What is assisted dying and how could the law change?

A proposed law to give terminally ill people in England and Wales the right to choose to end their life has been published. MPs will vote on the bill for the first time on 29 November.

A separate bill is under discussion in Scotland.

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

Labour MP Kim Leadbeater has introduced the Terminally Ill Adults (End of Life) Bill, which could change the legal position in England and Wales.

The bill says anyone who wants to end their life must:

A High Court judge must hear from at least one of the doctors, and can question the dying person, or anyone else considered relevant.

After the judge has made their ruling, a patient would have to wait another 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.

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

Ms Leadbeater said the law needed changing because some people “have a horrible, harrowing death”, no matter how good palliative care is.

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

The proposals would have to be approved by MPs and peers before becoming law.

The first debate and vote will take place in the House of Commons on Friday 29 November.

Prime Minister Sir Keir Starmer, who has previously said he backs changing the law, will allow Labour MPs to vote as they wish on the issue.

Both the British Medical Association, which represents doctors, and the Royal College of Nursing have neutral positions on assisted dying.

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

If passed by MSPs, eligible applicants would have to:

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 “very confident” the UK and Scottish governments could find a solution if his bill was backed by MSPs.

Opponents warn that people could be put under pressure to end their lives, and have urged the government to focus on improving palliative care instead.

Paralympian and House of Lords crossbencher Baroness Grey-Thompson is among those who are against changing the law.

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, formerly known as Twitter.

Dr Gordon Macdonald, chief executive of 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.”

Many MPs have not announced their position on the bill, but some have said they will not support it.

They include Health Secretary Wes Streeting, who has said the palliative care system is not good enough to support assisted dying. He has suggested the cost of implementing any changes to the law could lead to cuts in other NHS services.

The Justice Secretary Shabana Mahmood has also said she will vote against the bill.

Lib Dem leader Sir Ed Davey – who has also said his party’s MPs can vote with their conscience – said he was “very minded” to reject the bill.

Campaigners representing people with terminal and life-limiting illnesses have made a number of attempts to alter the law in recent years.

One of the highest-profile advocates for change is broadcaster Dame Esther Rantzen, who has been diagnosed with 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?”

Cancer patient Nathaniel Dye has worked with Kim Leadbeater on her bill, which he said would let people avoid the “worst case scenario of an horrific death”.

He said it would let him “commit one last act of kindness to my family and myself, and make my end as kind as compassionate as possible”.

The Dignity in Dying campaign group said the bill provides the “most detailed, robust proposal” 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.

The former Lord Chancellor, Lord Falconer, who introduced his own bill on the subject to the House of Lords in July 2024, argues the proposed bill “is workable” with “rock solid safeguards”.

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 some form of assisted dying.

Switzerland has allowed assisted suicide since 1942 and its Dignitas facility began operating in 1998.

The organisation accepts foreign patients as well as Swiss nationals, and said it had 1,900 UK members in 2023, a 24% rise on the previous year.

Between 1998 and 2023 Dignitas 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. It is not permitted in either the Northern or Australian Capital territories.

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.