has the capacity to make a decision to end their own life (see
section
3
),
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; and for connected purposes.
B e it enacted by the King’s most Excellent Majesty, by and with the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority of the same, as follows:—
A terminally ill person in England or Wales who—
has the capacity to make a decision to end their own life (see
section
3
),
is aged 18 or over at the time the person makes a first declaration (see section 8 ),
is ordinarily resident in England and Wales and has been so resident
for at least 12 months ending with the date of the first declaration,
and
is registered as a patient with a general medical practice in England
or Wales,
has a clear, settled and informed wish to end their own life, and
has made the decision that they wish to end their own life voluntarily
and has not been coerced or pressured by any other person into
making it.
when the terminally ill person is in England or Wales, and
For the purposes of this Act, a person is terminally ill if—
the person has an inevitably progressive illness or disease which cannot
be reversed by treatment, and
the person’s death in consequence of that illness or disease can
reasonably be expected within six months.
A person who would not otherwise meet the requirements of subsection (1) shall not be considered to meet those requirements solely as a result of voluntarily stopping eating or drinking.
For the purposes of
subsection (1)
, treatment which only relieves the symptoms
of an inevitably progressive illness or disease temporarily is not to be regarded
as treatment which can reverse that illness or disease.
For the avoidance of doubt, a person is not to be considered to be terminally
ill only because they are a person with a disability or mental disorder (or
both).
Nothing in this subsection results in a person not being regarded as terminally ill for the purposes of this Act if (disregarding this subsection) the person meets the conditions in paragraphs (a) and (b) of subsection (1) .
In this Act, references to a person having capacity are to be read in accordance with the Mental Capacity Act 2005.
There is to be a Voluntary Assisted Dying Commissioner.
The Commissioner is to be appointed by the Prime Minister.
The person appointed must hold or have held office as a judge of—
the Supreme Court,
the Court of Appeal, or
the High Court.
The Commissioner’s principal functions are—
receiving documents made under this Act;
making appointments to a list of persons eligible to sit on Assisted
Dying Review Panels (see
Schedule 2
);
making arrangements in relation to such panels and referring cases
to them (see
section 16
);
determining applications for reconsideration of panel decisions under section 18 ;
monitoring the operation of this Act and reporting annually on it (see section 49 ).
In this Act “the Commissioner” means the Voluntary Assisted Dying
Commissioner.
Schedule 1 makes provision about the Commissioner.
No registered medical practitioner is under any duty to raise the subject of
the provision of assistance in accordance with this Act with a person.
But nothing in
subsection (1)
prevents a registered medical practitioner
exercising their professional judgement to decide if, and when, it is appropriate
to discuss the matter with a person.
Where a person in England or Wales indicates to a registered medical
practitioner their wish to seek assistance to end their own life in accordance
with this Act, the registered medical practitioner may (but is not required to)
conduct a preliminary discussion about the requirements that need to be met
for such assistance to be provided.
If a registered medical practitioner conducts such a preliminary discussion
with a person, the practitioner must first ensure the provision of adjustments
for language and literacy barriers, including the use of interpreters.
If a registered medical practitioner conducts such a preliminary discussion
with a person, the practitioner must explain to and discuss with that person—
the person’s diagnosis and prognosis;
any treatment available and the likely effect of it;
all appropriate palliative, hospice or other care, including symptom
management and psychological support, and offer to refer them to a
registered medical practitioner who specialises in such care for the
purpose of further discussion.
A registered medical practitioner who is unwilling or unable to conduct the
preliminary discussion mentioned under
subsection (3)
is not required to refer
the person to another medical practitioner but must ensure that the person
is directed to where they can obtain information and have the preliminary
discussion.
No registered medical practitioner or other health professional shall raise the subject of the provision of assistance in accordance with this Act with a person under the age of 18.
This section applies where a registered medical practitioner (“the practitioner”)
conducts a preliminary discussion with a person.
Where the practitioner is a practitioner with the person’s GP practice, they
must, as soon as practicable, record the preliminary discussion in the person’s
medical records.
In any other case—
the practitioner must, as soon as practicable, give a written record of
the preliminary discussion to a registered medical practitioner with
the person’s GP practice, and
that registered medical practitioner must, as soon as practicable, include
the record in the person’s medical records.
A person who wishes to be provided with assistance to end their own life in
accordance with this Act must make a declaration to that effect (a “first
declaration”).
A first declaration must be—
in the form set out in regulations made by the Secretary of State,
signed and dated by the person making the declaration, and
witnessed by—
the coordinating doctor in relation to that person, and
another person,
both of whom must see the declaration being signed.
The coordinating doctor must give a copy of the first declaration to the
Commissioner as soon as reasonably practicable after it has been made.
Regulations under
subsection (2)
(a)
must provide that the first declaration
contains—
the following information—
the person’s full name and address;
the person’s NHS number;
contact details for the person’s GP practice;
the following further declarations by the person—
a declaration that they meet the initial conditions for eligibility
(see
subsection (5)
);
a declaration that they are content to be assessed, for the
purposes of this Act, by medical practitioners;
a declaration that they are making the first declaration
voluntarily and have not been coerced or pressured by any
other person into making it;
a declaration that they understand that they may cancel the
first declaration at any time.
In
subsection (4)
(b)
(i)
“the initial conditions for eligibility” are that the person
making the declaration—
is aged 18 or over,
is ordinarily resident in England and Wales and has been so resident
for at least 12 months, and
is registered with a general medical practice in England or Wales.
In this Act, “the coordinating doctor" means a registered medical practitioner—
who meets the requirements specified in regulations under
subsection
(7)
,
who has indicated to the person making the declaration that they are
able and willing to carry out the functions under this Act of the
coordinating doctor in relation to the person,
who is not a relative of the person making the declaration, and
who does not know or believe that they—
are a beneficiary under a will of the person, or
may otherwise benefit financially or in any other material way
from the death of the person.
The Secretary of State must by regulations make provision about the training,
qualifications and experience that a registered medical practitioner must have
in order to act as the coordinating doctor.
The regulations must provide that the practitioner must have had training
about the following—
assessing capacity;
assessing whether a person has been coerced or pressured by any
other person;
reasonable adjustments and safeguards for autistic people and people
with a learning disability;
domestic abuse.
Subject to that, the regulations may in particular provide that the required
training, qualifications or experience is to be determined by a person specified
in the regulations.
Regulations under
subsection (7)
must specify that training in respect of
domestic abuse, including coercive control and financial abuse, is mandatory.
A person may not witness a first declaration under
subsection (2)
(c)
(ii)
if they
are disqualified under
section 52
from being a witness.
This section applies in relation to the making of a first declaration by a person.
The Secretary of State may, by regulations, make provision about the forms
of proof of identity that are acceptable for the purposes of
subsection (2)
.
The coordinating doctor may witness the first declaration only if satisfied
that the requirements of
subsection (2)
have been met.
The coordinating doctor may witness the first declaration only if—
the coordinating doctor has conducted a preliminary discussion with
the person or is satisfied that another registered medical practitioner
has conducted such a discussion, and
the coordinating doctor has made or seen a written record of the
preliminary discussion.
The coordinating doctor must, as soon as reasonably practicable after a first
declaration is made by a person, carry out the first assessment.
“The first assessment” is an assessment to ascertain whether, in the opinion
of the coordinating doctor, the person—
is terminally ill,
has capacity to make the decision to end their own life,
was aged 18 or over at the time the first declaration was made,
is in England and Wales,
is ordinarily resident in England and Wales and has been so resident
for at least 12 months ending with the date of the first declaration,
is registered as a patient with a general medical practice in England
or Wales,
has a clear, settled and informed wish to end their own life, and
made the first declaration voluntarily and has not been coerced or
pressured by any other person into making it.
After carrying out the first assessment, the coordinating doctor must—
make a report about the assessment (which must meet the requirements
of regulations under
subsection (4)
);
give a copy of the report to—
the person who was assessed (“the assessed person”),
if the coordinating doctor is not a practitioner with the person’s
GP practice, a registered medical practitioner with that practice,
and
any other person specified in regulations made by the Secretary
of State;
if satisfied as to all of the matters mentioned in subsection
(2)
(a)
to
(h)
, refer the assessed person to another registered medical practitioner
who meets the requirements of
section 11
(8)
and is able and willing
to carry out the second assessment (“the independent doctor”).
The Secretary of State must by regulations make provision about the content
and form of the report.
The regulations must provide that the report must—
contain an explanation of why the coordinating doctor is, or (as the
case may be) is not, so satisfied;
contain a statement indicating whether the coordinating doctor is
satisfied as to the following—
that a record of the preliminary discussion has been included
in the person’s medical records;
that the making of the first declaration has been recorded in
the person’s medical records;
that the first declaration has not been cancelled;
be signed and dated by the coordinating doctor.
Where—
a referral is made under subsection (3) (c) ,
the independent doctor dies or through illness is unable or unwilling
to act as the independent doctor, and
no report under section 11 has been made by virtue of the referral,
a further referral may be made under subsection (3) (c) .
Where a referral is made to a registered medical practitioner by virtue of
subsection (6)
, that practitioner becomes the independent doctor (replacing
the registered medical practitioner to whom a referral was originally made)
and sections
11
to
13
and
15
apply accordingly.
Where a referral is made under
section 10
(3)
(c)
, the independent doctor must
carry out the second assessment of the person as soon as reasonably practicable
after the first period for reflection has ended.
“The second assessment” is an assessment to ascertain whether, in the opinion
of the independent doctor, the person who made the first declaration—
is terminally ill,
has capacity to make the decision to end their own life,
was aged 18 years or over at the time the first declaration was made,
has a clear, settled and informed wish to end their own life, and
made the first declaration voluntarily and has not been coerced or
pressured by any other person into making it.
In
subsection (1)
“the first period for reflection” means the period of seven
days beginning with the day the coordinating doctor made the report under
section 10
(3)
.
The independent doctor must carry out the second assessment independently
of the coordinating doctor, subject to
section 12
(7)
(sharing of specialists’
opinions).
After carrying out the second assessment, the independent doctor must—
make a report about the assessment (which must meet the requirements
of regulations under
subsection (6)
), and
give a copy of the report to—
the person who was assessed,
the coordinating doctor,
if neither the independent doctor nor the coordinating doctor
is a practitioner with the person’s GP practice, a registered
medical practitioner with that practice, and
any other person specified in regulations made by the Secretary
of State.
The Secretary of State must by regulations make provision about the content
and form of the report.
The regulations must provide that the report must—
contain a statement indicating whether the independent doctor is
satisfied as to all of the matters mentioned in
subsection (2)
(a)
to
(e)
;
contain an explanation of why the independent doctor is, or (as the
case may be) is not, so satisfied;
contain a statement indicating whether the independent doctor is
satisfied as to the following—
that a record of the preliminary discussion has been included
in the person’s medical records;
that the person signed the first declaration;
that the making of the first declaration has been recorded in
the person’s medical records;
that the first declaration has not been cancelled;
be signed and dated by the independent doctor.
A registered medical practitioner may carry out the functions of the
independent doctor under this Act only if that practitioner—
meets the requirements specified in regulations under subsection (9) ,
has not provided treatment or care for the person being assessed in
relation to that person’s terminal illness,
is not a relative of the person being assessed,
is not a partner or colleague in the same practice or clinical team as
the coordinating doctor,
did not witness the first declaration made by the person being assessed,
and
does not know or believe that they—
are a beneficiary under a will of the person, or
may otherwise benefit financially or in any other material way
from the death of the person.
The Secretary of State must by regulations make provision about the training,
qualifications and experience that a registered medical practitioner must have
in order to carry out the functions of the independent doctor.
The regulations must provide that the practitioner must have had training
about the following—
assessing capacity;
assessing whether a person has been coerced or pressured by any
other person;
domestic abuse.
Subject to that, the regulations may in particular provide that the required
training, qualifications or experience is to be determined by a person specified
in the regulations.
In
subsection (8)
(b)
the reference to “terminal illness” means the illness or
disease mentioned in
section 2
(1)
(a)
.
Regulations under
subsection (9)
must specify that training in respect of
domestic abuse, including coercive control and financial abuse, is mandatory.
In this section “assessing doctor” means—
the coordinating doctor carrying out the first assessment;
the independent doctor carrying out the second assessment.
The assessing doctor must—
examine the person and examine such of their medical records as
appear to the assessing doctor to be relevant;
make such enquiries of professionals who are providing or have
recently provided health or social care to the person as the assessing
doctor considers appropriate, and such other enquiries as the assessing
doctor considers appropriate;
explain to and discuss with the person being assessed—
the person’s diagnosis and prognosis;
any treatment available and the likely effect of it;
any available palliative, hospice or other care, including
symptom management and psychological support;
the nature of the substance that is to be provided to assist the
person to end their own life (including how it will bring about
death and how it will be administered);
discuss with the person their wishes in the event of complications
arising in connection with the self-administration of an approved
substance under
section 25
;
inform the person—
of the further steps that must be taken before assistance can
be provided to the person to end their own life in accordance
with this Act;
that the person may decide at any time not to take any of those
steps (and of how to cancel the first declaration and any of
those further steps);
advise the person to inform a registered medical practitioner with the
person’s GP practice that the person is requesting assistance to end
their own life (unless the assessing doctor is themselves a practitioner
with that practice);
in so far as the assessing doctor considers it appropriate, advise the
person to consider discussing the request with their next of kin and
other persons they are close to.
To inform their assessment, the assessing doctor must—
consider whether they should consult a health professional or social
care professional with qualifications in, or experience of, a matter
relevant to the person being assessed;
consult such a professional if they consider that there is a need to do
so.
Where an assessing doctor consults a professional under subsection (3) (b) , the assessing doctor must give a written record of the consultation to the other assessing doctor.
When carrying out an assessment in accordance with
subsection (2)
, the
assessing doctor must first ensure the provision of adjustments for language
and literacy barriers, including the use of interpreters.
To inform their assessment, the assessing doctor—
must, if they have doubt as to whether the person being assessed is
terminally ill, refer the person for assessment by a registered medical
practitioner who holds qualifications in or has experience of the
diagnosis and management of the illness or disease in question;
must, if they have doubt as to the capacity of the person being
assessed, refer the person for assessment by a registered medical
practitioner who is a practising psychiatrist registered in one of the
psychiatry specialisms in the Specialist Register kept by the General
Medical Council or who otherwise holds qualifications in or has
experience of the assessment of capacity;
must, if they make a referral under
paragraph (a)
or
(b)
, take account
of any opinion provided by that other registered medical practitioner.
An opinion provided to one assessing doctor under subsection (6) (a) or (b) must be shared with the other assessing doctor.
Where the independent doctor is required to obtain an opinion under subsection (6) (a) —
that duty may be discharged by an opinion obtained under that
provision by the coordinating doctor, or
the independent doctor may make their own referral under that
provision.
This section applies where the independent doctor has—
carried out the second assessment, and
made a report stating that they are not satisfied as to all of the matters
mentioned in
section 11
(2)
(a)
to
(e)
.
The coordinating doctor may, if requested to do so by the person who made
the first declaration, refer that person to a different registered medical
practitioner who meets the requirements of
section 11
(8)
and is able and
willing to carry out a further assessment of the kind mentioned in
section
11
(2)
.
Where a referral is made to a registered medical practitioner under
subsection
(2)
—
the coordinating doctor must provide that new registered medical
practitioner with the report by the independent doctor setting out
their reasons for refusal;
if the new registered medical practitioner reaches a different conclusion
from the original independent doctor, they must produce a report
setting out why they disagree;
those two reports must be made available to any subsequent decision
maker under this Act and to the Commissioner.
Where a referral is made to a registered medical practitioner under
subsection
(2)
, that referral is treated as a referral under
section 10
(3)
(c)
, the practitioner
becomes the independent doctor (replacing the registered medical practitioner
to whom a referral was originally made) and sections
11
,
12
and
15
apply
accordingly.
In consequence of a particular first declaration made by a person, the
coordinating doctor may make only one referral for a second opinion under
subsection (2)
; but this is subject to
subsection (6)
and
section 15
(6)
(a)
(ii)
.
Where—
a referral is made under subsection (2) to a practitioner,
the practitioner dies or through illness is unable or unwilling to act
as the independent doctor, and
no report under section 11 has been made by virtue of the referral,
a further referral may be made under subsection (2) .
The Secretary of State may, by regulations, make provision about cases where,
after a first declaration has been witnessed by the coordinating doctor, that
doctor dies or through illness or otherwise is unable or unwilling to continue
to carry out the functions of the coordinating doctor.
Regulations under subsection (1) may, in particular, make provision—
to ensure continuity of care for that person despite the change in the
coordinating doctor.
This section applies where—
after a first declaration has been witnessed by the coordinating doctor,
that doctor is unable or unwilling to continue to carry out the functions
of the coordinating doctor, or
after a referral is made under
section 10
(3)
(c)
(including a referral to
which
section 13
(4)
applies)
, but before a report under
section 11
has
been made by virtue of that referral, the independent doctor is unable
or unwilling to continue to carry out the functions of the independent
doctor,
and in this section such a coordinating or independent doctor is referred to as “the outgoing doctor”.
The outgoing doctor must as soon as practicable give written notice of their
inability or unwillingness to continue to carry out their functions under this
Act to—
the person seeking assistance,
the Commissioner, and
if the outgoing doctor is the independent doctor, the coordinating
doctor.
Any duty or power of the outgoing doctor under this Act that arose in
consequence of the declaration or referral mentioned in
subsection (1)
ceases
to have effect from the time the outgoing doctor complies with
subsection
(2)
; but this does not apply to any duty under subsection
(8)
or
(9)
.
The Secretary of State may by regulations make provision relating to the
appointment, with the agreement of the person seeking assistance, of a
replacement coordinating doctor who meets the requirements of
section 8
(6)
and who is able and willing to carry out the functions of the coordinating
doctor.
Regulations under
subsection (4)
may, in particular, make provision to ensure
continuity of care for the person seeking assistance despite the change in the
coordinating doctor.
Where the independent doctor gives a notice under subsection (2) —
a further referral may be made—
under section 10 (3) (c) (if section 13 does not apply), or
where
section 13
applies, under
subsection (2)
of that section,
and
gives a notice under
subsection (2)
to the person seeking assistance,
or
receives a notice under that subsection given by the independent
doctor in relation to the person seeking assistance.
Where the coordinating doctor is a practitioner with the person’s GP practice,
the coordinating doctor must, as soon as practicable, record the giving of the
notice in the person’s medical records.
In any other case—
the coordinating doctor must, as soon as practicable, notify a registered
medical practitioner with that practice of the giving of the notice, and
the practitioner notified under
paragraph (a)
must, as soon as
practicable, record the giving of the notice in the person’s medical
records.
This section applies where the Commissioner receives—
a first declaration made by a person,
a report about the first assessment of the person which contains a
statement indicating that the coordinating doctor is satisfied as to all
of the matters mentioned in
section 10
(2)
(a)
to
(h)
, and
a report about the second assessment of the person which contains a
statement indicating that the independent doctor is satisfied as to all
of the matters mentioned in
section 11
(2)
(a)
to
(e)
.
The Commissioner must, as soon as reasonably practicable, refer the person’s
case to an Assisted Dying Review Panel for determination of the person’s
eligibility to be provided with assistance under
section 25
.
But where the Commissioner receives a notification that the first declaration
has been cancelled—
the Commissioner must not refer the person’s case to such a panel,
and
if the person’s case has already been so referred, the Commissioner
must notify the panel of the cancellation.
Schedule 2 makes provision about Assisted Dying Review Panels.
The panel’s function is to determine whether it is satisfied of all of the
following matters—
the first declaration,
the first assessment and the report under
section 10
on that
assessment, and
the second assessment and the report under
section 11
on that
assessment;
that the person is terminally ill;
that the person has capacity to make the decision to end their own
life;
that the person was aged 18 or over at the time the first declaration
was made;
that before making the first declaration, but when the person was aged
18 or over, a registered medical practitioner conducted a preliminary
discussion with the person;
that the person is ordinarily resident in England and Wales and has
been so resident for at least 12 months ending with the date of the
first declaration;
that the person is registered as a patient with a general medical practice
in England or Wales;
that the person has a clear, settled and informed wish to end their
own life;
that the person made the first declaration voluntarily and was not
coerced or pressured by any other person into making that declaration.
Subject to the following and to Schedule
2
, the panel may adopt such
procedure as it considers appropriate for the case.
The panel—
must hear from, and may question, the coordinating doctor or the
independent doctor (and may hear from and question both);
must (subject to
subsection (6)
) hear from, and may question, the
person to whom the referral relates;
in a case to which
section 21
applies, may hear from and may question
the person’s proxy;
may hear from and may question any other person;
may ask any person appearing to it to have relevant knowledge or
experience to report to it on such matters relating to the person to
whom the referral relates as it considers appropriate.
Where the panel considers it appropriate for medical reasons, it may make
provision for the use of pre-recorded audio or video material for the purposes
of subsection (4).
The duty under
subsection (4)
(b)
to hear from the person to whom the referral
relates does not apply if the panel is of the opinion that there are exceptional
circumstances which justify not hearing from that person.
The panel—
must, if it is satisfied of all of the matters mentioned in subsection (2) , grant a certificate to that effect (a “certificate of eligibility”);
must refuse to do so in any other case.
The panel must notify the following of its decision—
the person to whom the referral relates;
the coordinating doctor;
the Commissioner;
any other person specified in regulations made by the Secretary of
State.
Where it grants a certificate of eligibility, it must give a copy of the certificate to each of these persons.
If the panel is notified that the first declaration has been cancelled, it must
cease to act in relation to the referral (and, in particular, it may not grant a
certificate of eligibility).
This section applies where—
a person’s case is referred under section
16
to an Assisted Dying
Review Panel (“the first panel”), and
the first panel refuses to grant a certificate of eligibility in respect of
the person.
The person may apply to the Commissioner for their case to be reconsidered
on the ground that the first panel’s decision—
contains an error of law,
is irrational, or
is procedurally unfair.
The Commissioner must consider an application without a hearing.
On the application—
if the Commissioner is satisfied that any of the grounds mentioned in
subsection (2)
applies, they must as soon as reasonably practicable
refer the person’s case to a different Assisted Dying Review Panel for
a fresh determination under section
17
;
in any other case, the Commissioner must dismiss the application.
The Commissioner must give reasons, in writing, for their decision.
The Commissioner must notify the following of the outcome of the application,
and give them a document containing their reasons for their decision—
the person who made the application;
the coordinating doctor;
any other person specified in regulations made by the Secretary of
State.
Where—
a certificate of eligibility has been granted in respect of a person, and
the second period for reflection has come to an end,
if the person wishes to be provided with assistance to end their own life in accordance with this Act, the person must make a further declaration to that effect (the “second declaration”).
In this section “the second period for reflection” means—
the period of 14 days beginning with the day on which the certificate
of eligibility was granted, or
where the coordinating doctor reasonably believes that the person’s
death is likely to occur before the end of the period of one month
beginning with the day that the certificate was granted, the period of
48 hours beginning with that day.
A second declaration must be—
in the form set out in regulations made by the Secretary of State,
signed and dated by the person making the declaration, and
witnessed by—
the coordinating doctor, and
a person other than the coordinating doctor or the independent
doctor,
both of whom must see the declaration being signed.
Regulations under
subsection (3)
(a)
must provide that a second declaration
contains—
the following information—
the person’s full name and address;
the person’s NHS number;
contact details for the person’s GP practice;
specified information about the certificate of eligibility;
the following further declarations by the person—
a declaration that they have made a first declaration and have
not cancelled it;
a declaration that they understand that they must make a
second declaration in order for assistance to be provided under
this Act;
a declaration that they are making the second declaration
voluntarily and have not been coerced or pressured by any
other person into making it;
a declaration that they understand that they may cancel the
second declaration at any time.
In this subsection “specified” means specified in the regulations.
The coordinating doctor may witness a second declaration only if the
coordinating doctor is satisfied (immediately before witnessing it) that the
person making the declaration—
is terminally ill,
has the capacity to make the decision to end their own life,
has a clear, settled and informed wish to end their own life, and
is making the declaration voluntarily and has not been coerced or
pressured by any other person into making it.
If the coordinating doctor is so satisfied, they must make a statement to that
effect.
The statement under subsection (6) must be—
in the form set out in regulations made by the Secretary of State,
signed and dated by the coordinating doctor, and
witnessed by the same person who witnessed the second declaration
under
subsection (3)
(c)
(ii)
.
Regulations under subsection (7) (a) must provide that a statement under subsection (6) contains—
the following information—
the person’s full name and address;
the person’s NHS number;
the coordinating doctor’s full name and work address;
specified information about the certificate of eligibility;
the following declarations by the coordinating doctor (in addition to
a declaration that they are satisfied of all of the matters mentioned in
subsection (5)
(a)
to
(d)
)—
a declaration that they are satisfied that a certificate of eligibility
has been granted in respect of the person;
a declaration that the second declaration was made after the
end of the second period for reflection;
if the second declaration was made before the end of the period
mentioned in
subsection (2)
(a)
, a declaration that they have the
belief mentioned in
subsection (2)
(b)
;
a declaration that they are satisfied that neither the first
declaration nor the second declaration has been cancelled.
In this subsection “specified” means specified in the regulations.
A person may not witness a declaration under
subsection (3)
(c)
(ii)
if they are
disqualified under
section 52
from being a witness.
Where the coordinating doctor has—
witnessed a second declaration, or
made or refused to make a statement under subsection (6) ,
the doctor must notify the Commissioner and give them a copy of the second declaration or (as the case may be) any statement under subsection (6) .
A person who has made a first declaration or a second declaration may cancel
it by giving oral or written notice of the cancellation (or otherwise indicating
their decision to cancel in a manner of communication known to be used by
the person) to—
the coordinating doctor, or
any registered medical practitioner with the person’s GP practice.
Where notice or an indication is given to the coordinating doctor under
subsection (1)
(a)
, the doctor must as soon as practicable notify the
Commissioner of the cancellation.
Where notice or an indication is given to a registered medical practitioner
under
subsection (1)
(b)
, the practitioner must, as soon as practicable, notify
the coordinating doctor and the Commissioner of the cancellation.
A cancellation under
subsection (1)
has effect from the time the notice or
indication is given.
This section applies where a person intending to make a first declaration or
a second declaration—
declares to a proxy that they are unable to sign their own name (by
reason of physical impairment, being unable to read or for any other
reason), and
authorises the proxy to sign the declaration on their behalf.
A declaration signed by a proxy—
in the presence of the person, and
in accordance with subsection (3) ,
has the same effect as if signed by the person themselves.
Where a proxy signs a declaration, the proxy is to add, after their signature—
their full name and address,
the capacity in which they qualify as a proxy,
a statement that they have signed in that capacity as a proxy, and
the reason why the person was unable to sign their name.
A proxy may not sign a declaration—
unless satisfied that the person understands the nature and effect of
the making of the declaration,
if disqualified under section 52 from being a proxy, or
if it is a second declaration and the proxy signed the first declaration
as a witness.
In this section “proxy” means—
a person who has known the person making the declaration personally
for at least two years, or
a person of a description specified in regulations made by the Secretary
of State.
For the purposes of this section “declaration” includes the cancellation of a
declaration.
The Secretary of State must by regulations make provision as to the
appointment of persons as independent advocates.
The regulations may, in particular, provide—
that a person may act as an independent advocate only in such
circumstances, or only subject to such conditions, as may be specified
in the regulations;
for the appointment of a person as an independent advocate to be
subject to approval in accordance with the regulations;
persons that may appoint independent advocates;
provision for payments to be made to, or in relation to, persons
carrying out the function of an independent advocate under this
section;
training that such advocates must undertake before being appointable;
obligations on persons performing functions on this Act to ensure the
presence of an independent advocate for a qualifying person.
The role of independent advocates is to provide support and advocacy to a
qualifying person who is seeking to understand options around end of life
care, including the possibility of requesting assistance to end their own life,
to enable them to effectively understand and engage with all the provisions
of this Act.
For the purposes of subsection (2) a person is a “qualifying person” if they—
have—
a learning disability,
a mental disorder under section 1 of the Mental Health Act
1983, or
autism,
they may experience substantial difficulty in understanding the
processes or information relevant to those processes or communicating
their views, wishes or feelings, or
they meet criteria that the Secretary of State may specify by regulations.
Regulations may not be made under this section unless a draft of the statutory
instrument containing them has been laid before and approved by a resolution
of each House of Parliament.
This section applies where—
a first declaration is made by a person;
a report about the first assessment of a person is made under
section
10
;
a report about the second assessment of a person is made under
section
11
;
a certificate of eligibility has been granted in respect of a person;
a panel has refused to grant such a certificate;
a second declaration is made by a person;
a statement is made under
section 19
(6)
, or the coordinating doctor
refuses to make such a statement, in relation to a person.
In this section “recordable event” means an event mentioned in a paragraph
of
subsection (1)
.
Where the coordinating doctor is a practitioner with the person’s GP practice,
the coordinating doctor must, as soon as practicable, record the occurrence
of the recordable event in the person’s medical records.
In any other case—
the coordinating doctor must, as soon as practicable, give a registered
medical practitioner with that practice notice of the occurrence of the
recordable event, and
that practitioner must, as soon as practicable, record the occurrence
of the recordable event in the person’s medical records.
A record made under
subsection (3)
or
(4)
of a declaration, report or statement
within
subsection (1)
must include the original declaration, report or statement.
This section applies where a person cancels a first declaration or a second
declaration under
section 20
.
If the notice or indication under that section is given to a registered medical
practitioner with the person’s GP practice, that practitioner must, as soon as
practicable, record the cancellation in the person’s medical records.
In any other case—
the registered medical practitioner to whom notice or indication of
the cancellation is given must, as soon as practicable, notify a registered
medical practitioner with that practice of the cancellation, and
the practitioner notified under
paragraph (a)
must, as soon as
practicable, record the cancellation in the person’s medical records.
This section applies where—
a certificate of eligibility has been granted in respect of a person,
the second period for reflection (within the meaning of section 19 (2) ) has ended,
that person has made a second declaration which has not been
cancelled, and
the coordinating doctor has made the statement under section 19 (6) .
The coordinating doctor may, in accordance with this section, provide that
person with an approved substance (see
section 27
) with which the person
may end their own life.
The approved substance must be provided directly and in person by the
coordinating doctor to that person.
When providing a substance under
subsection (2)
the coordinating doctor
must explain to the person that they do not have to go ahead and
self-administer the substance and that they may still cancel their declaration.
The coordinating doctor must be satisfied, at the time the approved substance
is provided, that the person to whom it is provided—
has capacity to make the decision to end their own life,
has a clear, settled and informed wish to end their own life, and
is requesting provision of that assistance voluntarily and has not been
coerced or pressured by any other person into doing so.
The coordinating doctor may be accompanied by such other health
professionals, and such other persons, as the coordinating doctor thinks
necessary.
An approved substance may be provided to a person under subsection (2) by—
preparing a device which will enable that person to self-administer
the substance, and
providing that person with the device.
In the case of an approved substance so provided, the reference in
subsection
(3)
to the approved substance is to be read as a reference to the device.
In respect of an approved substance which is provided to the person under subsection (2) , the coordinating doctor may—
prepare that substance for self-administration by that person, and
assist that person to ingest or otherwise self-administer the substance.
But the decision to self-administer the approved substance and the final act
of doing so must be taken by the person to whom the substance has been
provided.
Subsection
(8)
does not authorise the coordinating doctor to administer an
approved substance to another person with the intention of causing that
person’s death.
The coordinating doctor must remain with the person until—
the person has self-administered the approved substance and—
the person has died, or
it is determined by the coordinating doctor that the procedure
has failed, or
the person has decided not to self-administer the approved substance.
For the purposes of
subsection (11)
, the coordinating doctor need not be in
the same room as the person to whom the assistance is provided.
Where the person informs the coordinating doctor that they have decided
not to self-administer the approved substance, or there is any other reason
to believe that the substance will not be used, the coordinating doctor must
remove it immediately from that person.
Subject to
subsection (2)
, the coordinating doctor may authorise, in writing,
a named registered medical practitioner to carry out the coordinating doctor’s
functions under
section 25
.
A registered medical practitioner may be authorised under subsection (1) only if—
the person to whom the assistance is being provided has been
consulted and has consented, in writing, to the authorisation of that
practitioner, and
that practitioner has completed such training, and gained such
qualifications and experience, as the Secretary of State may specify by
regulations.
Regulations under
subsection (2)
(b)
may in particular provide that the required
training, qualifications or experience is to be determined by a person specified
in the regulations.
Where a registered medical practitioner is authorised under
subsection (1)
,
section 25
applies as if references to the coordinating doctor were to that
registered medical practitioner.
Where a registered medical practitioner who is authorised under
subsection
(1)
is not satisfied of all of the matters mentioned in
section 25
(5)
, they must
notify the coordinating doctor immediately.
Section
21
(signing by proxy) applies in relation to a consent under
subsection if the proxy signed the first or second declaration as a witness.”
(2)
(a)
as it applies in relation to a first or second declaration, except that, for
these purposes,
section 21
(4)
has effect as if for
paragraph (c)
there were
substituted—
“(c)
Regulations under
subsection (2)
(b)
must specify that training in respect of
domestic abuse, including coercive control and financial abuse is mandatory.
The Secretary of State must, by regulations, specify one or more drugs or
other substances for the purposes of this Act.
In this Act “approved substance” means a drug or other substance specified
in regulations under
subsection (1)
.
See section 37 for powers to make provision about—
approved substances, and
devices for use or used in connection with the self-administration of
approved substances.
This section applies where a person has been provided with assistance to end
their own life in accordance with this Act and has died as a result.
The coordinating doctor must complete a statement to that effect (a “final
statement”).
The statement mentioned in subsection (2) must be—
in the form set out in regulations made by the Secretary of State, and
signed and dated by the coordinating doctor.
The coordinating doctor must, as soon as practicable, give a copy of the final
statement to the Commissioner.
Regulations under
subsection (3)
(a)
must provide that a final statement
contains the following information—
the person’s full name, date of birth, sex, ethnicity, and last permanent
address;
whether, immediately before death, the person had a disability within
the meaning of
section 6
of the
Equality Act 2010
(other than a
disability consisting of the illness or disease which caused the person
to be terminally ill within the meaning of this Act);
the person’s NHS number;
the name and address of the person’s GP practice (at the time of
death);
the coordinating doctor’s full name and work address;
the date of each of the following—
the first declaration;
the report about the first assessment of the person;
the report about the second assessment of the person;
the certificate of eligibility;
the second declaration;
the statement under section 19 (6) ;
details of the illness or disease which caused the person to be
terminally ill (within the meaning of this Act);
the approved substance provided;
the date and time of death;
the time between use of the approved substance and death.
Where the coordinating doctor is a practitioner with the person’s GP practice,
the coordinating doctor must, as soon as practicable, record the making of
the statement in the person’s medical records.
In any other case—
the coordinating doctor must, as soon as practicable, inform a
registered medical practitioner with that practice of the making of the
statement, and
the practitioner so informed must, as soon as practicable, record the
statement in the person’s medical records.
A record made under subsection (6) or (7) must include the original statement.
This section applies where a person is not provided with assistance under
section 25
because the coordinating doctor is not satisfied as to all of the
matters mentioned in
section 25
(5)
.
The coordinating doctor must make a report which—
sets out the matters as to which they are not satisfied, and
contains an explanation of why they are not satisfied of those matters.
The Secretary of State may by regulations make provision about the content
or form of the report.
The coordinating doctor must give a copy of the report to—
the person,
if the coordinating doctor is not a practitioner with the person’s GP’s
practice, a registered medical practitioner with that practice, and
the Commissioner.
This section applies where a person is provided with assistance to end their
own life in accordance with this Act and either—
the person decides not to take the substance, or
the procedure fails.
The coordinating doctor must, as soon as practicable, notify the Commissioner
that this has happened.
Where the coordinating doctor is a practitioner with the person’s GP practice,
the coordinating doctor must, as soon as practicable, record that this has
happened in the person’s medical records.
In any other case—
the coordinating doctor must, as soon as practicable, inform a
registered medical practitioner with that practice that this has
happened, and
the practitioner so informed must, as soon as practicable, record that
fact in the person’s medical records.
No person is under any duty to participate in the provision of assistance in
accordance with this Act.
No registered medical practitioner is under any duty to become—
the coordinating doctor in relation to any person, or
the independent doctor in relation to any person.
No registered medical practitioner, other than the coordinating doctor or the
independent doctor, is under any duty to perform any function under or in
connection with this Act other than—
a function relating to the giving of notifications, or
a function relating to the recording of matters in a person’s medical
records.
No health professional or social care professional is under any duty to respond
when consulted under
section 12
(3)
(b)
(requirement for assessing doctor to
consult professional with relevant qualifications or experience).
No registered pharmacist or registered pharmacy technician is under any
duty to participate in the supply of an approved substance to a registered
medical practitioner for use in accordance with
section 25
.
No person is under any duty to—
act as a witness under this Act, or
act as a proxy under this Act.
Nothing in this section affects—
any duty relating to the giving of notifications under this Act or the
recording of matters in a person’s medical records,
any duty relating to a requirement to keep records or to provide
information, or
any duty of a professional to respond to enquiries made under
section
12
(2)
(b)
(enquiries by assessing doctor) relating to health or social care
the professional is providing, or has recently provided, to a person
seeking assistance under this Act.
Schedule
3
amends the
Employment Rights Act 1996
to make provision to
protect employees and other workers from being subjected to any detriment
for—
exercising (or proposing to exercise) a right under this section not to
participate in an activity or perform a function, or
participating in the provision of assistance in accordance with this Act
or performing any other function under this Act.
In this section—
a reference to a duty includes any duty, whether arising from any
contract, statute or otherwise;
“registered pharmacist” and “registered pharmacy technician” have
the same meaning as in the
Pharmacy Order 2010
(S.I. 2010/231) (see
article 3
of
that Order
).
A person is not guilty of an offence by virtue of—
providing assistance to a person to end their own life in accordance
with this Act, or performing any other function under this Act in
accordance with this Act, or
assisting a person seeking to end their own life in accordance with
this Act, in connection with the doing of anything under this Act.
Subsection
(1)
does not limit the circumstances in which a court can otherwise
find that a person who has assisted another to end their own life (or to attempt
to do so) has not committed an offence.
In the Suicide Act 1961, after section 2A (acts capable of encouraging or In sections 2(1) and 2A(1), a reference to an act that is capable of providing assistance to a person to end their own life in assisting a person seeking to end their own life in accordance It is a defence for a person charged with an offence under section 2 reasonably believed they were acting in accordance with the took all reasonable precautions and exercised all due diligence
assisting suicide) insert—
“2AA
Assistance provided under Terminally Ill Adults (End of Life) Act
2025
(1)
encouraging or assisting suicide or attempted suicide does not
include—
(a)
accordance with the Terminally Ill Adults (End of Life) Act
2025, or performing any other function under that Act in
accordance with that Act, or
(b)
with that Act, in connection with the doing of anything under
that Act.
(2)
to prove that they—
(a)
Terminally Ill Adults (End of Life) Act 2025, and
(b)
to avoid the commission of the offence.”
The doing of any of the following does not, of itself, give rise to any civil
liability—
providing assistance to a person to end their own life in accordance
with this Act;
performing any other function under this Act in accordance with this
Act;
assisting a person seeking to end their own life in accordance with
this Act, in connection with the doing of anything under this Act.
Subsection (1) does not apply—
in relation to an act done dishonestly, or in some other way done
otherwise than in good faith, or
to any liability in tort arising from a breach of a duty of care owed to
a person.
Subsection (1)
does not limit the circumstances in which a court can otherwise
find that a person who has assisted another person to end their own life, or
to attempt to do so, is not subject to civil liability.
A person who, by dishonesty, coercion or pressure, induces another person
to make a first or second declaration, or not to cancel such a declaration,
commits an offence.
A person who, by dishonesty, coercion or pressure, induces another person
to self-administer an approved substance provided under this Act commits
an offence.
A person who commits an offence under
subsection (1)
is liable on conviction
on indictment to imprisonment for a term not exceeding 14 years.
A person who commits an offence under
subsection (2)
is liable, on conviction
on indictment, to imprisonment for life.
Proceedings for an offence under this section may be instituted only by or
with the consent of the Director of Public Prosecutions.
A person commits an offence if they—
make or knowingly use a false instrument which purports to be—
a first declaration,
a second declaration, or
a certificate of eligibility, or
intentionally or recklessly conceal or destroy a first declaration or a
second declaration by another person.
A person commits an offence if, in relation to another person who has made
a first declaration under this Act, they knowingly or recklessly provide a
medical or other professional opinion in respect of a relevant matter which
is false or misleading in a material particular.
In
subsection (2)
“relevant matter” means a matter relating to any function
under this Act.
A person commits an offence if they intentionally or recklessly fail to comply
with an obligation under—
section 20 (2) or (3) (notification of cancellation of declaration), or
section 24 (recording of cancellations).
A person who commits an offence under this section is liable—
on summary conviction, to imprisonment for a term not exceeding
the general limit in a magistrates’ court or a fine, or both;
on conviction on indictment to imprisonment for a term not exceeding
5 years or a fine, or both.
Proceedings for an offence under this section may be instituted only by or
with the consent of the Director of Public Prosecutions.
A person commits an offence if, with the intention of facilitating the provision
of assistance to a person (B) under this Act to end their own life, they—
make or knowingly use a false instrument which purports to be—
a first declaration,
a second declaration, or
a certificate of eligibility,
provide a medical or other professional opinion in respect of B which
is false or misleading in a material particular, or
fail to comply with an obligation under
section 20
(2)
or
(3)
(notification
of cancellation of declaration).
In
subsection (1)
the reference to assistance under this Act includes assistance
purporting to be under this Act.
A person who commits an offence under this section is liable, on conviction
on indictment, to imprisonment for a term not exceeding 14 years.
Proceedings for an offence under this section may be instituted only by or
with the consent of the Director of Public Prosecutions.
The Secretary of State must by regulations make provision about approved
substances.
The regulations must make provision about—
the supply or offer for supply, or administration, of approved
substances;
the transportation, storage, handling and disposal of approved
substances;
the keeping of records of matters relating to approved substances.
The regulations may in particular make provision—
about the manufacture, importation, preparation or assembly of
approved substances;
for or in connection with the monitoring of matters relating to
approved substances;
requiring persons specified in the regulations, in specified cases, to
give information to the Secretary of State.
The regulations may in particular—
make provision relating to approved substances that is similar to, or
that corresponds to, any provision of the
Human Medicines Regulations
2012
(S.I. 2012/1916);
make provision applying any provision of
those Regulations
, with or
without modifications, in relation to approved substances.
(The regulations may also amend the Human Medicines Regulations 2012 .)
The Secretary of State may by regulations make provision about devices made
for use or used for, or in connection with, the self-administration of approved
substances.
Regulations under this section must make provision about enforcement (which
must include, but need not be limited to, provision imposing civil penalties).
Regulations under this section may make any provision that could be made
by an Act of Parliament; but they may not amend this Act.
In this section “device” includes information in electronic form for use in
connection with a device.
In
section 1
of the
Coroners and Justice Act 2009
(duty to investigate certain In this Chapter a reference to an “unnatural death” does not include
deaths), after
subsection (7)
insert—
“(7A)
a death caused by the self-administration by the deceased of an
approved substance, within the meaning of the Terminally Ill Adults
(End of Life) Act 2025, that was provided to the deceased in accordance
with that Act.”
“(4A)
Regulations under subsection (1) may make, in respect of cases where
assistance was provided or purportedly provided to the deceased under the Terminally Ill Adults (End of Life) Act 2025—(a)
such provision that is similar to, or that corresponds to,
provision mentioned in subsection (1) as the Secretary of State considers appropriate;(b)
such further provision as the Secretary of State considers
appropriate.(4B)
Regulations under subsection (1) must provide that in cases where
the cause of death appears, to the best of the knowledge and belief of the person issuing a certificate under the regulations, to be the self-administration by the deceased of an approved substance (within the meaning of the Terminally Ill Adults (End of Life) Act 2025) that was provided to the deceased in accordance with that Act, the certificate must—(a)
state the cause of death to be “assisted death”, and
(b)
contain a record of the illness or disease which caused the
person to be terminally ill within the meaning of that Act.”
In
Schedule 1
to
that Act
(suspension of investigations etc), in the definition
in paragraph 1(6) of “homicide offence”, after paragraph (d) insert—
The Secretary of State must issue one or more codes of practice in connection
with—
the assessment of whether a person has a clear and settled intention
to end their own life, including—
assessing whether the person has capacity to make such a
decision;
recognising and taking account of the effects of depression or
other mental disorders (within the meaning of the Mental
Health Act 1983) that may impair a person’s decision-making;
the information which is made available as mentioned in sections 5 and 12 on treatment or palliative, hospice or other care available to the person and under section 12 on the consequences of deciding to end their own life;
the provision of information and support to persons with learning
disabilities who are eligible to request assistance to end their own life
under this Act, including the role of advocates for such persons;
ensuring effective communication in connection with persons seeking
assistance under this Act to end their own lives, including the use of
interpreters;
the arrangements for providing approved substances to the person
for whom they have been prescribed, and the assistance which such
a person may be given to ingest or self-administer them;
the arrangements for a qualifying person requesting assistance to end
their own life to receive the support of an independent advocate under
section 22
;
responding to unexpected complications that arise in relation to the
administration of the approved substance under
section 25
, including
when the procedure fails;
the forms of proof of identity that are acceptable for the purposes of section 9 .
The Secretary of State may issue one or more codes of practice in connection
with any matters relating to the operation of this Act not required under
subsection (1)
as the Secretary of State considers appropriate.
Before issuing a code under this section the Secretary of State must consult
such persons as the Secretary of State considers appropriate.
A code issued under
subsection (1)
does not come into force until the Secretary
of State by regulations so provides.
When draft regulations are laid before Parliament in accordance with
section
54
, the code to which they relate must also be laid before Parliament.
A person performing any function under this Act must have regard to any
relevant provision of a code.
A 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.
The Secretary of State must issue guidance relating to the operation of this
Act.
The guidance need not (but may) relate to matters about which the Welsh
Ministers may issue guidance under
subsection (4)
(“Welsh devolved matters”).
Before issuing guidance under
subsection (1)
, the Secretary of State must
consult—
the Chief Medical Officer for England,
the Chief Medical Officer for Wales,
such persons with learning disabilities and other persons who have
protected characteristics as the Secretary of State considers appropriate,
such persons appearing to represent providers of health or care
services, including providers of palliative or end of life care, as the
Secretary of State considers appropriate,
if any part of the guidance relates to Welsh devolved matters, the
Welsh Ministers, and
such other persons as the Secretary of State considers appropriate.
The Welsh Ministers may issue guidance relating to the operation of this Act
in Wales, but the guidance must only be about matters within devolved
competence.
For this purpose, a matter is “within devolved competence” if provision about
it would be within the legislative competence of Senedd Cymru if it were
contained in an Act of the Senedd.
Before issuing guidance under
subsection (4)
, the Welsh Ministers must
consult—
the Chief Medical Officer for Wales,
the Secretary of State,
such persons with learning disabilities and other persons who have
protected characteristics as the Welsh Ministers consider appropriate,
such persons appearing to represent providers of health or care
services, including providers of palliative or end of life care, as the
Welsh Ministers consider appropriate, and
such other persons as the Welsh Ministers consider appropriate.
When preparing guidance under this section, an appropriate national authority
must have regard to the need to provide practical and accessible information,
advice and guidance to—
persons (including persons with learning disabilities) requesting or
considering requesting assistance to end their own lives;
the next of kin and families of such persons;
the general public.
An appropriate national authority must publish any guidance issued under
this section.
In this section—
“
appropriate national authority” means the Secretary of State or the
Welsh Ministers;
“
protected characteristics” has the same meaning as in Part 2 of the
Equality Act 2010 (see section 4 of that Act).
The Secretary of State must by regulations make provision securing that
arrangements are made for the provision of voluntary assisted dying services
in England.
In this section “commissioned VAD services” means services provided by
virtue of regulations under
subsection (1)
.
The Secretary of State may by regulations make other provision about
voluntary assisted dying services in England (whether or not the services are
commissioned VAD services).
Regulations under this section may for example provide that specified
references in the National Health Service Act 2006 to the health service
continued under section 1(1) of that Act include references to commissioned
VAD services.
Regulations under this section must provide that section 1(4) of that Act
(services to be provided free of charge except where charging expressly
provided for) applies in relation to commissioned VAD services.
Regulations under this section may make any provision that could be made
by an Act of Parliament; but they may not amend this Act.
In this section “voluntary assisted dying services” means—
services for or in connection with the provision of assistance to a
person to end their own life in accordance with this Act, and
The Welsh Ministers may by regulations make provision about voluntary
assisted dying services in Wales.
Regulations under subsection (1) may make any provision that—
could be made by an Act of Senedd Cymru, and
would be within the legislative competence of the Senedd if it were
contained in such an Act.
The Secretary of State may by regulations make provision about voluntary
assisted dying services in Wales.
Regulations under subsection (3) may make any provision that—
could be made by an Act of Parliament, and
would not be within the legislative competence of the Senedd if it
were contained in an Act of the Senedd.
Regulations under this section may not amend this Act.
In this section—
“voluntary assisted dying services” has the meaning given by section 41 ;
a reference to provision about voluntary assisted dying services
includes in particular provision securing that arrangements are made
for the provision of such services.
The Secretary of State must by regulations make provision prohibiting—
the publication, printing, distribution or designing (anywhere) of
advertisements whose purpose or effect is to promote a voluntary
assisted dying service;
causing the publication, printing, distribution or designing of such
advertisements.
The regulations may contain exceptions (for example, for the provision of
certain information to users or providers of services).
Regulations under this section may make any provision that could be made
by an Act of Parliament.
But regulations under this section—
may not amend this Act, and
must provide that any offence created by the regulations is punishable
with a fine.
In this section “voluntary assisted dying service” means—
any service for or in connection with the provision of assistance to a
person to end their own life in accordance with this Act, or
The Secretary of State may by regulations make provision requiring a
registered medical practitioner to notify the Commissioner of the occurrence
of an event of a specified description.
The Secretary of State may by regulations make provision enabling the
Commissioner, by notice, to require persons (or a specified description of
persons) to give the Commissioner information (or a specified description of
information).
Regulations under this section may—
specify the information which must be contained in a notification
under
subsection (1)
;
specify the manner in which such a notification must be given;
make provision about enforcement of the regulations.
In this section “specified” means specified in the regulations.
The Commissioner may disclose information to a person within
subsection
(3)
, for the purposes of any function of either of them.
A person within
subsection (3)
may disclose information to the Commissioner,
for the purposes of any function of either of them.
The persons within this subsection are—
the Care Quality Commission;
the General Medical Council;
the General Pharmaceutical Council;
the Nursing and Midwifery Council;
any other person specified in regulations made by the Secretary of
State.
The Commissioner and the Secretary of State may disclose information to
each other, for the purposes of—
any function of the Commissioner, or
any function of the Secretary of State relating to the operation of this
Act.
A disclosure of information which is required or authorised by or under this
Act does not breach—
any obligation of confidence owed by the person making the disclosure,
or
any other restriction on disclosure (however imposed).
This is subject to subsection (2) .
This Act does not (and regulations under it may not) require or authorise the
disclosure of information which would contravene the data protection
legislation (but in determining whether a disclosure required or authorised
by or under this Act would do so, the requirement or authorisation is to be
taken into account).
In this section “the data protection legislation” has the same meaning as in
the Data Protection Act 2018 (see section 3 of that Act).
As soon as reasonably practicable after the end of each reporting period, the
Secretary of State must prepare and publish, and lay before Parliament, a
report about—
progress made in that period in connection with the implementation
of this Act, and
the Secretary of State’s plans for implementing the Act in subsequent
reporting periods (including the expected timetable for
implementation).
For the purposes of this section the reporting periods are—
the period of one year beginning with the day on which this Act is
passed;
each subsequent period of six months (subject to subsection (3) ).
The sixth reporting period under subsection (2) (b) is the last reporting period.
For the first reporting period referred to under
subsection (2)
(a)
the report
must set out an assessment of the state of health services to persons with
palliative and end of life care needs and the implications of this Act on those
services.
The report under
subsection (4)
must, in particular, include an assessment of
the availability, quality and distribution of appropriate health services to
persons with palliative and end of life care needs, including—
pain and symptom management;
psychological support for those persons and their families;
information about palliative care and how to access it.
The Commissioner must, within six months of the Commissioner being
appointed under this Act, appoint a Disability Advisory Board to advise on
the implementation and impact of this Act in its operation on disabled people.
The Board must include—
people who have a disability under the Equality Act 2010,
representatives from disabled people’s organisations, and
other such persons or organisations as the Commissioner considers
relevant to the impact of the Act on disabled people.
Within six months of its appointment, the Advisory Board must report to the
Secretary of State and the Commissioner to advise on the implementation of
the Act and then annually thereafter report on the impact of the Act’s
operation on disabled people.
The Secretary of State must, within three months of receipt of any report
under subsection (3), lay the report before both Houses of Parliament.
The Commissioner must—
monitor the operation of the Act, including compliance with its
provisions and any regulations or code of practice made under it,
investigate, and report to an appropriate national authority on, any
matter connected with the operation of the Act which the appropriate
national authority refers to the Commissioner, and
submit an annual report to each appropriate national authority on the
operation of the Act.
The annual report must include information about the occasions when—
a report about the first assessment of a person does not contain a
statement indicating that the coordinating doctor is satisfied as to all
of the matters mentioned in
section 10
(2)
(a)
to
(h)
;
a report about the second assessment of a person does not contain a
statement indicating that the independent doctor is satisfied as to all
of the matters mentioned in
section 11
(2)
(a)
to
(e)
;
a panel has refused to grant a certificate of eligibility;
the coordinating doctor has refused to make a statement under
section
19
(6)
.
An annual report must include information about the application of the Act
in relation to—
persons who have protected characteristics, and
any other description of persons specified in regulations made by the
Secretary of State.
When preparing an annual report, the Commissioner must consult—
the Chief Medical Officer for England,
the Chief Medical Officer for Wales, and
such persons appearing to the Commissioner to represent the interests
of persons who have protected characteristics as the Commissioner
considers appropriate.
An appropriate national authority must—
publish any report received under this section,
prepare and publish a response to any such report, and
lay before Parliament or Senedd Cymru (as the case may be) a copy
of the report and response.
In this section “appropriate national authority” means the Secretary of State
or the Welsh Ministers.
In this section “protected characteristics” has the same meaning as in Part 2
of the Equality Act 2010 (see section 4 of that Act).
The Secretary of State must, during the period of 12 months beginning at the
end of the initial 5-year period—
undertake a review of the operation of this Act,
prepare a report on that review, and
as soon as reasonably practicable, publish and lay the report before
Parliament.
“The initial 5-year period” means the period of five years beginning with the
day on which this Act is passed.
The report must, in particular, set out—
the extent to which the Act has successfully met its aim of allowing
adults who are terminally ill, subject to safeguards and protections,
to request and be provided with assistance to end their own lives;
an assessment of the availability, quality and distribution of appropriate
health services to persons with palliative and end of life care needs,
including—
pain and symptom management;
psychological support for those persons and their families;
information about palliative care and how to access it;
an assessment of the impact of this Act on persons with learning
disabilities, including any concerns about the operation of this Act in
relation to such persons;
any concerns with the operation of this Act which have been raised;
the Secretary of State’s response to any such concerns, including any
recommendations for changes to codes of practice, guidance or any
enactment (including this Act).
In this section “relevant person” means a person in Wales who wishes to be
provided with assistance to end their own life in accordance with this Act.
Subsection (3) applies where the Welsh Ministers make regulations under section 42 (voluntary assisted dying services: Wales).
Regulations under that section must make such provision as the Welsh
Ministers consider appropriate for the purpose of ensuring that, where a
relevant person indicates that they wish to communicate in Welsh, all
reasonable steps are taken to secure that—
communications made by a person providing a voluntary assisted
dying service to the relevant person are in Welsh, and
any report about the first or second assessment of the relevant person
is in Welsh.
Where a relevant person informs the Commissioner that they wish to
communicate in Welsh, the Commissioner must take all reasonable steps to
secure that—
communications made by the Commissioner to the relevant person
are in Welsh,
each member of the panel to which the relevant person’s case is
referred speaks Welsh, and
communications made by that panel to the relevant person are in
Welsh,
and any certificate of eligibility issued by that panel must be in Welsh.
a first or second declaration,
a report about the first or second assessment of a person, or
a final statement,
must make provision for the forms to be in Welsh (as well as in English).
Before making regulations in pursuance of
subsection (5)
, the Secretary of
State must consult the Welsh Ministers.
In this section—
“
panel” and “referred” have the meaning given by
paragraph 1
of
Schedule 2
;
“
voluntary assisted dying service” has the meaning given by
section 41
.
The individuals specified in subsection (2) are disqualified from—
witnessing a second declaration by a person under section 19 (3) (c) (ii) ;
being a proxy for a person intending to have a document signed by
proxy under
section 21
.
Those individuals are—
any relative of the person;
anyone who knows or believes that they—
are a beneficiary under a will of the person, or
may otherwise benefit financially or in any other material way
from the death of the person;
any health professional who has provided treatment or care for the
person in relation to that person’s terminal illness;
any person who has not attained the age of 18.
In
subsection (2)
(c)
, the reference to “terminal illness” means the illness or
disease mentioned in
section 2
(1)
(a)
.
The Secretary of State may by regulations make—
such supplementary, incidental or consequential provision, or
such transitory, transitional or saving provision,
as the Secretary of State considers appropriate for the purposes or in consequence of any provision made by this Act.
A power to make regulations under any provision of this Act includes power
to make—
different provision for different purposes, and
incidental, consequential, transitional or saving provision.
Regulations under this Act are to be made by statutory instrument.
Any other statutory instrument made by the Secretary of State containing
regulations under this Act is subject to annulment in pursuance of a resolution
of either House of Parliament.
The Welsh Ministers may not make a statutory instrument containing
regulations under section
42
unless a draft of the instrument has been laid
before, and approved by a resolution of, Senedd Cymru.
This section does not apply to regulations under section 58 (commencement).
Before making regulations under section
8
,
10
,
11
,
19
,
26
or
28
, the Secretary
of State must consult—
the Commission for Equality and Human Rights, and
such other persons as the Secretary of State considers appropriate.
The persons to be consulted under subsection (1) (b) must include—
persons appearing to the Secretary of State to have expertise in matters
relating to whether persons have capacity, and
persons appearing to the Secretary of State to have expertise in matters
relating to whether persons have been coerced,
unless the Secretary of State considers that, having regard to the subject-matter of the proposed regulations, it would not be appropriate to consult such persons.
In this Act, references to the provision of assistance to a person to end their
own life in accordance with this Act are to the provision of assistance to that
person to end their own life in circumstances where the provision is authorised
by
section 1
.
In this Act—
“
approved substance” has the meaning given in
section 27
(2)
;
“
capacity” (except in
section 21
(3)
(b)
) is to be construed in accordance
with
section 3
;
“
certificate of eligibility” has the same meaning as in
section 17
;
“
the Commissioner” has the meaning given by
section 4
;
“
domestic abuse” has the meaning given by
section 1
of the
Domestic
Abuse Act 2021
(and accordingly includes behaviour that is controlling
or coercive or that constitutes economic abuse);
“
first assessment” has the same meaning as in
section 10
;
“
first declaration” has the same meaning as in
section 8
;
“
GP practice”, of a person, means the general medical practice with which
the person is registered;
“
health professional” means—
a registered medical practitioner;
a registered nurse;
a registered pharmacist or a registered pharmacy technician
within the meaning of the Pharmacy Order 2010 (S.I. 2010/231)
(see article 3 of that Order);
“
the independent doctor” has the meaning given in
section 10
(3)
(c)
;
“
learning disability” has the meaning given by section 1(4) of the Mental
Health Act 1983;
“
relative”, in relation to any person, means—
the spouse or civil partner of that person,
any lineal ancestor, lineal descendant, sibling, aunt, uncle or
cousin of that person or the person’s spouse or civil partner,
or
the spouse or civil partner of any relative mentioned in paragraph (b) ;
“
second assessment” has the same meaning as in
section 11
;
“
second declaration” has the same meaning as in
section 19
.
For the purpose of deducing any relationship mentioned in the definition of
“relative” in
subsection (2)
—
a spouse or civil partner includes a former spouse or civil partner and
a partner to whom the person is not married, and
a step-child of any person is treated as that person’s child.
For the purposes of this Act, a registered medical practitioner is not to be
regarded as benefiting financially or in any other material way from the death
of a person by reason only of the practitioner receiving reasonable
remuneration for the provision of services in connection with the provision
of assistance to that person in accordance with this Act.
Subject as follows, this Act extends to England and Wales only.
Sections
47
,
53
to
57
, this section and
section 59
come into force on the day
on which this Act is passed.
Section
4
, except
subsection (4)
of that section, and Schedule
1
come into force
at the end of the period of one year beginning with the day on which this
Act is passed.
The other provisions of this Act come into force on such day or days as the
Secretary of State may by regulations appoint.
But if any provision of this Act has not been fully brought into force before
the end of the period of four years beginning with the day on which this Act
is passed, that provision (so far as not already in force) comes into force at
the end of that period.
The Secretary of State may by regulations make transitional or saving provision
in connection with the coming into force of any provision of this Act.
The power to make regulations under this section includes power to make
different provision for different purposes.
Regulations under this section are to be made by statutory instrument.
This Act may be cited as the Terminally Ill Adults (End of Life) Act 2025.
The Commissioner is to be a corporation sole.
The Commissioner is not to be regarded as—
the servant or agent of the Crown, or
as enjoying any status, immunity or privilege of the Crown.
The Commissioner’s property is not to be regarded as property of, or
property held on behalf of, the Crown.
The Commissioner may do anything the Commissioner considers
appropriate for the purposes of, or in connection with, the Commissioner’s
functions.
The Prime Minister must appoint a person to be the Deputy Voluntary
Assisted Dying Commissioner (the “Deputy Commissioner”).
The person appointed must hold or have held office as a judge of—
the Supreme Court,
the Court of Appeal, or
the High Court.
The Commissioner may delegate any of the Commissioner’s functions to
the Deputy Commissioner, to the extent and on the terms that the
Commissioner determines.
The delegation of a function under
sub-paragraph (3)
does not prevent the
Commissioner from exercising that function.
The functions of the Commissioner are to be carried out by the Deputy
Commissioner if—
there is a vacancy in the office of the Commissioner, or
the Commissioner is for any reason unable or unwilling to act.
A person holds and vacates office as the Commissioner or Deputy
Commissioner in accordance with the terms and conditions of their
appointment as determined by the Secretary of State, subject to the
provisions of this paragraph.
An appointment as the Commissioner or Deputy Commissioner is to be
for a term not exceeding five years.
A person may not be appointed as the Commissioner or Deputy
Commissioner if a relevant appointment of them has been made on two
occasions.
“Relevant appointment” here means appointment as the Commissioner or Deputy Commissioner.
The Commissioner or Deputy Commissioner may resign by giving written
notice to the Secretary of State.
The Secretary of State may by notice in writing remove a person from the
office of Commissioner or Deputy Commissioner if satisfied that the
person—
has behaved in a way that is not compatible with their continuing
in office, or
is unfit, unable or unwilling to properly discharge their functions.
The Secretary of State may pay to, or in respect of, the person holding
office as the Commissioner or Deputy Commissioner—
remuneration;
allowances;
sums by way of or in respect of pensions.
The Commissioner may appoint staff.
Staff are to be appointed on terms and conditions determined by the
Commissioner.
The terms and conditions on which a member of staff is appointed may
provide for the Commissioner to pay to or in respect of the member of
staff—
remuneration;
allowances;
sums by way of or in respect of pensions.
In making appointments under this paragraph, the Commissioner must
have regard to the principle of selection on merit on the basis of fair and
open competition.
The Employers’ Liability (Compulsory Insurance) Act 1969 does not require
insurance to be effected by the Commissioner.
The Commissioner may make arrangements for persons to be seconded to
the Commissioner to serve as members of the Commissioner’s staff.
The arrangements may include provision for payments by the Commissioner
to the person with whom the arrangements are made or directly to seconded
staff (or both).
A period of secondment to the Commissioner does not affect the continuity
of a person’s employment with the employer from whose service he or she
is seconded.
Before appointing staff under
paragraph 6
or making arrangements under
paragraph 7
(1)
, the Commissioner must obtain the approval of the Secretary
of State as to the Commissioner’s policies on—
the number of staff to be appointed or seconded;
payments to be made to or in respect of staff;
the terms and conditions on which staff are to be appointed or
seconded.
A function of the Commissioner may be carried out by any of the
Commissioner’s staff to the extent authorised by the Commissioner (but
this is subject to
sub-paragraph (3)
).
Sub-paragraph (2) does not apply in respect of—
the Commissioner’s function under paragraph 2 (1) of Schedule 2 of making appointments to the list of persons eligible to be panel members;
the Commissioner’s function of determining applications for
reconsideration under section
18
.
The Secretary of State may—
make payments to the Commissioner of such amounts as the
Secretary of State considers appropriate;
give such financial assistance to the Commissioner as the Secretary
of State considers appropriate.
The Secretary of State may—
provide staff in accordance with arrangements made by the Secretary
of State and the Commissioner under
paragraph 7
;
provide premises, facilities or other assistance to the Commissioner.
The Commissioner must—
keep proper accounts and proper records in relation to them, and
prepare a statement of accounts in respect of each financial year in
the form specified by the Secretary of State.
The Commissioner must send a copy of each statement of accounts to the
Secretary of State and the Comptroller and Auditor General—
before the end of August next following the end of the financial
year to which the statement relates, or
on or before such earlier date after the end of that year as the
Treasury may direct.
The Comptroller and Auditor General must—
examine, certify and report on the statement of accounts, and
send a copy of the certified statement and the report to the Secretary
of State.
The Secretary of State must lay before Parliament each document received
under
sub-paragraph (3)
(b)
.
In this paragraph, “financial year” means—
the period beginning with the date on which the Commissioner is
established and ending with the second 31 March following that
date, and
each successive period of 12 months.
The application of the Commissioner’s seal is to be authenticated by the
signature of—
the Commissioner, or
a person who has been authorised by the Commissioner for that
purpose (whether generally or specially).
A document purporting to be duly executed under the Commissioner’s
seal or signed on the Commissioner’s behalf—
is to be received in evidence, and
is to be treated as duly executed or signed in that way, unless the
contrary is shown.
In Part 2 of the Table in paragraph 3 of the First Schedule to the
Public
“The Voluntary Assisted Dying Commissioner.”
Records Act 1958
(bodies whose records are public records), at the
appropriate place insert—
In
Part 3
of
Schedule 1
to the
House of Commons Disqualification Act 1975
(offices disqualifying person from membership of House of Commons), at
the appropriate place insert—
“The Voluntary Assisted Dying Commissioner or the Deputy
Voluntary Assisted Dying Commissioner.”
“The Voluntary Assisted Dying Commissioner.”
In
Part 1
of
Schedule 19
to the
Equality Act 2010
(public authorities subject
“The Voluntary Assisted Dying Commissioner.”
to public sector equality duty), at the end of the group of entries for bodies
whose functions relate to health, social care and social security insert—
In this Schedule—
“panel” means an Assisted Dying Review Panel.
The Commissioner must make appointments to a list of persons eligible to
sit as members of panels.
A person may be appointed to the list only if—
the person (a “legal member”)—
holds or has held high judicial office,
is one of His Majesty’s Counsel, or
has (at any time) been requested to act as a judge of the
Court of Appeal or the High Court by virtue of
section 9
(1)
of the
Senior Courts Act 1981
,
the person (a “psychiatrist member”) is—
a registered medical practitioner,
a practising psychiatrist, and
registered in one of the psychiatry specialisms in the
Specialist Register kept by the General Medical Council, or
the person is registered as a social worker in a register maintained
by Social Work England or Social Work Wales (a “social worker
member”).
In this paragraph “high judicial office” means office as—
a judge of the Supreme Court,
a judge of the Court of Appeal, or
a judge or deputy judge of the High Court.
Subject to the provisions of this paragraph, persons on the list hold and
vacate their appointments in accordance with the terms on which they are
appointed.
An appointment to the list is to be for a period not exceeding five years.
A person who has held appointment to the list is eligible for re-appointment
for one further period not exceeding five years.
The Commissioner must make arrangements for determining the
membership of a panel.
The arrangements must ensure that a panel consists of—
a legal member,
a psychiatrist member, and
a social worker member.
The Commissioner must ensure that each member of a panel has had
training in respect of domestic abuse, including coercive control and
financial abuse.
The legal member of a panel is to act as its chair.
Decisions of a panel may be taken by a majority vote; but this is subject
to
sub-paragraph (3)
.
The panel is to be treated as having decided to refuse to grant a certificate
of eligibility if any member—
votes against a decision to grant such a certificate, or
abstains from voting on such a decision.
Panels are to determine referrals in public; but this is subject to sub-paragraph (2) .
The chair of a panel may, at the request of the person to whom a referral
relates, decide that the panel is to sit in private.
The Commissioner may make staff and other facilities available to panels.
The Commissioner may give guidance about the practice and procedure
of panels.
Panels must have regard to any such guidance in the exercise of their
functions.
Panels must give reasons, in writing, for their decisions.
As soon as reasonably practicable after making a decision, a panel must
give the following a document containing its reasons for the decision—
the person to whom the referral in question relates;
the coordinating doctor in relation to the person;
the Commissioner.
The Commissioner may pay to or in respect of members of panels—
remuneration;
allowances;
sums by way of or in respect of pensions.
In
Part 3
of
Schedule 1
to the
House of Commons Disqualification Act 1975
(offices disqualifying persons from membership of House of Commons),
at the appropriate place insert—
“Person on the list of those eligible for membership of an Assisted
Dying Review Panel.”
The Employment Rights Act 1996 is amended as follows.
“43N Provision of assistance under Terminally Ill Adults (End of Life)
Act 2025(1)
A worker has the right not to be subjected to any detriment by any
act, or any deliberate failure to act, by the worker’s employer done on the ground that the worker has—(a)
exercised (or proposed to exercise) a right conferred on the
worker under section 31 of the Terminally Ill Adults (End of Life) Act 2025 (no obligation to provide assistance etc), or(b)
participated in the provision of assistance to a person to end
their own life in accordance with that Act, or performed any other function under that Act, in accordance with that Act.(2)
Subsection (1) does not apply where—
(a)
the worker is an employee, and
(b)
the detriment in question amounts to dismissal within the
meaning of Part 10.(3)
For the purposes of this section, and of sections 48 and 49 so far as
relating to this section, “worker” and “employer” have the extended meaning given by section 43K.”
Section 48 (complaints to employment tribunals) is amended as follows.
“(1WA)
A worker may present a complaint to an employment tribunal that
the worker has been subjected to a detriment in contravention of section 43N (1) .”
In subsection (2) , after “(1)” insert “, (1WA) ”.
Section 49 (remedies) is amended as follows.
In subsection (1) , after “section 48(1)” insert “, (1WA) ”.
In subsection (2) , after “subsections” insert “ (5YA) ,”.
“(5YA)
Where—
(a)
the complaint is made under section 48 (1WA) ,
(b)
the detriment to which the worker is subjected is the
termination of the worker’s contract, and(c)
that contract is not a contract of employment,
any compensation must not exceed the compensation that would be payable under Chapter 2 of Part 10 if the worker had been an employee and had been dismissed for a reason specified in section
98C .”
“98C Provision of assistance under Terminally Ill Adults (End of Life)
Act 2025An employee who is dismissed is to be regarded for the purposes of this Part as unfairly dismissed if the reason (or if more than one, the principal reason) for the dismissal is that the employee—
(a)
exercised (or proposed to exercise) a right conferred on the
employee under section 31 of the Terminally Ill Adults (End of Life) Act 2025 (no obligation to provide assistance etc), or(b)
participated in the provision of assistance to a person to end
their own life in accordance with that Act, or performed any other function under that Act, in accordance with that Act.”
“(2B)
This subsection applies if the reason (or, if more than one, the
principal reason) for which the employee was selected for dismissal was one of those specified in section 98C .”
In
section 108
(qualifying period of employment), in subsection (3), after
section 98C
applies,”.
paragraph (aa) insert—
“(ab)
In
section 205
(remedy for infringement of certain rights), after subsection In relation to the right conferred by
section 43N
(1)
, the reference in
(1) insert—
“(1XA)
subsection (1) to an employee has effect as a reference to a worker.”
In section 230 (definitions of employees, workers etc) in subsection (6)—
after “Part IVA” insert “, section 43N ”.
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; and for connected purposes.
Brought from the Commons on
Ordered to be Printed, .
© Parliamentary copyright House of Commons and House of Lords 2025
This publication may be reproduced under the terms of the Open Parliament Licence, which is published at www.parliament.uk/site-information/copyright
Published by the authority of the House of Lords