Terminally ill adults who are expected to die within six months would be able to request assistance to end their own life under proposed legislation for England and Wales.
Under a bill published on Monday, two independent doctors would have to be satisfied someone is eligible and has made their decision voluntarily. Requests would also have to be approved by a High Court judge.
Labour MP Kim Leadbeater, who has put forward the bill, said it includes “the strictest safeguards anywhere in the world”.
However, opponents of assisted dying have raised concerns that people could feel pressured into ending their lives.
MPs will take part in an initial debate and vote on the Terminally Ill Adults (End of Life) Bill on 29 November.
It will be the first time since 2015 that the House of Commons has voted on the issue of assisted dying. Back then, MPs rejected proposals to allow some terminally ill adults to end their lives with medical supervision.
If the bill passes the first vote, it will receive further scrutiny from MPs and peers, who could choose to amend it.
A final version would require approval by both the House of Commons and Lords to become law.
The government has taken a neutral stance, allowing MPs to have a free vote on the matter – meaning they can make their own choice and do not have to follow the party line.
Current laws in the UK prevent people from asking for medical help to die.
A separate bill to legalise assisted dying has also been proposed in Scotland.
The bill for England and Wales requires those who apply for assisted dying to:
- Be over the age of 18, a resident in England and Wales and registered with a GP for at least 12 months
- Have the mental capacity to make a choice about ending their life
- Express a “clear, settled and informed” wish, free from coercion or pressure, at every stage of the process
There would have to be a period of at least seven days between two doctors making their assessments and another 14 days after the judge has made a ruling, unless the person’s death is expected imminently.
The individual would be allowed to change their mind at any time and no doctors would be obliged to take part in the process.
If all the criteria and safeguards are met, the substance to end someone’s life must be self-administered.
A doctor may prepare the substance or assist the individual to ingest it but the final act of doing so must be taken by the person themselves.
It would remain illegal for a doctor or anybody else to end a person’s life.
Under the proposed legislation, it would also be illegal to pressure or coerce someone into making a declaration that they wish to end their life.
The offence would carry a sentence of up to 14 years in jail.
Campaigners supporting the bill, including broadcaster Dame Esther Rantzen, argue terminally ill people should get a choice over how they die to avoid unnecessary suffering.
Leadbeater said the current law in the UK was “not fit for purpose” and was “leading to people having horrible deaths, taking their own lives, having to go to other countries if they can afford it”.
She told the BBC she hoped MPs would be reassured by the bill’s safeguards, adding: “What I would say to colleagues is, if you vote against the bill, or even if you abstain, youâ€re saying that the status quo is OK and it’s not OK.”
Dame Esther, who revealed last year she had joined Dignitas after a terminal cancer diagnosis, described the new bill as “wonderfulâ€‌ and said reform would stop more people having to go through “agonising deaths”.
She said unless her current medication turns out to be “totally miraculous” and extends her life by a few years “there’s no way an assisted dying law can come into force in time for me”.
Elise Burns, from Kent, is terminally ill with breast cancer and wants the option of an assisted death.
“Iâ€m not scared to die but I am scared of a bad death – a long, drawn out, brutal, horrific death. That terrifies me,” she told the BBC.
“But also Iâ€m concerned for my family and friends. I donâ€t want them to see me go through that.”
Conservative MP Kit Malthouse, who is co-sponsoring the bill, told the BBC’s World Tonight he felt a lot of the concerns raised by other MPs had been addressed by the bill’s safeguards, calling the status quo a “horror show”.
“People wanted to see a bill that was well drafted, tightly drawn, had safeguards in it requiring third party validation, but in particular these periods of reflection that allow someone to think about the decision they’re taking and to record their thinking,” he said.
However, Nik Ward, who lives in Surrey and has motor neurone disease, is against changing the law.
He told the BBC he might have sought help to die if it had been an option after he was diagnosed, but now says life is precious and he is opposed to assisted dying.
“It redefines the norms of our society, in a way that is, I think, terribly dangerous,” he said.
Groups who oppose changing the law say vulnerable people could feel under pressure to end their lives for fear of being a burden on others and that the focus should be on improving palliative care.
Dr Gordon Macdonald, chief executive of Care Not Killing, said: “The safest law is the one we currently have.
“This bill is being rushed with indecent haste and ignores the deep-seated problems in the UKâ€s broken and patchy palliative care system.”
Dr Gillian Wright, a former palliative care doctor and campaigner, told the World Tonight there were concerns the bill contains “arbitrary criteria” to define terminal illness.
“It’s actually difficult at times to determine that someone has six months to live,” he said.
“It’s essentially an arbitrary criteria. Why should those with nine or 10 months to live not also have access [to assisted dying]. Perhaps they would suffer more.
“You can see that, right at the beginning, with the way this bill is designed…, it sets you up for extension, because it will almost immediately be challenged.”
Conservative MP Danny Kruger told the BBC that, despite the efforts that have been made to add safeguards to the bill, he was concerned that in practice judges and doctors would end up “rubber-stamping” decisions.
He said he agreed with Leadbeater that “the status quo is not OK”, but added the focus should be on delivering better quality palliative care.
“Due to innovations in medicine, pain relief and treatment… it should not be necessary for anybody to die in unbearable, physical agony anymore,” he said.
Health Secretary Wes Streeting, who has said he will vote against the bill, has raised similar concerns, saying end-of-life care is currently not good enough to give people a real choice.
In response to such fears, Leadbeater said: “This is not about either improving palliative care or giving people the choice at the end of life that I believe they deserve.
“We have to do both, and they have to run in parallel.”
The MP for Spen Valley said there would be “checks against coercion or pressure” at every stage, as well as a code of practice and “robust training” for doctors involved.
She added that if the bill did become law, there would also be a “period of implementation”, which would most likely be up to two years.
