Assisted Dying Bill [HL]

1 Assisted dying

(1)

Subject to the consent of the High Court (Family Division) pursuant to
subsection (2) , a person who is terminally ill may request and lawfully be
provided with assistance to end his or her own life.

(2)

Subsection (1) applies only if the High Court (Family Division), by order,
confirms that it is satisfied that the person—

(a)

has a voluntary, clear, settled and informed wish to end his or her
own life;

(b)

has made a declaration to that effect in accordance with section 3 ; and

(c)

on the day the declaration is made—

(i)

is aged 18 or over;

(ii)

has capacity to make the decision to end his or her own life;
and

(iii)

has been ordinarily resident in England and Wales for not less
than one year.

2 Terminal illness

(1)

For the purposes of this Act, a person is terminally ill if that person—

(a)

has been diagnosed by a registered medical practitioner as having an
inevitably progressive condition which cannot be reversed by treatment
(“a terminal illness”); and

(b)

as a consequence of that terminal illness, is reasonably expected to
die within six months.

(2)

Treatment which only relieves the symptoms of an inevitably progressive
condition temporarily is not to be regarded as treatment which can reverse
that condition.

3 Declaration

(1)

An application may be made to the High Court (Family Division) under
section 1 (2) only if—

(a)

the person has made and signed a declaration that he or she has a
voluntary, clear, settled and informed wish to end his or her life in
the form in the Schedule in the presence of a witness (who must not
be a relative or directly involved in the person’s care or treatment)
who signed the declaration in the person’s presence; and

(b)

that declaration has been countersigned in accordance with subsection
(3) by—

(i)

a suitably qualified registered medical practitioner from whom
the person has requested assistance to end their life (“the
attending doctor”); and

(ii)

another suitably qualified registered medical practitioner (“the
independent doctor”) who is not a relative, partner or colleague
in the same practice or clinical team, of the attending doctor;

neither of whom may also be the witness required under paragraph
(a) .

(2)

The attending doctor (but not the independent doctor) may, but need not be,
the registered medical practitioner who diagnosed that the person is terminally
ill or first informed the person of that diagnosis.

(3)

Before countersigning a person’s declaration, the attending doctor and the
independent doctor, having separately examined the person and the person’s
medical records and each acting independently of the other, must be satisfied
that the person—

(a)

is terminally ill;

(b)

has the capacity to make the decision to end their own life; and

(c)

has a clear and settled intention to end their own life which has been
reached voluntarily, on an informed basis and without coercion or
duress.

(4)

In deciding whether to countersign a declaration under subsection (3) , the
attending doctor and the independent doctor must be satisfied that the person
making it has been fully informed of the palliative, hospice and other care
which is available to that person.

(5)

If the attending doctor or independent doctor has doubt as to a person’s
capacity to make a decision under subsection (3) (b) or (c) , before deciding
whether to countersign a declaration made by that person the doctor must—

(a)

refer the person for assessment by an appropriate specialist; and

(b)

take account of any opinion provided by the appropriate specialist in
respect of that person.

(6)

A declaration under this section is valid and takes effect on such date as the
High Court (Family Division) may order.

(7)

A person who has made a declaration under this section may revoke it at
any time and revocation need not be in writing.

(8)

For the purpose of subsection (1) (b) (ii) , an attending or independent doctor
is suitably qualified if that doctor holds such qualification or has such
experience, including in respect of the diagnosis and management of terminal
illness, as the Secretary of State may specify in regulations (which may make
different provision for different purposes).

(9)

In this section , “appropriate specialist” means a registered practitioner (other
than the attending doctor or independent doctor) who is registered in the
specialty of psychiatry in the Special Register kept by the General Medical
Council.

4 Assistance in dying

(1)

The attending doctor of a person who has made a valid declaration may
prescribe medicines for that person to enable that person to end their own
life.

(2)

Any medicines prescribed under subsection (1) may only be delivered to the
person for whom they are prescribed—

(a)

by the attending doctor; or

(b)

by—

(i)

another registered medical practitioner; or

(ii)

a registered nurse;

who has been authorised to do so by the attending doctor;

(c)

after the assisting health professional has confirmed that the person
has not revoked and does not wish to revoke their declaration; and

(d)

after a period of not less than 14 days has elapsed since the day on
which the person’s declaration took effect.

(3)

If the attending doctor and the independent doctor agree that a person’s
death from terminal illness is reasonably expected to occur within one month
of the day on which a declaration takes effect, the period specified in
subsection (2) (d) is reduced to six days.

(4)

In respect of a medicine which has been prescribed for a person under
subsection (1) , an assisting health professional may—

(a)

prepare that medicine for self-administration by that person;

(b)

prepare a medical device which will enable that person to
self-administer the medicine; and

(c)

assist that person to ingest or otherwise self-administer the medicine;

but the decision to self-administer the medicine and the final act of doing so
must be taken by the person for whom the medicine has been prescribed.

(5)

Subsection (4) does not authorise an assisting health professional to administer
a medicine to another person with the intention of causing that person’s
death.

(6)

The assisting health professional must remain with the person until the person
has—

(a)

self-administered the medicine and died; or

(b)

decided not to self-administer the medicine;

and for the purpose of this subsection the assisting health professional is to
be regarded as remaining with the person if the assisting health professional
is in close proximity to, but not in the same room as, the person.

(7)

The Secretary of State may by regulations specify—

(a)

the medicines which may be prescribed under this section ;

(b)

the form and manner in which such prescriptions are to be issued;
and

(c)

the manner and conditions under which such medicines are to be
dispensed, stored, transported, used and destroyed.

(8)

Regulations under subsection (7) (c) must provide that an assisting health
professional—

(a)

must only deliver any medicines prescribed under this section to the
person for whom they have been prescribed immediately before their
intended use; and

(b)

in the event that the person decides not to self-administer the medicine,
must immediately remove it from that person and, as soon as
reasonably practicable, return it to the pharmacy from which it was
dispensed.

(9)

Regulations under subsection (7) may—

(a)

make different provision for different purposes; and

(b)

include consequential, incidental, supplementary or transitional
provisions.

(10)

In this section , “assisting health professional” means the attending doctor or
a person authorised by the attending doctor in accordance with subsection
(2) (b) .

5 Conscientious objection

A person is not under any duty (whether by contract or arising from any
statutory or other legal requirement) to participate in anything authorised by
this Act to which that person has a conscientious objection.

6 Criminal liability

(1)

A person who provides any assistance in accordance with this Act is not
guilty of an offence.

(2)

In the Suicide Act 1961, after section 2B (course of conduct), insert—

“2C Assisted dying

(1)

Sections 2, 2A and 2B do not apply to any person in respect of the
provision of assistance to another person in accordance with the
Assisted Dying Act 2021.”.

7 Inquests, death certification etc.

(1)

A person is not to be regarded as having died in circumstances to which
section 1(2)(a) or (b) of the Coroners and Justice Act 2009 (duty to investigate
certain deaths) applies only because the person died as a consequence of the
provision of assistance in accordance with this Act.

(2)

In the Births and Deaths Registration Act 1953, after section 39A (regulations
made by the Minister: further provisions), insert—

“39B Regulations: assisted dying

(1)

The Secretary of State may make regulations—

(a)

providing for any provision of this Act relating to the
registration of deaths to apply in respect of deaths which arise
from the provision of assistance in accordance with the Assisted
Dying Act 2021 with such modifications as may be prescribed
in respect of—

(i)

the information which is to be provided concerning
such deaths;

(ii)

the form and manner in which the cause of such deaths
is to be certified; and

(iii)

the form and manner in which such deaths are to be
registered;

(b)

requiring the Registrar General to prepare at least once each
year a report providing a statistical analysis of deaths which
have arisen from the provision of assistance in accordance with
the Assisted Dying Act 2021;

(c)

containing such incidental, supplemental and transitional
provisions as the Secretary of State considers appropriate.

(2)

Any regulations made under subsection (1)(a)(ii) must provide for the
cause of death to be recorded as “assisted death”.

(3)

Any report prepared by the Registrar General in accordance with
regulations made under subsection (1)(b) must be laid before both
Houses of Parliament by the Secretary of State.”

8 Codes of practice

(1)

The Secretary of State may issue one or more codes of practice in connection
with—

(a)

the assessment of whether a person has a clear and settled intention
to end their own life, including—

(i)

assessing whether the person has capacity to make such a
decision;

(ii)

recognising and taking account of the effects of depression or
other psychological disorders that may impair a person’s
decision-making;

(iii)

the information which is made available on treatment and end
of life care options available to them and on the consequences
of deciding to end their own life;

(b)

the counselling and guidance which should be made available to a
person who wishes to end his or her own life;

(c)

the arrangements for delivering medicines to the person for whom
they have been prescribed under section 4 , and the assistance which
such a person may be given to ingest or self-administer them; and

(d)

such other matters relating to the operation of this Act as the Secretary
of State thinks fit.

(2)

Before issuing a code under this section the Secretary of State must consult
such persons as the Secretary of State thinks appropriate.

(3)

A code does not come into operation until the Secretary of State by order so
provides.

(4)

The power conferred by subsection (3) is exercisable by statutory instrument.

(5)

An order bringing a code into operation may not be made unless a draft of
the order has been laid before, and approved by a resolution of, both Houses
of Parliament.

(6)

When a draft order is laid, the code to which it relates must also be laid.

(7)

A person performing any function under this Act must have regard to any
relevant provision of a code and failure to do so does not of itself render a
person liable to any criminal or civil proceedings but may be taken into
account in any proceedings.

9 Monitoring

(1)

The relevant Chief Medical Officer must—

(a)

monitor the operation of the Act, including compliance with its
provisions and any regulations or code of practice made under it;

(b)

inspect and report to the relevant national authority on any matter
connected with the operation of the Act which the relevant national
authority refers to the relevant Chief Medical Officer; and

(c)

submit an annual report to the relevant national authority on the
operation of the Act.

(2)

The Chief Medical Officers may combine their annual reports for the same
year in a single document (“a combined report”) in such manner as they
consider appropriate.

(3)

The relevant national authority must publish each annual report or combined
report it receives under this section and—

(a)

the Secretary of State must lay a copy of each report before both
Houses of Parliament; and

(b)

the Welsh Ministers must lay a copy of each report before Senedd
Cymru.

(4)

In this section —

“
relevant Chief Medical Officer” means—

(a)

in England, the Chief Medical Officer to the Department of
Health; and

(b)

in Wales, the Chief Medical Officer to the Welsh Government;

“
relevant national authority” means—

(a)

in England, the Secretary of State; and

(b)

in Wales, the Welsh Ministers.

10 Offences

(1)

A person commits an offence if the person—

(a)

makes or knowingly uses a false instrument which purports to be a
declaration made under section 3 by another person; or

(b)

wilfully conceals or destroys a declaration made under section 3 by
another person.

(2)

A person (A) commits an offence if, in relation to another person (B) who is
seeking to make or has made a declaration under section 3 , A knowingly or
recklessly provides a medical or other professional opinion in respect of B
which is false or misleading in a material particular.

(3)

A person guilty of an offence under subsection (1) (a) which was committed
with the intention of causing the death of another person is liable, on
conviction on indictment, to imprisonment for life or a fine or both.

(4)

Unless subsection (3) applies, a person convicted of an offence under this
section is liable—

(a)

on summary conviction, to imprisonment for a term not exceeding 6
months or a fine not exceeding the statutory maximum or both;

(b)

on conviction on indictment, to imprisonment for a period not
exceeding five years or a fine or both.

11 Regulations

(1)

Any power of the Secretary of State under this Act to make regulations is
exercisable by statutory instrument.

(2)

A statutory instrument containing regulations under this Act is subject to
annulment in pursuance of a resolution of either House of Parliament.

12 Interpretation

In this Act—

“
attending doctor” has the meaning given in section 3 ;

“
capacity” shall be construed in accordance with the Mental Capacity Act 2005;

“
independent doctor” has the meaning given in section 3 ;

“
relative”, in relation to any person, means—

(a)

the spouse or civil partner of that person;

(b)

any lineal ancestor, lineal descendant, sibling, aunt, uncle or
cousin of that person or the person’s spouse or civil partner;
or

(c)

the spouse or civil partner of any relative mentioned in
paragraph (b) ,

and for the purposes of deducing any such relationship a spouse or civil
partner includes a former spouse or civil partner, a partner to whom
the person is not married, and a partner of the same sex; and

“
terminal illness” has the meaning given in section 2 (1) (a) .

13 Extent, commencement, repeal and short title

(1)

This Act extends to England and Wales only.

(2)

The following come into force on the day on which this Act is passed—

(a)

sections 4 and 7 so far as they confer a power to make regulations;

(b)

section 8 so far as it confers a power to issue codes of practice or
orders;

(c)

sections 11 and 12 ; and

(d)

this section .

(3)

Subject to subsection (2) , the provisions of this Act come into force at the end
of the period of two years beginning with the day on which it is passed.

(4)

At any time during the period of 12 months beginning on the day 10 years
after the provisions in subsection (3) come into force, this Act may be repealed
by a resolution of each House of Parliament.

(5)

This Act may be cited as the Assisted Dying Act 2021.

Schedule

Section 3

Form of declaration

Declaration: Assisted Dying Act 2021

Name of declarant:	Date of Birth:
Address:

I have [condition], a terminal condition from which I am expected to die within six months of the date of this declaration.

The Attending Doctor and Independent Doctor identified below have each fully informed me about that diagnosis and prognosis and the treatments available to me, including pain control and palliative care.

Having considered all this information, I have a clear and settled intention to end my own life and, in order to assist me to do so, I have asked my attending doctor to prescribe medicines for me for that purpose.

I make this declaration voluntarily and in the full knowledge of its significance.

I understand that I may revoke this declaration at any time.


Signature:	Date:

Witness

Name of witness:

Address:

This declaration was signed by [name of declarant] in my presence and signed by me in [his/her] presence.


Signature:	Date:

Countersignature: Attending Doctor

I confirm that [name], who at the date of this declaration is [age] years of age and has been ordinarily resident in England and Wales for [time]:

(1) is terminally ill and that the diagnosis and prognosis set out above is correct;

(2) has the capacity to make the decision to end their own life; and

(3) has a clear and settled intention to do so, which has been reached on an informed basis, without coercion or duress, and having been informed of the palliative, hospice and other care which is available to [him/her].


Signature:	Date:

Name and Address of Attending Doctor:

Countersignature: Independent Doctor

I confirm that [name], who at the date of this declaration is [age] years of age and has been ordinarily resident in England and Wales for [time]:

(1) is terminally ill and that the diagnosis and prognosis set out above is correct;

(2) has the capacity to make the decision to end their own life; and


Signature:	Date:

Name and Address of Independent Doctor: