Assisted Dying Bill (HL Bill 25)

1 Assisted dying

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

(2) 5Subsection (1) applies only if the High Court (Family Division), by order,
confirms that it is satisfied that the person—

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

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

(c) 10on the day the declaration is made—

(i) is aged 18 or over;

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

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

2 15Terminal illness

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

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

(b) 20as a consequence of that terminal illness, is reasonably expected to die
within six months.

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

3 Declaration

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

(a) the person has made and signed a declaration that he or she has a
5voluntary, clear, settled and informed wish to end his or her life in the
form in the Schedule in the presence of a witness (who must not be a
relative or directly involved in the person’s care or treatment) who
signed the declaration in the person’s presence; and

(b) that declaration has been countersigned in accordance with subsection
10(3) by—

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

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

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

(2) The attending doctor (but not the independent doctor) may, but need not be,
the registered medical practitioner who diagnosed that the person is terminally
20ill or first informed the person of that diagnosis.

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

(a) 25is terminally ill;

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

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

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

(5) If the attending doctor or indpendent doctor has doubt as to a person’s
35capacity to make a decision under subsection (3)(b) or (c), before deciding
whether to countersign a declaration made by that person the doctor must—

(a) refer the person for assessment by an appropriate specialist; and

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

(6) 40A declaration under this section shall be valid and take effect on such date as
the High Court (Family Division) may order.

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

(8) For the purpose of subsection (1)(b)(ii), an attending or independent doctor is
45suitably qualified if that doctor holds such qualification or has such experience,
including in respect of the diagnosis and management of terminal illness as the
Secretary of State may specify in regulations (which may make different
provision for different purposes).

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

4 5Assistance 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
person for whom they are prescribed—

(a) 10by the attending doctor; or

(b) by—

(i) another registered medical practitioner; or

(ii) a registered nurse;

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

(c) 15after 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
20from 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) 25prepare 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
30must 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) 35self-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) 40The Secretary of State may by regulations specify—

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

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

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

(8) Regulations under subsection (7)(c) 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
5intended use; and

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

(9) 10Regulations under subsection (7) may—

(a) make different provision for different purposes; and

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

(10) In this section, “assisting health professional” means the attending doctor or a
15person authorised by the attending doctor in accordance with subsection
(2)(b).

5 Conscientious objection

A 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
20this 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
guilty of an offence.

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

“2C 25Assisted 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 the
Assisted Dying Act 2015.”.”

7 Inquests, death certification etc.

(1) 30A person is not to be regarded as having died in circumstances to which
section 1(2)(a) or (b) of the Coroners and Justice Act 2009 (duty to investigate
certain deaths) apply only because the person died as a consequence of the
provision of assistance in accordance with this Act.

(2) In the Births and Deaths Registration Act 1953, after section 39A (regulations
35made by the Minister: further provisions), insert—

“39B Regulations: assisted dying

(1) The Secretary of State may make regulations—

(a) providing for any provision of this Act relating to the
registration of deaths to apply in respect of deaths which arise
40from the provision of assistance in accordance with the Assisted
Dying Act 2015 with such modifications as may be prescribed in
respect of—

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

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

(iii) 5the form and manner in which such deaths are to be
registered;

(b) requiring the Registrar General to prepare at least once each
year a report providing a statistical analysis of deaths which
have arisen from the provision of assistance in accordance with
10the Assisted Dying Act 2015;

(c) containing such incidental, supplemental and transitional
provisions 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”.

(3) 15Any 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
section is exercisable by statutory instrument.

(5) 20A 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) The Secretary of State may issue one or more codes of practice in connection
25with—

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

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

(ii) 30recognising and taking account of the effects of depression or
other psychological disorders that may impair a person’s
decision-making;

(iii) the information which is made available on treatment and end
of life care options available to them and of the consequences of
35deciding to end their own life;

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

(v) the arrangements for delivering medicines to the person for
whom they have been prescribed under section 4, and the
40assistance which such a person may be given to ingest or self-
administer them; 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
45persons as the Secretary of State thinks appropriate.

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

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

(5) An order bringing a code into operation may not be made unless a draft of the
order has been laid before Parliament and approved by a resolution of each
House.

(6) 5When a draft order is laid, the code to which it relates must also be laid.

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

9 10Monitoring

(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) inspect and report to the relevant national authority on any matter
15connected with the operation of the Act which the relevant national
authority refers to the relevant Chief Medical Officer; and

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

(2) The Chief Medical Officers may combine their annual reports for the same year
20in a single document (“a combined report“) in such manner as they consider
appropriate.

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

(a) the Secretary of State must lay a copy of each report before Parliament;
25and

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

(4) In this section—

• “relevant Chief Medical Officer” means—

  (a)

  30in England, the Chief Medical Officer to the Department of
  Health; and

  (b)

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

• “relevant national authority” means—

  (a)

  35in England, the Secretary of State; and

  (b)

  in Wales, the Welsh Ministers.

10 Offences

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

(a) makes or knowingly uses a false instrument which purports to be a
40declaration made under section 3 by another person; or

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

(2) A person (A) commits an offence if, in relation to another person (B) who is
seeking to make or has made a declaration under section 3, A knowingly or

recklessly provides a medical or other professional opinion in respect of B
which is false or misleading in a material particular.

(3) A person guilty of an offence under subsection (1)(a) which was committed
with the intention of causing the death of another person is liable, on
5conviction 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) 10on 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) 15A 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;

• 20“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)

  25any lineal ancestor, lineal descendant, sibling, aunt, uncle or
  cousin of that person or the person’s spouse or civil partner; or

  (c)

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

  and for the purposes of deducing any such relationship a spouse or
  30civil partner includes a former spouse or civil partner, a partner to
  whom the person is not married, and a partner of the same sex; and

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

13 Extent, commencement, repeal and short title

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

(2) 35The 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) sections 11 and 12; and

(d) this section.

(3) 40Subject 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
after the provisions in subsection (3) come into force, this Act may be repealed
by a resolution of each House of Parliament.

(5) This Act may be cited as the Assisted Dying Act 2015.

Section 3

Schedule Form of declaration