Assisted Dying Bill – Update

The Terminally Ill Adults (End of Life) Bill recently passed its third reading in the House of Commons, with a vote of 314 to 291 on 20 June 2025, marking a significant step as it is the first time such legislation has advanced this far in England and Wales.

The bill now moves to the House of Lords for further scrutiny and confirmation on whether or not the legislation is approved.

What are the key provisions of the bill?

The bill allows adults aged 18 or over, who are terminally ill with a prognosis of six months or less to live, and who have mental capacity to make the decision, to request medical assistance to end their own life. The individual must also be ordinarily resident in England or Wales for at least 12 months and registered with a GP.

A person will be deemed as terminally ill only if they have a progressive illness or disease that cannot be reversed by treatment and must reasonably be expected to die within six months. Disabilities and mental health conditions will not be considered as terminal illnesses.

In terms of the key stages involved for someone seeking assisted dying, this would entail the following:

• A preliminary discussion with a medical professional regarding their diagnosis and prognosis, available treatment and care.
• Should the person still wish to seek assisted dying after the above, then they will sign a first declaration confirming that they are eligible. This will be witnessed by two people, including a medical professional, who will then be reviewed by a different medical professional to ensure that the eligibility criteria are satisfied.
• Should the two medical professionals confirm eligibility, then an Assisted Dying Review Panel will review the case and confirm whether assisted dying is approved and, if so, will issue a certificate of eligibility.
• A “cooling off/reflection period” of 14 days will pass, allowing the person to consider whether they still wish to proceed.
• If the person still wishes to continue with assisted dying at this stage, then they may make a second declaration confirming the same to be witnessed by two people, including a medical professional.

Once the person seeking assisted dying has sought approval by following the above series of safeguarding checks, they would then self-administer prescribed life-ending medication.

What happens next?

The bill’s passage through the House of Commons reflects shifting attitudes towards assisted dying, indicating growing support for its introduction to the jurisdiction of England and Wales. The House of Lords will now consider the bill with the power to debate, delay, and amend the legislation if deemed necessary.

What are some key concerns in relation to the bill?

The bill remains highly divisive with strong opinions on both sides regarding the morality and potential risks of legalising assisted dying.

For instance, people have ethical concerns regarding the risk of coercion or duress of vulnerable individuals into seek assisted dying, the threat towards the sanctity of life principle, what happens to medical professionals who do not wish to take part in assisted dying, the slippery slope that eligibility may be expanded perhaps to account for mental health conditions or certain disabilities.

Practically speaking, there are also concerns regarding whether court delays will impact the turn around for assisted dying requests to be assessed and completed, the risk of reduced government spending on palliative care, and whether it will open the door to legal disputes surrounding coercion into assisted dying, a misdiagnosis of a medical professional or the approval or denial of an assisted dying request.

If the bill is passed, England and Wales will join a growing number of jurisdictions that allow assisted dying. It is evident that clear guidance and training for healthcare professionals will need to be implemented to avoid some of the risks mentioned above. It will be interesting to see the outcome of the deliberations of the House of Lords and how the bill will operate in practice once implemented.

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