What is assisted dying and how could the law change?

On Friday, MPs have the first opportunity to debate and vote on a proposed law to legalise assisted dying in England and Wales.

At present, laws throughout the UK prevent people from asking for medical help to die.

The Terminally Ill Adults (End of Life) Bill was introduced by backbench Labour MP Kim Leadbeater. It is what’s known as a private members’ bill.

It would give terminally ill people the right to choose to end their life.

It says that anyone who wants to end their life must:

Under the proposals, a High Court judge would have to rule each time a person makes a request to end their life. A patient would then have to wait 14 days before acting.

A doctor would prepare the substance being used to end the patient’s life, but the person would take it themselves. The bill does not say which drug would be used.

It would be illegal to coerce someone into declaring they want to end their life, with a possible 14-year prison sentence.

The first debate and vote on the bill is taking place in the House of Commons on Friday 29 November.

If the bill passes on Friday, there are still many months of parliamentary activity before it can become law. If it’s rejected, that’s the end of the road.

MPs have been given a free vote on the issue, which means they can make their own decision rather than follow party instructions.

The government is impartial on the issue.

It is not clear how many MPs will support the bill as most have not said publicly how they intend to vote.

When MPs last voted on the issue in 2015, they rejected different proposals by 330 votes to 118.

Prime Minister Sir Keir Starmer previously said he backed a change in the law.

Work and Pensions Secretary Liz Kendall and Energy Secretary Ed Miliband have both said they will vote for the bill, as have seven MPs who have worked in the NHS.

However, several MPs have said they will vote against changing the law, including Health Secretary Wes Streeting. He argues that palliative care is not good enough to support assisted dying and that the cost of introducing it could mean cuts in other NHS services.

Justice Secretary Shabana Mahmood also opposes the proposals, as do the UK’s longest-serving male and female MPs, Labour’s Diane Abbott and the Conservative Sir Edward Leigh.

Three former Conservative Prime Ministers – Liz Truss, Boris Johnson and Baroness Theresa May – and former Labour Prime Minister Gordon Brown are against the bill. However, former Tory PM Lord David Cameron supports it. None of the former prime ministers is still an MP, so they cannot vote on Friday.

A separate bill is under discussion in Scotland.

Liberal Democrat MSP Liam McArthur drafted the Assisted Dying for Terminally Ill Adults (Scotland) Bill.

If passed by MSPs, eligible applicants would have to:

The bill is being considered by the health committee ahead of an initial vote by MSPs, which is not expected until 2025.

In October 2024, Scottish Health Secretary Neil Gray said the proposed legislation went beyond the limits of Holyrood’s powers, and was a matter for Westminster.

However, Mr McArthur said he was confident the UK and Scottish governments could find a solution if MSPs backed his bill.

Opponents warn that people could be put under pressure to end their lives and want improvements to palliative care instead.

Paralympian and House of Lords crossbencher Baroness Grey-Thompson is a vocal critic.

She told the BBC she is worried about “the impact on vulnerable people, on disabled people, [the risk of] coercive control, and the ability of doctors to make a six-month diagnosis”.

Actor and disability-rights activist Liz Carr, who made BBC One documentary Better Off Dead?, also opposes changing the law.

“Some of us have very real fears based on our lived experience and based on what has happened in other countries where it’s legal,” she wrote on X.

Dr Gordon Macdonald, from campaign group 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 UK’s broken and patchy palliative care system.”

Kim Leadbeater, the MP who introduced the bill, said the law needs changing because some people “have a horrible, harrowing death”, however good their end-of-life – or palliative – care is.

She said her bill includes “the strictest safeguards anywhere in the world”.

Cancer patient Nathaniel Dye worked with Ms Leadbeater on her bill. He said it would allow people a death which was “as kind and compassionate as possible”.

The Dignity in Dying campaign group said the bill provides the “most detailed, robust proposals” on the issue that “Westminster has ever considered”.

According to chief executive Sarah Wootton, the fact that every year “up to 650 terminally ill people end their own lives, often in lonely and traumatic ways,” shows that the status quo is not working.

One of the highest-profile advocates for change is broadcaster Dame Esther Rantzen, who has stage-four lung cancer.

“All I’m asking for is that we be given the dignity of choice,” Dame Esther told BBC News. “If I decide that my own life is not worth living, please may I ask for help to die?”

Both the British Medical Association, which represents doctors, and the Royal College of Nursing are neutral on the issue.

There is some debate over exactly what the various terms mean.

However, assisted dying generally refers to a person who is terminally ill receiving lethal drugs from a medical practitioner, which they administer themselves.

Assisted suicide is intentionally helping another person to end their life, including someone who is not terminally ill. That could involve providing lethal medication or helping them travel to another jurisdiction to die.

Euthanasia is the act of deliberately ending a person’s life to relieve suffering in which a lethal drug is administered by a physician. Patients may not be terminally ill.

There are two types: voluntary euthanasia, where a patient consents; and non-voluntary, where they cannot because, for example, they are in a coma.

The Dignity in Dying campaign group says more than 200 million people around the world have legal access to assisted dying.

Switzerland has allowed assisted suicide since 1942. Its Dignitas facility – which accepts foreign patients as well as Swiss nationals. Between 1998 and 2023 it helped 571 Britons to die.

Assisted suicide is also legal in Austria.

In the US, 11 states – Oregon, California, New Mexico, Colorado, Washington, Hawaii, New Jersey, Vermont, Maine and Washington DC – allow “physician-assisted dying”.

It permits doctors to prescribe lethal drugs for self-administration.

Voluntary euthanasia is legal in Canada where it is called medical assistance in dying. It can be provided by a doctor or nurse practitioner, either in person or through the prescription of drugs for self-administration.

It is also legal in Spain and Colombia, both of which also permit assisted suicide.

Assisted dying is legal in some parts of Australia but the law differs across states.

New Zealand’s End of Life Choice Act legalises assisted dying and allows adults in their final months of life to request assistance from a medical professional.

Three countries have laws that allow people who are not terminally ill to receive assistance to die: The Netherlands, Belgium and Luxembourg.