Assisted Dying for the Terminally Ill Bill [HL]

House of Lords

Session 2005 - 06
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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 an adult who has capacity and 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 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
Authorisation of assisted dying
Subject to the provisions of this Act, it shall be lawful for—
(a)
a physician to assist a patient who is a qualifying patient to die—
(i)
by prescribing such medication, and
(ii)
in the case of a patient for whom it is impossible or
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inappropriate orally to ingest that medication, by prescribing
and providing such means of self-administration of that
medication,

as will enable the patient to end his own life, and
(b)
a person who is a member of a health care team to work in conjunction
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with a physician to whom paragraph (a) of this section applies.
2
Qualifying conditions
(1)
Before the assisting physician can assist a patient to die the conditions specified
in subsections (2) and (3) must be satisfied, the patient must have made a
declaration in accordance with section 4 and the requirements of section 5(3)
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must have been complied with.
(2)
The first condition is that the attending physician shall have—
(a)
been informed by the patient in a written request signed by the patient
that the patient wishes to be assisted to die;
(b)
examined the patient and the patient’s medical records and satisfied
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himself that the patient does not lack capacity;
(c)
determined that the patient has a terminal illness;

HL Bill 36 54/1

Assisted Dying for the Terminally Ill Bill [HL]
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(d)
concluded that the patient is suffering unbearably as a result of that
terminal illness;
(e)
informed the patient of—
(i)
his medical diagnosis;
(ii)
his prognosis;
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(iii)
the process of being assisted to die; and
(iv)
the alternatives to assisted dying, including, but not limited to,
palliative care, care in a hospice and the control of pain;
(f)
ensured that a specialist in palliative care, who shall be a physician or a
nurse, has attended the patient to inform the patient of the benefits of
10
the various forms of palliative care,
(g)
recommended to the patient that the patient notifies his next of kin of
his request for assistance to die,
(h)
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
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made an informed decision; and
(i)
referred the patient to a consulting physician.
(3)
The second condition is that the consulting physician shall have—
(a)
been informed by the patient that the patient wishes to be assisted to
die;
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(b)
examined the patient and the patient’s medical records and satisfied
himself that the patient does not lack capacity;
(c)
confirmed the diagnosis and prognosis made by the attending
physician;
(d)
concluded that the patient is suffering unbearably as a result of the
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terminal illness;
(e)
informed the patient of the alternatives to assisted dying including, but
not limited to, 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
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made an informed decision; and
(g)
advised the patient that prior to being assisted to die the patient will be
required to complete a declaration which the patient can revoke.
(4)
For the purposes of this Act, a person lacks capacity in relation to being assisted
to die if at the material time he is unable to make a decision for himself in
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relation to that matter because of an impairment of, or a disturbance in the
functioning of, the mind or brain resulting from any disability or disorder of
the mind or brain.
3
Determination of lack of capacity
(1)
If, in the opinion of either the attending or the consulting physician, a patient
40
who wishes to make a declaration may lack capacity, the attending physician
shall refer the patient to a consultant psychiatrist, or a psychologist, who shall
be independent of the attending and consulting physicians, for an opinion as
to the patient’s capacity.
(2)
No assistance to end the patient’s life may be given unless the consultant
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psychiatrist or the psychologist has determined that the patient does not lack
capacity.

Assisted Dying for the Terminally Ill Bill [HL]
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4
Declaration
(1)
When the qualifying conditions have been met, a patient who wishes to be
assisted to die must make a declaration of his wish to die in the form prescribed
by regulations made by the Secretary of State.
(2)
The declaration must be witnessed by two individuals one of whom shall be
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either a solicitor who holds a current practising certificate or a public notary.
(3)
The solicitor or public notary may only witness the declaration if—
(a)
the patient is personally known to, or has proved his identity to, him;
(b)
it appears to him that the patient is of sound mind and has made the
declaration voluntarily; and
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(c)
he is satisfied that the patient understands the effect of the declaration.
(4)
The patient and witnesses shall sign and witness the declaration respectively
at the same time and each in the presence of the others.
(5)
Neither the attending or consulting physician, nor a member of the health care
team, a consultant psychiatrist or a psychologist consulted under section 3, nor
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a relative or partner (by blood, marriage or adoption) of the patient who wishes
to be assisted to die, may witness the declaration.
(6)
No person who owns, operates or is employed at a health care establishment
where the patient is a resident or is receiving medical treatment may witness
the declaration.
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5
Duties of assisting physician
(1)
The assisting physician shall be either the attending physician or the consulting
physician.
(2)
The assisting physician shall not take any action to assist the patient to die until
after the expiration of a period of 14 days from the date on which the patient
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informed the attending physician under section 2(2)(a) that the patient wished
to be assisted to die.
(3)
Before taking any step to assist the patient to die the existing physician shall
have—
(a)
informed the patient of his right to revoke the declaration, and
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(b)
asked the patient to confirm that the declaration has not been revoked,
and received such confirmation.
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Revocation of declaration
(1)
A patient may revoke his declaration orally or in any other manner and
irrespective of his physical or mental state.
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(2)
In the event of a declaration being revoked, the assisting physician, or if there
is no assisting physician, the attending physician, shall ensure that a note
recording its revocation is made on the patient’s file.
7
Conscientious objection
(1)
No person shall be under any duty to participate in any diagnosis, treatment
40
or other action authorised by this Act, apart from subsection (6), to which he
has a conscientious objection.

Assisted Dying for the Terminally Ill Bill [HL]
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(2)
No hospice, hospital, nursing home, clinic or other health care establishment
shall be under any obligation to permit an assisted death on its premises.
(3)
No person shall be under any duty to raise the option of assisted dying with a
patient, to refer a patient to any other source for obtaining information or
advice pertaining to assistance to die, or to refer a patient to any other person
5
for assistance to die under the provisions of this Act.
(4)
If an attending physician whose patient makes a request to be assisted to die in
accordance with this Act has a conscientious objection as provided in
subsection (1), the patient shall be free to consult another physician who does
not have a conscientious objection and who, for the purposes of this Act, shall
10
then be the patient’s attending physician.
(5)
If a consulting physician to whom a patient has been referred in accordance
with section 2(2)(i) has a conscientious objection as provided in subsection (1),
the patient shall be free to consult another consulting physician who does not
have a conscientious objection and who, for the purposes of this Act, shall then
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be the patient’s consulting physician.
(6)
Where a patient has consulted a physician under subsection (4) or (5) the
physician who has a conscientious objection shall immediately, on receipt of a
request to do so, transfer the patient’s medical records to the new physician.
8
Protection for health care professionals and other persons
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(1)
A physician who assists a qualifying patient to die, or attempts to do so, in
accordance with the requirements of this Act, shall not, by so doing, be guilty
of an offence.
(2)
A member of a health care team who works in conjunction with a physician
who assists a qualifying patient to die, or attempts to do so, in accordance with
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the requirements of this Act, or in reliance on information supplied to him that
the requirements of this Act in relation to the patient had been fully complied
with, shall not by so doing be guilty of an offence.
(3)
A person who is present when—
(a)
a qualifying patient dies, having received assistance to die, or
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(b)
an attempt is made to assist a qualifying patient to die,

shall not be guilty of an offence provided that he is present in reliance on
information provided to him that the requirements of this Act in relation to the
patient have been complied with.
(4)
A physician to whom subsection (1) of this section applies or a member of a
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health care team to whom subsection (2) of this section applies, shall be
deemed not to be in breach of any professional oath or affirmation.
(5)
No physician, psychiatrist, psychologist or member of a health care team may
take any part in assisting a qualifying patient to die, or in giving an opinion in
respect of such a patient, nor may any person act as a witness, if he has grounds
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for believing that he will benefit financially or in any other way, except for his
proper professional fees or salary, as a result of the death of that patient.