House of Lords portcullis
House of Lords
Session 2003 - 04
Internet Publications
Other Bills before Parliament

Assisted Dying for the Terminally Ill Bill [HL]


Assisted Dying for the Terminally Ill Bill [HL]

1

 

A

Bill

To

Enable a competent adult who is suffering unbearably as a result of a terminal

illness to receive medical assistance to die at his own considered and

persistent request; and to make provision for a person suffering from a

terminal illness to receive pain relief medication. 

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       

Authorisation of assisted dying

(1)   

Subject to the provisions of this Act, it shall be lawful for a physician to assist

a patient who is a qualifying patient, and who has made a declaration in

accordance with this Act that is for the time being in force, to die.

(2)   

For the purposes of this Act—

5

   

“assisted dying” means the attending physician, at the patient’s request,

either providing the patient with the means to end the patient’s life or

if the patient is physically unable to do so ending the patient’s life;

   

“attending physician” means the physician who has primary

responsibility for the care of the patient and the treatment of the

10

patient’s illness;

   

“competent” means having the capacity to make an informed decision,

and “competence” shall be construed accordingly;

   

“consulting physician” means a consultant physician practising in the

National Health Service who is qualified by speciality to make a

15

professional diagnosis and prognosis regarding the patient’s illness

and who is independent of the attending physician;

   

“declaration” means a witnessed declaration in writing made by the

qualifying patient in the form set out in the Schedule to this Act, as

amended from time to time by regulations;

20

   

“incompetent” means not having the capacity to make an informed

decision, and “incompetence” shall be construed accordingly;

   

“informed decision” means a decision by a qualifying patient to request

medical assistance to die, which is based on an appreciation of the

 
HL Bill 1753/3
 
 

Assisted Dying for the Terminally Ill Bill [HL]

2

 

relevant facts and after being fully informed by the attending

physician, and the consulting physician (save in respect of (c) below),

of—

(a)   

his medical diagnosis;

(b)   

his prognosis;

5

(c)   

the process of being assisted to die; and

(d)   

the alternatives, including, but not limited to, palliative care,

care in a hospice and the control of pain;

   

“medical care team” means a person or persons assisting the attending

physician in the provision of medical care to a patient, and includes but

10

without limitation a nurse or pharmacist;

   

“monitoring commission” means a commission set up by the Secretary of

State to monitor the workings of this Act in a country or region forming

a part of Great Britain;

   

“patient” means a person who is under the care of a physician;

15

   

“physician” means a registered medical practitioner;

   

“qualifying conditions” means those conditions set out in sections 2, 3, 4

and 5;

   

“qualifying patient” means a patient who has reached the age of majority,

who has been resident in Great Britain for not less than twelve months

20

as at the date of the declaration and in respect of whom all the

qualifying conditions under sections 2, 3, 4 and 5 are met;

   

“terminal illness” means an illness which in the opinion of the consulting

physician is inevitably progressive, the effects of which cannot be

reversed by treatment (although treatment may be successful in

25

relieving symptoms temporarily) and which will be likely to result in

the patient’s death within a few months at most;

   

“unbearable suffering” means suffering whether by reason of pain or

otherwise which the patient finds so severe as to be unacceptable and

results from the patient’s terminal illness; and “suffering unbearably”

30

shall be construed accordingly;

   

“waiting period” means that period of time between the date on which the

patient first informed the attending physician that the patient wishes to

be assisted to die in accordance with section 2(2)(a) and the date on

which the patient is assisted to die, and such period shall not be less

35

than 14 days in all; and

   

“witness” means a person who signs by way of attestation a declaration

made under section 4.

2       

Qualifying conditions

(1)   

Before the attending physician can assist a qualifying patient to die the

40

conditions specified in this section and sections 3, 4 and 5 must be satisfied.

(2)   

The attending physician shall have—

(a)   

been informed by the patient that the patient wishes to be assisted to

die;

(b)   

examined the patient and the patient’s medical records and have no

45

reason to believe the patient is incompetent;

(c)   

made a determination that the patient has a terminal illness;

(d)   

concluded that the patient is suffering unbearably as a result of that

terminal illness;

 

 

Assisted Dying for the Terminally Ill Bill [HL]

3

 

(e)   

informed the patient of—

(i)   

his medical diagnosis;

(ii)   

his prognosis;

(iii)   

the process of being assisted to die;

(iv)   

the alternatives, including, but not limited to, palliative care,

5

care in a hospice and the control of pain;

(f)   

if the patient persists with his request to be assisted to die, satisfied

himself that the request is made voluntarily and that the patient has

made an informed decision; and

(g)   

referred the patient to a consulting physician.

10

(3)   

The consulting physician shall have—

(a)   

been informed by the patient that the patient wishes to be assisted to

die;

(b)   

examined the patient and the patient’s medical records and satisfied

himself that the patient is competent;

15

(c)   

confirmed the diagnosis and prognosis made by the attending

physician;

(d)   

concluded that the patient is suffering unbearably as a result of the

terminal illness;

(e)   

informed the patient of the alternatives including, but not limited to,

20

palliative care, care in a hospice and the control of pain;

(f)   

if the patient still persists with his request to be assisted to die, satisfied

himself that the request is made voluntarily and that the patient has

made an informed decision; and

(g)   

advised the patient that prior to such assistance the patient will be

25

required to complete a declaration which the patient can revoke.

3       

Offer of palliative care

(1)   

The attending physician shall ensure that a specialist in palliative care who

shall be a physician or nurse has attended the patient to discuss the option of

palliative care.

30

(2)   

Only once the requirements of sections 2(2), 2(3) and 3(1) have been satisfied

may the patient make the declaration in the form set out in the Schedule.

4       

Declaration made in advance

(1)   

When the conditions set out in sections 2 and 3 have been met, a patient who

wishes to be assisted to die must make a declaration in the form set out in the

35

Schedule.

(2)   

The declaration must be witnessed by two individuals one of whom shall be a

solicitor who holds a current practising certificate.

(3)   

The solicitor may only witness the declaration if—

(a)   

the patient is personally known to the solicitor or has proved his

40

identity to the solicitor;

(b)   

it appears to the solicitor that the patient is of sound mind and has

made the declaration voluntarily; and

(c)   

the solicitor is satisfied that the patient understands the effect of the

declaration.

45

 

 

Assisted Dying for the Terminally Ill Bill [HL]

4

 

(4)   

The other witness may only witness the declaration if—

(a)   

the patient is personally known to that witness or has proved his

identity to that witness; and

(b)   

it appears to that witness that the patient is of sound mind and has

made the declaration voluntarily.

5

(5)   

The patient and witnesses shall sign and witness the declaration respectively

at the same time and each in the presence of the others.

(6)   

The attending or consulting physician, psychiatrist or member of the medical

care team, or a relative or partner (by blood, marriage or adoption) of the

qualifying patient signing this request may not witness the declaration.

10

(7)   

No person who owns, operates or is employed at a health care establishment

where the person is a patient or resident may witness the declaration.

(8)   

The declaration shall come into force after the requisite waiting period has

elapsed and shall remain in force (unless revoked) for six months.

5       

Further duties of attending physician

15

Before taking any step to assist the patient to die the attending physician shall

have—

(a)   

informed the patient of his right to revoke the declaration;

(b)   

verified immediately before assisting the patient to die that the

declaration is in force and that it has not been revoked by the patient;

20

and

(c)   

asked the patient immediately before assisting him to die whether he

wishes to revoke the declaration.

6       

Revocation of declaration

(1)   

A patient may revoke his declaration whether orally or in any other manner

25

without regard to his physical or mental state.

(2)   

In the event of a declaration being revoked, the attending physician shall

ensure that a note recording its revocation is made on the patient’s file and that

the declaration is removed from the patient’s medical file and destroyed.

7       

Duties of physicians, and conscientious objection

30

(1)   

No person shall be under any duty, whether by contract or by any statutory or

other legal requirement, to participate in any diagnosis, treatment or other

action authorised by this Act to which he has a conscientious objection.

(2)   

If an attending physician whose patient makes a request to be assisted to die in

accordance with this Act or to receive pain relief under section 15 has a

35

conscientious objection as provided in subsection (1), he shall take appropriate

steps to ensure that the patient is referred without delay to an attending

physician who does not have such a conscientious objection.

(3)   

If a consulting physician to whom a patient has been referred in accordance

with section 2(2)(g) has a conscientious objection as provided in subsection (1),

40

he shall take appropriate steps to ensure that the patient is referred without

delay to a consulting physician who does not have such a conscientious

objection.

 

 

 
previous section contents continue
 
House of Lords home page Houses of Parliament home page House of Commons home page search page enquiries

© Parliamentary copyright 2004
Revised 9 January 2004