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Assisted Dying Bill (HL Bill 6)

A

BILL

TO

Enable competent adults who are terminally ill to be provided at their request
with specified assistance to end their own life; and for connected purposes.

Be it enacted by the Queen’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:—

1 Assisted dying

(1) A person who is terminally ill may request and lawfully be provided with
assistance to end his or her own life.

(2) Subsection (1) only applies where the person—

(a) 5has a clear and settled intention to end his or her own life;

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

(c) on the day the declaration is made—

(i) is aged 18 or over; and

(ii) has been ordinarily resident in England and Wales for not less
10than one year.

2 Terminal illness

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

(a) has been diagnosed by a registered medical practitioner as having an
inevitably progressive condition which cannot be reversed by
15treatment (“a terminal illness”); and

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

(2) Treatment which only relieves the symptoms of an inevitably progressive
condition temporarily is not to be regarded as treatment which can reverse that
20condition.

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3 Declaration

(1) For the purposes of this Act, a person has a clear and settled intention to end
their own life if—

(a) the person has made and signed a declaration to that effect in the form
5in the Schedule in the presence of a witness (who must not be a relative
or directly involved in the person’s care or treatment) who signed the
declaration in the person’s presence; and

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

(i) 10the registered medical practitioner from whom the person has
requested assistance to end their life (“the attending doctor”);
and

(ii) another registered medical practitioner (“the independent
doctor”) who is not a relative, partner or colleague in the same
15practice or clinical team, of the attending doctor;

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

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

(3) 20Before countersigning a person’s declaration the attending doctor and the
independent doctor, having separately examined the person and the person’s
medical records and each acting independently of the other, must be satisfied
that the person—

(a) is terminally ill;

(b) 25has the capacity to make the decision to end their own life; and

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

(4) In deciding whether to countersign a declaration under subsection (3), the
30attending doctor and the independent doctor must be satisfied that the person
making it has been fully informed of the palliative, hospice and other care
which is available to that person.

(5) A declaration under this section shall be valid and take effect on the day that it
is countersigned by the independent doctor.

(6) 35A person who has made a declaration under this section may revoke it at any
time and revocation need not be in writing.

(7) For the purpose of subsection (1)(b)(ii), an independent doctor is suitably
qualified if that doctor holds such qualification or has such experience in
respect of the diagnosis and management of terminal illness as the Secretary of
40State may specify in regulations.

4 Assistance in dying

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

(2) Any medicines prescribed under subsection (1) shall only be delivered to the
45person for whom they are prescribed—

(a) by the attending doctor; or

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(b) by—

(i) another registered medical practitioner; or

(ii) a registered nurse;

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

(c) 5after the assisting health professional has confirmed that the person has
not revoked and does not wish to revoke their declaration; and

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

(3) If the attending doctor and the independent doctor agree that a person’s death
10from terminal illness is reasonably expected to occur within one month of the
day on which a declaration takes effect, the period specified in subsection
(2)(d) is reduced to six days.

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

(a) 15prepare that medicine for self-administration by that person;

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

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

but the decision to self-administer the medicine and the final act of doing so
20must be taken by the person for whom the medicine has been prescribed.

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

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

(a) 25self-administered the medicine and died; or

(b) decided not to self-administer the medicine;

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

(7) 30The Secretary of State may by regulations specify—

(a) the medicines which may be prescribed under this section;

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

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

(8) 35Regulations under subsection (7)(c) shall provide that an assisting health
professional—

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

(b) 40in the event that the person decides not to self-administer the medicine,
must immediately remove it from that person and, as soon as
reasonably practicable, return it to the pharmacy from which it was
dispensed.

(9) Regulations under subsection (7) may—

(a) 45make different provision for different purposes; and

(b) include consequential, incidental, supplementary or transitional
provisions.

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

5 Conscientious objection

5A person shall not be under any duty (whether by contract or arising from any
statutory or other legal requirement) to participate in anything authorised by
this Act to which that person has a conscientious objection.

6 Criminal liability

(1) A person who provides any assistance in accordance with this Act shall not be
10guilty of an offence.

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

2C Assisted dying

Sections 2, 2A and 2B shall not apply to any person in respect of the
provision of assistance to another person in accordance with that Act..

7 15Inquests, death certification etc.

(1) A person is not to be regarded as having died in circumstances to which section
8(1)(a) or (b) of the Coroners Act 1988 (duty to hold inquest) apply only
because the person died as a consequence of the provision of assistance in
accordance with this Act.

(2) 20In the Births and Deaths Registration Act 1953, after section 39A (regulations
made by the Minister: further provisions), insert—

39B Regulations: Assisted Dying

(1) The Secretary of State may make regulations—

(a) providing for any provision of this Act relating to the
25registration of deaths to apply in respect of deaths which arise
from the provision of assistance in accordance with the Assisted
Dying Act 2014 with such modifications as may be prescribed in
respect of—

(i) the information which is to be provided concerning such
30deaths;

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

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

(b) 35requiring the Registrar General to prepare at least once each
year a report providing a statistical analysis of deaths which
have arisen from the provision of assistance in accordance with
the Assisted Dying Act 2014;

(c) containing such incidental, supplemental and transitional
40provisions as the Secretary of State considers appropriate.

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

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

(4) The power of the Secretary of State to make regulations under this
5section is exercisable by statutory instrument.

(5) A statutory instrument containing regulations made under this section
by the Secretary of State is subject to annulment in pursuance of a
resolution of either House of Parliament..

8 Codes of practice

(1) 10The Secretary of State may issue one or more codes of practice in connection
with—

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

(i) assessing whether the person has capacity to make such a
15decision;

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

(iii) the information which is made available on treatment and end
20of life care options available to them and of the consequences of
deciding to end their own life; and

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

(2) Before issuing a code under this section the Secretary of State shall consult such
25persons as the Secretary of State thinks appropriate.

9 Monitoring

(1) The relevant Chief Medical Officer shall—

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

(b) 30inspect and report to the relevant national authority on any matter
connected with the operation of the Act which the relevant national
authority refers to the relevant Chief Medical Officer; and

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

(2) 35The Chief Medical Officers may combine their annual reports for the same year
in a single document (“a combined report“) in such manner as they consider
appropriate.

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

(a) 40the Secretary of State must lay a copy of each report before Parliament;
and

(b) the Welsh Ministers must lay a copy of each report before the National
Assembly for Wales.

(4) In this section—

  • 45“relevant Chief Medical Officer” means—

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    (a)

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

    (b)

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

  • 5“relevant national authority” means—

    (a)

    in England, the Secretary of State; and

    (b)

    in Wales, the Welsh Ministers.

10 Offences

(1) A person commits an offence if the person—

(a) 10makes or knowingly uses a false instrument which purports to be a
declaration made under section 3 by another person; or

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

(2) A person (A) commits an offence if, in relation to another person (B) who is
15seeking to make or has made a declaration under section 3, A knowingly or
recklessly provides a medical or other professional opinion in respect of B
which is false or misleading in a material particular.

(3) A person guilty of an offence under subsection (1)(a) which was committed
with the intention of causing the death of another person is liable, on
20conviction on indictment, to imprisonment for life or a fine or both.

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

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

(b) 25on conviction on indictment, to imprisonment for a period not
exceeding five years or a fine or both.

11 Regulations

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

(2) 30A statutory instrument containing regulations under this Act is subject to
annulment in pursuance of a resolution of either House of Parliament.

12 Interpretation

In this Act—

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

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

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

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

    (a)

    the spouse or civil partner of that person;

    (b)

    40any lineal ancestor, lineal descendant, sibling, aunt, uncle or
    cousin of that person or the person’s spouse or civil partner; or

    (c)

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

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

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

13 5Citation, commencement, repeal and extent

(1) This Act may be cited as the Assisted Dying Act 2014.

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

(a) sections 4, 7 and 11 so far as they confer a power to make regulations;

(b) section 8 so far as it confers a power to issue codes of practice;

(c) 10sections 11 and 12; and

(d) this section.

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

(4) At any time during the period of 12 months beginning on the day ten years
15after the provisions in subsection (3) come into force, this Act may be repealed
by a resolution of each House of Parliament.

(5) This Act does not extend to Scotland or Northern Ireland.

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Section 3

Schedule Form of declaration

Declaration: Assisted Dying Act 2014

Name of declarant: Date of Birth:
Address:
I have [condition], a terminal condition from which I am expected to die
5within six months of the date of this declaration.
The Attending Doctor and Independent Doctor identified below have
each fully informed me about that diagnosis and prognosis and the
treatments available to me, including pain control and palliative care.
Having considered all this information, I have a clear and settled
10intention to end my own life and, in order to assist me to do so, I have
asked my attending doctor to prescribe medicines for me for that
purpose.
I make this declaration voluntarily and in the full knowledge of its
significance.
15I understand that I may revoke this declaration at any time.
Signature: Date:
Witness
Name of witness:
Address:
20This declaration was signed by [name of declarant] in my presence and
signed by me in [his/her] presence.
Signature: Date:
Countersignature: Attending Doctor

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I confirm that [name], who at the date of this declaration is [age] years
of age and has been ordinarily resident in England and Wales for [time]:
(1) is terminally ill and that the diagnosis and prognosis set above is
correct;
5(2) has the capacity to make the decision to end their own life; and
(3) has a clear and settled intention to do so, which has been reached on
an informed basis, without coercion or duress, and having been
informed of the palliative, hospice and other care which is available to
[him/her].