliberate unlawful acts. Life and health insurance policies will also require careful revision, particularly regarding the distinction between suicide and assisted dying. Employer and public liability insurance will face similar challenges.
As the Assisted Dying Bill progresses through Parliament, it continues to raise profound legal, ethical, and regulatory questions. While the bill reflects a significant shift in public opinion, its implementation will require robust safeguards to protect vulnerable individuals and maintain public trust in the medical profession.
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"The information contained in this article does not represent a complete analysis of the topics presented and is provided for information purposes only. It is not intended as legal advice and no responsibility can be accepted by Altea for any reliance placed upon it. Legal advice should always be obtained before applying any information to particular circumstances."
