The Terminally Ill Adults (End of Life) Bill (the “Bill”) was presented to Parliament on 16 October 2024. The Bill seeks to enable adults who are terminally ill with 6 months of their life remaining, to request and receive assistance to end their own lives. The Bill is currently at the Committee Stage in the House of Commons, where it is being examined in detail and amendments can be introduced.
The Current Law on Assisted Suicide in the UK
Currently, under section 2(1) of the Suicide Act 1961, a person commits a criminal offence if they encourage or assist another individual with their suicide or attempted suicide, provided they do so with intent. All suicide deaths will be investigated by a coroner and, before a person is prosecuted for assisting, it is public policy to consider whether there is a public interest in prosecuting.
The case of Morris v Morris [2024] EWHC 2554 (Ch) demonstrates the real-life application of the Suicide Act 1961. In this case, Myra Morris, who suffered from a rare neurological degenerative disorder, wished to end her own life at the Pegasos clinic in Switzerland. Her husband was opposed to this, but, out of respect for her autonomy, travelled with her to Switzerland along with their two children and Myra’s sister. Upon their return, her husband reported Myra’s voluntary suicide and his involvement to the police. However, after reviewing the evidence, and considering the lack of encouragement and coercion from her husband, the police decided not to pursue charges.
The public policy requirement and the decision in Morris v Morris suggest that prosecution for this offence is uncommon when there is no undue influence or pressure exerted on the individual by others. The outcome depends on the available evidence and whether prosecuting serves the public interest.
The Bill
Although the proposal of legalising assisted suicide has been rejected by Parliament in previous votes in 1997 and 2015, the decision in Morris v Morris serves as an example of the shift in societal attitudes over the last decade. If the Bill becomes law, an eligible terminally ill adult could request assistance from a doctor to end their life and can legally receive that assistance. An adult must have an irreversible illness, disease or medical condition that is progressively worsening and is reasonably expected to result in death within six months.
According to the Bill, to be provided with assistance, the individual must have an initial discussion with a registered medical practitioner, must make an initial request for assistance with their death (First Declaration), undergo an assessment by two independent doctors, and obtain approval from the High Court. The individual would then need to reconfirm their request (Second Declaration) before being provided with the approved substance by the doctor to self-administer. A final statement confirming the lawful provision of assistance will then be entered into the patient’s medical record.
In response to concerns about the judicial system’s capacity to meet the Bill’s High Court approval requirement, it has recently been suggested that High Court approval will no longer be necessary. Instead, a separate panel will be established to review these cases.
Key Considerations
In determining whether to pass the Bill, there are many factors for Parliament to consider, one being that doctors will bear the responsibility of ensuring the patient has the capacity to, and is making the decision independently, free from pressure or coercion. The doctors will also be responsible for determining that the individual has a lifespan of just 6 months, which is an outcome that medical practitioners may be unwilling to reach in many circumstances. There are concerns surrounding the inevitable exploitation of this Bill by family members, or those closest to the patient encouraging this process for personal gain. It has also been questioned whether doctors possess the necessary training to make accurate independent assessments or detect exploitative behaviour.
In addition to this, there are concerns regarding the extent of NHS resources and funding for assisted suicide and whether it will affect the funding already allocated to existing palliative care services.
It is clear there are many legal implications for Parliament to consider when reviewing the Bill. However, there are also moral and Human Rights implications. The Bill’s compatibility with the European Convention on Human Rights is a relevant consideration for Parliament, specifically, the right to life under Article 2, which states that everyone’s right to life shall be protected by law. The Equality and Human Rights Commission (EHRC) has provided commentary on this for Parliament to consider. They have advised that, for the Bill to align with Article 2, appropriate safeguards must be in place to ensure a person has capacity to make the decision to end their life. The EHRC also note that Article 8, which protects the right to private life, includes an individual’s autonomy to decide the means and timing of their death.
While Parliament will consider the European Convention on Human Rights during the legislative process, the absence of a declaration of compatibility by the EHRC should not prevent the Bill from becoming law (section 19 of the Human Rights Act 1998).
Further Consideration
Although the Bill would legalise assisted suicide in certain circumstances, legal commentary implies that it may not have as far reaching an effect as the critics suggest due to the 6-month requisite. Parliament also must consider the implications of the Forfeiture Rule. Under this rule, an individual cannot benefit from another person’s estate if they have unlawfully killed that person or contributed to their death. However, the Court has the discretion to modify the rule when the offender’s conduct and the circumstances of the case justify such an adjustment.
This was demonstrated in Morris v Morris where the court modified the Forfeiture Rule after finding no evidence of assistance or undue influence from Myra’s husband and taking into consideration the police’s decision not to pursue charges as evidence to achieve justice, thereby allowing him to inherit from her estate.
If you have any concerns regarding the succession of your estate or would like further information regarding the implications of the proposed Bill, please contact our Private Client team.